A-Z Continues with M-R

M for Macrophages (what?!) These account for most of the white cells within breastmilk. Its job is to swallow pathogens / harmful bacteria by releasing fabulous lactoferrin and lysozyme, plus Secretory Iga which is that huge mummy anti-body machine. Macrophages are great for babies, but they also have an anti-inflammatory job for the breast itself, and spring into action if the mum is starting to get mastitis. How clever.

N for Nipples. Yes of course for nipples! We don’t often look at other women’s nipples unless we have a professional need to. As someone with this professional requirement, I can say that there are many types of nipples, from inverted and tethered, to inverted but can be coaxed out, to flat, to, small to very large, to thin and to thick. The nipple is where the milk is released into the baby’s mouth, not where it is made. I have read that it is breastfeeding (emphasis on breast), and so the size and shape of the mum’s nipple makes no difference to the breastfeeding experience. Yes, it’s true that it is indeed breastfeeding. It’s also true to say that the baby only knows its mum’s own nipples and doesn’t know that there are other mums with different shaped nipples. However; for some babies their mums’ nipples can take time to get to know. When babies are born alert, they have an instinct to get to their mums’ breasts and feed. They make a “sweeping” action with their heads which brushes their lips and cheeks over the nipples to make them evert or protrude more before babies breastfeed. A mum may have a long or very thick nipple which may cause difficulty too at the new-born stage. If babies are having difficulty in breastfeeding because of a difficult attachment, then help should always be given speedily.

0 for Oxytocin. How could this essential for a peaceful life hormone not be here? Oxytocin is produced beautifully by part of the brain when a person is feeling content. This can be as simple as eating a favourite food or being with someone nice or having a gorgeous bath (either alone or with someone nice!) During breastfeeding this wonder hormone releases milk from the milk sacs, pushes it into the milk duct system and out through the nipple. This is what causes the “let-down” or “milk ejection” reflex. I prefer to call it the milk ejection reflex as I think it describes well the “whoosh” of the milk being released. Sometimes mums find that the reflex is delayed, particularly when using a breast pump. Taking a breath or 2. Thinking of milky waterfalls and other nice stuff can help. If mums are not too exposed to the public gaze, a breast massage and some hand expression helps here. Did you know that as well as mums having skin to skin contact with their babies, upper back massage has a direct link to oxytocin release too?

P for Prolactin. This has to follow oxytocin really. Prolactin is a hormone produced by part of the brain. Its responsible for stimulating breast development, and for making breastmilk. So; prolactin makes breastmilk and oxytocin releases it. One needs the other. Prolactin is at its highest in mums at delivery. It needs nurturing along, if the mum has had a difficult delivery or a Caesarean section. Again, in tandem with oxytocin; lots of skin to skin contact, and breastfeeding help and support in those early hours and days is so helpful. Expressing colostrum in addition to breastfeeding may be necessary to begin the milk-making process if things have been hard from the beginning. Breastfeeding will work if help is asked for and given. See R for Rest for more about prolactin.

Q for Questions. Knowing the questions to ask about breastfeeding is always helpful. That expression, “you don’t know what you don’t know” is true. If a baby is finding attaching to breastfeed difficult, or breastfeeding hurts the mum’s nipples and/or breast, then asking why this is happening gives mums a sense of control. Similarly; if a baby is not gaining weight very easily, by asking the question why, and getting a response will help her to be part of any plan to make things improve. Mums are mums for the rest of their lives and will have lots of decisions to make on their children’s behalf. Feeling enabled and empowered from the start is so important to growing in confidence to feel like a good enough mum.

R for Rest. Yes really! As hard as it may seem to believe; mums can rest when breastfeeding. Taking the time to “do it” as a task may be a funny way to think about it but it’s worth the investment. We’ve already had a quick look at Prolactin; the milk-making hormone and how it combines with oxytocin. Prolactin piggy-backs onto sleep and rest. This means that it’s so worthwhile in those first few weeks to try to get some decent rest. All breastfed babies get raggedy and challenging little humans in the evening when the prolactin hormone is at its lowest in the mum’s blood circulation, so try resting/feet up (for prolactin) with a cuppa and tasty snack (for your energy) late afternoon to see if this helps those testing evenings.  

Eight more letters to go! Nearly there!