NORMAL AND CAESARIAN SECTION DELIVERY AND THE INITIATION OF LACTATION IN WOMEN

Abstract

Summary Studies were undertaken to determine the effects of Caesarean section and normal delivery on the timing of milk ‘coming in’ and the changes in milk composition during the first 7 days post‐partum. The time interval between delivery and milk ‘coming in’ was determined in a group of 107 women who delivered normally and 57 women who delivered by Caesarean section. Progressive changes in the concentration of lactose, glucose, total protein, casein, fat, α‐lactalbumin, lactorferrin, albumin, sodium, chloride, potassium, IgA, IgG and IgM were measured in small samples of milk (0·5 ‐ 3·0 ml) expressed from 11 women who delivered normally and 8 women who delivered by Caesarean section. The time interval between delivery and milk ‘coming in’ in women who delivered normally and those who delivered by Caesarean section was 59 ± 16·3 h and 63·6 ± 24·2 h (mean ± SD). respectively. The concentration of lactose and potassium increased by approximately 100% and 50%, respectively, from the low values between 0 and 30 h, to normal milk values by 5 days after delivery In both groups of women, whereas the concentration of total protein, α‐lactalbumin, lactoferrin, albumin, sodium, chloride. IgA, IgG and IgM decreased to approximately 28%, 85%, 71%, 26%, 36%, 47%, 7%. 13% and 12%, respectively, of the day I values by 5 days of lactation in both groups of women. The method of delivery made no significant (P > 0.05) difference to the timing of either milk ‘coming in’ or the changes in the concentration of milk constituents in the mammary secretion during the first 7 days post‐partum.