上海产科临床医学中心建设规划.pptVIP

2004-11-16 Dystocia Breastfeeding What is lactogenesis? Lactogenesis is a series of cellular changes by which mammary epithelial cells differentiate and mature into secretory cells. This process occurs in two stages. Stage 1 ： takes place during the second half of pregnancy and marks the development of secretory units in the breast and the production of small amount of milk. After about 15 to 16 weeks of gestation, a minute amount of milk containing lactose and casein is secreted. Further differentiation of mammary epithelial cells is prevented by the high levels of circulating progesterone during pregnancy. This stage also notably coincides with colostrum production. Lactogenesis Following delivery, circulating progesterone levels become markedly decreased with removal of the placenta. This hormonal change, along with the elevation of both prolactin and cortisol, triggers the onset of copious milk production, known as stage 2 of lactogenesis. Lactogenesis *Lactation is maintained and regulated throughout the breastfeeding period by multiple hormones. Removal of milk from the breast via nipple stimulation triggers the release of prolactin and oxytocin from the anterior and posterior pituitary gland, respectively. * *Prolactin is required for milk secretion, whereas oxytocin is responsible for the contraction of myoepithelial cells leading to milk ejection. A breastfeeding occurrence will result in an elevation of blood prolactin for the next breastfeeding. How can I counsel a woman regarding initiation, frequency and duration of breastfeeding? According to the American Academy of Pediatrics, breastfeeding should begin promptly after birth. Although nursing is frequency based on infant demand, it is recommended that it occur approximately 8 to 12 times per day. The duration of feeding varies among individuals. The time spent breastfeeding decreases as the infant matures. Typically, 10 to 15 minutes is spent on each breast imm