Въпрос за кърмене и зелени акита?

Честото хранене най-често не увеличава млечната секреция, а я намалява поради недоброто изпразване на гърдата и поради недостатъчната пауза между кърменията.

Endocrine vs. Autocrine control theory

There is also a second level of potential problems with scheduled feedings. It was well known that prolactin, the milk-producing hormone, was very important in the early months for good milk production. Yet, research also shows that prolactin levels decline to a lower plateau over the first few months postpartum, less important later than early on. This apparent contradiction has been explained in part by the theory of endocrine versus autocrine control. Endocrine control refers to the idea that hormones-- namely prolactin and oxytocin-- are the major drivers of milk production. This appears to be established shortly after parturition, and can be inhibited by retained placental fragments or other hormonally related health problems that mother may have. Endocrine control seems to be primary for approximately the first three months or so, until prolactin levels diminish.

It is now believed, partly due again to Dr. Hartmann's work, that another process referred to as autocrine (local) control takes over at about this time. Under the theory of autocrine control, the body continues milk production at a more local level that has been set during the early period. What appears to affect successful long term lactation is the proper development of adequate prolactin receptors during the endocrine control period, which in turn appears to be correlated with frequency of feedings: the more frequent the feeds, the greater the stimulation of receptor development (DeCarvalho, et al; Perry HM & Jacobs, LS).

In studies of women who are relactating after a period of non-lactation with a naturally born child, it has been noted that it is far easier to bring a milk supply back during the first three months postpartum than further down the line. The body produces many milk-making cells during pregnancy, then seems to pare these down over some months after delivery, efficiently keeping only the number necessary plus a few extra "off-line" cells that can be called back into production in a pinch; this natural process is called involution.

Many women claim success in schedule-feeding their breastfed babies during the first couple of months. However, they also have an unusually high rate of milk supply failure around 3-4 months, as evidenced by babies slowing down in growth below acceptable standards, requiring supplementation, and/or involuntary weaning as baby rejects the slower flowing lower volume breast for a more copious bottle.

In light of Dr. Hartmann's work, it becomes clear as to just why some babies never thrive on 3-4 hour schedules, some thrive for the first few months before falling out, and why some succeed the whole duration of lactation. It has everything to do with individual physiology plus breastfeeding management (schedule vs. cue), and nothing to do with proper following of an arbitrary or even "average" routine/schedule. Mothers who have not succeeded in combining breastfeeding with schedules have been told that they lacked the physical ability to produce enough milk, or else that they were not implementing the curriculum correctly, and are bearing a far too heavy burden of guilt and inadequacy!

Myth 1:   Frequent nursing leads to poor milk production, a weak let-down response, and ultimately unsuccessful breastfeeding.

FACT:   Milk supply is optimized when a healthy baby is allowed to nurse as often as he indicates the need.  The milk-ejection reflex operates most strongly in the presence of a good supply of milk, which normally occurs when feeding on baby’s cue.

De Carvalho 1983, 307-ll; Hill 1992, 605-12; Klaus 1987, 623-33; Neifert 1996, 6-9; Lawrence 1994, 188; Salariya 1978, 1141-43; Slaven 1981, 392-93; Stuart-Macadam 1995, 129; Woolridge 1992, 113-19.

Myth 2:    A mother only needs to nurse four to six times a day to maintain a good milk supply.

FACT:   Research shows that when a mother breastfeeds early and often, an average of
9.9 times a day in the first two weeks, her milk production is greater, her infant gains
more weight, and she continues breastfeeding for a longer period.  Milk production has been shown to be related to feeding frequency, and milk supply declines when feedings
are infrequent or restricted.

Daly 1995, 21-37; De Carvalho 1983, 307-11; De Coopman 1993, 35-40; Riordan 1993, 88.

Myth 3:    Babies get all the milk they need in the first five to ten minutes of nursing.

FACT:   While many older babies can take in the majority of their milk in the first five to ten minutes, this cannot be generalized to all babies.  Newborns, who are learning to nurse and are not always efficient at sucking, often need much longer to feed.  The ability to take in milk is also subject to the mother’s let-down response.  While many mothers may let down immediately, some may not.  Some may eject their milk in small batches several times during a nursing session. Rather than guess, it is best to allow baby to suck until he shows signs of satiety such as self-detachment and relaxed hands and arms.

Lucas 1981, 195; Stuart-Macadam 1995, 220-37.

Myth 4:    A breastfeeding mother should space her feedings so that her breasts will have time to refill.

FACT:  Every baby/mother dyad is unique.  A lactating mother’s body is always making milk.  Her breasts function in part as “storage tanks,” some holding more than others.  The emptier the breast, the faster the body makes milk to replace it; the fuller the breast, the more production of milk slows down.  If a mother consistently waits until her breasts “fill up” before she nurses, her body may get the message that it is making too much and may reduce total production.

Daly 1995, 27-37; Lawrence 1994, 240-41.

Myth 5:    Babies need only six to eight feedings a day by eight weeks of age, five to six feedings a day by three months, no more than four or five feedings a day by six months of age.

FACT:   A breastfed baby’s frequency of feeding will vary according to the mother’s milk supply and storage capacity, as well as baby’s developmental needs.  Growth spurts and illnesses can temporarily change baby’s feeding patterns.  Studies show that breastfeeding babies fed on cue will settle into a pattern that suits their own unique situation. In addition, the caloric intake of breastfed baby increases toward the end of the feeding putting arbitrary limits on the frequency or duration of feedings may lead to inadequate caloric intake.

Daly 1995, 21-6; Klaus 1987, 623-33; Lawrence 1994, 253; Millard 1990, 211; Woolridge 1995, 217-42.