Breastmilk

Breast milk is milk in humans is made ​​by the mother to feed her child. For newborns, it is the main source of nutrients because they can not digest other foods. In addition, breast milk plays a major role in the defense of a baby, since the individual's immune system has not yet been well established. Mother's milk is produced by the mammary glands in the breast .

The most common way a child gets into breast milk, is right on the chest. The milk can, however, also be, and are given by expression in a vial to the child. It can also prevent the child gets breast milk from another woman. A woman giving other children breastfeeding as a profession called min . However, it can also be a donor of milk, for example, from a woman from the family or friends, or by means of a mother's milk bank.



Content
[ hide ]  *1 Milk  ==[Milk  edit ] == ===The beginning of the milk [  edit ] === Milk production is already in the fifth month of pregnancy going. Its secretion is inhibited only by the hormones progesterone and estrogen . These hormones namely inhibit the action of prolactin, the hormone that allows for the correct secretion of milk. ===During pregnancy [  edit ] === The development of the breasts during pregnancy, the breasts prepares for milk production. The placenta produces a lot of estrogen during pregnancy. Estrogens ensure the development of the mammary glands and the milk ducts. Also, the fat content in the breasts is increased. Also, progesterone plays a role in the full development and enhances the effect of the oestrogens. ===After birth <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] === <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">The milk is then really got going after delivery. The inhibitory activity of progesterone then falls away namely, because the placenta is removed from the body. Before birth, coming just a few milliliters of milk from the breasts, but after that there is much more out. The first milk produced is called colostrum. The maximum amount of colostrum that may be produced is only 1% of the quantity of breast milk which is usually produced.In the second and third week after birth the composition changes gradually.
 * 1.1 The beginning of the milk production
 * 1.2 During pregnancy
 * 1.3 After birth
 * 1.4 Hormonal regulation
 * 1.4.1 Regulation of prolactin
 * 1.4.2 letdown
 * 1.4.3 Menstrual Cycle
 * 1.5 Artificial lactation
 * 2 Composition of milk
 * 2.1 Colostrum
 * 2.2 'normal' milk
 * 2.2.1 Proteins
 * 2.2.1.1 Casein
 * 2.2.1.2 α-Lactalbumin
 * 2.2.1.3 immunoglobulins
 * 2.2.1.4 Lactoferrin
 * 2.2.1.5 Lysozyme
 * 2.2.1.6 haptocorrin
 * 2.2.1.7 Growth Factors
 * 2.2.1.8 Pre-biotic components
 * 3 Pumping
 * 3.1 Hand
 * 3.2 With a breast pump
 * 3.3 Storing breast milk
 * 4 Medications and breast milk
 * 4.1 Classification of risky medication
 * 4.2 Undesirable substances in breast milk
 * 4.2.1 Passive diffusion
 * 4.2.2 Ion trapping
 * 4.2.3 Molecular Weight
 * 4.2.4 Fat solubility
 * 4.2.5 Milk / plasma ratios
 * 4.2.6 Concentration in plasma
 * 4.2.7 Available quantity of the substance
 * 4.3 Inhibition of the milk production
 * 5 See also
 * 6 External links

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">In the weeks following the baby's birth control hormones that regular milk that is thin, watery and sweet, is produced instead of colostrum. The growth hormone , cortisol , parathyroid hormone and insulin ensure that the necessary amino acids , fatty acids , glucose, and calcium are supplied.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">The basal prolactin level decreases after the birth to the 'normal' level, that of the pregnancy. But every time the baby is fed from the nipple stimulation signals the pituitary making 10 to 20 times more than the normal amount of prolactin is produced. The effect lasts about an hour, but ensures that the milk glands keep producing milk. If this mechanism is lacking namely, there will be after about one week no milk can be produced anymore. But the production of milk can continue for years if the child breastfed remains. The total production is often off after six to seven months because usually starts with the introduction of solid foods and the baby needs less milk and therefore less (often) to drink. ===Hormonal regulation <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] === <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Lactation consists of two phases: the milk by the alveolar cells and milk secretion. Milk production is a continuous process. The secretion and production by alveolar cells takes place at the same time. But both processes are regulated separately.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">In milk production by cells is prolactin, that due to the anterior pituitary is issued, is of great importance. The secretion is oxytocin, which is issued by the very neurohypophysis, important. ====<span class="mw-editsection-bracket" style="color:rgb(85,85,85);"><span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;">[Regulation  of prolactin <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;">edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">]  ==== <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">The anterior pituitary is stimulated to release prolactin in the blood by various hormones, including TRH , vasopressin and angiotensin . These hormones remain in the blood after they have been issued and thus provide, in principle, for a constant stimulus. The secretion of PIH ( Prolactin-Inhibiting hormone, which is assumed to be the same as dopamine is), however, is against this. However, this effect can be (temporarily) raised by reflex. ====Letdown <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] ==== <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Constant milk is produced in the mammary glands, but can not easily get into the milk ducts. If the baby is at the breast, he gets the first 30 to 60 seconds, almost no milk.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">The sensors around the nipple marks sensors of the epithelium in the upper lip of the child. At the touch of the areola by the lips of the infant go impulses from sensors around the nipple to the pituitary via the spinal cord and brainstem to the hypothalamus . As a result, the secretion of prolactin, oxytocin and ACTH stimulated and that of gonadotropins, the sex hormones, inhibited. It is therefore a neural afferent (afferent) and hormonal efferent (wicking) away (seen from the brains).

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">The oxytocin in the blood stimulates the breasts in the myoepithelial cells, which surround the alveoli. As a result, they will contract and will come in the milk ducts. The pressure which is provided here is approximately 10 to 20 mm Hg. Only then the child actually gets milk. The reflex occurs in both breasts than on, not only in the breast which the baby is drinking.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Sometimes the reflex can also occur if the mother or the baby touches upon hearing cry, this may also be another baby. The emotional cues are then enough to bring the milk ejection reflex in motion. This can also happen during orgasm, because then release oxytocin. ====Menstrual cycle <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] ==== <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">In most mothers enters the menstrual cycle, after the birth of the child does not go to a first few weeks after cessation of the lactation. The signals go to the hypothalamus in the breasts ensure that the production ofgonadotropin-releasing hormone (GnRH) is inhibited. This can be done by the signal itself and the subsequent coming prolactin. The inhibition of GnRH then ensures that the production of the hormones LH (luteinizing hormone ) and FSH ( follicle stimulating hormone ), is inhibited. For some mothers, especially mothers who are breastfeeding little is enough LH and FSH is produced after several months. This causes the menstrual cycle back on track. ===Artificial lactation <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] === <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Milk can also be artificially initiated. This can be either with medication or by stimulating the nipples. For this, the woman does not become pregnant or before breast-feeding have been given to do. Women who have been breastfeeding can again (easier) lactate, this is called relactatie.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Milk production by stimulation of the nipples can be achieved by massaging both several times a day (manual 'flasks'), to suck at the breast, or "flasks" with a breast pump. This causes the milk glands in the same way as stimulated by breastfeeding a child. The hormones then provide for the development of the mammary glands so that it is made of milk. There is no difference in the composition of breast milk produced by natural or artificial lactation. If the milk has been once started, the created amount of milk is dependent on the demand for milk.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Milk production may be several reasons for artificial underway. For example, it may be necessary to be able to give an adopted child breastfeeding. It can also be accomplished sexual reasons (erotic lactation), for example in an Adult Nursing Relationship. The lactating woman namely can get a nice feeling when someone is drinking at the breast and can therefore someone other than a child in a sexual context breastfeeding.The one who is fed can also find it exciting to milk directly to drink from the breast or expressed milk. This may also be a reason for a lactating woman or not someone else than her child to drink her milk. ==<span class="mw-editsection-bracket" style="color:rgb(85,85,85);"><span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;font-family:sans-serif;">[Composition  of milk <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;font-family:sans-serif;">edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">]  == ===<span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[Colostrum  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] === <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Colostrum is the milk that comes out of the breasts during the pregnancy and the milk that is produced in the first few days. It is usually yellowish in color and is quite thin. This milk contains lactose and proteins, but virtually no fat. Colostrum also contains many minerals and fat-soluble vitamins A and E and immunoglobulins, mostly of the type IgA, which protect the newborn against infection until their own immune system is not yet well enough developed. Vitamin D and K need to be supplemented. ==='Normal' milk <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] === Two glasses with each 25 mL of milk: the left is milk, a 'full' breast;Right behind milk, from an almost "empty" breast<p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">This milk after 3 to 4 days after birth only made. This milk is thin (less thin than colostrum), watery and sweet, the high lactose content. Usually comes first watery milk from the breast. Here is usually low in fat and high in carbohydrates and milk mentioned. For Milk is thirst-quenching. The milk is progressively fatter and fatter. This milk is called behind milk and hongerstillend.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">However, the composition of human milk varies considerably. This depends on the diet of the mother and the time of the day. Also, the composition over a period of several weeks or months changes that breast-feeding.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">In comparison with cow's milk, the differences in lactose, protein, and ash remarkable. There is in fact one and a half times as much milk lactose, a sugar. In cow's milk, there are normally two to three times more protein than in breast milk. There's also more ash, where calcium and other minerals are in, in.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Carbohydrates are mainly lactose in milk. Some lactose-based oligosaccharides are also found. The fat is composed mainly of triglycerides of palmitic acid and oleic acid (OPO triglycerides) and also a large amount of lipids with mutual bonds. These fats are good for health.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">The proteins in the milk consists of casein , α-lactalbumin , lactoferrin , IgA , lysozyme, and albumin . In acidic environments such as the stomach, α-lactalbumin unfolds and binds to oleic acid. They form a complex called HAMLET and have a killing effect on cancer cells. It is assumed that this has a protective effect against cancer in infants.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">In addition to all foods also provide breast milk for protection against infections . For example, there are many different types of antibodies in the milk.Several white blood cells, such as neutrophils and macrophages , there is also in it. Some of them kill bacteria that can cause deadly infections in newborn babies. In particular are antibodies and macrophages is important to the Escherichia coli to kill bacteria. These bacteria can cause fatal diarrhea in babies.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">As newborn babies cow's milk instead of getting breast milk, protective substances die quickly. Namely, they can not survive in the environment of the human body.

The total quantity of milk from both breasts at the same time pumping once obtained. (Available amount at one feed)<p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Shortly after giving birth women can produce up to 600 ml per day. Later, women produce on average 800 to 1100 ml of milk per day. At the peak of the lactation period can sometimes produce 1.5 liter and twins sometimes more. There is even milk showed up to 5L. Overall milk production depends on how much milk the baby is drinking and how often and how much express any breast milk the mother. This takes a lot of energy from the mother, about 650 to 750 kilocalories per liter. The composition and calorific value may vary depending on the diet, and other factors such as how full the breasts.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">The amount produced is usually much less than the quantity that can be produced. Research has shown that as many as four times as much as the breasts of milk can produce as is normally produced. Because breast milk is not needed in such large quantities is less created.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Some substances are large amounts in the milk up. There will be, for example, 50 grams of fat and about 100 grams of lactose each day in the milk, which is converted from glucose in the mother's body. Also coming 2 to 3 grams of calcium phosphate in the milk. Unless the mother large quantities of milk and drink plenty of vitamin D ingested, the discharge from the mammae of calcium and will phosphate are much larger than the intake. In order to obtain calcium phosphate and then pass the parathyroid glands increase and the bones are decalcified. During pregnancy, this is usually not a big problem, but during lactation may be more important. ====<span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[Proteins  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] ==== <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">As outlined above, breast milk contains many different proteins. They all have different features for children.

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<span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[Casein  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] ===== <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">β-Casein is the major casein in human milk. The calcium ions can bind to itself, and probably contributes to the large amount of calcium in the milk. Also comes κ-caseinfor milk. It has been shown that κ-casein, the bacterium Helicobacter pylori counteracts. This bacterium occurs mainly in young children. A third form, α <sub style="line-height:1;">s1  -casein, has been demonstrated in low concentrations, but its function in breast milk is unknown.

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<span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[α-lactalbumin  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] ===== <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">α-Lactalbumin binds calcium and zinc ions to itself. However, this amount is small, but it may have a positive influence on the absorption of minerals. This effect has been demonstrated with α-lactalbumin from cow's milk, but not yet in the milk of human beings.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">In addition, it can also have an anti-microbial function. Three polypeptide chains of α-lactalbumin have exhibited antimicrobial activity against the bacteria Escherichia coli ,Klebsiella pneumoniae , Staphylococcus aureus , S. epidermidis , Streptococci, and Candida albicans .

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<span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[Immunoglobulins  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] ===== <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">The most common immunoglobulin in milk is IgA (> 90% of the total immunoglobulins in the milk). The concentration thereof is relatively high, namely, 1 to 2 g / L in the early stage of the lactation, and for up to two years later, 0.5 to 1 g / L. IgA antibodies to E. coli, V. cholerae , H. influenzae , S. pneumoniae , C. difficile and Salmonellahave been demonstrated in breast milk.

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Lactoferrin <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] ===== <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Another important protein is lactoferrin . The two iron ions can bind to itself and is responsible for the amount of iron in breast milk. It also stimulates the absorption of iron in the intestines. This is due to receptors for human lactoferrin.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Lactoferrin also has anti-microbial activity. It has a bacteriostatic (not slaying, but inhibitory) against iron-dependent bacteria. This is due to the great affinity with iron. There is also a bacteriocide (killing) function shown against some bacteria (non-iron-dependent).

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">It is possible that the binding of lactoferrin to its receptors in the gut, the cause of the release of cytokines . Of lactoferrin is known to increase the production of cytokines such as TNF-α , IL-1β , IL-8 and nitric oxide .

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Lysozyme <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] ===== <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Lysozyme is in relatively high concentrations in milk. This enzyme can gram positive bacteria kill through the outer wall thereof to break down. In vitro (in test tubes) is also shown that lysozyme in combination with lactoferrin gram negative bacteria can kill.

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Haptocorrin <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] ===== <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">In milk of humans haptocorrin virtually the only substance that vitamin <sub style="line-height:1;">B12 is bound. In addition, it is likely to have an inhibitory effect on the growth of bacteria.

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Growth factors <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] ===== <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Different types of growth factors, including various forms of IGF (insulin-like growth factors), and epidermal growth factor (EGF), have been demonstrated in breast milk. These growth factors provide for growth of certain cell types, especially in the digestive system.

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Prebiotic components <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] ===== <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">The microbial flora in breast-fed infants is different than children who receive formula. Several pathogenic bacteria, such as E. coli, Bacteroides , Campylobacter, and Streptococci, are to a lesser extent, but the body's more bacteria, for example, Lactobacilli and Bifidobacteria . These bacteria inhibit the growth of pathogenic bacteria by the pH decrease in the intestines (making more acidic). In breast milk is a substance that does this. The exact composition of this substance is not yet known. ==Pumping <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;font-family:sans-serif;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] == A manual breast pumpBoth breasts simultaneously with an electric pump gekolfd<p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Breast milk can be by expression for several reasons. For example, because the child can not or will not drink to the chest. It is also possible to stockpile or because the parent is not always the child and wants to breastfeed in this manner.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">There are several ways to print milk flasks These include:

===Hand <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] === <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Hand pumping is usually used when there is not as much need for pumping. With the hand is gekolfd by using the thumb and the other fingers to place the areola and pressing (to the rib cage toe). Then move to the fingers towards the nipple. The reflex will come out milk first. In the first few days after birth will not be any (colostrum) come out. ===With a breast pump <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] === <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Mothers who express milk more frequently tend to use a breast pump. A hand pump is usually used to occasionally butts and electric pump with regular pumping. ===Storing breast milk <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] === <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Breast milk is like most other nutrients limited shelf life. Below is the circumstances in which the milk for how long may be kept. ==Medication and breast <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;font-family:sans-serif;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] == <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Some medications may have some influence on the milk. Some inhibit or stimulate its production, other end up in the milk and may thus have a negative influence on the child. ===Classification of risky medication <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] === <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Medications can be classified for use in nursing mothers. They are classified into five categories based on the risks for mother and child when used by nursing mothers.
 * Manual
 * With a manual breast pump
 * With an electric breast pump

===Undesirable substances in breast milk <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] === <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">The substances in certain drugs can get into the milk. Which substances in the milk may end up, depends on certain factors:
 * L1: Medication is occupied by a large number of lactating mothers, and there are no indications of adverse effects for the child.
 * L2: The drug is administered to relatively few mothers and did not lead to a decline in the health of the child. Any risks are so small that they are negligible.
 * L3: No research has been done on possible adverse reactions in nursing mothers, but side effects are possible. If research is done, there were slight side effect with no danger to the life of the child. The drug should be used only if the benefits outweigh the disadvantages.
 * L4: There is evidence that the drug may have side effects on the child or on the milk of the mother. Use is recommended only in some cases.
 * L5: There are proven significant side effects. The drug should not be prescribed to breastfeeding mothers.

====Passive diffusion <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] ==== <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Substances are usually released into milk through passive transport by diffusion . Substances go because of the place with the highest concentration to an area with a low concentration. In the first period after the birth the milk producing cells are most porous, but the quantity of colostrum is usually low. As a result, the operation of any unwanted substances in the milk is minimal.
 * Concentration of the substance in the plasma of the mother
 * Molecular weight of the fabric (light substances are more easily in the milk)
 * Extent to which the substance binds to certain proteins (substances that bind to proteins are not or little easier in the milk)
 * Fat content of milk (fat-soluble substances are easier to get milk with a higher fat content)

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Usually, diffuse substances from the milk from medications again. If the substances are degraded in the maternal plasma, the concentration decreases. The agents then go into the plasma. This can therefore be compensated for by not breast-feed when the concentration of a substance is high in the plasma. When drugs with a long half-life (the time after which half of the total quantity of substance has been degraded), this can not usually. ====Ion trapping <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] ==== <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">"Ion trapping takes place in weak bases. The breast milk (pH 7.2) is slightly more acidic than plasma (pH 7.4), and because of this some weak bases can become more strongly polarized. They can therefore no longer diffuse back and become trapped in the milk. Conversely, some weak acids can not diffuse back into the milk. ====Molecular Weight <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] ==== <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">The size of the molecules of a substance can ensure that it can be more difficult to diffuse through the cell membrane. In general, the larger the dust, the less of it in the milk. At a size of 500 to 800 daltons, it is already quite difficult for the substance to come into breast milk and is at more than 1000 daltons that amount even negligible. ====<span class="mw-editsection-bracket" style="color:rgb(85,85,85);"><span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;">[Fat  solubility <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;">edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">]  ==== <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Substances which can dissolve well in fat, can easily end up in the milk. This can happen in the milk-producing cells, where the substance is then dissolved in fats that the cell should still off. It can also take place after the substance has already ended up in the milk, after which it dissolves in the fat in the milk and gets stuck there. ====Milk / plasma ratio <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] ==== <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">The milk / plasma ratio (abbreviated M / P) is sometimes useful to determine in advance how much of a dust into the milk. This ratio is very different from the moment at which the breast milk comes out of the chest.Hence it is usually the M / P at the time immediately after administration used. A high M / P indicates an easy diffusion to the milk and a low M / P in the relatively difficult diffusion to the mother's milk. However, the M / P says hardly anything about the concentration of the substance in the milk. That depends mainly on the concentration in maternal plasma. ====Plasma concentration <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] ==== <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">The concentration of a substance in the mother's plasma is one of the most important (kinetic) factors that determine how much of a substance in the mother's milk enters. The concentration is determined by the dosage of a drug, half-life, the distribution of the substance in the body, the available quantity and the extent to which it binds to proteins. In general, the higher the concentration in the plasma, the higher the pressure in order to diffuse the substance into the milk. ====Available quantity of the substance <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] ==== <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">The available quantity plays a role in the increase of the concentration in the plasma. Before the substance in the plasma ends up, it can be already partly degraded or are not allowed to pass to the plasma. The mode of administration is important. The final concentration in the plasma (shortly after administration) will differ for oral , rectal , intravenous , intramuscular or subcutaneous administration. ===Inhibition of milk <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] === <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">The quantity of milk produced is important for the growth of the child. If the production of mother's milk is inhibited, it can have a negative influence on the growth. For certain types of medications are known to inhibit the production of milk, namely, ergot alkaloids, for example, bromocriptine and cabergoline, estrogens , progestogens , pseudoephedrine and to a lesser extent alcohol .

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">The effect of medication with estrogen may vary individually. In some women, there is little impact on milk production, others just very. A decrease in the milk production can also be relatively slow. These women usually notice anything about the amount of milk produced. The most sensitive period in the postpartum, before milk production has come to full power. Usually are advised to wait as long as possible with the start of contraceptives.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Ergot alkaloids inhibit the secretion of prolactin (and thus ultimately also of the milk production).