Increase milk supply during pregnancy

Pregnant and Breastfeeding - La Leche League GB

If you’re expecting a baby and are continuing to breastfeed your older child, many questions may be going through your mind. Mothers can breastfeed while pregnant; some go on to nurse both their new baby and their older child after the birth. This is known as ‘tandem nursing’.

Breastfeeding during pregnancy is a special, unique relationship and one that may constantly evolve to take into account your changing needs and those of your older child. Breastfeeding can help you meet your child’s needs more easily, especially if he is tired or unwell, and it continues to give him important nutritional and immunological benefits. However, breastfeeding whilst pregnant can often invoke intense feelings. Extra support at this time can be crucial and you may find talking things over at your local LLL meetings really helpful.

Is it safe?
Nutrition
Morning sickness
Milk supply and colostrum
Managing when you are not enjoying it
Coping with questions and comments
Deciding to wean
Tandem feeding
Further Reading

Is it safe?

Research tells us there’s usually no reason why a mother shouldn’t breastfeed while pregnant. Although breastfeeding may help a slow labour to progress, the amount of oxytocin normally released is not usually enough to cause the cervix to open before it is ready to do so. Oxytocin is also released during sex, which is generally considered to be safe during pregnancy. If you are expecting multiples or considered to be at risk for miscarriage/early delivery you may be advised to stop breastfeeding. You could discuss this with a breastfeeding-friendly caregiver.

Nutrition

You won’t be depriving your unborn baby of nutrients by continuing to breastfeed so long as you eat reasonably well. Getting plenty of rest and eating nutrient dense food will help you stay well-nourished and healthy.

The UK Department of Health recommends that all pregnant women take a vitamin D and folic acid supplement (often taken in the form of the Healthy Start vitamins).

Calcium needs during pregnancy and the first six months of breastfeeding it is normal to experience a gradual loss of bone density. Even if breastfeeding continues, recovery of bone mineral content (BMC) starts from around 3–6 months and is generally complete by about 12 months after birth. If a mother has breastfed there may even be a small overall increase. When a mother becomes pregnant again before 12 months BMC actually continues to increase and tandem nursing mothers have no increased risk for osteoporosis. During pregnancy your body absorbs more calcium from the food you eat. If you feel your diet is low in calcium, then eating foods rich in calcium (eg leafy greens, nuts and seeds) may be a good idea but otherwise there’s no need for any extra.

Morning sickness

Pregnant mothers often have nausea, whether breastfeeding or not, though breastfeeding while pregnant may make it worse. Eating frequent healthy snacks can help manage nausea, as can getting more rest. Some mothers find motion sickness wristbands work for them.

Milk supply and colostrum

Around the fourth or fifth month (sometimes before) your milk production is likely to reduce due to pregnancy hormones. The composition of your milk will also change and become more similar to weaning milk. Your child may nurse less or wean completely. Some children resume nursing at a later stage. The drop in milk production is due to hormonal changes and nursing more frequently or pumping won’t increase production in the same way it does when you are not pregnant. Your baby may need age appropriate supplements and a baby under 12 months may need his weight monitored. Continuing to breastfeed during pregnancy has no effect on the milk supply that you will have following the birth of your new baby. Colostrum is produced during pregnancy whether or not it is being removed.

Managing when you are not enjoying it

You may experience nipple soreness, increased nausea and/or feelings of irritability caused by pregnancy hormones. Limiting nursing times, (eg to a few minutes or even a few sucks), ensuring a deep latch, distraction, and offering other snacks/liquids can all help to make nursing through pregnancy more manageable. Support from family and friends can help you get more rest.

Coping with questions and comments

Pregnancy and breastfeeding can be an emotionally challenging time. It can be difficult if you hear negative comments from others. Talking about the importance of breastfeeding to you and your child can sometimes help people appreciate that this is something you have carefully considered and that it is your choice for your family. Sharing information/research and surrounding yourself with supportive people can also help. Your local LLL group will be a good source of support.

Deciding to wean

The decision to stop breastfeeding is a very personal one and one only you or your child will make. It is useful not to have too many expectations when you get pregnant.

Tandem feeding

Continuing to nurse your older child after your new born arrives can help maintain and strengthen your special bond. Mothers often say that tandem feeding helps their older child to be more accepting of their newborn sibling and helps them through the emotional transition of having to now share their mum. Tandem feeding can also foster a special bond between the siblings. Our page Tandem Nursing has more information.

Written by Mhairi Kasapidis, Sue Upstone & mothers of La Leche League GB.

5 Ways to Prepare for Breastfeeding While Pregnant – Nourisher

Breastfeeding feels like the first test of motherhood. It’s quite unfair actually. You’ve JUST made it to the finish line of your pregnancy, gone through labor and dealt with the emotional shock of meeting a tiny human that is half of your DNA. Instead of taking a good nap (or having that long awaited glass of wine) there is a startling jolt of reality that this baby is 100% dependent on you. He or she will be placed on your breast and before you know it, it’s go time!

Here are five ways to prepare for breastfeeding before your baby arrives.

Learn (and Practice!) the Main Breastfeeding Positions

We here stories like this from Nourisher moms all of the time!

“Minutes after my son was born a nurse hovered over me watching me try and latch him on for the first time. I knew what to look for in a latch, but unsurprisingly, he didn’t get it right away. “Maybe try him in the football hold,” she recommended.

Panic set in. The football hold? I had no idea what she was talking about! How could I already be bad at this, it had only been ten minutes? I mumbled something incoherent before she gracefully lifted him up and placed his body under my arm with his head in my palm. Baby latched and I breathed a sigh of relief.”

Case in point, study the various breastfeeding positions so that you know the different ways to hold your baby right from the start.

Take an In Person or Online Breastfeeding Class

The first time you hear the words “latch” “engorgement” “let down” and “colostrum” should be in an environment where you can absorb information — i.e. not in a hospital room with a screaming hungry newborn.

Learn the basics of breastfeeding before your baby arrives. This way the process will get off to a less-chaotic start. Most hospitals hold classes on breastfeeding and lactation consultants offer in-person training. But if getting dressed and out the door at 8 or 9 months pregnant doesn’t sound like your thing, take an online class! Nourisher friend Lindsey Shipley of the Lactation Link offers amazing online tutorials and webinars.

Understand Where Your Milk Supply Comes From

You don’t know it yet, but your milk supply will become a focal point of your day in a few weeks or months. Unfortunately you have no way of knowing if your milk supply will be abundant, just right, or if you’ll have a low supply. Regardless of where your body will fall on the milk-supply spectrum, it’s important to know where your supply comes from and how you can influence production.

Supply and Demand
The greatest way to maintain a healthy milk supply is to feed or pump frequently. Your body will produce on a supply and demand basis, so the more demand, the more supply.

Meeting Calorie Goals
Breastfeeding mothers don’t have to eat one specific type of diet, but they do need to be hitting the correct calorie amount in order to make milk. It’s all too easy to stop taking care of your body when your baby arrives.

Milkful Nursing Bars are a wholesome, convenient, energy-packed snack made specifically for breastfeeding moms. Eating one or two bars a day ensures you’re eating healthy ingredients and not snacking on cheap sugar products or failing to meet your calorie count. We recommend buying bars ahead of time (they have a shelf life of 5 months) and keeping several in your hospital bag for when baby arrives.

Additionally, learn what foods you can and can’t eat when breastfeeding. Hint: It’s more relaxed than pregnancy!

Hydrating
Drinking water to thirst is extremely important for breastfeeding women. Always keep a water bottle on hand so that your body is never straining for liquid to make milk.

Order Your Breast Pump, Necessary Accessories and Milk Storage Solution

Pumping is an entirely different facet of breastfeeding. Some women are exclusive pumpers, meaning their baby primarily drinks expressed breastmilk from a bottle rather than from their bodies. Some women pump breastmilk once or twice a day so that they have a bottle on-hand for occasional feedings from other people. And then some women never pump breastmilk because they are never separated from their child.

How do you know which category you will fall into? For starters, consider what will happen at the end of your maternity leave. If there is a set date that you will be returning to work and you still want to continue breastfeeding, you’ll need to pump.

If your plans don’t involve daily separation from your child but you think you’ll want an occasional break from feeding, you’ll need to pump.

Now, you don’t need to feel pressure to pump right away. In fact, many lactation consultants recommend holding off on pumping until a breastfeeding routine is established. But we recommend having your pumping gear ready so that you can easily transition to this next stage of breastfeeding.

Here’s what we recommend purchasing during your pregnancy in preparation for pumping:

1. An electric or manual pump
A dual pump means you can pump from both breasts at the same time (a massive timesaver!)

2. A hands-free pumping bra
This bra is not necessary if you’re going the manual route, but a hands-free bra means you aren’t sitting there holding your breast shields up to your body for 20 minutes at a time.

3. A breast milk storage solution
If you know pumping will eventually be a big part of your routine, go straight for the breast milk bags. These store up to 6 ounces of breast milk and are cost effective. You can also purchase 2.7 ounce vials that are easier to fill and defrost for feedings in the early weeks.

4. Bottles
Some babies prefer one style of bottle to another so you can either purchase a few different styles or borrow from a mommy-friend. Once your baby sets a preference, it’s a good idea to stick to one brand so you’re not trying to mix and match parts in the middle of the night.

5. Bottle brush and sanitizing steam bags
Have a new clean brush ready that is only dedicated to washing bottles, and buy a steam sanitizer bag for easy sterilization.

Mentally Prepare Yourself For a Newborn’s Breastfeeding Schedule

Alright mamas-to-be it’s time to buckle in. Breastfeeding is a job, and most likely the routine is going to kick your butt the first couple of weeks.

Newborn babies need to eat at every two hour mark until they get back up to their birth weight. Every two hours, 24/7. That means a typical day could have feedings at 6 a.m., 8 a.m., 10 a.m., 12 p.m., 2 p.m., 4 p.m., 6 p.m., 8 p.m., 10 p.m. 12 a.m., 2 a.m., 4 a.m.

The good news is that it is over quickly. The bad news is when you’re in that schedule, it feels like there is no way can you keep going. Trust us, you can!

Psych Yourself Up for the Routine
Go into that crazy feeding schedule knowing you will be challenged but you will make it through. Try to think of each feeding as a positive because it means your child is gaining weight quickly. Once you are given the go-ahead by your pediatrician you can relax into 3-4 hour stretches between feedings.

Know Pain is Only Temporary
Understand that it’s natural for breastfeeding to feel painful at first, but your body toughens up and it gets easier. Many women fail when they begin breastfeeding because it’s uncomfortable. When a baby latches in the first few weeks there is about a 10 second “ow ow ow” where you hold your breath and tense up while your nipples sting. (We would equate it to the pain of a clothespin on your finger.)

Pretty soon you’ll stop having to hold your breath and before you know it, latching is no big deal. Breastfeeding can feel uncomfortable at first, but with all new things, it becomes the norm quickly as your body and mind adjust.

Keep Reading 9 Healthy and Delicious Recipes for Eating Milkful Nursing Bars ›

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Breast changes from the beginning of pregnancy to the end of breastfeeding

Medela's experts explain the changes that occur in the breast from the beginning of pregnancy to the end of breastfeeding, as well as tips for taking care of your breasts throughout this period.

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From the moment of conception, your body begins to prepare for the birth of your baby. This applies not only to the uterus - the anatomy of the breast also changes radically. This article will tell you what to expect in each trimester, during and after breastfeeding. nine0003
First trimester breast changes

Early in pregnancy, many women notice changes in their breasts. Moreover, often they become the first signs of pregnancy. Fluctuations in hormone levels and changes in the structure of the mammary glands can cause increased sensitivity and soreness of the nipples and breasts as early as the third or fourth week. For some pregnant women, breast tenderness persists until childbirth, but for most it goes away after the first trimester. nine0003
“Sometimes during pregnancy, breasts grow very quickly in the first weeks, and sometimes their size increases gradually,” says Dr. Jacqueline Kent, a leading lactation specialist at the University of Western Australia. “All women are different. For some, breast size may not change much until childbirth or even after them. In general, we can say that by the time the milk arrives, the breast will most likely become one and a half times larger than before pregnancy! ¹

As soon as your regular bras start to feel tight (usually around 12 weeks), it's time to buy a maternity bra. The most comfortable, according to many women, are seamless models with wide straps made of soft, breathable fabric. It is best to avoid underwired bras as they can put pressure on the developing milk ducts. nine0003
It is important to take your measurements correctly in order to find the right bra with a good fit. Take measurements every couple of months, as you may need a different size bra as your baby grows and your breasts get bigger.

Breast changes in the second trimester

From about the 15th week of pregnancy, newly formed cells that produce milk are activated in the breast, and by about the 22nd week, production begins. ¹ But don't worry - most of this milk will be absorbed by the body without going out, as pregnancy hormones prevent it from being overproduced or excreted. nine0003
“During the second trimester, you may notice that the nipples and areolas (the areas of skin around the nipples) become darker and larger,” says Dr. Daniel Prime, Medical Research Associate at Medela. tubercles - the so-called glands of Montgomery. They secrete oil that moisturizes the nipples and will protect them from inflammation and infection when you start to feed. Scientists believe that the smell of this fat is similar to the smell of amniotic fluid and helps the newborn baby find the nipple. ” nine0015 2

Do not use harsh soap for breast hygiene and do not rub hard with a towel as this can damage this natural lubricant. Just wash your breasts with warm water and pat dry. And if someone tells you to pinch or rub your nipples to prepare them for breastfeeding, don't listen to them!

If you have flat or inverted nipples, your pregnancy is over 32 weeks, and your pregnancy is normal, you can try inserting special nipple formers* into your bra in consultation with your doctor. They help to gently pull out the nipples so that it is easier for the newborn to grasp them. Consult your healthcare professional or read our article on flat and inverted nipples to learn more. nine0003
If breast size increases dramatically during pregnancy, breast skin may itch and stretch marks may appear on it. A good moisturizer can help soothe itching. The appearance of stretch marks usually depends on genetics and skin type. If you have a predisposition to stretch marks, it is unlikely that you will be able to prevent them, but, fortunately, over time they will become lighter and less noticeable.

Breast changes in the third trimester

In the last trimester, you may again experience soreness and heaviness in your chest. A sleep bra will keep you comfortable at night, while a supportive sports bra will help you avoid soreness and ligament damage during exercise. nine0003
Don't forget to buy a pair of nursing bras one month before your baby is born. If possible, consult a specialist in the store or study the online guide to select the appropriate model and size. Every woman is different, but usually cups of a nursing bra are chosen one or two sizes larger than before pregnancy. The underbust girth may also increase as the ribcage expands to provide enough room for the baby. The sales assistant should choose the size of your bra, taking into account the appearance of milk after childbirth. Models with fasteners that can be unfastened with one hand make it easier to attach the baby to the breast. nine0003
Surprising but true: milk appears in the breast even before the baby is born. This is why your nipples may start to produce some colostrum (the first breast milk), which will be quite thick and sticky. Sometimes this happens as early as 14 weeks, but more often it still happens in late pregnancy. To avoid the appearance of stains and smudges on clothes, you can use special bra pads.

“If you have diabetes or have been diagnosed with gestational diabetes, your doctor may tell you to express some colostrum by hand and freeze it. A recent study showed that after the 36th week it is quite safe if the pregnancy does not have other complications, ³, says Dr. Prime, “Storing colostrum can come in very handy because babies with diabetic mothers are at higher risk of hypoglycemia (low blood sugar) and frequent colostrum feeding is the best remedy. . However, be prepared for the fact that there will be very little colostrum. You may only be able to express a few drops at first, and that’s perfectly fine.”

What happens to the breast after childbirth

Approximately two to four days after the baby is born (sometimes later if there was a caesarean section or a traumatic delivery), you will feel your breasts becoming heavier and firmer - this means that the milk has come. ⁴

“This breast fullness is not only due to excessive milk production – there is also an increase in the amount of blood circulating around the breast and the volume of lymphatic fluid,” explains Dr. Prime, “All this is the result of a gradual decrease in pregnancy hormone levels that began after the birth of a child and which allows the hormones responsible for the production of milk to enter into work. nine0003
During this period, you may experience soreness and discomfort in your breasts, a condition called breast swelling. This is quite common and usually resolves after a few days, during which time breastfeeding must continue. Read on for our tips on how to relieve swelling and discomfort, and if the problem persists, see a lactation consultant or healthcare provider.

What happens to the breast during lactation

For about the first three months of breastfeeding, your breasts are likely to fill up a lot before feeding. Over time, you may notice that your breasts become less full, but this does not mean at all that your milk production has decreased. If you are breastfeeding your baby exclusively and on demand, and at the same time he is growing well, then everything is in order with the amount of milk.

“Be prepared for the fact that after six months of breastfeeding, your breast size will begin to decrease,” Dr. Kent explains, “This is not a sign that your body is producing less milk. Most likely, the amount of adipose tissue in the breast simply decreased. By the time your baby is 15 months old, your breasts may be back to their pre-pregnancy size, but not smaller. However, whether you continue breastfeeding or not, you may still produce 100 to 300 ml of milk per day.” nine0003
This may be due to the start of more efficient milk production after six months of breastfeeding, which, according to Dr. Kent's research, may be the result of redistribution of breast tissue. ⁵

How your breasts change after you stop breastfeeding

When you finally stop breastfeeding—be it after three weeks, three months, or three years—the breast changes associated with lactation disappear. “After the complete cessation of breastfeeding, the breasts, as a rule, return to the size that they were before pregnancy. This usually happens in about three months, and for someone else while breastfeeding,” Dr. Kent explains, “If you get pregnant again, the whole process starts all over again.” nine0003
Literature

1 Cox DB et al. Breast growth and the urinary excretion of lactose during human pregnancy and early lactation: endocrine relationship. Exp Physiol . 1999;84(2):421-434. - Cox D.B. et al., "Breast growth and urinary lactose excretion during pregnancy and lactation: an endocrine relationship." Exp Physiol. 1999;84(2):421-434.

2 Doucet S et al. The secretion of areolar (Montgomery’s) glands from lactating women elicits selective, unconditional responses in neonates.PLoS One . 2009;4(10): e 7579. - Doucet S. et al., "Papillary gland secretion (Montgomery's glands) in lactating women induces a selective unconditioned response in the newborn. " PLOS One. 2009;4(10):e7579.

3 Forster DA et al. Advising women with diabetes in pregnancy to express breastmilk in late pregnancy (Diabetes and Antenatal Milk Expressing [DAME]): a multicentre, unblinded, randomized controlled trial. Lancet. nine0078 2017;389(10085):2204-2213. - Forster D.A. et al., "Women with Gestational Diabetes are Recommended to Express Milk Late in Pregnancy (Diabetes and Antenatal Pumping [ DAME ]): A Multicenter, Open, Randomized, Controlled Trial. Lancet (Lancet). 2017;389(10085):2204- 2213.

4 Infant and young child feeding: model chapter for textbooks for medical students and allied health professionals, Geneva : World Health Organization ; 2009. AVAILABLE FROM : https://www.ncbi.nlm.nih.gov/NBKS/NBK148965/ - "POSTICION" POSTICION "POSTRISS" POSTRIMENT "POST textbook for students of medical and related professions. Geneva: World Health Organization, 2009. Article cited: https://www.ncbi.nlm.nih.gov/books/NBK148965/

5 Kent JC et al. Breast volume and milk production during extended lactation in women. Exp Physiol. 1999;84(2):435-447. - Kent J.S. et al., "Amount and production of breast milk during long-term lactation in women". Ex Physiol. 1999;84(2):435-447.

Read instructions before use. Consult a specialist about possible contraindications. nine0011
* RU № ФСЗ 2010/07352 of 07/19/2010

Breast changes during pregnancy

If you think that breasts grow only in youth, you are wrong! The complex internal structures needed to feed a baby only begin to form during pregnancy, and until recently we didn't even know how it happened.

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Did you think about your breasts during pregnancy? Surely only in the context of buying a special bra. Meanwhile, at this time, huge changes take place in the chest. Not only the uterus, but also the breast undergoes an amazing transformation to prepare for the birth of the baby. But to understand, let's go back a little...

Breast development during adolescence

The breast changes continuously from adolescence until menopause. Unlike other organs, it does not grow until it is "activated" by hormones produced during puberty. However, even when the breast appears to be fully developed, it is not yet mature.

“After the completion of puberty, the female breast continues to develop. With each cycle, the amount of secretory [milk-producing] tissue increases slightly, and this continues until about 35 years old, says Professor Peter Hartmann from the University of Western Australia, an expert in the field of lactation, After reaching this age, breast development stops, it becomes mature , but remains "sleeping" for the time being. nine0003
During the menstrual cycle, the cells of the breasts are renewed, which can make them more sensitive, painful or swollen. ¹

You may have noticed that at the beginning of the cycle, the breasts are somewhat lumpy to the touch. During this period, preparation for a possible pregnancy takes place. If pregnancy does not occur, a new cycle of falling and rising hormone levels begins. ²

Internal breast changes during pregnancy

When conception occurs, the cycle is interrupted. From the end of the first month of pregnancy, the breast begins to gradually turn into a milk-producing organ.

At this time, the number and branching of the milk ducts increase and an extremely complex feeding system is formed. At the same time, cells called lactocytes begin to develop in the breast, which produce milk. The amount of blood going to the breast doubles during pregnancy. That is why the veins sometimes shine through the skin. nine0015 3

"After the birth of the placenta, the level of progesterone begins to fall and the process of lactation starts"

“When pregnancy occurs, the breast literally turns on,” says Professor Hartmann. “After conception, the secretory tissue of the breast begins to grow. There are clusters of tubercle-like glands in the breasts, and when pregnancy occurs, these tubercles begin to grow and form ducts and tiny sacs, called alveoli, that will store the milk.” nine0003
All of these processes in the breast can cause sensations of heaviness, soreness and swelling, which are early signs of pregnancy. Read more in the article about how breasts change during pregnancy.

Structure of the lactating breast

Believe it or not, scientists have only recently discovered how the complex system of ducts located in the breast works.

Until the beginning of this century, most medical knowledge about milk production was based on experiments conducted by the English surgeon, Sir Astley Cooper, in the 1840s. nine0015 4 He concluded that milk is stored in the ducts and exits through 15 to 20 orifices in the nipple. Professor Hartmann's colleague, Dr. Donna Geddes, along with a team of scientists backed by Medela, discovered that breasts function very differently. ⁵ The ducts are indeed small tubes only a few millimeters in diameter, but they serve to transport the milk, not to store it. Milk is produced and stored in the alveoli. These sacs are connected to the ducts by even smaller tubes called tubules. nine0015 6

The milk stays in these sacs until the body releases the hormone oxytocin, which happens when the baby starts suckling. The alveoli are surrounded by muscle cells that contract under the influence of oxytocin, and these contractions move the milk through the ducts to the nipple. This process is called the milk flush reflex. Sometimes it can be felt as a tingling or slight movement that occurs in the breast when you start to feed the baby, but some women do not feel it at all. nine0015 7

Dr. Geddes and colleagues also found that there are fewer holes in the nipples than previously thought: usually around nine, sometimes as few as four. The ducts have to expand by almost 68% to accommodate the entire volume of milk flowing rapidly to these several outlets. ⁸

“Throughout breastfeeding, the structure and function of the breasts remain virtually unchanged until the baby begins to consume less milk,” explains Prof. Hartmann. nine0003
The breast begins to produce milk during pregnancy

From about the middle of pregnancy, the alveoli are already capable of producing milk. Fortunately, pregnancy hormones limit the production, ⁹ otherwise, by the time of delivery, the breast would simply burst.

“Producing 800 ml of milk a day during pregnancy is absolutely useless,” notes Professor Hartmann. “Therefore, the level of progesterone in the body rises, which prevents the activation of production. However, after the birth of the placenta, the level of progesterone begins to fall rapidly and the process of lactation starts.” nine0003
What happens to your breasts when you stop breastfeeding? She goes into a state of rest, but not immediately. “When a woman completely stops breastfeeding, it takes some more time – usually a month or two – for milk production to completely stop,” explains Professor Hartmann, “In humans, the process of stopping milk production takes a long time, although in other mammals this happens pretty fast. "

The breasts eventually return to their pre-pregnancy state. If you become pregnant again, the same cycle of growth and development will begin all over again. nine0015 1

Would you like to know more? Download the free e-book Surprising Breast Milk Facts or read our article Why Colostrum Is So Important?.

Literature

1 Hassiotou F, Geddes D. Anatomy of the human mammary gland: Current status of knowledge. Clin Anat . 2013;26(1):29-48. - Hassiot F., Geddes D., "The structure of the female breast: what we know today." nine0078 Wedge Anat. (Clinical Anatomy) 2013;26(1):29-48.

2 Reed BG, Carr BR. The normal menstrual cycle and the control of ovulation. In: De Groot LJ et al., editors. Endotext [Internet]. South Dartmouth, MA, USA: MDText.com, Inc.; 2000. [ cited 2018 April 13] Available from : https://www. ncbi.nlm.nih.gov/books/NBK279054/. - Reid BJ, Carr BR, "Normal menstrual cycle and ovulation control". In De Groot L.J. et al. (ed.) Endotext [Internet]. South Dartmouth, Massachusetts, USA: MD Text . com , Inc ; 2000. [cited April 13, 2018] Article reference: https://www.ncbi.nlm.nih.gov/books/NBK279054/

3 Geddes DT. Ultrasound imaging of the lactating breast: methodology and application. Int Breastfeed J . 2009;4(1):4. - Geddes D.T., "Lactating Breast Ultrasound: Methodology and Application". Int Brestfeed J. 2009;4(1):4.

4 Cooper AP . On the anatomy of the breast. London: Harrison and Co; 1840. 193 p . - A.P. Cooper, "On the structure of the breast. " London Publishing House Harrison and Co .; 1840. p. 193.

5 Ramsay DT et al. Anatomy of the lactating human breast redefined with ultrasound imaging. J Anat . 2005;206(6):525-534. - Ramsey D.T. and co-authors, "The structure of the lactating female breast: a new look through ultrasound." nine0078 F Anat. 2005;206(6):525-534.

6 Geddes DT. Inside the lactating breast: the latest anatomy research. J Midwifery Womens Health. 2007;52(6):556-563. — Geddes D.T., "Lactating Breasts" by J Midwifery Women's Health. 2007;52(6):556-563.

7 Kent JC et al. Response of breasts to different stimulation patterns of an electric breast pump. J Hum Lact . 2003;19(2):179-186. - Kent J.S. et al., Breast Response to Various Types of Electric Breast Pump Stimulation.
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