The concentrations of hormones that stimulated breast development during pregnancy decreases promptly after delivery.

The time it takes for the return of these hormones to prepregnancy levels is determined in part by whether the mother breast-feds her infant.

a. Milk.

Does not appear until three or four days after delivery.

b. Colostrum.

This is the watery prolactations secretion that is first evident during the second trimester. It is secreted for the first several days after delivery in increasing amounts. Characteristics of colostrum are as follows:

(1) Thick, yellow fluid during pregnancy which changes to thin before delivery.

(2) Higher in protein and inorganic salts than breast milk.

(3) Lower in fats and carbohydrates than breast milk.

(4) Contains high levels of antibodies, which protect the infant against enteric infections.

(5) Nutritive value is lower than that of breast milk.

(6) Acts as a laxative for the newborn.

c. Lactation.

(1) As previously mentioned, breast milk usually comes three or four days postpartum. The color is bluish white. The milk causes a fullness and tenderness to the breasts which is known as engorgement. This congestion usually subsides in one to two days. Ejection reflex can be adversely affected by extreme factors such as anxiety, tension, or severe cold or pain. The infant should be breast-fed in a comfortable, relaxed setting. Some medications may be excreted through the breast milk.

(2) Suppression of breast milk by non-nursing mothers is simple and most natural. The mother should:

(a) Not allow the infant to suck.

(b) Not stimulate the breast or nipples.

(c) Wear a tight bra.

(d) Avoid hot showers.

(e) Apply ice packs to the breast if engorgement occurs.

NOTE: Hormonal methods to suppress breast milk are administered during the postpartum period. This method suppresses the production of prolactin.

(3) The dietary requirements of the lactating mother should include increase amounts of protein, calcium, iron, and vitamins. An increase in fluid intake is also necessary. The amount of breast milk production is directly proportional to fluid intake. Additional fluids are required in hot, humid climates.