ALL MUM MUST KNOW(sedar atau tidak)!!

Breast milk refers to the milk produced by a mother to feed her baby. It provides the primary source of nutrition for newborns before they are able to eat and digest other foods; older infants and toddlers may continue to be breastfed. The baby nursing from its own mother is the most ordinary way of obtaining breastmilk, but the milk can be pumped and then fed by baby bottle, cup and/or spoon, supplementation drip system, and nasogastric tube. Breastmilk can be supplied by a woman other than the baby's mother; this is known as wetnursing.
Production
Under the influence of the hormones prolactin and oxytocin, women produce milk after childbirth to feed the baby. The initial milk produced is often referred to as colostrum, which is high in the immunoglobulin IgA, which coats the gastrointestinal tract. This helps to protect the newborn until its own immune system is functioning properly, and creates a mild laxative effect, expelling meconium and helping to prevent the build up of bilirubin (a contributory factor in jaundice).
There are many reasons a mother may not produce enough breast milk. Some of the most common are an improper latch (i.e. the baby does not connect efficiently with the nipple), not nursing or pumping enough to meet supply, certain medications (including the contraceptive pill), illness, and dehydration. A rarer reason is Sheehan's syndrome, also known as postpartum hypopituitarism, which is associated with prolactin deficiency; this syndrome may require hormone replacement.
Lack of supply can be addressed by nursing and/or pumping more frequently.[citation needed] The more the mother nurses her baby, or pumps, the more milk is produced.[citation needed] It is very helpful to nurse on demand - to nurse when the baby wants to nurse rather than on a schedule. If pumping; it is helpful to have an electric high grade pump so that all of the milk ducts are stimulated. Some mothers try to increase their milk supply in other ways - by taking the herb fenugreek, used for hundreds of years to increase supply ("Mother's Milk" teas contain fenugreek as well as other supply-increasing herbs); there are also prescription medications that can be used, such as Domperidone (off-label use) and Reglan.[citation needed] Increasers of milk supply are known as galactagogues.
Composition
The exact integrated properties of breast milk are not entirely understood[citation needed], but the nutrient content after this period[citation needed] is relatively consistent and draws its ingredients from the mother's food supply. If that supply is found lacking, content is obtained from the mother's bodily stores. The exact composition of breast milk varies from day to day, depending on food consumption and environment, meaning that the ratio of water to fat fluctuates. Foremilk, the milk released at the beginning of a feed, is watery, low in fat and high in carbohydrates relative to the creamier hindmilk which is released as the feed progresses. The breast can never be truly "emptied" since milk production is a continuous biological process.
Human milk contains 0.8% to 0.9% protein, 3% to 5% fat, 6.9% to 7.2% carbohydrates and 0.2% ash (minerals). Carbohydrates are mainly lactose; several lactose-based oligosaccharides have been identified as minor components. The principal proteins are casein homologous to bovine beta-casein, alpha-lactalbumin, lactoferrin, IgA, lysozyme and serum albumin. Non-protein nitrogen-containing compounds, making up 25% of the milk's nitrogen, include urea, uric acid, creatine, creatinine, amino acids and nucleotides.[2][3]
Mother's milk has been shown to supply a type of endocannabinoid (the natural neurotransmitters which marijuana simulates), 2-Arachidonoyl glycerol.[4]
Though now it is almost universally prescribed, in the 1950s the practice of breastfeeding went through a period where it was out of vogue and the use of infant formula was considered superior to breast milk.
However, it is now universally recognized that there is no commercial formula that can equal breast milk. In addition to the appropriate amounts of carbohydrate, protein and fat, breast milk also provides vitamins, minerals, digestive enzymes and hormones - all of the things that a growing infant will require. Breast milk also contains antibodies and lymphocytes from the mother that help the baby resist infections. The immune function of breastmilk is individualized, as the mother, through her touching and taking care of the baby, comes into contact with pathogens that colonize the baby and consequently her body makes the appropriate antibodies and immune cells. This is a process that obviously cannot be replicated on an industrial basis.
Women who are breastfeeding should consult with their physician regarding substances that can be unwittingly passed to the infant via breast milk, such as alcohol, viruses (HIV or HTLV-1) or medications.
Most women who do not breastfeed use infant formula, but breast milk donated by volunteers to human milk banks can be obtained by prescription.[5] Cow's milk is recommended as a substitute, but only for children over one year of age.
Comparison to other milks
All mammal species produce milk, but the composition of milk for each species varies widely and other kinds of milk are often very different from human breast milk. As a rule, the milk of mammals that nurse frequently (including human babies) is less rich, or more watery, than the milk of mammals whose young nurse less often. Human milk is noticeably thinner and sweeter than cow's milk. Left in a cup, the cream will rise and form a thin layer.
Whole cow's milk does not contain sufficient vitamin E, iron, or essential fatty acids, which can make infants fed on cow's milk anemic. Whole cow's milk also contains excessive amounts of protein, sodium, and potassium which may put a strain on an infant's immature kidneys. In addition, the proteins and fats in whole cow's milk are more difficult for an infant to digest and absorb than the ones in breast milk.[6] Evaporated milk may be easier to digest due to the processing of the protein but is still nutritionally inadequate. A significant minority of infants are allergic to one or more of the constituents of cow's milk, most often the high amounts of lactose (milk sugars) and agglutinin. These problems can also affect infant formulas derived from cow's milk.
Extraordinary consumption
In the ancient world, breast milk was sometimes consumed by fertility cults, and in other religious ceremonies.[citation needed]
Preliminary research indicates that breast milk can induce apoptosis in some types of cancer cells [7]. Adults with GI disorders and organ donation recipients can also benefit from the immunologic powers of human breast milk. More research is needed in these areas.
In Costa Rica, there have been trials to produce cheese and custard from human milk as an alternative to weaning.[8]
A controversial Swiss restaurateur has created a menu based around foods cooked in human breast milk [9].




LACTATION
Hormonal influences
From the fourth month of pregnancy (the second and third trimesters), a woman's body produces hormones that stimulate the growth of the milk duct system in the breasts:
Progesterone — influences the growth in size of alveoli and lobes. Progesterone levels drop after birth. This triggers the onset of copious milk production.[2]
oestrogen — stimulates the milk duct system to grow and become specific. Oestrogen levels also drop at delivery and remain low for the first several months of breastfeeding.[2] It is recommended that breastfeeding mothers avoid oestrogen-based birth control methods, as a spike in estrogen levels may reduce a mother's milk supply.
Follicle stimulating hormone (FSH)
Luteinizing hormone (LH)
Prolactin — contributes to the increased growth of the alveoli during pregnancy.
Oxytocin — contracts the smooth muscle of the uterus during and after birth, and during orgasm. After birth, oxytocin contracts the smooth muscle layer of band-like cells surrounding the alveoli to squeeze the newly-produced milk into the duct system. Oxytocin is necessary for the milk ejection reflex, or let-down to occur.
Human placental lactogen (HPL) — From the second month of pregnancy, the placenta releases large amounts of HPL. This hormone appears to be instrumental in breast, nipple, and areola growth before birth.
By the fifth or sixth month of pregnancy, the breasts are ready to produce milk. It is also possible to induce lactation without pregnancy.

Lactogenesis I
During the latter part of pregnancy, the woman's breasts enter into the Lactogenesis I stage. This is when the breasts make colostrum (see below), a thick, sometimes yellowish fluid. At this stage, high levels of progesterone inhibit most milk production. It is not a medical concern if a pregnant woman leaks any colostrum before her baby's birth, nor is it an indication of future milk production.

Lactogenesis II
At birth, prolactin levels remain high, while the delivery of the placenta results in a sudden drop in progesterone, estrogen, and HPL levels. This abrupt withdrawal of progesterone in the presence of high prolactin levels stimulates the copious milk production of Lactogenesis II.
When the breast is stimulated, prolactin levels in the blood rise, peak in about 45 minutes, and return to the pre-breastfeeding state about three hours later. The release of prolactin triggers the cells in the alveoli to make milk. Prolactin also transfers to the breast milk. Some research indicates that prolactin in milk is higher at times of higher milk production, and lower when breasts are fuller, and that the highest levels tend to occur between 2 a.m. and 6 a.m.[3]
Other hormones—notably insulin, thyroxine, and cortisol—are also involved, but their roles are not yet well understood. Although biochemical markers indicate that Lactogenesis II begins about 30–40 hours after birth, mothers do not typically begin feeling increased breast fullness (the sensation of milk "coming in") until 50–73 hours (2–3 days) after birth.
Colostrum is the first milk a breastfed baby receives. It contains higher amounts of white blood cells and antibodies than mature milk, and is especially high in immunoglobulin A (IgA), which coats the lining of the baby's immature intestines, and helps to prevent germs from invading the baby's system. Secretory IgA also helps prevent food allergies.[4] Over the first two weeks after the birth, colostrum production slowly gives way to mature breast milk.[2]

Lactogenesis III
The hormonal endocrine control system drives milk production during pregnancy and the first few days after the birth. When the milk supply is more firmly established, autocrine (or local) control system begins. This stage is called Lactogenesis III
During this stage, the more that milk is removed from the breasts, the more the breast will produce milk.[5][6] Research also suggests that draining the breasts more fully also increases the rate of milk production.[7] Thus the milk supply is strongly influenced by how often the baby feeds and how well it is able to transfer milk from the breast. Low supply can often be traced to:
not feeding or pumping often enough
inability of the infant to transfer milk effectively caused by, among other things:
jaw or mouth structure deficits
poor latching technique
rare maternal endocrine disorders
hypoplastic breast tissue
a metabolic or digestive inability in the infant, making it unable to digest the milk it receives
inadequate calorie intake or malnutrition of the mother

Milk ejection reflex
The release of the hormone oxytocin leads to the milk ejection or let-down reflex. Oxytocin stimulates the muscles surrounding the breast to squeeze out the milk. Breastfeeding mothers describe the sensation differently. Some feel a slight tingling, others feel immense amounts of pressure or slight pain/discomfort, and still others do not feel anything different.
The let-down reflex is not always consistent, especially at first. The thought of breastfeeding or the sound of any baby can stimulate this reflex, causing unwanted leakage, or both breasts may give out milk when an infant is feeding from one breast. However, this and other problems often settle after two weeks of feeding.[citation needed] Stress or anxiety can cause difficulties with breastfeeding.
A poor milk ejection reflex can be due to sore or cracked nipples, separation from the infant, a history of breast surgery, or tissue damage from prior breast trauma. If a mother has trouble breastfeeding, different methods of assisting the milk ejection reflex may help. These include feeding in a familiar and comfortable location, massage of the breast or back, or warming the breast with a cloth or shower.

Afterpains
The surge of oxytocin that triggers the milk ejection reflex also causes the uterus to contract. During breastfeeding, mothers may feel these contractions as afterpains. These may range from period-like cramps to strong labour-like contractions and can be more severe with second and subsequent babies.[8]

Lactation without pregnancy
Women who have never been pregnant are sometimes able to induce enough lactation to breastfeed. This is called "induced lactation". A woman who has breastfed before and re-starts is said to "relactate". If the nipples are consistently stimulated by a breast pump or actual suckling, the breasts will eventually begin to produce enough milk to begin feeding a baby. Once established, lactation adjusts to demand. This is how some adoptive mothers, usually beginning with a supplemental nursing system or some other form of supplementation, can breastfeed.[9] There is thought to be little or no difference in milk composition whether lactation is induced or a result of pregnancy.[citation needed] Rare accounts of male lactation (as distinct from galactorrhea) exist in medical literature.
Some drugs, primarily atypical antipsychotics such as Risperdal, may cause lactation in both women and men. Also, some couples may use lactation for sexual purposes.