Anatomy of Breast

Milk Production
Milk-ejection
Deepak Ghimire

Anatomy of Breast
The nipple is the central area
through which the milk ducts
open.
The areola is the circular dark
area around the nipple.
The "bumps" on the areola and
nipple are Montgomery's
tubercles.
These tubercles contain the
opening of sebaceous and sweat
glands (Montgomery glands)
that secrete lubricating
substances for the nipple.

Milk production
Milk is produced in the alveolus.
The alveolus is made up of gland
cells around a central duct.
The milk is produced by the gland
cells.
Surrounding the gland cells are
the myoepithelial cells which
contract to cause milk ejection
into the milk duct.
The milk then travels down the
lactiferous ducts.

Lateral view with anatomical overlay

Milk production
Milk is stored largely in
the alveoli with little
storage in the ducts
between breastfeedings.
Mothers continue to
make milk between
feedings and they make
more milk during feedings

Milk production

When an infant breastfeeds, the infant

draws the nipple and the areola into
their mouth.

The mother's nipple elongates to

about twice its normal length.

The nipple height is compressed

between the tongue and the palate.
Milk is ejected about 0.03 seconds
after maximum nipple elongation

http://www.breastfeedingbasics.org/cgi-bin/getcite.cgi?name=SMITH1988

LACTATION
Lactation is the process by which milk
is synthesized and secreted from the
mammary glands of the postpartum
female breast in response to an infant
sucking at the nipple

Four Important Hormones are

Involved

Estrogen
progesterone
prolactin
oxytocin

Stages of lactation
There are four stages of lactation:
1. Mammogenesis (growth of the breasts)
2. Lactogenesis (the functional change of the breasts so that they can
secrete milk)
3. Galactopoiesis (maintaining the production of milk)
4. Involution (the termination of milk production).
http://www.fastbleep.com/medical-notes/o-g-and-paeds/16/79/496

ROLE OF HORMONES
Progesterone

influences the growth in size of alveoli and lobes

high levels of progesterone inhibit lactation before birth.
Progesterone levels drop after birth
this triggers the onset of copious milk production

Estrogen
stimulates the milk duct system to grow and differentiate
Like progesterone, high levels of estrogen also inhibit lactation.
Estrogen levels also drop at delivery and remain low for the first several
months of breastfeeding
Breastfeeding mothers should avoid estrogen-based birth control methods, as a
spike in estrogen levels may reduce a mother's milk supply.

ROLE OF HORMONES
Prolactin
contributes to the increased growth and differentiation of
the alveoli
also influences differentiation of ductal structures
High levels of prolactin during pregnancy and
breastfeeding also increase insulin resistance, increase
growth factor levels (IGF-1) and modify lipid metabolism
in preparation for breastfeeding.
During lactation, prolactin is the main factor
maintaining tight junctions of the ductal epithelium and
regulating milk production through osmotic balance.

ROLE OF HORMONES
Oxytocin
contracts the smooth muscle of the uterus during and
after birth
After birth, oxytocin contracts the smooth muscle
layer of band-like cells surrounding the alveoli to
squeeze the newly produced milk into the duct
system.
Oxytocin is necessary for the milk ejection reflex,
or let-down to occur.

Importance of Reflexes in baby

Role of Prolactin

Role of Oxytocin

Role of prolactin and oxytocin

Prolactin signals for milk

production

oxytocin operates to push out the

breastmilk that accumulates in the
breast ducts

Mechanism of Milk Production

Suckling infants compress the areola with

their gums which stimulates oxytocin
release.

The oyxtocin release causes an increase in

the diameter of the milk ducts and
movement of milk in the ducts toward the
nipple.

Mothers may feel a sensation of pins and

needles, pressure, or pain in the breast
with milk ejection.

This sensation may disappear as lactation

continues over a several month period of
time.

 Initial milk ejection is

manifested by
an increase in diameter of
the milk duct
movement of the milk fat
globules
occurred at an average of
50 seconds after suckling
began

LEVEL OF HORMONES

 MECHANISM
OF BREAST
MILK
PRODUCTION

Action of hormones
When a baby sucks on the nipple, the stimulation is transmitted to the
pituitary gland and hormones called prolactin and oxytocin are
produced.

Prolactin signals for milk production

oxytocin operates to push out the breastmilk that accumulates in the
breast ducts.

Breastmilk is released when the baby sucks on the nipple.

It may not work at first, as both baby and mother are beginners, but
with repetition, both will grow more adept at it.

Milk ejection reflex

This is the mechanism by which milk is transported
from the breast alveoli to the nipple.
Suckling by the baby stimulates theparaventricular
nuclei and supraoptic nucleus in the hypothalamus,
which signals to the posterior pituitary gland to
produce oxytocin.
Oxytocin stimulates contraction of the myoepithelial
cells surrounding the alveoli, which already hold milk.
The increased pressure causes milk to flow through
the duct system and be released through the nipple.