Breastfeeding known as nursing, is the feeding of babies and young children with milk from a woman's breast. Health professionals recommend that breastfeeding begin within the first hour of a baby's life and continue as and as much as the baby wants. During the first few weeks of life babies may nurse every two to three hours, the duration of a feeding is ten to fifteen minutes on each breast. Older children feed less often. Mothers may pump milk so that it can be used when breastfeeding is not possible. Breastfeeding has a number of benefits to both baby, which infant formula lacks. Deaths of an estimated 820,000 children under the age of five could be prevented globally every year with increased breastfeeding. Breastfeeding decreases the risk of respiratory tract infections and diarrhea, both in developing and developed countries. Other benefits include lower risks of asthma, food allergies, type 1 diabetes, leukemia. Breastfeeding may improve cognitive development and decrease the risk of obesity in adulthood.
Mothers may feel pressure to breastfeed, but in the developed world children grow up when bottle fed. Benefits for the mother include less blood loss following delivery, better uterus shrinkage, decreased postpartum depression. Breastfeeding delays the return of menstruation and fertility, a phenomenon known as lactational amenorrhea. Long term benefits for the mother include decreased risk of breast cancer, cardiovascular disease, rheumatoid arthritis. Breastfeeding is less expensive than infant formula. Health organizations, including the World Health Organization, recommend breastfeeding for six months; this means that no other foods or drinks other than vitamin D are given. After the introduction of foods at six months of age, recommendations include continued breastfeeding until one to two years of age or more. Globally about 38% of infants are only breastfed during their first six months of life. In the United States in 2015, 83% of women begin breastfeeding and 58% were still breastfeeding at 6 months, although only 25% exclusively.
Medical conditions that do not allow breastfeeding are rare. Mothers who take certain recreational drugs and medications should not breastfeed. Smoking, limited amounts of alcohol, or coffee are not reasons to avoid breastfeeding. Changes early in pregnancy prepare the breast for lactation. Before pregnancy the breast is composed of adipose tissue but under the influence of the hormones estrogen, progesterone and other hormones, the breasts prepare for production of milk for the baby. There is an increase in blood flow to the breasts. Pigmentation of the nipples and areola increases. Size increases as well, but breast size is not related to the amount of milk that the mother will be able to produce after the baby is born. By the second trimester of pregnancy colostrum, a thick yellowish fluid, begins to be produced in the alveoli and continues to be produced for the first few days after birth until the milk "comes in", around 30 to 40 hours after delivery. There is no evidence to support increased fluid intake for breastfeeding mothers to increase their milk production.
Oxytocin contracts the smooth muscle of the uterus during birth and following delivery, called the postpartum period, while breastfeeding. Oxytocin contracts the smooth muscle layer of band-like cells surrounding the alveoli to squeeze the newly produced milk into the duct system. Oxytocin is necessary for the milk ejection reflex, or let-down, in response to occur. Not all of breast milk's properties are understood, but its nutrient content is consistent. Breast milk is made from nutrients in the mother's bodily stores, it has an optimal balance of fat, sugar and protein, needed for a baby's growth and development. Breastfeeding triggers biochemical reactions which allows for the enzymes, growth factors and immunologic substances to defend against infectious diseases for the infant; the breast milk has long-chain polyunsaturated fatty acids which help with normal retinal and neural development. The composition of breast milk changes depending on how long the baby nurses at each session, as well as on the child's age.
The first type, produced during the first days after childbirth, is called colostrum. Colostrum is easy to digest, it has a laxative effect that helps the infant to pass early stools, aiding in the excretion of excess bilirubin, which helps to prevent jaundice. It helps to seal the infants gastrointestional tract from foreign substances, which may sensitize the baby to foods that the mother has eaten. Although the baby has received some antibodies through the placenta, colostrum contains a substance, new to the newborn, secretory immunoglobulin A. IgA works to attack germs in the mucous membranes of the throat and intestines, which are most to come under attack from germs. Breasts begin producing mature milk around the fourth day after birth. Early in a nursing session, the breasts produce foremilk, a thinner milk containing many proteins and vitamins. If the baby keeps nursing hindmilk is produced. Hindmilk has texture because it contains more fat. Breastfeeding can begin after birth; the baby is placed on the feeding starts as soon as the baby shows interest.
According to some authorities the majority of infants do not begin to suckle if placed between the mother's breasts but rather enter a period of rest and quiet alertness. During this time they seem to be more interested in the mother's face her eyes, than beginning to suckle, it has been speculated tha
The uterine appendages are the structures most related structurally and functionally to the uterus. They can be defined in different ways: Some sources define the adnexa as the fallopian tubes and ovaries. Others include the supporting tissues". Another source defines the appendages as the "regions of the true pelvis posterior to the broad ligaments". One dictionary includes the fallopian tubes and ligaments; the term "adnexitis" is sometimes used to describe an inflammation of the uterine appendages. In this context, it replaces the terms salpingitis; the term adnexal mass is sometimes used when the location of a uterine mass is not yet more known. 63% of ectopic pregnancies present with an adnexal mass. Depending on the size of the mass, it could be a medical emergency. Term "Adnexectomy" in Gynaecology is used for Salpingo-Oophorectomy. Adnexa
The abdomen constitutes the part of the body between the thorax and pelvis, in humans and in other vertebrates. The abdomen is the frontal part of the abdominal segment of the trunk, the dorsal part of this segment being the back of the abdomen; the region occupied by the abdomen is termed the abdominal cavity. In arthropods it is the posterior tagma of the body; the abdomen stretches from the thorax at the thoracic diaphragm to the pelvis at the pelvic brim. The pelvic brim stretches from the lumbosacral joint to the pubic symphysis and is the edge of the pelvic inlet; the space above this inlet and under the thoracic diaphragm is termed the abdominal cavity. The boundary of the abdominal cavity is the abdominal wall in the front and the peritoneal surface at the rear; the abdomen contains most of the tubelike organs of the digestive tract, as well as several solid organs. Hollow abdominal organs include the stomach, the small intestine, the colon with its attached appendix. Organs such as the liver, its attached gallbladder, the pancreas function in close association with the digestive tract and communicate with it via ducts.
The spleen and adrenal glands lie within the abdomen, along with many blood vessels including the aorta and inferior vena cava. Anatomists may consider the urinary bladder, fallopian tubes, ovaries as either abdominal organs or as pelvic organs; the abdomen contains an extensive membrane called the peritoneum. A fold of peritoneum may cover certain organs, whereas it may cover only one side of organs that lie closer to the abdominal wall. Anatomists call the latter type of organs retroperitoneal. Digestive tract: Stomach, small intestine, large intestine with cecum and appendix Accessory organs of the digestive tract: Liver and pancreas Urinary system: Kidneys and ureters – but technically located in retroperitoneum – outside peritoneal membrane Other organs: SpleenAbdominal organs can be specialized in some animals. For example, the stomach of ruminants is divided into four chambers – rumen, reticulum and abomasum. In vertebrates, the abdomen is a large cavity enclosed by the abdominal muscles and laterally, by the vertebral column dorsally.
Lower ribs can enclose ventral and lateral walls. The abdominal cavity is upper part of the pelvic cavity, it is attached to the thoracic cavity by the diaphragm. Structures such as the aorta, inferior vena cava and esophagus pass through the diaphragm. Both the abdominal and pelvic cavities are lined by a serous membrane known as the parietal peritoneum; this membrane is continuous with the visceral peritoneum lining the organs. The abdomen in vertebrates contains a number of organs belonging, for instance, to the digestive tract and urinary system. There are three layers of the abdominal wall, they are, from the outside to the inside: external oblique, internal oblique, transverse abdominal. The first three layers extend between the vertebral column, the lower ribs, the iliac crest and pubis of the hip. All of their fibers merge towards the midline and surround the rectus abdominis in a sheath before joining up on the opposite side at the linea alba. Strength is gained by the criss-crossing of fibers, such that the external oblique are downward and forward, the internal oblique upward and forward, the transverse abdominal horizontally forward.
The transverse abdominal muscle is triangular, with its fibers running horizontally. It lies between the underlying transverse fascia, it originates from Poupart's ligament, the inner lip of the ilium, the lumbar fascia and the inner surface of the cartilages of the six lower ribs. It inserts into the linea alba behind the rectus abdominis; the rectus abdominis muscles are flat. The muscle is crossed by three fibrous bands called the tendinous intersections; the rectus abdominis is enclosed in a thick sheath formed, as described above, by fibers from each of the three muscles of the lateral abdominal wall. They originate at the pubis bone, run up the abdomen on either side of the linea alba, insert into the cartilages of the fifth and seventh ribs. In the region of the groin, the inguinal canal, a passage through the layers; this gap is where the testes can drop through the wall and where the fibrous cord from the uterus in the female runs. This is where weakness can form, cause inguinal hernias.
The pyramidalis muscle is triangular. It is located in the lower abdomen in front of the rectus abdominis, it is inserted into the linea alba halfway up to the navel. Functionally, the human abdomen is where most of the alimentary tract is placed and so most of the absorption and digestion of food occurs here; the alimentary tract in the abdomen consists of the lower esophagus, the stomach, the duodenum, the jejunum, the cecum and the appendix, the ascending and descending colons, the sigmoid colon and the rectum. Other vital organs inside the abdomen include the kidneys, the pancreas and the spleen; the abdominal wall is split into the posterior and anterior walls. The abdominal muscles have different important functions, they assist in the breathing process as accessory muscles of respiration. Moreover, these muscles serve as protection for the inner organs. Furthermore, together with the back muscles they provide postural support and are important in defining the form; when the glottis is closed and the thorax and pelvis are fixed, they are integral in the cough, defecation, childbirth and singing functions.
Ovulation is the release of eggs from the ovaries. In humans, this event occurs when the ovarian follicles rupture and release the secondary oocyte ovarian cells. After ovulation, during the luteal phase, the egg will be available to be fertilized by sperm. In addition, the uterine lining is thickened to be able to receive a fertilized egg. If no conception occurs, the uterine lining as well as blood will be shed during menstruation. In humans, ovulation occurs about midway after the follicular phase; the few days surrounding ovulation, constitute the most fertile phase. The time from the beginning of the last menstrual period until ovulation is, on average, 14.6 days, but with substantial variation between females and between cycles in any single female, with an overall 95% prediction interval of 8.2 to 20.5 days. The process of ovulation is controlled by the hypothalamus of the brain and through the release of hormones secreted in the anterior lobe of the pituitary gland, luteinizing hormone and follicle-stimulating hormone.
In the preovulatory phase of the menstrual cycle, the ovarian follicle will undergo a series of transformations called cumulus expansion, stimulated by FSH. After this is done, a hole called the stigma will form in the follicle, the secondary oocyte will leave the follicle through this hole. Ovulation is triggered by a spike in the amount of LH released from the pituitary gland. During the luteal phase, the secondary oocyte will travel through the fallopian tubes toward the uterus. If fertilized by a sperm, the fertilized secondary oocyte or ovum may implant there 6–12 days later; the follicular phase is the phase of the menstrual cycle. The follicular phase lasts from the beginning of menstruation to the start of ovulation. For ovulation to be successful, the ovum must be supported by the corona radiata and cumulus oophorous granulosa cells; the latter undergo a period of mucification known as cumulus expansion. Mucification is the secretion of a hyaluronic acid-rich cocktail that disperses and gathers the cumulus cell network in a sticky matrix around the ovum.
This network stays with the ovum after ovulation and has been shown to be necessary for fertilization. An increase in cumulus cell number causes a concomitant increase in antrum fluid volume that can swell the follicle to over 20 mm in diameter, it forms a pronounced bulge at the surface of the ovary called the blister. Estrogen levels peak towards the end of the follicular phase; this causes a surge in levels of follicle-stimulating hormone. This lasts from 24 to 36 hours, results in the rupture of the ovarian follicles, causing the oocyte to be released from the ovary. Through a signal transduction cascade initiated by LH, proteolytic enzymes are secreted by the follicle that degrade the follicular tissue at the site of the blister, forming a hole called the stigma; the secondary oocyte leaves the ruptured follicle and moves out into the peritoneal cavity through the stigma, where it is caught by the fimbriae at the end of the fallopian tube. After entering the fallopian tube, the oocyte is pushed along by cilia, beginning its journey toward the uterus.
By this time, the oocyte has completed meiosis I, yielding two cells: the larger secondary oocyte that contains all of the cytoplasmic material and a smaller, inactive first polar body. Meiosis II follows at once but will be arrested in the metaphase and will so remain until fertilization; the spindle apparatus of the second meiotic division appears at the time of ovulation. If no fertilization occurs, the oocyte will degenerate between 24 hours after ovulation. 1-2% of ovulations release more than one oocyte. This tendency increases with maternal age. Fertilization of two different oocytes by two different spermatozoa results in fraternal twins; the mucous membrane of the uterus, termed the functionalis, has reached its maximum size, so have the endometrial glands, although they are still non-secretory. The follicle proper has met the end of its lifespan. Without the oocyte, the follicle folds inward on itself, transforming into the corpus luteum, a steroidogenic cluster of cells that produces estrogen and progesterone.
These hormones induce the endometrial glands to begin production of the proliferative endometrium and into secretory endometrium, the site of embryonic growth if implantation occurs. The action of progesterone increases basal body temperature by one-quarter to one-half degree Celsius; the corpus luteum continues this paracrine action for the remainder of the menstrual cycle, maintaining the endometrium, before disintegrating into scar tissue during menses. The start of ovulation can be detected by signs; because the signs are not discernible by people other than the female, humans are said to have a concealed ovulation. In many animal species there are distinctive signals indicating the period when the female is fertile. Several explanations have been proposed to explain concealed ovulation in humans. Females near ovulation experience changes in the cervical mucus, in their basal body temperature. Furthermore, many females experience secondary fertility signs including Mittelschmerz and a heightened sense of smell, can sense the precise moment of ovulation.
Many females experience heightened sexual desire in the several days before ovulation. One study concluded. Symptoms related to the onset of ovulation, the moment of ovulation a
The pelvis is either the lower part of the trunk of the human body between the abdomen and the thighs or the skeleton embedded in it. The pelvic region of the trunk includes the bony pelvis, the pelvic cavity, the pelvic floor, below the pelvic cavity, the perineum, below the pelvic floor; the pelvic skeleton is formed in the area of the back, by the sacrum and the coccyx and anteriorly and to the left and right sides, by a pair of hip bones. The two hip bones connect the spine with the lower limbs, they are attached to the sacrum posteriorly, connected to each other anteriorly, joined with the two femurs at the hip joints. The gap enclosed by the bony pelvis, called the pelvic cavity, is the section of the body underneath the abdomen and consists of the reproductive organs and the rectum, while the pelvic floor at the base of the cavity assists in supporting the organs of the abdomen. In mammals, the bony pelvis has a gap in the middle larger in females than in males, their young pass through this gap.
The pelvic region of the trunk is the lower part of the trunk, between the thighs. It includes several structures: the bony pelvis, the pelvic cavity, the pelvic floor, the perineum; the bony pelvis is the part of the skeleton embedded in the pelvic region of the trunk. It is subdivided into the pelvic spine; the pelvic girdle is composed of the appendicular hip bones oriented in a ring, connects the pelvic region of the spine to the lower limbs. The pelvic spine consists of the coccyx; the pelvic cavity defined as a small part of the space enclosed by the bony pelvis, delimited by the pelvic brim above and the pelvic floor below. Each hip bone consists of 3 sections, ilium and pubis. During childhood, these sections are separate bones, joined by the triradiate cartilage. During puberty, they fuse together to form a single bone; the pelvic cavity is a body cavity, bounded by the bones of the pelvis and which contains reproductive organs and the rectum. A distinction is made between the lesser or true pelvis inferior to the terminal line, the greater or false pelvis above it.
The pelvic inlet or superior pelvic aperture, which leads into the lesser pelvis, is bordered by the promontory, the arcuate line of ilium, the iliopubic eminence, the pecten of the pubis, the upper part of the pubic symphysis. The pelvic outlet or inferior pelvic aperture is the region between the subpubic angle or pubic arch, the ischial tuberosities and the coccyx. Ligaments: obturator membrane, inguinal ligament Alternatively, the pelvis is divided into three planes: the inlet and outlet; the pelvic floor has two inherently conflicting functions: One is to close the pelvic and abdominal cavities and bear the load of the visceral organs. To achieve both these tasks, the pelvic floor is composed of several overlapping sheets of muscles and connective tissues; the pelvic diaphragm is composed of the coccygeus muscle. These arise between the symphysis and the ischial spine and converge on the coccyx and the anococcygeal ligament which spans between the tip of the coccyx and the anal hiatus; this leaves a slit for the urogenital openings.
Because of the width of the genital aperture, wider in females, a second closing mechanism is required. The urogenital diaphragm consists of the deep transverse perineal which arises from the inferior ischial and pubic rami and extends to the urogential hiatus; the urogenital diaphragm is reinforced posteriorly by the superficial transverse perineal. The external anal and urethral sphincters close the urethra; the former is surrounded by the bulbospongiosus which narrows the vaginal introitus in females and surrounds the corpus spongiosum in males. Ischiocavernosus clitoridis. Modern humans are to a large extent characterized by large brains; because the pelvis is vital to both locomotion and childbirth, natural selection has been confronted by two conflicting demands: a wide birth canal and locomotion efficiency, a conflict referred to as the "obstetrical dilemma". The female pelvis, or gynecoid pelvis, has evolved to its maximum width for childbirth—a wider pelvis would make women unable to walk.
In contrast, human male pelvises are not constrained by the need to give birth and therefore are more optimized for bipedal locomotion. The principal differences between male and female true and false pelvis include: The female pelvis is larger and broader than the male pelvis, taller and more compact; the female inlet is oval in shape, while the male sacral promontory projects further. The sides of the male pelvis converge from the inlet to the outlet, whereas the sides of the female pelvis are wider apart; the angle between
Menstruation known as a period or monthly, is the regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina. The first period begins between twelve and fifteen years of age, a point in time known as menarche. However, periods may start as young as eight years old and still be considered normal; the average age of the first period is later in the developing world, earlier in the developed world. The typical length of time between the first day of one period and the first day of the next is 21 to 45 days in young women, 21 to 31 days in adults. Bleeding lasts around 2 to 7 days. Menstruation stops occurring after menopause, which occurs between 45 and 55 years of age. Periods stop during pregnancy and do not resume during the initial months of breastfeeding. Up to 80% of women report having some symptoms prior to menstruation. Common signs and symptoms include acne, tender breasts, feeling tired and mood changes; these may interfere with normal life, therefore qualifying as premenstrual syndrome, in 20 to 30% of women.
In 3 to 8%, symptoms are severe. A lack of periods, known as amenorrhea, is when periods do not occur by age 15 or have not occurred in 90 days. Other problems with the menstrual cycle include painful periods and abnormal bleeding such as bleeding between periods or heavy bleeding. Menstruation in other animals occur in primates; the menstrual cycle occurs due to the fall of hormones. This cycle results in the thickening of the lining of the uterus, the growth of an egg; the egg is released from an ovary around day fourteen in the cycle. If pregnancy does not occur, the lining is released in; the first menstrual period occurs after the onset of pubertal growth, is called menarche. The average age of menarche is 12 to 15. However, it may start as early as eight; the average age of the first period is later in the developing world, earlier in the developed world. The average age of menarche has changed little in the United States since the 1950s. Menstruation is the most visible phase of the menstrual cycle and its beginning is used as the marker between cycles.
The first day of menstrual bleeding is the date used for the last menstrual period. The typical length of time between the first day of one period and the first day of the next is 21 to 45 days in young women, 21 to 31 days in adults. Perimenopause is when fertility in a female declines, menstruation occurs less in the years leading up to the final menstrual period, when a female stops menstruating and is no longer fertile; the medical definition of menopause is one year without a period and occurs between 45 and 55 in Western countries. During pregnancy and for some time after childbirth, menstruation does not occur; the average length of postpartum amenorrhoea is longer. In most women, various physical changes are brought about by fluctuations in hormone levels during the menstrual cycle; this includes muscle contractions of the uterus that can accompany menstruation. Some may notice water retention, changes in sex drive, breast tenderness, or nausea. Breast swelling and discomfort may be caused by water retention during menstruation.
Such sensations are mild, some females notice few physical changes associated with menstruation. A healthy diet, reduced consumption of salt and alcohol, regular exercise may be effective for women in controlling some symptoms. Severe symptoms that disrupt daily activities and functioning may be diagnosed as premenstrual dysphoric disorder. Symptoms before menstruation are known as premenstrual molimina. Many women experience painful cramps known as dysmenorrhea, during menstruation. Pain results from muscle contractions. Spiral arteries in the secretory endometrium constrict, resulting in ischemia to the secretory endometrium; this allows the uterine lining to slough off. The myometrium contracts spasmodically in order to push the menstrual fluid through the cervix and out of the vagina; the contractions are mediated by a release of prostaglandins. Painful menstrual cramps that result from an excess of prostaglandin release are referred to as primary dysmenorrhea. Primary dysmenorrhea begins within a year or two of menarche with the onset of ovulatory cycles.
Treatments that target the mechanism of pain include non-steroidal anti-inflammatory drugs and hormonal contraceptives. NSAIDs inhibit prostaglandin production. With long-term treatment, hormonal birth control reduces the amount of uterine fluid/tissue expelled from the uterus, thus resulting in shorter, less painful menstruation. These drugs are more effective than treatments that do not target the source of the pain. Risk factors for primary dysmenorrhea include: early age at menarche, long or heavy menstrual periods, a family history of dysmenorrhea. Regular physical activity may limit the severity of uterine cramps. For many women, primary dysmenorrhea subsides in late second generation. Pregnancy has been demonstrated to lessen the severity of dysmenorrhea, when menstruation resumes. However, dysmenorrhea can continue until menopause. 5–15% of women with dysmenorrhea experience symptoms severe enough to interfere with daily activities. Secondary dysmenorrhea is the diagnosis given when menstruation pain is a secondary cause to another disorder.