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Throughout a woman's pregnancy, high levels of estrogen and progesterone keep the flow of milk in check, even after the surge in prolactin production that occurs during the seventh month of pregnancy.

As soon as the infant is born, levels of estrogen, progesterone, and prolactin decline, and the level of oxytocin increases, which prompts delivery of a premilk liquid called colostrum. This thick, yellow substance is rich in antibodies that help fight off infections and allergies, prevent intestinal problems, and build up the infant's immune system.

Preparing to Breast-Feed

Most new mothers feel awkward and nervous the first few times they breast-feed. That's because it involves positions, movements, and feelings that are new. Although it is not within the scope of this book to address all of the issues surrounding breast-feeding, this book does give you a solid foundation on matters concerning breast health.

The Wonders of Breast-Feeding

When a baby begins to suckle, prolactin levels rise, prompting the production of milk. The nerves that surround the nipple and areola signal the hypothalamus, which then transmits a message to the pituitary gland to release oxytocin. The oxytocin stimulates the myoepithelial cells and the breast muscles to push I he breast milk toward the ampulla, where the milk collects before it is released through the nipple

The reflex that releases the milk from the breasts to the infant is called the let-down or the milk-ejection reflex. It operates automatically in the majority of women. It is often accompanied by the following signs:

* Tingling or mild pain in the breasts

* Appearance of milk even before the baby begins to nurse

* Uterine contractions

* Release of milk from both nipples at the same time

* A feeling of fullness or warmth in the breasts

The letdown reflex is intimately tied to a woman's emotional state. That's why some women find that they begin to leak milk when they hear their child cry or even when they think about their infant. The let-down reflex is an excellent example of the connection between mind and body.

Negative emotions or events can have a corresponding negative effect on let-down. Women who are experiencing pain, embarrassment, anger, fatigue, illness, or fear may find it hard to get their milk flowing initially.

A trusted friend or a lactation expert from organizations such as La Leche League International and the International Childbirth Education Association can help in these matters.

The American Academy of Pediatrics recommends that mothers breast-feed their infants for at least 6 months, preferably 1 year or longer. If you must breast-feed for a shorter time, do so while slowly weaning your child to formula.

If you must return to work but also want to continue to breast-feed, use a breast pump and save your milk for your infant. Some mothers combine breast-feeding and formula feeding.

Discuss your options with your doctor, or contact La Leche League International or the International Childbirth Education Association for more information.

SELF CARE DURING BREAST-FEEDING

* Keep your nipples clean (do not use soap) and dry them after bathing and nursing to prevent cracking.

* Remember that whatever you eat is transferred to your child. The best foods are fruits and vegetables, whole grains, and other natural foods. Avoid processed foods; the additives and chemicals are passed along in your breast milk.

* Increase your food intake by 500 to 600 calories a day to provide nutrition for your infant.

* Drink plenty of liquids, such as fruit and vegetable juices, pure water, and herbal teas (no caffeine). Contrary to popular opinion, nursing mothers do not need to drink milk in order to produce milk. Avoid caffeine and alcohol.

* Avoid exposure to pesticides, herbicides, cigarette smoke, and other toxic chemicals, including chemicals used in cleaning products and those used to treat your garden. These can find their way into your breast milk.

* Take vitamins as recommended by your physician.

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This article is not designed as a substitute for personal medical advice but as a supplement to advice for those wishes to understand more about her condition.

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