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Secretion of the Mammary Gland in the Newborn

milk, gm, birth, mother and cells

SECRETION OF THE MAMMARY GLAND IN THE NEWBORN Symptoms.—On about the second or third day, rarely later, one notices almost invariably in every newborn child, without regard to sex, a swelling of the breast which increases on the following days and usually reaches its acme from the eighth to the twelfth day. From this time on the swelling gradually diminishes and disappears completely in the third or fourth week. The skin is entirely unchanged over the swell ing. On squeezing the gland a milky secretion exudes which is called "witch's milk." This secretion has been examined repeatedly and con tains much albumin, casein, fat, milk-sugar, and salts; its ash contains chlorine, phosphoric acid, sodium, potassium, magnesium and iron. It is similar in composition to colostrum. Chemical analysis of this secretion in Genscr's case gave the following quantities per litre: 5.57 Gm. casein; 4.90 Gm. albumin; 9.56 Gm. rnilk-sUgar; 14.56 Gm. fat; 8.26 Gm. inorganic salts. Microscopically are found milk globules, leucocytes and so-called colostrum corpuscles which, according to Czerny, are milk glob ules laden with leucocytes, or according to others with epithelial cells. The secretion of milk persists usually into the llth month. It is said that this secretion may be kept up for a very long time by regularly emptying the gland of its contents. This secretion of the mammary gland in the newborn must he regarded as a physiological process. Whereas former theories sought to explain this secretion on the ground of a fatty meta morphosis of the central cells of the foetal "anlage" of the gland, which is solid Biker), or with a desquamation of the glandular epithelium (Epstein), we at present believe that the same stimulation which calls forth the development of the mammary gland in the mother operates on the mammary gland of the foetus and produces the same reaction (Knopfclmacher). According to J. Halban this agent is a secretion of

the placenta and moreover of the epithelium of the chorion. The secre tion passes into the maternal blood and then into the foetal circulation and causes development of the lacteal gland. This explanation how ever does not cover the fact that the secretion of milk does not start until the fcctus has been born. At birth the mammary gland of the newborn shows similar changes to that of the mother; proliferated, feebly staining epithelium, dilated ducts, and surrounding the ducts, haemorrhages, lencocytes, eosinophiles and giant cells. Shortly after birth the so-called "puerperal involution" (Ilalban) commences, which operates upon the breast of the child in the same way as it does upon that of a non-nursing mother. The excitation of the milk secretion after birth, which probably depends upon the same cause in both mother and child, is supposed to be due to a cessation of the placental action. A ferment secreted by the placenta inhibits the secretion; its cessation, as the result of the birth, is followed by secretion. Schein assumes a hyperfemia of the gland to be responsible for this. This explanation, however, does not seem to be satisfactory and we must say that the cause for the excitation of the milk secretion is not yet clearly established.