Lactation

This book had its genesIs In the frustrations of the editors in locating authoritative, up-to-date material for an interdisciplinary graduate course in mammary gland biology, lactation, and breast-feeding. As we turned to the original literature several reasons for the dearth of usable material became clear: (1) In the areas of mammary gland biology and physiology, particularly as they relate to the human, reviews simply have not kept up with current research, which has in the last two decades provided tremendous insight into the mechanisms of milk secretion and its control. (2) The lack of interest in human milk as infant food inhibited researchers until very recently from investigating human lactation. (3) Much of the relevant clinical information remains anecdotal with little scientific basis. In this book we have tried to present the fundamentals of mammary gland physiology at the organismic and cellular levels in a form readily understood by physicians, scientists, and other professionals. This basic information is accompanied by authoritative reviews of the nutritional and immunological properties of human milk and by clinically relevant chapters designed to help health care professionals deal with the medical problems of the breast-feeding mother and her infant. We have strived in these chapters for up-to-date, authoritative, but readable accounts. In so far as possible we have avoided areas where much of our understanding rests on speculation. In the clinical domain this was not always possible because of a lack of solid, scientific information about breast-feeding.

I. Introduction. - 1. An Introduction to Lactation and Breast-Feeding. - II. The Scientific Basis of Lactation. - 2. Anatomy of the Breast. - 3. The Mechanisms of Milk Secretion. - 4. Regulation of Mammary Development and Lactation. - 5. Cellular and Molecular Aspects of the Hormonal Control of Mammary Function. - 6. In Vitro Model Systems for the Study of Hormonal Control of Mammary Gland Growth and Differentiation. - III. The Nutritional and Immunologic Significance of Mammary Secretions. - 7. Nutritional Aspects of Human Lactation. - 8. The Immunology of Breast Milk. - IV. Medical Management of Breast-Feeding. - 9. Routine Management of Breast-Feeding. - 10. Infant Problems in Breast-Feeding. - 11. Maternal Problems in Lactation. - 12. Psychological Implications of Breast-Feeding for the Mother. - 13. Drugs, Toxins, and Environmental Agents in Breast Milk. - 14. Lactation and Contraception. - 15. Pregnancy, Lactation, and Breast Cancer.