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Breast feeding can be overwhelming and difficult especially to those mothers who have never had a delivery before. I met this mother who had just delivered. She did not know how to place the baby on her breast, her breasts were over sensitive and she had no breast milk at the time. She did not know what to do. In order to help such mothers; we need to know how the breast produces milk and how the baby suckles.

In normal breastfeeding, there are two elements necessary for getting milk from the breast to the baby: A breast that produce and release the milk, and A baby who is able to remove the milk from the breast with effective suckling. The manner in which the baby is attached to the breast will determine how successfully these two elements come together. If the milk is not removed from the breast, more milk will not be made.


On outside of the breast.

  • Areola. It’s a darkened area around the nipple. The baby needs to get a large amount of the areola into his/her mouth to feed well. On the areola are the glands that provide an oily fluid to keep the skin healthy. The glands are the source of mother’s smell, which helps the baby to find the breast and recognize her.

Inside the breast is,

  • Fat and supporting tissue. Give the breast its size and shape.
  • Nerves. Transmit messages from the breast to the brain to trigger the release the lactation hormones.
  • Alveoli. This are little sac of milk producing cells that produce milk.
  • Milk ducts. That carries milk to the nipple. The baby needs to compress this ducts that are under the areola in order to remove milk effectively.
  • Surrounding each alveolus are little muscles that contract to squeeze milk out into the ducts. There is also a network of blood vessels around the alveolus that brings the nutrients to the cells to make milk.

It’s important to reassure the mothers, that there are many variations in the size and shape of women’s breasts. The amount of milk produced does not depend on breast size. Be sure to tell every mother that her breasts are good for breastfeeding, and avoid frightening words. Small breast may not be able to store as much milk between feeds as larger breast, but the amount of milk produced in a day is as much as from the larger breasts. Encourage mothers with small breast to breastfeed more often.


The first stage of milk production is under the control of hormones or chemical messengers in the blood. During pregnancy, the hormones help the breast to develop and in grow in size. The breasts also start to make colostrum. After delivery, the hormones of pregnancy decreases.

Prolactin and oxytocin hormones become important to help production and flow of milk. The breast starts to make larger quantities of milk. Usually it takes 30 to 40 hours after birth before large amount of milk is produced. Colostrum is already there when the baby is born.


It’s the hormone that makes the alveoli produce milk. It works after the baby has taken the feed to make the milk for the next feed. Prolactin can make the mother feels sleepy and relaxed Prolactin is high in the first 2 hours after birth. It is at night. Hence breastfeeding at night allows for more prolactin secretion.


It is the hormone that causes cells around the alveoli to contract and makes milk flow down the ducts. This is essential to enable the baby to get milk. This reflex is called letdown. It may happen severally during breastfeeding. The reflex may feel different or less noticeable as time goes by.


  • Painful uterine contractions, sometimes with rush of blood from vagina.
  • Sudden thirst
  • Milk spraying from her breast, or leaking from the breast which is not being suckled
  • Feeling a squeezing sensation in the breast.

When the milk ejects, the rhythm of the baby’s suckling changes from rapid to slow deep sucks and swallows. Seeing, hearing, touching, and thinking lovingly about the baby, helps the oxytocin reflex.


  • Be pleased about her baby and confident that her milk is the best.
  • Relaxing and getting comfortable for the feeds
  • Expressing a little milk and gently stimulating the nipple
  • Keep her baby near so that she can see, touch, smell and respond to her baby.
  • Back Rubbing. The mother may ask someone to massage her upper back, especially along the side of the backbone.

Oxytocin release can be inhibited temporarily by;

  • Extreme pain, such as a fissured nipple or stitches from a caesarean birth or episiotomy.
  • Stress from any cause, including doubts, embarrassment, or anxiety
  • Nicotine and alcohoL

Sometimes milk can be produced in one breast but not the other-usually when a baby suckles only one side. This is because milk contains an inhibitor that can reduce milk production. If milk is not removed and the breast is full, this inhibitor decreases production of milk. And when the baby breastfeed the inhibitor levels falls and milk production increases. Thus the amount of milk produced depends on how much is removed. Therefore, to ensure plentiful milk production, make sure that milk is removed from the breast efficiently.

To prevent inhibitor of lactation from reducing milk production, a mother should ensure that

  • The baby is well attached
  • Encourage frequent feeding
  • Allow baby to feed as long as she or he wants at each breast
  • Let the baby finish the first breast before offering the second breast
  • If the baby does not suckle, express the milk so that milk production continues.


The baby’s suckling controls the prolactin production, the oxytocin reflex and the removal of the inhibitor within the breast. For the mother to produce the milk that her baby needs, her baby must suckle often in the right way. A baby cannot get the milk by suckling only on the nipple.

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