ABSTRACT
This chapter provides a better understanding of how breastfeeding works. The size and shape of the breast, nipple and areola vary dramatically between women without affecting the ability to breastfeed. The nipples generally become more erect in pregnancy and in lactation as does their protractility. During pregnancy, prolactin levels rise steadily, from approximately 10 ng per ml in the non-pregnant state to approximately 200 ng per ml at term. Milk secretion is held in check by high circulating plasma concentrations of progesterone and oestrogen originating in the placenta. Lactation is a natural survival mechanism and is not easily disrupted, contrary to nineteenth-century beliefs that it was dependent on relaxation and contentment. When a baby suckles, oxytocin is released for the posterior pituitary gland within 1 minute. Understanding how breastfeeding works may facilitate problem solving. Breastmilk production is controlled by the release of oxytocin and prolactin.
