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The composition of milk. General

• The composition of human milk is fully consistent with the needs of the rapidly growing body of the child and the most balanced;
• Milk individually on the composition of which is governed by the child, that is, the two mothers of the milk is different, besides changing during one feeding, as well as throughout the entire period of lactation;
• All nutrients are in optimal form for absorption. No, even the best mix, is not a full substitute for breast milk.
In addition to the child’s optimal balance of fats, proteins and carbohydrates in breast milk contains substances that contribute to its digestion (autofermenty), the body immune to various kinds of diseases, the ideal composition of vitamins and enzymes.

Benefits of breastfeeding

The immediate benefits of breastfeeding
• reducing the risk of intestinal infections, prevention dysbacteriosis;
• reducing the risk of respiratory viral diseases such as otitis media;
• reducing the risk of allergic diseases (especially with hypoallergenic diet mother, in cases of predisposition to allergies of the child);
• Benefits of physical development of children;
• regulation of the biological age of maturation of children, slow biological maturation and, as a consequence, aging;
• advantages of neuro-psychological development of children, it may be more rapid, children are more active and emotionally and motor.
Remote advantages of breastfeeding
• neuro-psychological development, intelligence, social adaptation (breastfeeding contributes to a sense of self-confidence and sense of security, which in turn reduces the aggressiveness of an older age (relative to intelligence – there are studies by setting a higher level of IQ in children breastfed);
• reducing the risk of obesity and diabetes;
• Full reproductive function (especially for girls, reducing the probability of infertility and miscarriage);
• Formation of maxillo-facial skeleton, speech and hearing disorders (prevention of malocclusion, reducing the risk of speech and hearing disorders).
Benefits for Mom
• physical contact and emotional contact with the child, reducing the likelihood of neurosis;
• reducing the likelihood of cancer of breast and reproductive organs;
• Accelerating the size of uterine involution after delivery, reducing the risk of endometritis;
• normalization of cholesterol levels, reducing the risk of gall stone disease and osteoporosis;
• Cost savings and time;
• invaluable convenience for an active life with a child (food is always with them in the right quantity and the required temperature).

Dynamics of change in the composition of milk during lactation.

In the process of lactation is changing many biological properties and nutrients of milk. At maturity of the milk is divided into colostrum, transitional and mature milk.
Colostrum is a thick, sticky yellowish liquid that fills the breast during the last trimester of pregnancy. Appears immediately after birth and before the arrival of the transitional milk (usually within 1-3 days after birth). Provided in a very small quantity, which is enough for the child and does not overload his kidneys and digestive system. Has aperient effect to facilitate a discharge of meconium. The composition is like medicine.
Note: the introduction of water and lactation aid in the first days of life is a gross interference in the process of natural feeding and significantly reduces the effect of colostrum.
Transitional milk is approximately 4 to 13 days after birth. It may be accompanied by swelling of the mammary glands and a slight increase in body temperature. This process is also called the “rising tide”. Parish transitional milk comes in individual time after birth. Sometimes there is a delayed secretion of milk (galaktostaz) until 15-20 days after birth.
Mature milk usually appears by 15 day after birth.
In the literature on breastfeeding see the words “early” and “later milk. This terms are the evolution of the composition and properties of milk during one feeding from one breast.
Early (front) accumulates in breast milk between feedings and is produced in the early feeding. It has a bluish tint, can be transparent. Front milk is produced in large volume and meet the needs of the child not only in nutrients, but also to drink.
Later (back), milk produced at the end of lactation, after the front sucked milk. It is white, sometimes with a yellowish tinge. It is more dense, because it has more fat, which is the main source of energy when breastfeeding. Sucking back the milk, the child is making more effort.
In the breast milk of 87-90% water, so the child in the first 4-6 months does not need dopaivanii water even in hot climates.
Note: if a child receives more than milk and water, it will suck less milk, thereby reducing the number of the latter.

General rules for the organization full breastfeeding

1. A very important condition for the early establishment of lactation is the earlier the baby’s mother’s breast in the first 30 minutes – 2 hours after birth and lack of dogrudnogo feeding.
2. Correct the baby’s chest – a guarantee of effective sucking, lack of cracks and development of the required amount of milk.
3. Feeding on demand, rather than the regime. Must be at least 12 apposition day. Benefits of breastfeeding on demand: less problems with breast engorgement, the child gains weight more quickly, a rapid increase in the number of milk and increased yield, it is easier to form a child’s skills in breastfeeding.
4. Must night feeding. They are a condition of sufficient and long lactation, as well as produced the greatest amount of prolactin is at night in the interval from 3 to 8 in the morning.
5. The first 6 months of a child, who is to breastfeeding does not need feeding (juices, vegetable and fruit purees) and dopaivanii water.
6. With on-demand breast-feeding does not need pumping. Additional decantation may giperlaktatsii. Pumping is only justified in the following cases: post-partum engorgement, lactostasis, mastitis, insufficient lactation (on the recommendation of a specialist, such as a consultant on breastfeeding), with separation of a child with her mother.
7. The duration of breastfeeding. Do not limit your baby in nursing. Most of them are saturated for 10-20 minutes, but there are those who suck the breasts 30 minutes, 1 hour or more. Because the process of sucking for a child – not only food, but also communicate with her mother. The amount of time does not affect the formation of cracks and abrasions nipples. When the child ate and satisfied his interest in communicating with his mother, he releases the breast himself. “Lazy” and “nimble” sucker. Active sucker with a strong sucking reflex.
8. Alternating breasts. In one feeding given a chest. In case of insufficient lactation, and if the child is large and requires more, you can give both breasts per feeding. In this case, follow two basic rules:
• have the first chest child is at least 15-20 minutes. It should be possible to empty the breast (breast becomes soft, when pressing hardly stand a drop in white (rear) of milk);
• next feeding should begin with the breast, which was the last in the previous feeding.
9. In breastfeeding baby does not need a pacifier. The use of pacifiers – a habit my mother, which leads to nipple confusion, poor sucking, reduce the amount of milk. Dummy use is justified in the absence of my mother, if the child is over three months, subject to adequate breastfeeding and lack of problems by applying. If a child needs Fattened or drink (for medical reasons), the lactation aid and additional fluid should be given only from a spoon or a syringe or pipette. Do not use bottle nipples. This may lead to rejection of the breast. Note: In the early days of feeding can be a stomach ache – uterine contractions. When feeding from the second breast may leak milk. This effect of oxytocin, which will take place, when lactation is established. After feeding, the child can hold vertically or put on the mother’s abdomen to otrygnul air (may instead hiccup).

The main problems with breastfeeding

• cracked nipples, causes, care for the breast; means healing the crack.
• lack of milk (gipolaktatsiya) criteria for adequacy of milk; giperlaktatsiya.
• lactostasis; mastitis; causes, prevention, treatments.
• lactational crisis.

Cracks nipples. Motivations.

• poor latch. Typically, nipple cracks appear due to improper latch. It is therefore very important that the baby is already in the first lactation was attached properly. (see Appliances latch)
• Hypersensitivity skin nipples. There are situations when a baby is attached correctly, and my mother still there are cracks and abrasions. In this situation, we are talking about the high sensitivity of the skin nipples (usually, and the woman herself acknowledged that his chest and before the pregnancy was very sensitive).
• Confusion about the nipples. It occurs in children who suck a pacifier from birth or receiving Fattened bottle with a pacifier. Kid gets confused and tries to suck the breast as a pacifier, a pacifier, as the chest. And, if the nipple is still as it sucked, the chest – no: there are cracks, scratches, abrasions.
• Improper care of the breast. In Soviet times, all too often mums encouraged to wash your breasts with soap before and after feeding, handling breast Zelenkov and so on. Of course such a “caring” for breast led to injuries and to ensure that the baby refused the breast. Here’s why. At areola have special bumps – Montgomerovy glands that secrete a substance that protects the nipples. In addition, this substance seems to smell of amniotic fluid, which facilitates the task of finding the child breast and stimulates it to sucking. Now imagine that instead of Shishi, smelling of familiar and pleasant, kid gets something to the contrary – comes denial.
• Failure to correctly pick up the chest in the child.

Proper care for breast

• Do not wash your breasts with soap, do not smudge Zelenkov and so on. Suffice hygienic shower 1-2 times a day (without the use of soap and other means to care for the body).
• Express breast before feeding a few drops of colostrum / milk and lubricate the nipple, then the baby.
• After feeding, do the same and give the breast dry off in the air (air bath for 5-10 minutes) and only then, if necessary, apply an ointment or cream.
• Ensure that the area was dry nipples.
• Teach the child the right to seize the chest.
• Properly collect the chest in a child: the little finger (without manicure) to put in a child’s mouth in the course of the nipple and turn it between the gums. Kid gives his chest.
• Wear comfortable nursing bra made of natural fabrics. Adjust the straps so that the nipples were at the armpits.

Lack of milk. Hypogalactia. Nursing crisis.

Gipolaktatsiya or lack of milk. True or primary gipolaktatsiya extremely rare – only in 2-5% of women. A little more, we are seeing secondary gipolaktatsiyu, which happens because of improper organization of breastfeeding. And finally, most often the consultant is dealing with a false lack of milk.
Therefore, if you suspect a lack of milk, first of all, can not grasp at the bottle with the mixture, and must either alone or with the help of a specialist (a consultant on breastfeeding) to understand the situation. Usually, my mother, who complains about the lack of milk, the question “why do you think so?” Answers:
• crying more than you need;
• constantly “hangs” on the chest and sucks a long time during one feeding.
Test wet diapers. To eliminate the problem, you must first (before the panic, to run for a mixture therefore, etc.) to perform a test on the wet diaper. This is a very simple test, but very effective and, in contrast to the control of feeding (which offer a clinic) provides an objective assessment of the situation.
To do this, remove the baby diapers and count how many times the child write for days. Let’s start from birth. In the first three days is enough only 2-urination, the third to sixth – 4, starting with the sixth, there should be no less than 6 times a day. This lower boundary. There may be more, but based on the WHO until the 10 th day of life pipsqueak can easily exist without the lactation aid in compliance with such rules, and regardless of the weight loss (it is a full-term baby).
As soon as my mother’s milk has come, the number of urination increases strongly, their numbers are from 10 to 20 and more per day. If the results of “test for wet diapers” your baby pees more than 6-8 times per day, with the urine a pale yellow or transparent, and without pungent smell, then with the amount of milk you are all fine.
Weight Control. Immediately it should be noted that the control of weighing (weighing before and after feeding) nervous about the mother and child, resulting in a baby can do to stop gaining weight. Suffice it to watch an increase for 1 week, if you have a concern. If – no, one weighing in a month is enough. Last week, the child adds an average of 125-200gramm.
If, following “test for wet diapers, you find that your baby pees less 6raz or weekly gain he has less than 125 grams, and in doing so noted: anxiety child and cry during or immediately after feeding, the mother of feeling full discharge breast still in active nursing baby. It can assume a temporary shortage of milk (secondary gipolaktatsiya).
Her reasons:
• physical fatigue, nervous tension and anxiety the mother;
• poor latch (there is a painless option improper latch);
• incorrect organization of breastfeeding (feeding on the regime, the big night interruptions in feeding, dopaivanie water or something else, sucking pacifiers, bottle feeding, lactation aid, etc.);
• lactational crisis – this is a temporary decrease in milk.
Nursing crises often occur in the first 3 months of lactation, but sometimes happen in 7-8 months. Their frequency – about 1.5 months, the duration of 3-4 days, sometimes up to 6-8. for a child of such crisis does not pose danger.
What mum if stepped lactational crisis?
• respite from household chores, attention and assistance to relatives;
• Maximum body contact with the child;
• increase the number of latch, feeding on demand through the mother 1-1,5 hours;
• The use of additional funds to increase lactation (see additional funds to increase lactation).
Typically, these measures sufficient to lactation for 3-4 days to restore in full. It is unacceptable that at the beginning of the crisis has already made attempts to introduce lactation aid. Lactation is not will establish, and, conversely, will reduce. The main thing – to believe that you could do it.

Giperlaktatsiya (excess milk)

The main reasons giperlaktatsii: frequent changes of the breast; additional decantation after feeding; physiological reasons; stimulation of oxytocin during childbirth.
If giperlaktatsii must:
• establish a change of the breast. For one feeding to give the child only one breast. Apposition or 2-3 (if the intervals between feedings no more than 1,5-2 hours) to do one breast, and then 2.3 apposition to the other. With this method, the breast, which is “not working” can overflow. If this happens, it is possible during the next shift to feeding her baby for 2-5 minutes to suck a little milk, or Express breast that the breast, but only to facilitate the state, but not completely.
• some limited fluid intake and stop drinking laktogonnye means;
• wear a bra;

Lactostasis. Mastitis. Treatment.

These phenomena are easily confused, which often happens. Therefore, for the start will give them definition.
Lactostasis – a violation of the outflow of milk from the breast.
Symptoms: slight thickening in the breast, usually in one lobe, painful to the touch, easy porozovenie skin, with rastsezhivanii decreased in size or disappear, there may be a rise in body temperature.
Reasons: a long break in feeding; uncomfortable bra, suboccluding chest; use the same posture during feeding.
Mastitis – inflammation of the breast is infected.
Symptoms: “stone” seal covering a significant part of his chest is very painful, intense color (from red to cyanotic); rastsezhivaetsya with difficulty or not at all rastsezhivaetsya; body temperature is high, breaching the outflow of milk allocation drops of pus in rastsezhivanii.
Reasons: not cured lactostasis; long unhealed cracked nipples, the presence of her mother in the body of infection.
Treatment.
In the first painful sensation in the breast should respond immediately. In my practice, we use the following treatment regimens:
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