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What is Let-Down Effect?

A natural process that stimulates the breast to release breast milk.

How is the let-down effect triggered?

· Baby suckling

· Sound of baby’s cry (even other people’s baby)

Ø  From lactating mother’s ear senses sends signals to the hypothalamus from auditory centers

·  Breast pump or massage

Mechanism:

· When the baby suckles on the nipple, the mechanoreceptor on the nipple will be stimulated and send a signal to the hypothalamus via the mother’s spinal cord.

· Hypothalamus (in the brain) then sends the signal to the oxytocin neuron to secrete the oxytocin hormone from the posterior pituitary gland.

Ø  Oxytocin hormones cause the myoepithelial cells to contract.

Ø  Myoepithelial cells: surround secretory cells and contract to cause milk ejection into ducts

· At the same time, the hypothalamus sends a signal to prolactin inhibitory neurons to secrete more prolactin secretion.

Ø  Prolactin is responsible for lactogenesis.

Ø  Prolactin sends signals to milk glands in the breasts to produce more milk.

Ø  Prolactin secreted from the anterior pituitary gland

· Milk then will be let down (released) through the nipple into the baby’s mouth.

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NUR FATIMA ASHIRA BT MOHD RAPI 150182 (NUTRITION)

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NUR FATIMA ASHIRA BT MOHD RAPI 150182 (NUTRITION)

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The let-down reflex causes breastmilk to flow. This occurrence is caused by two hormones known as oxytocin and prolactin. Sucking, baby crying, and mother emotion can all trigger this process.
Prolactin is responsible for making more breast milk, and oxytocin triggers the let-down or release of the breast milk.

Mechanism:
When the infant sucks at the mother's breast, the small nerves of mechanoreceptors in the nipple convey information to the mother's brain via the spinal cord, triggering the let-down reflex. The messages will next be delivered to the hypothalamus, a region of the brain, which will produce two hormones. The posterior pituitary gland secretes oxytocin, while the anterior pituitary secretes prolactin. By inducing myoepithelial cells to contract, oxytocin aids in the release or push out of breast milk, whilst prolactin aids in the production of breast milk in the mammary gland via lactogenesis.

Factors that can trigger it:
• The sound of a baby crying -> picked up by a breastfeeding mother's ear -> this information is then sent to the hypothalamus from auditory centres, causing a similar cascade of events and causing milk to be expelled even when the baby isn't suckling.
• Thinking about or gazing at a photograph of your baby.
• Massage or pumping of the breasts

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The let-down reflex is the release of milk from the mother's breast. There are a few factors that stimulate the reflex to occur, which are;

1. Sound of baby's crying.
2. The thought of nursing the baby.
3. The touching of breast or nipple area with fingers or by a breast pump.

This reflex might be impacted and takes some time to occurs if the mother is feeling very anxious and tired or upset and even in pain.

Get to notice that your let-down reflex is starting when experiencing/noticing;

- A tingling feeling in the breasts.
- Cramps in the uterus (usually in the first few postpartum days)
- A feeling of fullness in the breasts.
- Milk starts to drip from the breast (the other breast).
- The baby's feeding action slowly changing from suckling to swallowing.

Do check out this website for more interesting info regarding the let-down reflex: https://parenting.firstcry.com/articles/a-guide-to-let-down-reflex-milk-ejection-reflix/

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ANIS NUR ATIQAH BT KHAIRIL AKMAL 151365 DIETETIC

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ANIS NUR ATIQAH BT KHAIRIL AKMAL 151365 DIETETIC

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The let-down reflex is the making of breastmilk flow. This event causing by two hormones called oxytocin and prolactin. This process can triggered by sucking, baby's crying and mother emotion.

Hormones function:
Oxytocin: Contract myoepithelial cells in breast to eject milk through lactiferous ducts.
Prolactin: Produce milk.

Process:
1) When the baby suckling, mechanoreceptors in the nipple will detect and send ascending sensory messages up to mother's brain via spinal cord.
2) Then, it go to a part of the brain called hypothalamus. Hypothalamus will sends an on and go messages to another neuron called oxytocin neuron to release oxytocin hormone from pituitary gland in mother's brain causing myoepithelial cells to contract.
3) After that, hypothalamus will turn off another neuron called prolactin inhibitory neuron lead to more prolactin being secretes from anterior pituitary causing lactogenesis (making milk inside mammary glands).
4) These two hormones cause milk to be made via prolactin and ejected from lactiferous ducts by the action of oxytocin on the myoepithelial cells.
5) This events can also be triggered by the baby's crying that will be picked up by lactating mother's ear and the information will be sent via other sort of higher centers of the brain.
6) The higher centers will send a message to hypothalamus to initiate the cascade of the events causing milk to be ejected even baby's is not sucking.

Let-down reflex will slow when mother:

In pain

Smoking and drink alcohol

Stress and anxiety

Take a lot of caffeine

Unhealthy diet

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Let-down reflex, also called milk ejection reflex as it triggers the breastmilk flow.

1. First, the breast is suckled by the baby, and those tiny nerve is triggered and sends the messages to Hypothalamus via spinal cord.
2. Hypothalamus send the messages to oxytocin neuron to release oxytocin from posterior pituitary gland.
3. Hypothalamus also inhibit prolactin inhibitory neuron, thus the prolactin is released from anterior pituitary gland into bloodstream.
4. Prolactin will stimulate the milk biosynthesis within the alveolar cells of breast.
5. Oxytocin stimulate the contraction of myoepithelial cells surrounds the alveoli, causing the milk to be expelled into ducts leading to nipples.
6. Oxytocin also widen the milk ducts, allow milk to flow down easier.
7. Thus, the milk is ejected and feed a baby.

Tips to help Let-down reflex to occur when feeding.

1. Relax:
Through calming music, warm shower and slow deep breathing.
2. Gently massage breast:
Stroke breast towards nipple using the flat of your hands.
Gently roll nipple between fingers.
3. Feeds baby in a familiar and comfortable environment.

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Let down reflex (milk ejection reflex) :

By sucking at the breast, the baby triggers tiny nerves in the nipple.

These nerves cause hormones to be released into your bloodstream.

One of these hormones (prolactin) acts on the milk-making tissues.

The other hormone (oxytocin) causes the breast to push out or ‘let down’ the milk.

The let-down may happen if you see or hear your baby or even just think about them.

The let-down can also be triggered by touching your breast and nipple area with your fingers or by using a breast pump.

Many things might lead to a delay in the let-down of breast milk. There are a number of potential causes for a slow or difficult let-down that is alcohol, caffeine, cold temperatures, exhaustion, embarrassment, pain, previous breast surgery, smoking and stress.

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NURUL NAJWA ZULKIBLI (150112) (NUTRITION)

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NURUL NAJWA ZULKIBLI (150112) (NUTRITION)

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The let-down reflex is what makes breastmilk flow. When the baby sucks at the breast, tiny nerves are stimulated. This causes two hormones – prolactin and oxytocin – to be released into the bloodstream. Some women feel the let-down reflex as a tingling sensation in the breasts or a feeling of fullness, although others don’t feel anything in the breast.
Most women notice a change in their baby’s sucking pattern as the milk begins to flow, from small, shallow sucks to stronger, slower sucks.

THE MECHANISM

1. Tiny nerves in the breast are stimulated when the baby suckles.
2. Mechanoreceptors (in the nipples) are triggered and the impulses will be sent to the mother's brain through the spinal cord.
3. Hypothalamus will send the impulses to the oxytocin neuron.
4. Posterior pituitary gland is stimulated and releases the oxytocin hormone.
5. Oxytocin hormone cause the muscles around the mammary gland to contract.
6. The milk is being pushed out of the nipple.
7. Hypothalamus turns off the prolactin inhibitory neuron and causes the prolactin hormone to be released from the anterior pituitary gland.
8. More milk produced.

Things that make let-down reflex ineffective (slower)

pain

embarrassment

anxiety

stress

caffeine and alcohol use

smoking

Other things that trigger Let-Down Reflex

baby's cry

mother's emotion

https://www.breastfeeding.asn.au/bf-info/early-days/let-down-reflex
https://www.pregnancybirthbaby.org.au/let-down-reflex

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Huda Nabilah Binti Sudin (Dietetics) 151534

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Huda Nabilah Binti Sudin (Dietetics) 151534

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The let-down reflex is what makes breastmilk flow. When the baby sucks at the breast, tiny nerves are stimulated. This causes two hormones – prolactin and oxytocin – to be released into the bloodstream. Prolactin helps make the milk, while oxytocin causes the breast to push out the milk. Milk is then released or let down through the nipple.

Other than that, sound from baby's crying also stimulate the hypothalamus to stimulate the process of let-down reflex.

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What is the let-down reflex?
The let-down reflex is what makes the breast milk flow. When the baby sucks at the breast, tiny nerves are stimulated. This reflex makes the milk in the mother's breast available to the baby.

Two hormones involved in the let-down reflex:
- prolactin
- oxytocin

Prolactin act as milk-making tissue which stimulates the mammary glands to produce milk.

Oxytocin causes the breast to push out or 'let down' the milk

Factors that can slow or inhibit the let-down reflex:
1. anxiety
2. pain
3. embarrassment
4. stress
5. cold
6. excessive caffeine use
7. smoking
8. use of alcohol
9. use some medication

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A simple note of the illustration process; the let-down reflex.

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The Let-Down Reflex: an involuntary reflex as the trigger from any stimulus which allows the milk to flow freely.

The stimuli for let-down reflex will be detected by the higher centers of the brain e.g. auditory center, vision center; and send information to the hypothalamus resulting milk production!

Example of the stimuli:
1. Looking at the picture of your baby
2. Breast pump or hand massage
3. Baby crying
4. Thinking of your baby
5. Baby suckling the nipple

Do watch this youtube video entitled “Breastfeeding hormones in play” by Deakin University. It provides a better illustrations on how the hormones works during milk production and breastfeeding which includes the let-down reflex.
Link: https://youtu.be/6ECZnmcgHOc

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what is Let-Down Reflex ;
- in simple words, it is a process that make breastmilk flow.

Mechanism ;
- When baby start sucking, tiny nerves in the nipple are triggered.
- The receptors around the mother's breast will send 2 signals to the mother's brain via spinal cord and sent to the hypothalamus.
- Hypothalamus will then stimulates oxytocin releasing neuron to secrete oxytocin through posterior pituitary gland and will cause the myoepithelial cells around the mammary glands to contract.
- The second signal sent was to stop the prolactin inhibitory neurons so the prolactin can be secreted from the anterior pituitary gland. These prolactin hormones involve in lactogenesis where milk is produced in this process.
- These 2 hormones works together as the prolactin help produce milk while oxytocin help to eject the milk out from the lactiferous duct.

This Let-Down Reflex occur when ;

in response to your baby sucking at the breast

hearing, seeing or thinking about your baby

using a breast pump, hand expressing or touching your breasts or nipples

looking at a picture of your baby

hearing your baby (or another baby) cry

Strategies to encourage the reflex ;
The let-down reflex can be affected by stress, pain and tiredness. There are many things to try if you are experiencing difficulty.

Ensure that your baby is correctly attached to the breast. A well-attached baby will drain a breast better.

Feed or express in a familiar and comfortable environment.

Try different methods to help you to relax: calming music, a warm shower or a warm washer on the breast, some slow deep breathing, or a neck and shoulder massage.

Gently hand express and massage your breast before commencing the feed.

Look at and think about your baby.

If you are away from your baby, try looking at your baby’s photo.

Always have a glass of water nearby.

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Let-down reflex is an automatic natural reaction that happens in a lactating woman. It makes breastmilk flow so it is also called the milk ejection reflex.

The let-down reflex starts when the baby sucks at the mother's breast and this stimulates the tiny nerves of mechanoreceptors in the nipple to send messages to the mother's brain via the spinal cord. Then, the messages will be sent to the hypothalamus which is a part of the brain to release two hormones. Oxytocin is released from the posterior pituitary while prolactin is released from the anterior pituitary. Oxytocin helps to trigger the release or push out of breast milk by causing the myoepithelial cells to contract while prolactin helps to make more breast milk in the mammary gland via lactogenesis.

There is also a back-up mechanism that helps any lactating mother to nourish any child. The sound of a baby's cry can trigger the cascade of events that causes the milk to be ejected.

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Mahmud Izuddin Khan Bin Akbar Khan
153920

“Let-down” is define as  the release of milk from the breast. It is a normal reflex that occurs when nerves in breasts are stimulated, usually as a result when baby sucking.Breastfeeding not only creates a bond between mother and baby, it also provides  baby with nutrients that promote healthy growth. Breast milk has natural antibodies that strengthen baby’s immune system, protecting them from infections and diseases. Breastfeeding also has long-term benefits. For example, breastfeed babies are less likely to be obese or develop type 2 diabetes later in life.

The let-down reflex (milk ejection reflex)

By sucking at the breast, baby will triggers tiny nerves in the nipple.

These nerves cause hormones (prolactin) to be released into mother’s bloodstream to stimulate the alveoli to produce breastmilk

The other hormone (oxytocin) causes the breast to release or ‘let down’ the milk.

The let-down reflex makes the milk in breasts available to baby.

Cells around the alveoli contract and squeeze out the milk, pushing it down the ducts towards the nipple.

Oxytocin also makes the milk ducts widen, making it easier for the milk to flow down them.

-https://www.breastfeeding.asn.au/bf-info/early-days/let-down-reflex
-breastfeeding.support.org

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What is Let-Down Reflex?
A pathway that communicate between the baby and the mother or a physiological response for mother to release milk from the breast when triggered by the:

baby suckling

baby's cry

mother's emotion

Mechanism:
- Mechanoreceptors (located in the nipple)

It detects when the baby begin to suckle.

Send impulse to the hypothalamus via spinal cord.

- Hypothalamus will:

1. Turn on oxytocin neuron

Hypothalamus will send a message to secrete ‘oxytocin’ from the posterior part of the brain.

This oxytocin hormone that were secreted will triggered the myoepithelial cells to contract

This contraction will cause the milk to be ejected out from the lactiferous ducts in the mammary gland.

2. Turn off the prolactin inhibitory neuron

Hypothalamus will send a message to turn of the ‘prolactin inhibitory neuron.

Thus, more prolactin will be secreted from the anterior pituitary.

This prolactin hormone is important for the lactogenesis, which is the process to produce milk.

Back-up mechanism:
- Let-Down Reflex also can be triggered by the sound of a baby's cry.
- The sound can be picked up by the lactating mother.
- Then, auditory centers will sent a signal to the hypothalamus.

Factor that cause let-down reflex to slow:

anxiety

pain

embarrassment

stress

excessive caffeine use

smoking

use of alcohol

*** - Milk will produce via prolactin while milk will be ejected out via oxytocin.

Further information:

1. https://www.pregnancybirthbaby.org.au/let-down-reflex

2. https://www.webmd.com/baby/what-is-the-let-down-reflex#1

3. https://kellymom.com/bf/got-milk/supply-worries/letdown/

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The let-down reflex stimulates the secretion of milk from the breast. Stimulators of the let-down reflex includes the following :

1. infant suckling

2. baby's cry

3. sexual arousal

The stimuli from the baby suckling is are sent as nerve impulses to the hypothalamus. Hypothalamus will respond by promoting oxytocin release from the posterior pituitary gland. The oxytocin then contracts the myoepithelial cells that lines the alveoli present in the breast. Thus, milk is released through the lactiferous duct to the infant.

On the other hand, prolactin is also a hormone secreted by the anterior pituitary gland that stimulates milk production. Suckling is also a major stimulator for the release of prolactin. Other stimulators of prolactin are :

1. sleep

2. stress

3. sexual intercourse

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Letdown Reflex / Milk Ejection Reflex

Objective/purpose
-starts milk flowing when the baby feeds

Mechanism
1. When the baby sucks at the breast, tiny nerves in the breast are stimulated.
2. Mechanoreceptors in the nipple are triggered and will send messages to the mother's brain through the spinal cord.
3. Hypothalamus will send the impulse to the oxytocin neuron which will stimulate the releasing of oxytocin hormone from the posterior pituitary.
4. The function of the oxytocin hormone is to cause the muscles around the mammary glands to contract and push the breast milk out of the nipple.
5. Besides that, the hypothalamus also will turn off the prolactin inhibitory neuron which functions to inhibit the release of prolactin hormone
6. Therefore, prolactin hormone starts to release from the anterior pituitary gland and its function is to produce more milk (lactogenesis)

The stimulus that brings the occurrence of letdown reflex
1. baby sucking at the breast
2. see or think about the baby
3. breast pumping, hand expressing or touching the breasts or nipples
4. hearing baby cry (not necessary own baby)

Although the letdown reflex is an automatic natural reaction that happens in the mother's body during breastfeeding, there are many factors that can reduce or inhibit the occurrence of the letdown reflex such as
1. Emotions like anxiety, pain, embarrassment and stress
2. Excessive caffeine use
3. Smoking
4. Alcohol intake
5. Some types of medication
6. Unhealthy diet
7. Mother who has undergone breast surgery before

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Nik Nuraina Syafiqa Bt Nik Nasruddin (153700)

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Nik Nuraina Syafiqa Bt Nik Nasruddin (153700)

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The Let-Down reflex
1. When a baby starts to suck her mother's nipple, mechanoreceptors in the nipple send a signal via intercostal nerves to the dorsal root ganglion. Then via the spinal cord to the hypothalamus.
2. Hypothalamus stimulates paraventricular cells to produce oxytocin through posterior pituitary gland.
3. Hypothalamus also block prolactin inhibited neurons from releasing dopamine which allows lactotrophic cells in the anterior pituitary gland to release prolactin.
4. Prolactin will stimulate alveolar cell milk production which called lactogenesis.
5. Oxytocin will stimulate the myoepithelial cells to contract which pushes the milk into lactiferous ducts and a process called milk let down happened.
6. Interestingly, the sounds of baby's crying can trigger this whole cascade event to any lactating mother.

ADDITIONAL INFO:
Initially, after childbirth,

breast make colostrum

- it is high in immune cells and              antibodies
- lower in fat content
- acts as a laxative ; help pass baby's first stool called meconium.

After few days,

breast starts produce milk

- it is higher fat content (the fat content increasing as session continues)
- lactose
- vitamins (vitamin D slightly insufficient because mom mostly stay indoors, often supplemental vitamin D required)
- micronutrients
- proteins (casein and maternal antibodies)
- it also contains secretory IgA which supplements the baby's GI immune system)

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Nik Nur Syahirah Binti Nik Aizam (153440)

Let-down Reflex

Mechanism:-
1. When there is baby suckling, the mechanoreceptors in the nipple will detect it.
2. A message will be send to the mother's brain via the spinal cord.
3. After the message reaches the hypothalamus, there will be two action occur involving two hormones:
a. Oxytocin
- The hypothalamus will send on message  to oxytocin neuron
- It will secrete and release oxytocin (from the posterior pituitary)
- Causing the myoepithelial cells to contract
- Milk will eject out of the lactiferous ducts
b. Prolactin
- The hypothalamus will send off message to prolactin inhibitory neuron
- It will release prolactin (from anterior pituitary)
- Causing lactogenesis to occur (production of milk)
4. Both the prolactin and oxytocin are important to produce milk and eject it out of the lactiferous ducts.

More information:
* the sound of any crying baby also can trigger let-down reflex
- the lactating mother will pick up the sound of crying baby
- then, the higher center will send message to the hypothalamus
- this will initiate the event where milk will be ejected even the baby is not suckling
- as a result, any potential lactating mother can nourish any hungry child.

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The Let Down Reflex During Breastfeeding

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Learn about the breastfeeding let-down reflex, what it feels like, and the problems and solutions for a slow, overactive, or painful letdown.

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Let down reflex: reflex that make breastmilk flows.
- The let down reflex is a physiological response to the baby’s sucking. They stimulate the mechanoreceptors in the nipple, which send the signal to the mother’s hypothalamus via the spinal cord and causes the release of prolactin and oxytocin. Thus, the breastmilk will come out from the milk ducts and flow to the baby’s mouth
- Prolactin act to produce milk.
- Oxytocin act to let down/ push out the milk
Hypothalamus help to;
- send signal to Oxytocin neuron in Posterior pituitary to secrete oxytocin.
- send off signal to Prolactin inhibitory neuron in Anterior pituitary to cause prolactin secretion and causes lactogenesis.

This can also be triggered by;
- Hearing a baby’s cry even when it is not the mother’s baby (back up mechanism to feed any hunger baby)
- Touching the breast and nipple area with fingers or by using a breast pump
- Looking, hearing or thinking about baby

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Nur Amanina Natasha binti Mohd Hanafiah 154966

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Nur Amanina Natasha binti Mohd Hanafiah 154966

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Let-Down Reflex is the process to produce & make breastmilk to be released from breast.

Process:

1. Mechanoreceptors within the nipples will detect the stimuli when baby is suckling then the messages will be send to the hypothalamus through spinal cord.

2. Hypothalamus will send two types of impulses to different neurons.
- Hypothalamus send 'on' signal to oxytocin neuron at posterior pituitary gland to release ocytoxin hormone.
-Hypothalamus will send 'off' signal to prolactin inhibiting neuron at anterior pituitary gland to produce prolactin hormone.

3. The contraction of myoepithelial cells at mammary gland is stimulate by oxytocin thus ejection milk to lactiferous duct and flow to nipples pores to be suckled by infant. While prolactin will stimulates lactogenesis, which is the milk production in mammary gland.

4. This let-down reflex also can be triggered by the sound of crying baby eventhough the baby is not yours.

Advantages of breastfeeding:

For mother- Breastfeeding will release oxytocin which will help mother's uterus return to its pre-pregnancy size and may reduce uterine bleeding after birth.

For baby- Breasfeed baby may become healthier because breast milk have antibodies that help baby to fight off viruses and bacteria.

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What is Let- down reflex ?

also known as milk ejection reflex

a process that involve hormonal control of lactation to produce and eject breastmilk

Mechanism of Let-down reflex :

When baby sucks nipple, the stimuli from suckling will trigger sensory receptors in nipple known as mechanoreceptors

It cause the mechanoreceptors in nipple send sensory impulse that will travel to brain via spinal cord of the lactating mother.

When the sensory impulse reach at brain, it will stimulate hypothalamus.

At the same time, hypothalamus send 2 types of efferent impulses to anterior pituitary gland and posterior pituitary gland.

For breastmilk ejection,

Hypothalamus send  ‘ON” signal to oxytocin neuron at posterior pituitary gland.

Oxytocin neuron from posterior pituitary gland secrete hormone oxytocin to mammary glands and transported through bloodstream.

The release of oxytocin causes contraction of myoepithelial cells in the alveoli at mammary glands.

Other than contraction of myoepithelial cells in the alveoli, oxytocin also widen milk ducts.

Then, milk is ejected from mammary glands to lactiferous duct and flow through nipple pore into baby’s mouth.

Thus, baby receives milk by suckling the nipple pore

For breastmilk production,

Hypothalamus send  ‘OFF’ signal to a neuron called prolactin inhibitory neurons at anterior pituitary gland.

The hypothalamus stop prolactin inhibitory neurons.

Prolactin inhibitory neurons at anterior pituitary gland secrete hormone prolactin into mammary glands and transported through bloodstream.

More prolactin is secreted from anterior pituitary gland  causes lactogenesis occurs which breast milk production has started inside mammary glands.

Other factor that trigger let-down reflex among lactating mothers:

Hearing the sound of baby crying

-          The information is sent to higher center of brain

-          Then, it will be sent to hypothalamus.
- As it reach hypothalamus, it will initiate cascade of the events that cause milk ejection

Conditioned stimuli that cause milk ejection

see baby or think about them

smell baby

touching breast and nipple area with fingers or using a breastpump

Stressors that slow milk ejection:
-          distraction, embarrassment, fear, or anxiety

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NURUL NADIAH AQILAH BINTI MUZAFFAR 154971

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NURUL NADIAH AQILAH BINTI MUZAFFAR 154971

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Let-down reflex is an important process of breastfeeding which is making the breastmilk starts to flow.

When the baby is suckling the breast, the nerves will be triggered.
The mechanoreceptors around the breast send messages to the mother's brain through her spinal cord. These messages will go to the parts of the mother's brain which is hypothalamus. The hypothalamus will send messages to the oxytocin neurons to secrete oxytocin. The oxytocin that is released from posterior pituitary gland cause the contraction of myoepithelial cells around the mammary glands.

The hypothalamus will stop the prolactin inhibitory neurons to secrete prolactin hormone from the anterior pituitary gland. This prolactin hormone will cause lactogenesis or the production of milk happen in the mammary glands. Thus, the prolactin will help in milk production while the oxytocin will eject the milk out from the lactiferous duct.

The other factors that can trigger let-down reflex are:
- the sounds of the mother's baby or other baby's cry
- touching the breasts or nipples
- using the breast pump
- look at the baby's picture or thinking about the baby

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Eny Chakneetta A/P Sum Kit (153217)

Let down reflex mechanism
-milk ejection reflex

1.       When baby sucking at the breast, it will detect by mechanoreceptor on the nipple.

2.       Then, the receptor will send ascending sensory messages to mother’s brain called hypothalamus via spinal cord and give signal to secrete oxytocin from posterior pituitary gland and prolactin from anterior pituitary.

·         Prolactin responsible in production of breast milk or lactogenesis.

·         Oxytocin helps to stimulate myoepithelial cells for contraction to eject milk via lactiferous ducts.

Hence, milk can be ejected from mother’s breast.

Let down reflex also can be triggered when lactating mothers hear the sound of baby crying. This information will be sent to higher center of the brain and to hypothalamus and cause ejection of milk. This mechanism also can be called as back up mechanism to feed any hungry child. Let-down reflex can occur when lactating mothers are seeing or thinking about the baby and when using a breast pump.

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Nor Aida Azwin Binti Abd Aziz
155021

1. When a baby suckling trigger the mechanoreceptor in the nipple to stimulate. This mechanoreceptor send messages to spinal cord through the ascending sensory information to the hypothalamus. This hypothalamus then send information to oxytocin neuron to release oxytocin.
Oxytocin function - Contraction of myoepithelial cell
Hence, the milk is ejected.

2. Hypothalamus also send off signal to prolactin inhibitory neuron.
Prolactin inhibitory neuron function - inhibit prolactin
Prolactin function - production of milk
Hence, the prolactin can secrete more for milk production.

3. Sound of child's cry also can trigger and sent information to the higher brain center and sending the information to the hypothalamus for milk production via these two event mentioned above.

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The Let-down Reflex
1. Infant suckling stimulates mechanoreceptors in nipple to send message to the hypothalamus via spinal cord.
2.  Hypothalamus sends an off signal to prolactin inhibitory neuron, resulting in more prolactin release by prolactin cells in anterior pituitary gland.
3. Prolactin stimulates lactogenesis (breast milk production).
4. At the same time, hypothalamus also sends an on signal to an oxytocin neuron, resulting in a release of oxytocin hormone by the posterior pituitary gland.
5. Oxytocin cause myoepithelial cells in mammary gland to contract, thus eject milk into lactiferous ducts towards the nipple.
6. This Let-down reflex also can be triggered by the sound of baby's cry.

A short and simple video on the Let-down reflex

Additional notes:
*Breastfeeding is beneficial for both the mother and the infant.
1. Protects infant from illnesses and diseases as breast milk is packed with disease fighting ingredients (antibodies), vitamins and nutrients for infant's well-being.
2. The release of oxytocin contracts the uterus and helps it to return to its original size.

#Breastfeeding is not a CHOICE, it is a RESPONSIBILITY.

By: Ramizah Amni Binti Badrol Hisham (150209)

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Nur Afiqah Aliah Binti Mohd Azmi (155002)

Let- down reflex is what makes breastmilk flow.
1) When the baby sucks the breast, it will stimulate the tiny nerves in the nipple.
2) This will causes two hormones prolactin and oxytocin released into the bloodstream.
3) Prolactin helps make the milk. Oxytocin causes the breast to push out or "let down" the milk.
4) Milk is then released down through the nipple available for the baby.
5) Cells around the alveoli will contract and squeeze out the milk by pushing down the the duct towards nipple.
6) Oxytocin also can make the milk duct widen to make the milk flow down easier.

Hypothalamus functions:
1) Sends message to the oxytocin neuron in the posterior pituitary, which will secrete oxytocin hormone.
2) Hypothalamus will sends off signals to a prolactin inhibitory neuron in the anterior pituitary. Then will cause in more prolactin being secreted.

Factor that causes let-down reflex:
- Response to the baby sucking the breast
- Hearing, seeing or thinking about the baby
- Using a breast pump
- Looking at the baby picture
- Hearing a baby cry

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MUHAMMAD AMIRUL BIN MOHD HAMIZUL(151986)

The word "let down" refers to the flow of milk from your breast. When the nerves in your breasts are stimulated, such as when your baby is sucking your nipple, this is a normal reflex.

1. The baby begins to suckle to drain milk out of the breast.
2. In the nipple, there are receptors called mechanoreceptors.
3. Mechanoreceptors detect when the baby begins to suckle and transmit a signal to the mother's brain through the spinal cord.
4. These are known as ascending sensory signals, and they go up the spinal cord to the hypothalamus, a region of the mother's brain.
5.  The importance of the hypothalamus in the let-down reflex:-

Firstly, the hypothalamus communicates with the oxytocin neuron. The oxytocin neuron will then secrete oxytocin hormone from the pituitary gland's posterior part.
The function of oxytocin hormone is to contract the myoepithelial cells.

Secondly, the hypothalamus will send off a signal to prolactin inhibitory neurons.  Prolactin inhibitory neurons create the prolactin hormone from the anterior pituitary. Therefore,  the lactogenese occurs, which is the making of milk inside the mammary gland.

In conclusion milk will be produced by prolactin, and milk will be ejected, or shot out of the lactiferous ducts, by the action of oxytocin on the myoepithelial cells.

Best fact about Let-down Reflex👍
The sound of a baby's cry might potentially set off this whole chain of actions. It isn't even necessary for it to be your child. The sound of a baby's cry will be picked up by a mother's ear, especially if she is nursing, and this information will be transferred to other higher brain centers . Even if a baby isn't sucking, those higher centers will send a message to the hypothalamus telling it to start this chain of events and cause milk to be ejected.

thank you 😊

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KOK WEI XUAN (153630)

Let-down reflex

Also called the milk ejection reflex (MER), is a breastmilk flow when a baby starts to suck at the breast and the tiny nerves (mechanoreceptors) are stimulated to send a message to the hypothalamus in the brain to release hormone prolactin(anterior pituitary) and oxytocin (posterior pituitary) into the bloodstream.

The hormone, prolactin acts on the milk-making tissues to make more breast milk while hormone oxytocin triggers the breast to release or “let down” the milk. The let-down reflex makes the milk in the breasts available to the baby.

Mammary glands (alveoli) are made up of secretory cells and myoepithelial cells. Secretory cells are responsible to secrete milk whereas myoepithelial cells around the secretory cells contract and squeeze out the milk, pushing it down the ducts towards the nipple. Oxytocin also helps to make the milk ducts widen for easier milk flow down them.

The let-down may happen if a mother sees or hear a baby or even just think about them. It can also be triggered by touching the breast and nipple area with your fingers or by using a breast pump.

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Siti Nurhaliza bt Zawawi 154992

1. In the nipple, there are mechanoreceptors. When the baby begins to suckle, the mechanoreceptors will detect and send the message to the mother’s brain via spinal cord.

2. The message will go to a part of brain called hypothalamus.

3. The hypothalamus does two important things.

4. Firstly, the hypothalamus will send the message to another kind of neuron which is oxytocin neuron to secrete oxytocin hormone from the posterior pituitary gland.

5. The function of oxytocin hormone is to cause the myoepithelial cell that are lined in mammary gland to contract.

6. Next, hypothalamus will send an off signal to prolactin inhibitory neuron and cause more prolactin hormone being secreted from the anterior pituitary gland and causes lactogenesis.

7. These two hormones are going to cause milk to be made via prolactin and milk to be ejected or shot out of the lactiferous duct via the action of oxytocin on myoepithelial cells.

8. This whole chain of event can also be triggered by the sound of the baby’s cry even though it is not their own baby.

9. The sound of the baby’s crying will be picked up by the lactating mother’s ear and the information will be sent to hypothalamus.

10. The hypothalamus will initiate this cascade of event and cause milk to be ejected even if the baby isn’t suckling.

11. This is kind of backup mechanism and this whole pathway is called let down reflex.

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Nurul Fatin Nadirah Binti Mohammad Shahril 153146

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Nurul Fatin Nadirah Binti Mohammad Shahril 153146

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Definition: Discharge of milk from the mammary glands depends not only on the suction exerted by the baby during sucking but also on the contractive mechanism which expresses the milk from the alveoli into the ducts.

Process:

1. Infant suckling stimulates the hypothalamus.

2. Hypothalamus signals the posterior pituitary gland to release oxytocin and prolactin.

3. Oxytocin stimulates the release of milk.

4. Prolactin stimulates milk production.

Additional notes:

Possible causes of a slow or difficult let-down:

- Alcohol use

- Caffeine

- Stress

- Previous breast surgery

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Hajaratul Husna Binti Mohamad Roshidi
153964

Letdown reflex is how or what makes the breastmilk flow . It will happen when the baby sucks at the breast then automatically the tiny nerves will stimulated . Its also can triggered by hearing, seeing or thinking about the baby.  This process causes by two hormone which is prolactin and oxytocin .

Prolactin : The function is to make or produce the milk.

Oxytocin : The function is to make the breast push out the milk.

Process :
- The baby's sucking triggers nerve cells in the nipple and give signalling to the brain to release the oxytocin hormone .
- The milk ducts widen and all the muscle around milk cells will contract due to oxytocin .
- The breast milk will comes out from the milk ducts then will flow to baby's mouth
- The baby received the mothers milk.

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Name: Nur Athirah Binti Mohd Adip Chen
Matric No.: 150247

Additional points that are not included in Figure 1:

-        Mechanoreceptors in the nipple will detect when the baby begins to suckle, and messages will be sent to the brain via mother’s spinal cord.

-        Besides causing the oxytocin neuron to release oxytocin, the hypothalamus will also send a turn off signal to the prolactin inhibitory neuron, resulting in more prolactin and milk production.

-        There is also a backup mechanism:

The let-down reflex can also be initiated by baby’s crying. Sound of baby’s cry (does not have to be the mom’s baby) will be picked up by a lactating mother’s ear and the information will be sent to the hypothalamus by the higher centers in the brain. This will initiate the cascade of events and cause the milk to be ejected even though the baby is not suckling.

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Let down reflex is a reflex that makes a mother's breastmilk flow.
It is initiated when the baby starts sucking the breast and the nerves are stimulated to send signals to the hypothalamus via the mother's spinal cord. This signal will cause the hypothalamus to trigger the oxytocin neuron to release oxytocin hormone from the posterior pituitary. The release of the oxytocin hormone causes the myoepithelial cells that are located in the mother's mammary gland to contract which will help the breast milk to be squeezed into the milk ducts and further pushed out of the nipple for the baby to consume the milk. Moreover, oxytocin is also able to initiate the let down reflex of a breastfeeding mother whenever the mother hears a baby cry.
Besides triggering oxytocin neuron, hypothalamus also will inhibit the prolactin inhibitory neuron from inhibiting the production of prolactin hormone from the anterior pituitary. This will result in more prolactin being secreted. Prolactin functions to send signals to milk glands in the breasts to produce more milk.

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Personal note on Let-down Reflex.

First and foremost, the suckling of a baby initiates the nerve impulses from mechanoreceptors in the nipple to send an ascending sensory message to the hypothalamus in the brain through the spinal cord.

Next, the hypothalamus undergoes two reactions as below:
1. Hypothalamus sends a message to oxytocin neurons to secrete oxytocin from the posterior pituitary gland to cause myoepithelial cells that lined the mammary gland to contract and eventually eject the milk.
2. At the same time, the hypothalamus sends an off-signal to prolactin inhibitory neuron in order to allow the production of prolactin from the anterior pituitary gland. The prolactin will then send to the mammary gland to carry out lactogenesis. In other words, the function of prolactin that has been sent to mammary glands is to make milk.

The milk is stored in the mammary gland before being ejected via lactiferous ducts that are controlled by the action of oxytocin on the mammary glands' myoepithelial cells.

Moreover, the sound of a child's cry will also trigger the whole cascade of events.

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The Let-Down Reflex
The let-down reflex is the action that stimulates breastmilk flow. Babies do not suck the milk out of the breast, it is ejected by the let-down reflex.

Mechanism

When the baby starts suckling, the mechanoreceptor will be stimulated and send a signal to the hypothalamus via the mother's spinal cord.

Hypothalamus sends a signal to the oxytocin neuron that secretes oxytocin (which is located in the pituitary gland). Oxytocin hormone will cause the myoepithelial cells to contract.

Hypothalamus also sends a signal to prolactin inhibitory neuron which results in more secretion of prolactin. Prolactin is responsible for lactogenesis.

Milk is then released or let down through the nipple into the baby's mouth.

Factors triggering the let-down effect.

baby suckling

hearing, seeing, or thinking about your baby

the use of breast pump, hand expressing, or touching your breasts or nipples

looking at a picture of your baby

hearing your baby or another baby) cry

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The let-down reflex (milk ejection reflex)

By sucking at the breast, your baby triggers tiny nerves in the nipple.

These nerves cause hormones to be released into your bloodstream.

One of these hormones (prolactin) acts on the milk-making tissues.

The other hormone (oxytocin) causes the breast to push out or 'let down' the milk.

The let-down reflex makes the milk in your breasts available to your baby.

Cells around the alveoli contract and squeeze out the milk, pushing it down the ducts towards the nipple.

Oxytocin also makes the milk ducts widen, making it easier for the milk to flow down them.

The let-down may happen if you see or hear your baby or even just think about him.

The let-down can also be triggered by touching your breast and nipple area with your fingers or by using a breast pump.

People often say that your let-down may not work as well if you are very anxious, extremely tired, upset or in pain. The truth is that breastfeeding is a powerful process. With support and encouragement, mothers cope with many different stresses and still breastfeed successfully.

You may be aware of the let-down as:

a tingling feeling, which can be quite strong

a feeling of sudden fullness

milk dripping from the other breast

a change in the baby's sucking pattern from a quick suck-suck to a rhythmic suck-swallow pattern as the milk begins to flow.

In the early days you might feel your uterus contract when you let down, especially if this is not your first baby.

Let-downs usually occur more than once during a feed; however most mothers will only notice the first. These other let-downs occur in response to changes in a baby's suckling. Some mothers feel the let-down in the early days or weeks, but later find that this feeling goes away.
Ways you can help your let-down to occur when feeding or expressing:

Relax. While you feed or express, breathe slowly and deeply. Some mothers find it helpful to have a warm drink first or listen to calming music. Warmth may also help, for example having a warm shower or placing a warm face washer on your breast for a few minutes before starting.

Gently massage your breasts. Stroke your breast towards the nipple with the flat of your hand or edge of a finger. Gently roll your nipple between your fingers.

Think about your baby. If you are expressing, you may find it easier to express while you are close to your baby. When you are away from your baby, you may find it helpful to look at a photo of your baby.

Support. Your support person may also help by giving you a gentle back and shoulder massage to help you relax. Some mothers, however, prefer to express or feed in private as they feel under pressure if anyone is watching them.

By sucking at the breast, your baby triggers tiny nerves in the nipple. These nerves cause hormones to be released into your bloodstream. One of these hormones (prolactin) acts on the milk-making tissues. The other hormone (oxytocin) causes the breast to push out or 'let down' the milk.

Breastfeeding: an introduction booklet

Breastfeeding: an Introduction provides a basic outline of the key aspects of breastfeeding.

© Australian Breastfeeding Association Reviewed Augst 2017

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The let-down reflex (milk ejection reflex)By sucking at the breast, your baby triggers tiny nerves in the nipple.These nerves cause hormones to be released into your bloodstream.One of these hormones (prolactin) acts on the milk-making tissues.The other hormone (oxytocin) causes the breast to push out or 'let down' the milk.The let-down reflex makes the milk in your breasts available to your baby.Cells around the alveoli contract and squeeze out the milk, pushing it down the ducts towards the nipple.Oxytocin also makes the

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Personal note on Let Down Reflex

Letdown reflex is a condition where the milk is ready to flow.

When the infant begins to suckle, the mechanoreceptors inside the nipples will detect and send messages to the hypothalamus.

They send messages to the mother's brain (to the hypothalamus) via spinal cord.

Hypothalamus will perform two important things.

1. First, hypothalamus sends the message to the oxytocin neuron in the posterior pituitary, which will secrete a hormone called oxytocin. Function oxytocin: cause the myoepithelial cell to contract.

2. Next, the hypothalamus will send off signals to a prolactin inhibitory neuron in the anterior pituitary. This results in more prolactin being secreted. Function prolactin: to produce/ making milk.

Other factor trigger let down reflex:

The sound of baby’s cry

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The Let Down Reflex

1. The baby sucks on the mother’s breast to receive the mother’s milk.

2. Baby’s sucking (stimuli) triggers the nerve cells in the nipple, signaling the brain to release the hormone Oxytocin from posterior pituitary

3. Milk ducts widen and muscles around milk cells contract due to oxytocin

4. Breast milk comes out of the milk ducts, into the baby’s mouth

The let-down reflex occurs

-in response to the baby sucking at the breast

-hearing, seeing or thinking about the baby

-using a breast pump, hand expressing or touching your breasts or nipples

-looking at a baby picture

-hearing the baby (or another baby) cry

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Let-down Reflex (milk ejection reflex)

Process:
1. When a baby is suckling, mechanoreceptors in the nipple detect the stimuli and then send messages to the hypothalamus via the spinal cord.

2. Then, hypothalamus sends out 2 signals:
a. On signals (to turn on) to oxytocin neurons in the posterior pituitary gland. Oxytocin neurons produce and release oxytocin hormones
b. Off signals (to turn off) to prolactin inhibitory neurons in the anterior pituitary gland. As the prolactin inhibitory neurons are off, prolactin neurons can produce and release prolactin hormones.

3. Prolactin hormones cause lactogenesis (secretory cells in the alveolus of mammary gland produce milk).
Oxytocin hormones cause contraction of myoepithelial cells (surround secretory cells) to eject milk.

4. Milk is ejected out of the nipple to feed the baby.

Other stimuli: sound of a baby's cry (any baby)

When a lactating mother's ears receive the sound of a baby's cry, the messages are sent to the hypothalamus via higher centers. Then, oxytocin and prolactin are released. Milk will be produced and secreted.
This is a back-up mechanism which means a crying baby can be fed by any lactating woman (even though she is not the baby's own mother).

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- In the nipple have mechanoreceptors that will detect when baby begins to suckle, then they send messages to mother's brain.
- Hypothalamus sends a go message to oxytocin neuron that releases oxytocin hormone.
- Oxytocin releases from posterior pituitary gland in the mother.
- Oxytocin functions is to cause the myoepithelial cells to contract.
- Second, hypothalamus has to turn off a different kind of neuron called a prolactin inhibitory neuron.

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The let-down reflex, also known as the milk ejection reflex (MER), is a natural reflex that triggers the breast to release the breastmilk.

Process:

The mechanoreceptor will detect when the baby starts to suckle the mother's nipple.

The mechanoreceptor will send a signal to the hypothalamus to release two hormones, which are oxytocin and prolactin.

The hypothalamus sends the ON signal to the oxytocin neuron to release the oxytocin hormone. The oxytocin hormone triggers the breast to let down milk and causes the milk ducts to widen, making it easier for the milk to flow.

Next, the hypothalamus sends the OFF signal to the prolactin inhibitory neuron. As a result, more prolactin will be secreted. Prolactin is important for milk production (lactogenesis).

Breastmilk is ejected from the milk ducts into the baby’s mouth.

Factors that trigger the let-down reflex:

Hearing your baby or another baby cry

Using a breast pump, hand expressing or touching your breasts or nipples

In response to your baby sucking at the breast,

Hearing, seeing, or thinking about your baby

Looking at a picture of your baby

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1)When baby begin to suckle,mechanoreceptor in nipple triggered and send message to mother’s brain via spinal cord to hypothalamus,
2)Hypothalamus will send the message to oxytocin neuron that will release oxytocin. Oxytocin is release from posterior pituitary in mother. The function of oxytocin is to cause myoepithelial cell to contract.
3)At the same time, hypothalamus has to turn off different kind of neuron, to send off signal to neuron call prolactin inhibitory neuron that inhibit production of prolactin.
4)After the hypothalamus has send signal off to prolactin inhibitory neuron, production of prolactin start. Prolactin cause lactogenesis(making of milk) inside mammary gland.
5)Prolactin from anterior pituitary will make milk and oxytocin from posterior pituitary will ejected the milk to the baby.

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1. What is let-down reflex?
Let-down reflex is the process to produce and make the breastmilk to be released from breast through nipple pores.

2. When does it occur?
-in response to your baby sucking at the breast.
-hearing your baby/ other baby cry.
-seeing, thinking about your baby or looking at a picture of your baby.
-using a breast pump, hand expressing or touching your breasts or nipples.

*The let-down reflex generally occurs 2 or 3 times in a feed. Most women only feel the first, if at all.

3. How does the mechanism carry out?
-The baby's suckling stimulation is detected by mechanoreceptors in nipples of a lactating mother.
- The mechanoreceptors will send ascending sensory message to hypothalamus through spinal cord.
-After the hypothalamus receives and interprets the message, it will send 'OFF' signal to turn off the prolactin inhibitory neuron. So, the prolactin cells are free to secrete more prolactin from anterior pituitary gland.
-Prolactin will stimulate the milk synthesis/ lactogenesis by secretory cells in mammary gland.
-Meanwhile, hypothalamus also sends 'ON' signal to stimulate oxytocin neuron to release oxytocin from  posterior pituitary gland.
-Oxytocin will stimulate contraction of myoepithelial cells that surround the secretory cells in mammary gland to eject the milk produced into the lactiferous ducts and flow towards the nipple pores to feed the baby.
-The sound of crying of a baby, when picked up by the ear of a lactating mother, will also send message to higher centers of brain and to hypothalamus and let-down reflex will be triggered.

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Let-down Reflex

Definition:
A reflex that triggers the release of Milk from the breasts.

Mechanism:
1. When the baby begins to suckle, the mechanoreceptors in the nipple will send messages to the mother's brain via her spinal cord. The ascending sensory messages will reach the mother's hypothalamus.
2. Hypothalamus will:
- Turn on the oxytocin neuron, which releases oxytocin from the posterior pituitary gland in the mother. Oxytocin causes myoepithelial cells in the mammary glands to contract so that milk can be ejected out of the lactiferous ducts.
- Turn off the prolactin inhibitory neuron, hence more prolactin is secreted. Prolactin is responsible for lactogenesis (the making of milk inside the mammary gland).
3. Thus, milk will be produced and ejected.

Other let-down trigger:
1. When the mother hears a baby's cry, and it doesn't even need to be her baby.
2. If a mother has not nurse for too long and her breasts get too full.
3. When the mother thinks of her baby or looks at her baby's picture.
4. Breast massage

Factors that may slow or inhibit let-down reflex：
1. Negative emotions like fear, sadness or worry
2. Pain
3. Cold
4. Alcohol
5. Excessive caffeine use

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What is Let-Down Effect?

A natural process that stimulates the breast to release breast milk.

How is the let-down effect triggered?

· Baby suckling

· Sound of baby’s cry (even other people’s baby)

Ø  From lactating mother’s ear senses sends signals to the hypothalamus from auditory centers

·  Breast pump or massage

Mechanism:

· When the baby suckles on the nipple, the mechanoreceptor on the nipple will be stimulated and send a signal to the hypothalamus via the mother’s spinal cord.

· Hypothalamus (in the brain) then sends the signal to the oxytocin neuron to secrete the oxytocin hormone from the posterior pituitary gland.

Ø  Oxytocin hormones cause the myoepithelial cells to contract.

Ø  Myoepithelial cells: surround secretory cells and contract to cause milk ejection into ducts

· At the same time, the hypothalamus sends a signal to prolactin inhibitory neurons to secrete more prolactin secretion.

Ø  Prolactin is responsible for lactogenesis.

Ø  Prolactin sends signals to milk glands in the breasts to produce more milk.

Ø  Prolactin secreted from the anterior pituitary gland

· Milk then will be let down (released) through the nipple into the baby’s mouth.

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MOHAMAD SHAQIF HAZIF BIN RAJA ZAINUDDIN (154974) ~ LETDOWN REFLEX

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MOHAMAD SHAQIF HAZIF BIN RAJA ZAINUDDIN (154974) ~ LETDOWN REFLEX

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letdown reflex ->> is what makes breastmilk flow, ability to communicate between the baby and the mother <<

Nipples have mechanoreceptors (can detect when the baby starts suckling) -> Send messages to the mother’s brain via her spinal cord (ascending sensory messages)-> Go to the hypothalamus

First, the hypothalamus sends a signal to a neuron known as a oxytocin neuron -> Oxytocin neuron releases a hormone called oxytocin (secrete from the posterior part of another segment in brain called pituitary gland)-> The oxytocin hormone cause myoepithelial cells to contract

Second, the hypothalamus sends an off signal to a neuron known as a prolactin inhibitory neuron -> causing it to secrete more prolactin (release from anterior pituitary) -> Prolactin will cause lactogenesis ( making of milk inside the mammary gland)

*Prolactin helps make the milk, while oxytocin causes the breast to push out the milk. Milk is then released or let down through the nipple. Milk will be ejected from the lactiferous ducts

As a backup mechanism

*because it means that potentially any lactating mother in the vicinity could nourish any hungry child.

The sound of a baby crying can also triggered the entire event -> The sound of a baby’s cry will be picked up by a lactating mother’s ear -> The information will be sent via other higher center of brain (auditory centers & other higher parts of brain) -> and will send a message to hypothalamus to initiate the flow of the event -> This causes milk to be ejected even the baby is not suckling.

Extra info
Letdown reflex also occurs when using:
1. using a breast pump
2. Looking at picture of your baby
3. Thinking about your baby

Possible causes for a slow letdown:
Anxiety, pain, embarrassment, stress, cold, excessive caffeine use, smoking, use of alcohol or the use of some medications

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Syaza Farzana Binti Mohammad Zamri (152715)

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Syaza Farzana Binti Mohammad Zamri (152715)

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Let-down reflex
- The process by which milk is released from the milk glands to the milk ducts in preparation for breastfeeding.
- also known as milk ejection reflex.

Mechanism of Let-down reflex:

- When the baby begins to suckle, the mechanoreceptors in the nipple will detect and send the message to the hypothalamus in the brain via mother's spinal cord.

-Then, hypothalamus will send on signal to  oxytocin neuron at posterior pituitary gland to secrete oxytocin hormone.
Oxytocin stimulate contraction of myoepithelial cells at mammary gland to release milk.

-At the same time, hypothalamus will send off signal to prolactin inhibitory neuron to secrete prolactin hormone.
Prolactin stimulates lactogenesis (breastmilk production).

The other factors that trigger let-down reflex:
-Hearing a baby cry
-Using a breast pump or touching the breast and nipple area.
-Looking at a picture of baby.

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RUSYDA BT SHAHRUL MIZAL, 154176, DIETETIK

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RUSYDA BT SHAHRUL MIZAL, 154176, DIETETIK

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What is the let-down reflex? The let-down reflex is what makes breastmilk flow. When the baby sucks at the breast, tiny nerves are stimulated. This causes two hormones, prolactin and oxytocin, to be released into the  bloodstream.

I think this is really exciting and unique. Because there are connections between mom and the baby. Because the way baby can get the milk by suckle and the process of the milk to make sure the baby get the milk is so in detail.

I believe most women notice a change in their baby’s sucking pattern as the milk begins to flow, from small, shallow sucks to stronger, slower sucks. Because i do watch my little brother do this.

This process happen when :

- baby sucking at the breast
- hearing, seeing or thinking about baby
- using a breast pump, hand expressing or touching your breasts or nipples

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what is let down reflex ?
let down reflex is the condition that makes the breastmilk flow.

The let-down reflex (milk ejection reflex)

- when the baby suckle, the actual suction of that act does help to drain milk from the breast.
- The mammary gland that were lined by the myoepithelial cell contain the milk that are drained into the nipple via lactiferous duct.
- The mechanoreceptor that are located in the nipple will detect when the baby begins to suckle and it will send the message to the mother's brain via her spinal cord (called as ascending sensory message) to the hypothalamus in the brain.
-Hypothalamus will release two type of hormone which are oxytocin and prolactin.
- Hypothalamus will send a signal to the oxytocin neuron to release hormone oxytocin that are secreted from the posterior part of the pituitary gland.
- This hormone will contract the myoepithelial cell to eject the milk.
_ simultaneously, hypothalamus will send off signal to the prolactin inhibitory neuron to stop release a prolactin from anterior part of the pituitary gland that cause lactogenesis or producing milk in the mammary gland.

The let-down reflex also occurs when:

hearing, seeing or thinking about your baby

using a breast pump, hand expressing or touching your breasts or nipples

looking at a picture of your baby

hearing your baby (or another baby) cry

The let-down reflex can be affected by stress, pain and tiredness. There are many things to try if you are experiencing difficulty.

Ensure that the baby is correctly attached to the breast. A well-attached baby will drain a breast better.

Feed or express in a familiar and comfortable environment.

Try different methods to help you to relax: calming music, a warm shower or a warm washer on the breast, some slow deep breathing, or a neck and shoulder massage.

Gently hand express and massage your breast before commencing the feed.

Look at and think about your baby.

If you are away from your baby, try looking at your baby’s photo.

Always have a glass of water nearby.

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What is Let-down Reflex?

An involuntary reflex during the period of time when a women is breastfeeding which causes the milk to flow freely.

Mechanism of let-down reflex:
1. In the nipple itself, are things called mechanoreceptors, they are activated when the baby begins to suckle and they send messages to the mother's brain via her spinal cord.
2. These ascending sensory messages go toward the brain through the spinal cord. They go to a part of the brain called the hypothalamus.
3. Firstly, the hypothalamus sends an ON message to the neuron called an oxytocin neuron. These oxytocin neurons release oxytocin hormone from the posterior pituitary gland of the mother's brain cause the myoepithelial cells that surround the mammary gland to contract.
4. Secondly, the hypothalamus sends an OFF signal to a neuron called prolactin inhibitory neuron that inhibits prolactin hormone secretion. When the hypothalamus is going to turn off the off signal, thus more prolactin being secreted from the anterior pituitary gland. These prolactin hormone cause milk production in the mammary gland.
5. Those two hormones cause milk to be made via prolactin and milk to be ejected, or shot out of the lactiferous ducts via the action of oxytocin on the myoepithelial cells.

Other factors that trigger let-down reflex:

Hearing, seeing or thinking about your baby

Using a breast pump, hand expressing or touching your breasts or nipples

Looking at a picture of your baby

Hearing your baby (or another baby) cry

What inhibits a letdown?

Stress

Negative emotions

Not watching your diet

Too much caffeine

Alcohol

Smoking

Common breastfeeding problems:

Sore nipples

Breast engorgement

Plugged milk duct

Low breast milk supply

Overabundant supply of milk

Infection or painful lumps

Inverted nipples

Benefits of breastfeeding:

Promotes infant immunity

Cost-effective

Works as a contraceptive

Nurtures mother-baby bond

Environment-friendly

Induces oxytocin production

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NUR QIYAH BINTI AZIZON (154272) | Let-Down Reflex in breastfeeding. 

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NUR QIYAH BINTI AZIZON (154272) | Let-Down Reflex in breastfeeding. 

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1. What is Let-Down Reflex?

• Also known as milk ejection reflex, is a natural process that triggers breast to release breast milk.
• It typically happens at the beginning of breastfeeding. Normally around 2 mins of suckling/pumping.

2. The mechanism of Let-Down Reflex:
i. As the baby sucks, mechanoreceptors in the breast are stimulated and send signal known as ascending sensory messages via spinal cord to a part of the brain called the hypothalamus to release two hormones;

Oxytocin released by oxytocin neuron from posterior pituitary → stimulates myoepithelial cells that surround the mammary glands to eject the milk out of the nipple.
Prolactin, secreted by prolactin cells from anterior pituitary after the prolactin inhibitory neuron is turned off by hypothalamus → responsible for the making of milk inside the mammary gland or known as the process of lactogenesis.

ii. These two hormones are playing parts in the making of milk (prolactin) and milk to be ejected through lactiferous ducts (oxytocin) out of the nipple so the baby can be fed.

3. Other factors that can trigger a let-down

• The sound of a baby's cry— picked up by a lactating mother's ear and this information is then send to the hypothalamus from auditory centers to initiate similar cascade of events and cause milk to be ejected even if a baby isn't suckling.
• Thinking about or looking at your baby's picture.
• Breast massage or pumping.

3. Signs of let-down reflex may occur (may differ from one mom to another)

• Tingling sensation; like needle pricking sensation.

• The breasts suddenly feel full.

• The feeling of cramping in your uterus.

• The change in your baby’s sucking pattern during breastfeeding; stronger and slower sucking rhythm.

• You may notice your baby gulping sound, indicating that he receives the breast milk.

• The breast milk may drip or leak on the side of breast not used for nursing.

• When you pump, you will see that your milk starts spraying instead of slow drip.

4. How long does it last?

• Around 5-10 minutes, varies for each mom. Once it is over, milk flow slows down to drip or nothing. When this happens, the baby will automatically change the sucking pattern to initiate let down again so the milk will flow again. The cycle continues until the feeding finishes.

5. Do both breasts let-down at the same time? - Yes

6. Factors inhibiting let-down reflex

• Feeling of pain (including sore nipple or pumping problem)

• Stress and anxiety

• Cold

• Excessive caffeine usage

• Certain medication

Sources:

https://livingwithlowmilksupply.com/what-is-let-down-reflex

https://www.youtube.com/watch?v=cMhgFt1xT7c

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Nasrien Firzanah Binti Fadzil Mohamed 153199

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Nasrien Firzanah Binti Fadzil Mohamed 153199

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Let-down Reflex

In the nipple, there are things called mechanoreceptors. They detect when the baby begins to suckle. It sends messages to the mother's brain, hypothalamus via the spinal cord. The hypothalamus sends an 'on' signal to the oxytocin neuron which will release oxytocin hormone from the posterior pituitary gland. That oxytocin hormone causes the myoepithelial cells to contract. The hypothalamus also sends an 'off' signal to prolactin inhibitory neuron to stop the making of prolactin. The result is more prolactin being secreted from the anterior pituitary. Prolactin induces lactogenesis. Prolactin causes the milk to be made while oxytocin causes the milk to be ejected or shot out of the lactiferous ducts.
More interesting fact, the sound of a baby's cry will be picked up by a lactating mother's ear. The information will be sent to the hypothalamus through another sort of higher centre in the brain and will stimulate the mechanism eventhough no baby is suckling.

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Let-down reflex is also known as milk ejection reflex.

When a baby suckles at the breast, mechanoreceptors in the nipples are stimulated. Sensory impulse from mechanoreceptors travels to brain by sensory neuron via spinal cord. At the brain, the impulse stimulate the hypothalamus.

Then, the hypothalamus sends 2 types of impulses to different neurons. Hypothalamus send ON signal to oxytocin neuron at posterior pituitary gland to release hormone oxytocin.  Hypothalamus send OFF signal to prolactin-inhibiting neuron at anterior pituitary gland to produce prolactin hormone.

Oxytocin stimulates the contraction of myoepithelial cells at mammary gland, thus eject milk to lactiferous duct and flow to nipple pores to be suckled by infant. Prolactin stimulates lactogenesis, which is the milk production in mammary glands.

Besides, the suckling action of infant will trigger the reflex, other stimulus such as hearing a baby's cry could also stimulate cascade. From the ear of lactating mother, the impulse will be sent via higher center to hypothalamus and trigger the reflex. The crying of baby is not limited to own baby, even other babies' cry could stimulate the reflex. This is to ensure that all the crying babies could be fed even if their mothers are not around.

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1. suckling of the nipple by the baby or cry of a baby stimulates the mechanoreceptor to send a message in the mother's brain (in the hypothalamus)
2. message sends to posterior pituitary by oxytocin neuron to stimulate the release of oxytocin to the mammary gland to stimulate myoepithelial cells to eject milk out.
3. simultaneously, the hypothalamus sends off signals to the anterior pituitary to turn off the function of the pituitary inhibiting hormone (PIH) so more of the prolactin is produced and released into the mammary gland to start producing milk.

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onenote - Mechanism of lactation (let down reflex)