In regard to the many recent questions about the commercial availability
and/or the pharmaceutical compounding of oxytocin nasal spray, I want to
suggest a very effective non-medicinal way for triggering the milk
ejection reflex that has been empirically observed by many. Nerves from
multiple areas of the breast converge toward the nipple-areolar complex
in order to enter the base of the nipple and wrap around each of the
individual galactophores buried deep in the center of the nipple itself.
(Montagna and McPherson). There is no fat in the connective tissue of the
nipple-areolar complex. (Bricout). This provides easy access to nerves as
they pass beneath the skin of the areola. The unique anatomy of the
nipple-areolar complex lends itself to the use of the reverse pressure
softening technique (Cotterman) at any stage of lactation to stimulate
milk ejection. Firm inward pressure on the central areola for
approximately 60 seconds may operate in two separate ways: 1) Stimulation
of the neurohormonal arc, resulting in oxytocin release and circulatory
delivery to the myepithelial cells of the alveoli and ducts 2) Automatic
reflex reaction of myoepithelial cells in the anterior breast and around
deep subareolar ducts themselves in response to direct physical
stimulation. The name "Tap reflex" is given to this phenomenon in
veterinary literature (Mepham, Hurley). (The "butting" of the udder by a
calf or kid illustrates the instinctive action of the young to produce
the natural occurence of milk ejection by one or both of these
mechanisms.)
Jean
**********************
K. Jean Cotterman RNC, IBCLC
Dayton, OH USA
Montagna W, Macpherson E, Some Neglected Aspects of the Anatomy of Human
Breasts, Journ Inv Derm, July 1974, Vol 63;1: p. 10-16.
Bricout N, Breast Surgery, Springer-Verlag France, Paris, 1996
Cotterman KJ, Reverse Pressure Softening: A Simple Tool to Prepare Areola
for Easier Latching During Engorgement, Journal of Human Lactation, May
2004, vol. 20, iss. 2, pp. 227-237.
Mepham TB, Physiology of Lactation, Open University Press, Philadelphia,
1987.
Hurley WL, Milk Ejection,
http://classes.aces.uiuc.edu/AnSci308/milkejection.html
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