Physiology of lactation in preterm mothers : initiation and maintenance

The initiation of lactation in women, as in other mammals, depends on the growth of the glandular tissue of the breast (mammogenesis) and the differentiation of the mammary secretory epithelial cells (lactocytes) during pregnancy (lactogenesis I). After birth the continuous nourishment of the fetus from the mother via the umbilical cord is replaced by the equally important but intermittent nourishment from the mother's breast. Thus the onset of copious milk production (lactogenesis II) is closely coupled with factors controlling the birth process. In mothers who birth preterm infants, mammogenesis and lactogenesis I may be truncated, but the resilience of lactation is such that these women usually are able to eventually achieve successful lactation. Close consideration must be given to all physiological aspects of this complex process when assisting preterm mothers in establishing successful lactation so that they can provide mothers' milk, the nutrition of choice, for their preterm infants.