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Lactation

Lactation is the release of milk by the mammary gland. Lactation is a complex neurohumoral process, in which the main role is played by the lactogenic hormone (see), produced by the pituitary gland, and the activity of the latter is controlled by the hypothalamus. The hormones of the adrenal cortex, thyroid gland and neuroreflex processes also take part in the regulation of lactation. Communication of the mammary gland with the central nervous system is carried out through a powerful receptor apparatus, embedded in the skin of the nipple and areola, as well as in the gland itself. Therefore, regular breastfeeding is of great importance for the development of lactation and its further preservation.

On the first day after birth, colostrum is excreted in small amounts (see), from the 2nd — 3rd day - colostrum milk, from the 4th-5th day - transitional milk. The final composition of breast milk (see) acquires on the 2-3rd week. The increase in secretion can occur gradually, reaching great intensity on the 4-5th day; with the rapid development of lactation on the 3-4th day after birth, the mammary glands within a few hours sharply increase in volume, become dense and painful, and the body temperature may rise. This lasts for 1-2 days, after which normal lactation is established under the condition of good emptying of the mammary glands. In primiparids, late lactation is sometimes observed: milk secretion begins only on the 5-6th day and later, slowly increasing over 3 weeks. Subsequently, the secretion of milk gradually and continuously increases, reaching a maximum between the 10th and 20th weeks and remaining at this level until the end of the lactation period.

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The duration of lactation depends on the individual characteristics of the breast, the development of its parenchymal elements and on how long the mother is breastfeeding. To ensure good lactation, a pregnant woman should be trained in breathing exercises that improve blood circulation and increase the tone of the mammary glands. For 1.5 months before delivery it is recommended to systematically massage the mammary glands. After the birth, from the very first days the mother must strictly follow the rules of breastfeeding (see. Feeding children ), express the milk residues after each feeding. The right regimen of the nursing day is of great importance for good lactation: regular good nutrition, during the winter period it is necessary to take preparations of vitamins C, groups B, D and A. It is important to regularly stay in the fresh air, enough hours of sleep. Violation of the day regimen and feeding regimen, overwork, mental experiences, and acute and chronic lactating diseases ( diabetes , nephritis , tuberculosis , etc.) can lead to a decrease in milk excretion (the so-called secondary hypogalactia). Older primiparous, and in young, with weak breast development, primary hypogalactia may develop. The complete absence of milk excretion (agalactia) is very rare.

If one regimen fails to improve lactation, nursing is prescribed prolactin intramuscularly (5 IU 2–3 times a day for 5–6 days), vitamin E in oil (10–15 mg of tocopherol per dose 2 times a day for 10–15 days); sometimes nicotinic acid has a good effect inside (0.04–0.05 g, 2-3 times a day for 10–15 minutes. before feeding the baby for 10–12 days).

Sometimes there is a spontaneous release of milk from the breast outside or during feeding - galactorrhea, which does not require special treatment; in order to avoid skin maceration, gauze bandages are applied to the mammary gland.