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Curr Probl Pediatr Adolesc Health Care. 2017 Dec;47(12):305-310. doi: 10.1016/j.cppeds.2017.10.001.

The Nuts and Bolts of Breastfeeding: Anatomy and Physiology of Lactation.

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Division of General Academic Pediatrics, Children's Hospital of The King's Daughters, Eastern Virginia Medical School, Norfolk, VA. Electronic address:


Breastmilk is the physiologic norm for infant nutrition. Despite recommendations from major health organizations, many women in the U.S. are not achieving this metric. Understanding breast anatomy and lactation physiology will allow physicians to gain knowledge of the processes, which control lactation enabling physicians to appropriately manage the breastfeeding dyad. The interplay of hormones involved in lactation and milk management affect milk initiation, as well as ongoing milk production (galactopoesis). The unique components of breastmilk that provide protection against infection and chronic diseases also change between and during feeds. Colostrum and the importance of early skin-to-skin after delivery will also be discussed.

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