The breast is a major component of a woman’s beauty, but it is not only a symbol of feminine beauty, but also has the function of secreting milk and feeding babies. Breast milk is the source of baby’s life, and breast is the breeding ground for breast milk, but many pregnant women, especially new mothers, lack the relevant knowledge and do not pay enough attention to breast care, and often interrupt breastfeeding after delivery due to factors such as nipple indentation and blocked milk ducts, which directly affect the normal development of babies. The breast is the lactation organ, familiar with its structure and function, and strengthen the health care of the breast during pregnancy is the key to ensure breastfeeding. I. Structure of the breast The breast is composed of skin, breast tissue and its surrounding connective tissue and fat. The breast gland is composed of tens of thousands of mammary vesicles, which are small sacs surrounded by many cell arrangements. The lactating cells have the function of secreting milk and are the target organs of prolactin, which causes them to secrete milk. Outside the lactating cells around the follicles are myocytes, which are the target organs of oxytocin and cause the milk inside the follicles to be squeezed into the milk ducts when they contract. Each follicular cavity is connected to a tiny milk duct, which converges to the milk duct, and below the areola the milk duct expands and is called the milk sinus, where milk can be stored. Later on, it becomes thin and passes into the nipple, which opens on the surface of the body. There are about a dozen common milk ducts in the nipple, and the vesicles and ductal tissue are functional units closely related to lactation and milk discharge. They are surrounded by connective tissue and fat, which serve as support and protection. The size of the breast is related to the amount of fat and connective tissue, and the amount of breast tissue contained in women is generally similar, so the size of the breast is not directly related to the amount of lactation. Prolactin is the main hormone that promotes lactation, and it is secreted by the prolactin cells in the anterior pituitary gland. It acts directly on the receptors on the membrane of the lactating cells of the mammary gland to produce lactation. Prolactin levels in the blood have circadian rhythmic changes, with more secretion at night after sleep, peaking at 4~5 am and gradually decreasing later. The secretion of prolactin after suckling is to prepare for the next milk production. Therefore, prolactin is very important to maintain milk production. The more you suckle, the higher the prolactin level. Prolactin inhibitory factor can regulate the secretion of prolactin. For example, milk stagnation in the breast can induce the occurrence of prolactin inhibitory factor, which inhibits prolactin and reduces milk secretion. Conversely, when the breast is emptied, the production of prolactin inhibitory factor can be reduced, ensuring adequate milk re-secretion. When the baby sucks, the pituitary gland releases more prolactin, which travels through the bloodstream to the mammary gland and acts on the muscle cells in the outer layer of the mammary gland vesicles, causing the smooth muscle fibers to contract and squeeze the mammary gland vesicles to eject milk. After the milk is ejected and emptied from the breast, the pituitary gland is reflexively stimulated to secrete prolactin to prepare for the continuation of milk secretion. Combined with the above lactation and drainage mechanisms, sucking by the baby is the main impulse to stimulate the secretion and release of prolactin, and the more frequent and effective the sucking, the more milk is produced. The breast is an organ of supply and demand, and increasing effective sucking will definitely meet the amount needed by each child. Breast care during pregnancy 1. Early pregnancy (1-12 weeks) ① Nipple stretching: Pregnant women start nipple stretching exercises from early pregnancy. Place two thumbs parallel to each side of the nipple and slowly pull away in the inner and outer direction, pulling the areola skin and subcutaneous tissue so that the nipple protrudes outward, repeat the exercise several times, then place two fingers on the upper and lower sides of the nipple and pull the nipple upward and downward longitudinally, twice a day for 5 minutes each time. ② Nipple pulling: hold the breast with one hand, and pinch the thumb, index finger and middle finger of the other hand to pull the nipple outward, twice a day, 10~20 times each time. 2.Mid pregnancy (13-27 weeks) Continue nipple stretching and pulling exercises. To prevent nipple cracking and pain during breastfeeding, start scrubbing your nipples with a towel and water repeatedly for 10 minutes each time in the fourth to sixth month of pregnancy, with appropriate force when scrubbing, but without damaging the skin. 3, late pregnancy (after 28 weeks) Pull the nipples 2~3 times a day to make the flat, sunken nipples bulge to accommodate the need for postpartum breastfeeding and to avoid difficulties for the baby to suckle. In addition, in order to promote the blood circulation of the breast and breast development, you should insist on doing breast health exercises after 28 weeks of pregnancy. The methods are as follows: ① Breast massage: palm root avoiding the nipple, spiral around the breast evenly massage the breast wall, once a day, 15 minutes each time. ②Breast patting: rhythmically pat the breast wall with four fingers from around the chest wall towards the nipple, once a day for 15 minutes each time. ③Breast shaking: Hold the breast with your hand and gently shake the breast up, down, left and right, once a day for 15 minutes each time. ④ Nipple cross exercise: put two thumbs parallel to the left and right sides of the nipple, slowly pull away from the nipple to the outer sides, pull the areola skin and subcutaneous tissue, so that the nipple protrudes outward, repeat several times, then put two thumbs on the upper and lower sides of the nipple, pull away from the nipple to the upper and lower longitudinal, repeat several times, twice a day, 15 minutes each time. Postpartum breast care ①The newborn can suck on the nipple 30 minutes after delivery to help establish the lactation reflex as early as possible and ensure smooth breastfeeding. ②Before the lactation reflex is established, you should first warm up both breasts with a towel, and after 3-5 minutes, start massaging from one breast (the same method as during pregnancy) alternately, and after the massage, milking should be done to stimulate lactation. When the lower milk reflex is established, because the baby needs less milk, the milk is often left in the breast, the milk will be squeezed out after massage to empty the breast, promote milk secretion and prevent the occurrence of mastitis. ③ Milking thumb on the areola, the other four fingers placed on the opposite side to the chest wall rhythmically squeeze, fingers fixed, do not slide on the skin, repeat squeeze, stimulate the spray breast reflex, squeeze the breast sinus along the nipple in turn, empty the breast. V. Prenatal care guidance 1. After pregnancy, the breasts grow further, and the bra usually worn during pregnancy is obviously too small, in order to ensure a smooth feeding of the baby after delivery, should wear loose, comfortable cotton bras, in order to make the blood circulation to the breasts smooth and promote the normal development of breast tissue. At the same time, wearing a bra can protect the cleanliness of the breasts and nipples from the friction of clothes. Bras should be changed and washed regularly to keep them clean, especially in summer, to ensure that the skin and clothing are clean and dry. 2, when sleeping, pay attention to the appropriate sleeping position, preferably in a side-lying position or supine position, so that blood circulation is smooth. The prone position tends to squeeze the breasts, which does not ensure the delivery of hormones for breast development, thus affecting breast development. 3, after 3 months of pregnancy, nipples and sebaceous glands around the areola often have secretions overflowing, and every night should be warm water scrubbing nipples, and coated with oil, so that the delicate nipple skin keratinization thickened, to enhance the toughness and resistance, to prevent nipple dropout when breastfeeding after childbirth. 4, 1 week before delivery: clean the nipple dirt with warm boiling water every day. During pregnancy, a little secretion from the mammary glands accumulates at the mouth of the mammary ducts, resulting in blockage of the mammary ducts. If there is dirt on the nipples, apply vegetable oil to soften them, then wash them with soap and water, then wash and dry them with warm boiled water. If the above measures are not effective, remove the dirt by gently plucking the sterilized cotton swab in parallel, and do not damage the tissue to make it smooth. Six, puerperal care guidance 1, flat nipples before breastfeeding, hot compresses for 3 to 5 minutes, while massaging the breast to stimulate the lactation reflex, squeeze out a little milk, soften the areola, followed by pinching the nipple to cause the lactation reflex, so that the areola along with the nipple is sucked by the baby, forming a “long nipple” in the mouth to make sucking successful. 2, nipple cracking Once the nipple cracking, should take active measures, the mother and baby should take a comfortable and relaxed feeding position. Before feeding, the line breast hot compress, the time limit of 3 ~ 5 minutes to cause the drainage reflex, so that infants looking for milk, stimulate the nipple to cause lactation reflex, feeding should first let the baby sucking damage light side, to reduce the sucking force on the other side of the breast. After feeding, squeeze out a small amount of milk and apply it to the nipple and areola to briefly expose and dry the nipple. Because milk is rich in protein, it can play a role in repairing the epidermis. 3.Breast overfilling Before breastfeeding, apply hot compresses to the breasts using the above methods, followed by massaging, patting and shaking the breasts and using a breast pump to suck out the milk to soften the breasts so that the baby can suck the nipple and most of the areola properly. Increase the frequency of breastfeeding to empty the breast. Wear support bras with appropriate tightness to improve blood circulation. 4. Milk stagnation When breastfeeding due to milk stagnation caused by blocked milk ducts, breastfeeding should first be done on the blocked side of the breast, as hungry babies have the strongest sucking power to help suck through the milk ducts. If for some reason breastfeeding is unfavorable, a breast pump can be used to suck out the milk and empty the breast. 5. Mastitis Early treatment is the same as for breast duct obstruction. If the condition does not improve or worsens within 36 hours after the onset of the disease, you must go to the hospital. Acute mastitis is an inflammation of the connective tissue outside the milk ducts, not inside the milk ducts, so it is safe for the mother to continue breastfeeding her baby with mastitis. Abrupt weaning or interruption of breastfeeding can prolong the course of mastitis or lead to complications.