Maternal Physiology and Anatomy Flashcards

Which hormone is primarily responsible for the milk ejection (let-down) reflex?

Answer: Oxytocin

Oxytocin, released from the posterior pituitary gland, causes contraction of myoepithelial cells around the alveoli, ejecting milk into the ducts.

During which stage of lactogenesis does copious milk production begin?

Answer: Lactogenesis II (2-5 days postpartum)

Lactogenesis II is triggered by the rapid fall in progesterone after delivery of the placenta.

What is the function of Montgomery's tubercles on the areola?

Answer: They secrete an oily substance that lubricates and protects the nipple and areola

Montgomery's tubercles are modified sebaceous glands that secrete a lipoid fluid that lubricates the areola and has antibacterial properties.

What role does prolactin play in milk production and how does its release pattern relate to feeding frequency?

Answer: Prolactin is released in response to nipple stimulation and is highest during nighttime feedings; frequent feeding maintains elevated prolactin levels

Prolactin is released in response to nipple stimulation, with naturally higher levels at night.

What structural change occurs in the breast during pregnancy that prepares it for milk production?

Answer: Proliferation of alveolar and ductal tissue under the influence of estrogen, progesterone, prolactin, and human placental lactogen

The mammary gland undergoes significant development with proliferation of alveolar lobules and ductal branching.

A mother presents with unilateral breast engorgement 5 days postpartum. The affected breast is warm, firm, and tender but she has no fever. What is the most likely physiology?

Answer: Physiological engorgement due to increased blood flow and milk volume with insufficient drainage of that breast

Unilateral engorgement without systemic symptoms indicates physiological engorgement from milk accumulation and vascular congestion.