All About Breastfeeding, a Sarah Jane Sandy Collaboration

Did you guys know that we have not one, but TWO, in-house nutritionists that can help you on your health and wellness journey? One of those lovely ladies, Sarah Jane Sandy, runs her own private practice, specializing in fertility, pregnancy, and all things women’s health related. She recently started a new blog series focusing on the new journey of Motherhood, and she wrote a little somethin’ somethin’ that we thought you guys might be interested in when it comes to nutrition, exercise, and recovering from birth. Note that this is just an excerpt, and the original blog post can be found here: Mama and Baby Blog Series : Breastfeeding.

Today I’m digging deep into the world of Breastfeeding, which tends to be one of the most under discussed, and yet hardest, parts of welcoming a new babe into the world. One way or another, that babe is going to make it’s debut earth-side … but breastfeeding isn’t as black and white as that.

A quick note: FED IS BEST. Not all women can or want to breastfeed. And you know what? That’s ok! I’ve said it before, and I’ll say it again, everyone experiences the journey of Mamahood differently – and whatever works for you is what’s best for you and babe.

Pregnancy and Lactation

The hormones of pregnancy – including estrogen, progesterone, prolactin, and others – cause complex changes to occur in the breast. The various hormones each play a specific part in preparing the body for breastfeeding; however, the biggest change that women notice? Enlargement! 

During the first trimester of pregnancy, the ducts and alveoli in the breast multiply rapidly. Your breasts may be tender, and their size increases in preparation for breastfeeding. Lactogenesis is the term denoting the origin, or the beginning, of lactation, and it occurs in three stages:
  • Lactogenesis I
  • Lactogenesis II
  • Lactogenesis III
Lactogenesis I starts about 12 weeks before delivery, as the mammary glands begin to secrete colostrum. Breast size increases further as the alveoli become filled with colostrum, but the presence of high levels of the hormone progesterone in the mother’s blood inhibits the full production of milk until after birth.

Lactogenesis II begins after birth when the placenta is delivered. Progesterone levels fall while prolactin levels remain high. Prolactin is the main hormone in charge of lactation, and it, in turn, is controlled by hormones secreted by the pituitary, the thyroid, the adrenal glands, the ovaries, and the pancreas. More blood flows to the breasts, carrying more oxygen. Anywhere between two to five days postpartum, the “milk comes in.” The amount of milk produced increases rapidly, and its consistency gradually changes from colostrum to mature milk. Sodium, chloride, and protein levels in the milk decrease, and levels of lactose and other nutrients increase. The color gradually changes from the golden yellow, typical of colostrum, to a bluish white. Since this process is controlled by hormones, the breasts begin to produce milk whether a mother is breastfeeding or not. At this stage of lactogenesis, it is important to breastfeed often (and/or pump, if the baby is not feeding well), because frequent breastfeeding in the first week after birth seems to increase the number of prolactin receptors in the breast. A receptor’s job is to recognize and respond to a specific hormone. Having more prolactin receptors makes the breast more sensitive to prolactin, which researchers believe affects how much milk a mother produces in the next stage of lactogenesis.

Lactogenesis III is also referred to as galactopoiesis. This is when the mature milk supply is established. During this time, milk production switches from endocrine (hormonal) control to autocrine control, meaning that continued milk production depends more on the ongoing removal of milk from the breasts than on the hormones circulating in the blood. The “supply and demand” principle takes over at this point. The more a mother nurses, the more milk she will produce. If a mama nurses less, her milk production will slow down.

Breastmilk Supply and Demand

Understanding how milk production works can help a Mama ensure that her baby is getting enough milk at the breast. For example, sometimes mothers feel that their baby has completely emptied their breast and that there is no more milk available, even though the baby wants to nurse. Knowing that new milk is constantly being produced in the alveoli will give a new Mama the confidence she needs to put her baby to the breast, even when it feels “empty.”

Emptying the breasts is what keeps milk production going. A baby’s sucking sends messages to the brain, which then releases the hormone oxytocin. Oxytocin causes the muscle cells around the alveoli to contract, pushing milk down through the ducts to the nipple. This movement of milk down the ducts is called the milk-ejection reflex. Mamas may experience it as a tingling feeling or a sense of release in the breast, which is why it is also called the “let-down.” The let-down empties the alveoli and makes the milk available to the baby at the nipple. When the alveoli are empty, they respond by making more milk.

To ensure that you are properly “emptying” your breasts and promoting further milk production:
  • Make sure baby is nursing efficiently (we’ll go into complications that can affect this next!)
  • Use breast massage and compression
  • Offer both sides at each nursing – wait until baby is finished with the first side before offering the second. Switch nursing may be helpful if baby is not draining the breast well.
Pump after nursing if baby does not adequately soften both breasts. If baby empties the breasts well, then pumping is more useful if done between nursing sessions (in light of our goal to keep the breasts as empty as possible).

To read more about Breastfeeding, including how to handle some potential complications, check out the rest of this post here: Mama and Baby Series : Breastfeeding.

A great way to get back into the swing of things after giving birth … check out a REBEL class! Obviously wait until your body is ready - don’t push yourself too hard - but know that we’ll be waiting for you, with our studio doors wide open :).

Another great option to ease back into things is by training one-on-one with one of our personal trainers. We are realistic in goal setting, and we can explain what to expect in each session. We can also optimize each session - with your end goals in mind. Our trainers get to know your body and what you’re capable of and tailor each session to YOU.