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Question for Tiktok, mostly - How does it all work?

(33 Posts)
NotQuiteCockney Sun 16-Jan-05 11:33:17

I have a couple of questions about how breasts actually work.

1. Does supply work by circadian rhythms? Do my boobs know what time it is, and hence how much milk to make?

2. I understand the initial let-down is from the reservoirs. I can feel the reservoirs. That's all fine. But where do later let-downs come from? Are they hind-milk? Am I making it as it comes out? It comes out pretty fast, I think. I don't think it's other reservoirs, as my boobs feel entirely soft by this time ...

3. What happens when let-down happens? Why does it hurt? Are there muscles, or what?

NotQuiteCockney Sun 16-Jan-05 11:33:51

Oh, and thanks in advance for any answers you can provide. It's great having access to a BF professional like this.

tiktok Sun 16-Jan-05 12:15:24

Circadian rhythms - yes, apparently, because prolactin levels have been shown to be higher at night...though this is prob not all that significant as bf gets established.

Let down is know as the milk ejection reflex, or MER, and it works on muscles surrounding the milk storage cells in the breast, stimulated by the release of oxytocin which itself is stimulated by the baby sucking. I suppose initial MER is from the reservoirs, but it's usually held to refer to the action on the milk deeper inside the breast. There will be a number of MERs each time the baby comes to the breast, and there is no such thing as 'the' hindmilk despite what you read. Milk gets creamier the less there is in the breast - it's a gradual process, not a sudden change. It gets creamier purely and simply because the 'stickier' cream components come away from the storage cells later, 'cos they have stuck

Milk is produced in direct response to its removal. The more frequent and the more effective the removal of milk, the faster it is replaced. The breast doesn't empty completely, but there are degrees of fullness. This allows the baby to 'self-regulate' so he drives the supply by what he asks for. In addition, mothers' storage capacity differs - unrelated to the outward size of their breasts which is mainly govered by the amount of body fat. So it is crazy to say babies 'should' only feed every X hours for Y minutes - this does not take into account the wonderful human variability, and the way nature accounts for this by making the supply and production 'elastic' to fit all needs.

A very, very few women find their MER does cause them pain, but most people don't.

Hope this helps

Prufrock Sun 16-Jan-05 12:39:16

Whilst we are asking questions tiktok, can I butt in?

I have always wondered about alcohol and bf (in fact it was the subject of my first ever Mumsnet post). I do drink in moderation whilst bf and am happy that I am not poisoning my baby. But what I've never understood is how bm I have produced whilst drunk loses it's alcohol - I mean, if I go away for an evening, get completely hammered and miss the evening feed, I know my body has produced milk overnight (when my blood alcohol levels are high) because my boobs are engorged in the am. So there must be milk in my breasts already - how come when I get home it is Ok to feed my baby this milk? does teh alcohol not stay in it?
(I wouldn't want you to think I'm questioning your wonderful advice btw - just curious about the chemistry)

hermykne Sun 16-Jan-05 12:42:50

can i butt in too, seeing as my thread has is off the top 50!!!!
tiktok please let me know about foods in your diet affecting b/milk? and how long before they affect the milk and do they affect baby, as my ds thru up 4 times last night and i had prawns for dinner at 6pm.

KateandtheGirls Sun 16-Jan-05 13:23:28

Prufrock, I always thought you were supposed to "pump and dump" in that situation, so that you get rid of the milk that has been contanimated (for want of a better word) with alcohol.

Interested to hear what Profrock's take on it is.

KateandtheGirls Sun 16-Jan-05 13:23:50

I mean tiktok's take on it of course.

Prufrock Sun 16-Jan-05 13:31:50

Nope- tiktok and mears and others whose opiniosn I respect have said before that there is no need at all to pump and dump. I believe them - but I just want to know why [frustrated emoticon]

KateandtheGirls Sun 16-Jan-05 13:35:24

Really?

collision Sun 16-Jan-05 14:25:26

I am interested in all these questions and answers and I think tiktok is great!

spots Sun 16-Jan-05 15:49:25

And I have an 'always wondered' too... but it's not important so if Tiktok gets too busy answering the others just ignore this...

what is breastmilk made of? what would it be being used for if it wasn't being made into breastmilk? does everyone have the 'ingredients' in their bodies or just lactating mothers? apart from the energy used to make it and the water content, does your body 'give up' anything to make it?

rattled that off, sounds a bit long winded! sorry!

tiktok Sun 16-Jan-05 16:12:17

I understand the question is that alcohol gets into the breastmilk - so why doesn't it stay there, hanging about, waiting to 'get into' the baby at the next feed? Well, I have to say the exact biochemstry of this is miles over my head, but apparently what happens is that unlike (say) the urine in the bladder, 'alcohol is not trapped in breast milk, but is constantly removed as it diffuses back into the bloodstream'...this is from this scientific answer which goes on to explain more about the timing of the whole process.

Pumping and dumping does not hasten the process of elimination, and in fact it is a pointless thing to do - you just hafta wait until your body goes through the process at the same speed as it gets rid of alcohol in the bloodstream (via, I suppose, the liver)....so alcohol in the milk diffuses back into the bloodstream, hurtles round the body in the circulation, and is dealt with in the normal way as you de-toxify and become alcohol free.

Some components of some foods do get into the breastmilk, in varying amounts.

I am not sure exactly what is in breastmilk, and nor is anyone, as far as I can tell. They keep discovering new stuff!

I am not sure how it is made - this says something about it but it is all v. technical. The basic thing is having been pregnant and having breasts, but there are many cases where adoptive mothers have induced a milk supply, and one or two where men have got some milk, too, simply by having the baby suck on the breast.

Prufrock Sun 16-Jan-05 17:54:20

Thank you v. much.

Clayhead Sun 16-Jan-05 18:06:41

This thread is fascinating! Even though my bf days are (finally and a bit sadly) over.

Thanks for asking NQC

spots Sun 16-Jan-05 18:40:51

Great, tiktok, thanks!

IlanaK Sun 16-Jan-05 19:02:37

Just butting in here too.....about the breast storage capacity. I read this the other day in LLL Breastfeeding ANswer Book (which I have to say is the most fascinating book I have EVER read!). Anyway, perhaps I read it wrong, but I thought it said that breast milk storage capacity (but not the ability to make enough milk for your baby) WAS in fact related to breast size. Or did I read it wrong?

hermykne Sun 16-Jan-05 20:36:47

my god i justread the 2 links tik tok, fascinating stuff, going to plonk it infront of dh to read..to see his reaction that'll be good

chocolatecath Sun 16-Jan-05 20:46:56

Question for TikTok. Are you a BFC and if so, who did you train with and how long have you been doing it? I am thinking (just thinking) of training to become one. I hope it's alright to ask that question. I am fairly new here and maybe that's why I can't find your member profile which might answer my question! Also, are you a Health Professional? Thank you. (Oh, and if there are any other BFC's out there, I would be interested in hearing your responses too. Thanks again).

ghosty Sun 16-Jan-05 20:52:25

I have always wondered about the ability to breastfeed vs breast size too.
I have average sized boobs, breastfeeding DD wasn't a problem.
I have a friend who has enormous boobs and couldn't breastfeed and a friend who is practically flat chested and she is still breastfeeding her very chunky 14 month old.
Isn't it also related to nipple shape rather than breast size?
Fascinating thread by the way ....

tamum Sun 16-Jan-05 20:57:08

I guess what tiktk was alluding to was the fact that breast tissue is composed of a mixture of ductal/lobular tissue and fat, and the proportion of the two will vary between individuals. So someone who appeared to be very busty might have breasts made up of a high proportion of fat whereas someone fairly flat-chested might have breasts made up almost entirely of ductal tissue.

ghosty Mon 17-Jan-05 06:33:06

Ah ha .... thanks tamum

NotQuiteCockney Mon 17-Jan-05 06:39:39

Thanks tiktok. I hadn't realised MER only hurt for a very very few women ... that almost makes me feel lucky or something. (It's not a really big problem, the pain is pretty brief. Feels like being jabbed with pins in the first months, but is now calming down anyway.)

Oh, I have one more - why do we get really full reservoirs in the first months, but not later? Where is the milk coming from? I'm sure older babies don't take less - or do they?

Ghosty, I had heard of babies being unable to get enough of larger boobs into their mouths ... I suspect this is something that can be fixed with positioning? I certainly know that breast size and shape changes which positions work for you.

kinderbob Mon 17-Jan-05 06:47:17

I thought that because BM is a converted blood product that the alcohol is absorbed and processed by the liver in the same way that the alcohol in your blood stream is. Thus if you are okay to drive, you are okay to feed.

tiktok Mon 17-Jan-05 09:20:24

Not sure what you mean by reservoirs, NQC....the breasts tend to feel fuller all over in the early weeks/mths and then less full later, leading to mothers thinking their milk has gone, espcially if this change happens suddenly. Some women find it happens at about six weeks, but more typically, I would say it occurs at about 10-12 weeks.

In the early weeks, mothers may tend to over-produce, if anything, as if nature is making absolutely sure there is enough, not 'knowing' what this baby is like or how many there are of this baby ; )

Additionally, there is still some fat in the breasts which fills them out.

When bf gets very well-established, the supply is 'calibrated', that is, more neatly matches the needs of the baby (it can still be encouraged to increase if necessary, and if the baby starts to feed more often for some reason, more milk is made without anyone really noticing too much), and in addition, there is less fat because the breast tissue has actually developed more milk producing and storing tissue, replacing the fat.

tiktok Mon 17-Jan-05 09:20:54

Just thought - are you meaning 'ducts' when you say 'reservoirs', NQC?

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