The physiology of lactation

The evidence is now overwhelming that prolonged breastfeeding is one of the most important contributors to infant health. However, only 69% of women initiate breastfeeding in the UK, and this declines rapidly to 42% at 6 weeks. The majority of problems could be avoided if mothers were given adequate support; therefore, these figures represent a failure by the healthcare system to provide women with the help they need to sustain breastfeeding. Mothers of pre-term infants are especially vulnerable to lactation failure, and require expert intervention if breastfeeding is to succeed. The aim of this article is to provide healthcare professionals responsible for assisting women with the management of lactation and breastfeeding with an up-to-date knowledge of the anatomy and physiology of the breast, the mechanisms of milk secretion and the principles of breastfeeding, so that clinicians are able to address management issues during the critical period following delivery.