MAMMAE

(PAYUDARA)

LACTATION
OLEH :
Dr.dr. HMA Ashari SpOG(K)
• Lactasi : proses pemberian makanan paling awal dari IBU – Bayi baru lahir
• Payu Dara (Kelenjar Mammae) : mengalami pertumbuhan sejak sebelum
pubertas, sebagai tanda munculnya tanda kelamin sekunder (Thelarche) yang
kemudian diikuti tumbuhnya rambut ketiak & rambut kemaluan /pubis
(Pubarche)
• Tumbuhnya tanda kelamin sekunder ini akibat pengaruh dari hormon Estrogen
yang berasal dari Kelenjar Adrenal (Suprarenalis)
• Pertumbuhan selanjutnya akan dipengaruhi hormon Estrogen yang berasal dari
Ovarium apabila Siklus Endokrinologi Reproduksi Wanita (SERW) sudah mulai
 Why breastfeeding?
• The best gift from a mother for her baby to
start a new life…
• Cost effective
–Always available
• Comfort
– Breastfeeding offers mothers to sit and lie down
– Bonding between the mother and the baby
• Convenient
– Easy to carry around, always available
– A baby fed breast milk less susceptible to infection than a baby fed
breast milk substitute

(Source: WHO, 1997)

Affandi B. Breastfeeding & Contraception. Dep. Obstetrics & Gynecology, University of Indonesia, Jakarta Jan 2008
 Benefits behind breastfeeding
• Best source of infant nutrient
• Infant protection against gastrointestinal
infection by diarrhoeal pathogens
• Prolong the duration of lactational
amenorrhae for the mother
– Natural contraceptive method
• More rapid post-partum weight loss

(Source: WHO, 2002; Contraception Report, 2003)

Affandi B. Breastfeeding & Contraception. Dep. Obstetrics & Gynecology, University of Indonesia, Jakarta Jan 2008
PAYU DARA :
- membesar akbt hypertropi dr alveoli, vena2,
juga akibat dari hormon PROLACTIN, & hormon OXYTOCIN yg
mulai berfungsi mebuat ASI pd khmln sekitar 24 mg mulai nampak disbt
COLUSTRUM yg sangat bermanfaat krn penuh zat kekebalan utk
bayinya nanti
Hipothalamus

Hipophisis

6
(Adeno hypophysis) (Neuro hypophysis)

Pars intermedia MSH

7
1. After puberty, oestrogen
promotes the development of the
connective tissue and lactiferous
ducts.
2. Progesterone develops the
glandular tissue(a complex of
lobes) in which milk is produced.
3. After delivery the sex hormone
levels fall and prolactine, secreted
in larrge amounts during
pregnancy, is free to stimulate
milk production.
4. High prolactine levels, as well as
oxytocine release are maintained
during nursing by nerve stimuli
triggered by the suckling infant.
 Phase I :
Placental phase of preparation
for lactation (breast
development lasting about three
months) ; a secretory activity
beginning in the fouth month
with the production of
colostrum, continuing until after
delivery
 Phase II :
Phase of milk secretion ;
prolactin stimulates milk
secretion by acting directly on
the alveoli of the mammary
gland, whose functioning is
inhibited by estrogen and
progesterone until after the birth
of the infant and the expulsion of
the placenta.
 Phase III:
Phase of maintenance of
lactation; controlled by
prolactin, which stimulates
and maintains secretory
activity, and oxytocin
(released from the
posterior pituitary),
responsible for milk
ejection.
Factor2 yg mempengaruhi Secresi Prolaktin
1. Nutrisi :
Stlh makan (protein) terjd pe↗an secresi Prl, asam
aminoTirosin & Triptofan (didlm protein) yg mampu
memicu secresi Prl, & hanya pd or sehat bkn or dg
prolaktinoma, selain makanan, minuman (Bir) jg
memicu secresi Prl (sewkt laktasi)
2. Temperatur:
20 ‘ stlh mandi sauna terjd pe↗Prl,
peningkatan suhu dr 27-45 drjt C slm 1 jam
me↗Prl 53 %, sdg pe↘ dr 27–13 drjt C Prl
me↘ 37 %