Breastfeeding involves a prolactin-mediated milk secretion reflex and an oxytocin-mediated milk ejection reflex.
Prolactin and milk production
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The anterior pituitary produces prolactin, which acts on the breast's alveolar epithelial cells to produce milk.
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Suckling stimulates nerve endings in the nipple, carrying impulses to the anterior pituitary and triggering prolactin release.
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More suckling and greater demand increase milk production. Earlier initiation brings the reflex into action sooner.
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Mothers should initiate feeding early, feed frequently, and allow complete breast emptying at each session.
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Prolactin production is higher at night, so night feeding helps maintain the milk secretion reflex.
Oxytocin and milk flow
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The posterior pituitary produces oxytocin, which ejects milk from the milk glands into the lactiferous sinuses.
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The thought, sight, or sound of the baby can stimulate the milk ejection reflex.
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Positive emotions and a relaxed, confident attitude help milk ejection. Tension, lack of confidence, pain, and lack of sleep hinder milk flow.
Factors reducing milk production
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Dummies, pacifiers, and bottles interfere with breastfeeding and also predispose neonates to diarrhea.
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Additional feeds such as sugar water, tonic, honey, breast milk substitutes, or formula can reduce breastfeeding success. Prelacteal feeds precede the first breastfeeding session; supplemental feeds are given alongside breastfeeding.
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Even a single prelacteal or supplemental feed may reduce the chances of successful breastfeeding.
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Sore or cracked nipples, engorged breasts, lack of night feeding, and inadequate breast emptying reduce milk production.
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Inadequate emptying may occur with a sick or small neonate when the mother does not express milk, or with less frequent feeding.