BLNST key terms

Anterior pituitary hormone released in pulses after nipple stimulation that drives alveolar milk synthesis. Baseline levels rise during pregnancy, and suckling maintains receptor numbers; without ongoing milk removal, prolactin secretion and milk production decline.

Posterior pituitary hormone triggering contraction of myoepithelial cells around alveoli, ejecting milk into ducts. Release is conditioned by sensory cues and can be inhibited by pain, stress, or embarrassment, so milk may be present yet hard to obtain.

Secretory differentiation beginning mid-pregnancy, when mammary tissue develops the capacity to synthesize milk components. Colostrum forms during this stage, but copious milk secretion is held back by high progesterone until delivery of the placenta.

The onset of copious milk secretion, typically 30 to 72 hours after birth, triggered by the rapid fall in progesterone after placental delivery. Signs include breast fullness, warmth, and a change from colostrum to transitional milk.

Onset of copious milk production later than about 72 hours postpartum. Risk factors include prolonged labor, cesarean birth, retained placental fragments, obesity, diabetes, and infrequent or ineffective milk removal, and it warrants closer follow-up of intake and weight.

Thick, yellowish first milk produced in late pregnancy and the first days after birth. It is low in volume but rich in secretory immunoglobulin A, lactoferrin, and leukocytes, and acts as a laxative that helps clear meconium and bilirubin.

The dominant antibody in human milk, produced by maternal plasma cells and transported into milk. It coats the infant's intestinal mucosa, blocking pathogen adherence without provoking inflammation, and is the main reason breastfed infants have fewer gastrointestinal and respiratory infections.

Complex indigestible carbohydrates abundant in human milk that act as soluble decoy receptors for pathogens and selectively feed beneficial gut bacteria such as Bifidobacterium. They support gut barrier function and immune development and are largely absent from infant formula.

The milk ejection response in which oxytocin causes myoepithelial contraction and milk flows from alveoli into ducts. Mothers may feel tingling, pressure, or nothing at all, and leakage from the opposite breast is a common sign.

A whey protein in milk that accumulates when milk stays in the breast and locally suppresses further synthesis. Frequent, complete milk removal lowers its concentration and sustains production, which is why stasis reduces supply.

The combined local and endocrine control of milk volume: prolactin supports synthesis, FIL adjusts output to demand within each breast, and receptor numbers set capacity. Effective emptying and frequent stimulation are the practical levers clinicians address.

Clustered milk-synthesizing sacs lined with lactocytes and surrounded by contractile myoepithelial cells. Milk made in alveoli is squeezed into ducts during let-down; clusters of alveoli form lobules drained by a single duct.

Contractile cells wrapped around each alveolus and along ducts. Oxytocin stimulates them to shorten, raising pressure inside the alveolus and moving milk toward the nipple.

Sebaceous glands on the areola that secrete oily fluid, keeping the skin supple and emitting scent cues that help the newborn locate the breast. Their secretions also have mild antibacterial properties.

The pigmented circle around the nipple containing Montgomery glands and smooth muscle. Its size and color vary widely; persistent shape change after a feed, or blanching, can signal compression or vasospasm.

Whitening of the nipple tip or areola after feeding, often from shallow latch, strong suction, or vasospasm. It may be painful and can be mistaken for thrush; assessment distinguishes compression from Raynaud phenomenon.

A structured breastfeeding assessment tool scoring Latch, Audible swallowing, Type of nipple, Comfort, and Hold/help, each from 0 to 2. It standardizes documentation and flags dyads needing extra support, though it is not a measure of milk transfer.

How the mother holds the infant and how the infant takes the breast. Effective attachment means a wide gape, chin to breast, nose clear, and more areola visible above than below, producing comfortable, effective milk removal.

Clinical estimation of how much milk an infant actually removes during a feed, using audible swallowing, suck-swallow-breathe coordination, breast softening, weight before and after feeding, and infant satisfaction. It guides decisions about supplementation.

Weighing the infant on a calibrated electronic scale before and after a feed to estimate intake in grams, roughly equivalent to milliliters. It is useful for short-term clinical questions but is affected by scale sensitivity, clothing, and spillage.

Cracks, fissures, blisters, or bruising of the nipple, usually caused by shallow attachment or inefficient sucking. It raises the risk of mastitis and candidiasis and is managed by correcting latch and supporting healing rather than stopping feeding.

Inflammation of breast tissue, often infectious, presenting with a painful, red, hot, wedge-shaped area, fever, and flu-like symptoms. Management includes effective milk removal, cold therapy, anti-inflammatory measures, and antibiotics when infection is suspected.

A walled-off collection of pus within the breast, usually a complication of untreated mastitis. It presents as a fluctuant, persistently tender mass with fever and requires imaging plus drainage, with breastfeeding usually continued on the affected side.

Painful swelling of the breast from increased milk volume, vascular congestion, and edema, typically around days three to five postpartum. Frequent effective removal, cold packs, and anti-inflammatory measures help; prolonged engorgement impairs transfer and reduces supply.

Nipples that do not protrude sufficiently for the infant to grasp easily. Many infants feed well with good technique and breast shaping; devices and shields are reserved for persistent difficulty and should not replace skilled positioning help.

A thin silicone cap placed over the nipple during feeding. It can help with flat nipples or a disorganized suck but may reduce transfer and supply, so use is time-limited and paired with monitoring and a plan to wean from it.

Ankyloglossia, a restrictive lingual frenulum limiting tongue movement. Presentation ranges from asymptomatic to poor latch, nipple pain, and inadequate transfer; management is individualized and may include frenotomy plus feeding therapy.

Feeding only human milk, with no other liquids or solids except vitamins, minerals, or medicines, for about the first six months. It is the recommended standard and is associated with lower rates of gastrointestinal and respiratory infection.

Introduction of solid foods and other liquids alongside continued breastfeeding, recommended from about six months. Breastfeeding continues to supply a substantial share of energy and immune protection well into the second year.

The rate of weight gain over time, plotted on a growth standard. A normal breastfed infant typically regains birth weight by about two weeks and gains roughly 20 to 30 grams per day in early months; faltering requires feeding assessment.

Growth charts describing how children should grow under optimal conditions, with a breastfed cohort as the reference. They are the preferred tool for assessing breastfed infants because formula-fed growth patterns differ.

The infant's weight-adjusted dose of a drug received through milk, expressed as a percentage of the maternal dose. Values generally under 10 percent are considered compatible with breastfeeding, though drug-specific data and infant factors also matter.

The concentration of a drug in milk divided by its concentration in maternal plasma. A low ratio suggests limited transfer, but interpretation requires the relative infant dose because maternal potency and infant clearance vary.

A free, peer-reviewed database from the U.S. National Library of Medicine summarizing published evidence on drugs and other substances during lactation. It is a practical first-line reference when counseling mothers about medication.

A substance or intervention intended to increase milk production, such as domperidone, metoclopramide, or fenugreek. Evidence is limited and effects modest; the priority is correcting ineffective removal and stimulation before adding medication.

A World Health Organization and UNICEF program recognizing facilities that implement the Ten Steps to Successful Breastfeeding. It covers practices such as early skin-to-skin contact, rooming-in, and avoiding unnecessary supplements.

A World Health Assembly resolution setting standards that restrict promotion of breast-milk substitutes, bottles, and teats. Health workers have duties under it, including not distributing free samples or accepting industry gifts that create conflicts of interest.

Placing the naked infant prone on the mother's bare chest, covered for warmth. It stabilizes temperature, breathing, and glucose, promotes early feeding cues and lactation, and is used routinely after birth and during painful procedures.

A situation where a secondary interest, such as industry funding or gifts, could improperly influence professional judgment or patient advice. In lactation practice, disclosure and refusal of promotional inducements protect the integrity of infant feeding support.

A patient's voluntary agreement to a test or treatment after receiving adequate information about benefits, risks, and alternatives. In lactation care it applies to procedures such as frenotomy, supplementation, and off-label medication use.

A collaborative process in which clinician and patient exchange evidence and values to reach a care plan together. It is central when feeding options carry trade-offs, such as supplementing for weight concerns versus protecting supply.