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Perhaps even more remarkable than any visible transformation are the extensive changes taking place inside your breasts. The developing placenta stimulates the release of the hormones estrogen and progesterone, which in turn stimulate the complex biological system that makes milk production possible.
Before pregnancy, supportive tissue, milk glands, and protective fat make up a large portion of your breasts. The amount of fatty tissue is an inherited trait and varies among women, which is why breasts come in such a variety of sizes and shapes. The size of your breasts doesn’t determine your ability to produce milk or breastfeed.
Your breasts have been preparing for your pregnancy since you were in your mother’s womb. (By the time you were born, your main milk ducts – a network of canals designed to transport milk through your breasts – had already formed.)
Your milk glands stayed quiet until puberty, when a flood of estrogen caused them to grow and swell. During pregnancy, those glands shift into high gear.
What is lactation?
Lactation is the process of producing and releasing milk from the mammary glands in your breasts. Lactation begins in pregnancy when hormonal changes signal the mammary glands to make milk in preparation for the birth of your baby. It’s also possible to induce lactation without a pregnancy using the same hormones that your body makes during pregnancy. Lactation ends once your body stops producing milk.
Feeding your baby directly from your breasts is called breastfeeding (or sometimes chestfeeding) or nursing. You can also feed your baby milk that you have expressed or pumped from your breast and saved in a bottle.
Where does human milk come from?
Human milk comes from your mammary glands inside your breasts. These glands have several parts that work together to produce and secrete milk:
- Alveoli: These tiny, grape-like sacs produce and store milk. A cluster of alveoli is called lobules, and each lobule connects to a lobe.
- Milk ducts: Each lobe connects to a milk duct. You can have up to 20 lobes, with one milk duct for every lobe. Milk ducts carry milk from the lobules of alveoli to your nipples.
- Areola: The dark area surrounding your nipple, which has sensitive nerve endings that lets your body know when to release milk. To release milk, the entire areola needs stimulation.
- Nipple: Your nipple contains several tiny pores (up to about 20) that secrete milk. Nerves on your nipple respond to suckling (either by a baby, your hands or a breast pump). This stimulation tells your brain to release milk from the alveoli through the milk ducts and out of your nipple.
It helps to think of the lactation system as a large tree. Your nipple is the trunk of the tree. The milk ducts are the branches. The leaves are the alveoli.
Why do people lactate?
The primary reason people lactate is to feed a baby. Lactation is a biological, hormonal response that occurs during and after pregnancy to feed a newborn baby. Your body triggers specific hormones to initiate milk production and ejection (releasing of milk). All mammals lactate for this purpose and it’s possible to induce lactation in men and in non-pregnant women using the right hormone medications.
What triggers lactation?
A series of hormonal events, which begin when you’re pregnant, trigger the lactation process. That process is called lactogenesis.
Stage one lactogenesis: This begins around the 16th week of pregnancy and lasts until a few days after you give birth.
- Estrogen and progesterone rise and cause your milk ducts to grow in number and size. This causes your breasts to become fuller. It’s highly nutritious and filling and serves as your baby’s first milk.
Stage two lactogenesis: This stage starts about two or three days postpartum (after giving birth). It’s when milk production intensifies.
- Once your baby and placenta are delivered, a sudden drop in your estrogen and progesterone causes the hormone prolactin to take over.
- Prolactin is the hormone that produces milk.
- You’ll notice your milk production increases dramatically at this stage. It’s often referred to as milk “coming in.”
- Your breasts are often engorged (or overly full of milk) to the point where they feel sore, painful or tender.
Stage three lactogenesis: This describes the rest of the time you lactate.
- Lactation generally continues as long as milk is removed from your breast.
- The more milk that’s removed, the more milk your body makes to replace it. Frequent feeding or pumping will cause your body to make more milk.
Hormones for lactation
The hormone prolactin controls the amount of milk you produce, and your body begins producing prolactin early in pregnancy. At first, the high levels of estrogen, progesterone and other pregnancy hormones suppress prolactin. Once you deliver the placenta, those pregnancy hormones drop and prolactin takes charge.
When your baby suckles, it stimulates nerves that tell your body to release prolactin and oxytocin. Prolactin causes the alveoli to make milk and oxytocin causes muscle contractions that push out of the alveoli and through the milk ducts.
When milk is released, it’s called a “letdown,” and it takes about 30 seconds of suckling before the letdown occurs. Because you can’t control which breast receives the hormones, the letdown can cause milk to drip from both nipples.
Inducing lactation in people who aren’t pregnant requires medication that mimics hormones your body makes during pregnancy. Suckling from the nipple can initiate lactation, either with a breast pump or by a baby. This is a complex process that involves working closely with a healthcare provider who understands the needs of non-pregnant people and has experience initiating lactation.
When do you lactate during pregnancy?
Lactation begins as early as a few weeks into the second trimester of your pregnancy. As estrogen and progesterone levels rise, your body prepares for lactation by increasing the number of milk ducts in your breasts, and those milk ducts will transport milk from the alveoli to your nipples. About midway through pregnancy, your body creates colostrum, which is your baby’s first milk.
Can you lactate when you’re not pregnant?
Yes, it’s possible to lactate if you’re not pregnant. Inducing lactation is a complex process that usually involves using hormone-mimicking drugs for several months to produce milk. The second part of lactation is expressing the milk through your nipple. Stimulation from infant suckling, pumping with a breast pump or hand-expressing signals the brain to release the milk. It’s common for people in this situation to receive assistance from a healthcare provider who understands the needs of non-pregnant people and has experience initiating lactation.
How do you stop lactation?
There are many reasons why you might need to stop producing milk, and you can stop lactating either naturally or with the help of hormonal drugs.
Natural milk suppression
Lactation is a supply-and-demand process. Your milk supply gradually goes down as your baby relies less on breast milk, or as you reduce the number of times you nurse or pump. Generally, if you decrease the volume of milk removed from your breasts, your body will slow milk production.
Suppressing your milk can feel uncomfortable and most people will become engorged (the term for overfilled breasts). You may also leak milk or develop a clogged milk duct. However, you can treat that pain by taking an over-the-counter pain reliever, wearing a firm bra or using an ice pack on your breasts.
Medications can also be an option if you need to stop producing milk. Your healthcare provider can explain more about lactation-suppressing drugs, as well as the benefits and possible side effects.
Where are the mammary glands located?
Mammary glands are commonly called breasts and both genders have them. They are located on your chest and are composed of connective tissue, fat and special glandular tissue that makes milk. A woman’s glandular tissue is slightly different because it contains the alveoli and lobules necessary for producing milk. Women also have much more glandular tissue.
What’s in breast milk?
Mature breast milk is perfectly designed and contains water, fat, carbohydrates, protein, vitamins and minerals, and amino acids. It also contains white blood cells, antibodies, enzymes, and other substances that boost your baby’s immune defenses.
There are more than 200 known beneficial components in breast milk, with more being discovered all the time. For example, researchers now believe that a fatty acid in breast milk promotes the growth of a baby’s brain and retina, and may even enhance cognitive development. Many of these elements, including infection-fighting white blood cells, can’t be manufactured.
Mature milk comes in approximately two to four days after your baby’s birth, depending on the frequency of nursing in the first hours and days after birth. Your milk production will adjust to accommodate your baby’s appetite and how often she nurses.
How breast milk changes for your baby
Breast milk is the ultimate personalized food. One of the wonderful characteristics of human milk is the way it changes to meet your baby’s needs as he grows.
The breast milk a mother produces for her premature baby differs from the milk she would produce for a full-term newborn, and that differs from the milk she’ll have for her 6-month-old baby. All breast milk, however, contains exactly the nutritional and protective components needed most by each baby at every age.