Breast milk (stanya) is the nourishing fluid that is produced in the breasts (stana) forming the primary food for the infants. In Ayurveda, according to the branch ‘Kaumarabhritya’ includes the diseases in the neonates and infants. The diseases of newborn are caused by faulty nutrition, vitiated breast milk (dushta stanya or dosha) and presence of psychiatric conditions (graha dushti). (Su Sa. Sutra Sthana 1/8/5) There is emphasis on breast feeding explained through the concept of stanya vignyana. The knowledge or literature available on stanya is dispersed in various parts across different Samhita. This article deals with all the basic concepts related to stanya and breast milk in terms of pathology, physiology and therapeutics as mentioned in the Ayurveda Samhita and possible research perspectives in the field.
| Section/Chapter/topic | Concepts/Stanya |
|---|---|
| Authors | Bhojani M. K. 1, Joglekar Aishwarya 2 |
| Reviewer | Basisht G.3, |
| Editor | Deole Y.S.4 |
| Affiliations |
1 Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India 2 Department of Samhita Siddhant, All India Institute of Ayurveda, New Delhi, India 3 Rheumatologist, Orlando, Florida, U.S.A. 4 Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India |
| Correspondence emails |
meera.samhita@aiia.gov.in, carakasamhita@gmail.com |
| Publisher | Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India |
| Date of publication: | September 27, 2023 |
| DOI | 10.47468/CSNE.2023.e01.s09.152 |
Etymology
“Stanodbhavam stanyam”- the entity produced or secreted from breast (stana) is termed as ‘stanyam’. (Dalhana on Su. Sa. Nidana Sthana 10/18) Monniere Williams dictionary mentions it as that which is drawn from the breast i.e. breast milk or mothers milk.[1]
Synonyms
Naari ksheer, naari dugdha, stree dugdha, stree ksheera, ksheera, dugdha, manusha ksheera, manusha dudha, stanodbhava, yoshita stanya
Physiology of stanya according to ayurveda
Stanya is regarded as upadhatu (the minor structural components that stabilize and sustain the body) and prasada bhaga (essence or formed from nutrient part) of rasa dhatu metabolism, produced in the breast/mammary glands in females. [Cha. Sa. Chikitsa Samhita 15/17, Bhoja Samhita] Bhoja mentions stanya as not having any movement or physiological functions in body (gativivarjita) as it does not participate in further metabolic activities in the body. Sushruta mentions stanya as a product of digested food (pakwahara). [Su. Sa. Nidana Sthana 10/18] Like shukra, its presence is felt across the body. [Su. Sa. Nidana Sthana 10/19]
Kashyapa opines that stanya is produced from the rakta dhatu. [Kashyapa Samhita Rakta Gulma Adhyaya] This can be justified as the stanya is produced and expressed from the stana which consists of sira which are the upadhatu of rakta dhatu.
The metabolism of rasa- rakta dhatu form the major canvas for the understanding the stanya physiology. Like menstruation (artava), stanya is observed for limited time during the course of life of a female i.e. post delivery period or lactation period. Sushruta states that it is expressed within 3 of 4 days of child birth and its secretion continues till the stanyapanayana or weaning occurs. [Su. Sa. Shareera Sthana 10/14] [A.H. Uttar Tantra 1/14]
The development of breasts occurs after the menarche by physiologically accelerated growth of mammary glands during the pregnancy. [Su. Sa. Nidana Sthana 10/17] In the state of pregnancy, the rasa dhatu metabolism is directed towards stanya formation. [Cha. Sa. Shareer Sthana 6/23 ,Kashyap Samhita Sutrasthana 1]
As per Vagbhat, the gross amount of breast milk (stanya) present in an individual is 2 anjali[2] (approximately 200ml with 1 anjali corresponding to 135ml according to a previous study). [A.H. Shareera Sthana 3/81] According to contemporary approach average breast milk production is about 500-700ml per day.[3] It is defined to have pure white colour and becomes homologous with water when mixed. It possesses a characteristic sweet/ madhura smell when unvitiated. [Su. Sa. Shareera Sthana 8/14, Su. Sa. Nidana Sthana 10/25] Any deviation from the normal colour and consistency of stanya reflects underlying pathological condition. Sushruta has also explained the physiology of stanya.
Following factors are responsible for the appearance of breast milk in the post-natal period which also facilitates the process of labour. [Su. Sa. Nidana Sthana 10/22]-
- Apatya sparsha- Touching the child.
- Apatya darshana- Sight of the new-born.
- Apatya smarana- Thinking about the child.
- Grahanat shareerasya¬- Holding the new-born close to the mother.
Contemporary view also suggests that the hormonal and emotional factors play a key role in the breast milk physiology.[4] Thus in the conditions like decreased lactation (stanya-kshaya), counselling can prove to be more beneficial.
The main function of stanya is providing the nourishment to child as explained through the jeevana karma (promoting vitality). [Su. Sa. Sutra Sthana 15/14] The entire sustainance of the child for the first six months to one year is dependent on the stanya, which also determines the health profile of the infant. Another karma of stanya is peenatvajanana i.e. providing proper structure and nourishment to the stana or breast tissue. [Su. Sa. Sutra Sthana 15/5] Kashyapa has also emphasized the same stating the breast milk as jeevana (vitalizer), pushtikara (nourishing), vriddhikara (growth promoting), balavardhana (strengthening), ojaskara (promotinig essence part of life) [Kashyap Samhita Ksheera Vigyana Adhyaya]
Ayurveda mentions that the, expression of breast milk from the right breast at first is indicative of male progeny, while that from left breast is indicative of female progeny. [Su. Sa. Shareera Sthana 3/34, Cha. Sa. Shareera Sthana 2/24]
Breas milk (stanya) is formed in the mammary glands (stanyavahi sira) in breasts (stana). Stanyashaya (site of breast milk) is also termed as ‘ksheerashya’ or a part of 'strotas’ comprising of stanyavaha sira present exclusively in females. [Su. Sa. Shareera Sthana 5/10] Blood vessels in chest (vakshagata sira) representing the rakta dhatu are also present in the stana comprising of stanamoola sira, which are two in number. [Su. Sa. Shareera Sthana 5/37, Su. Sa. Shareera Sthana 7/22] It is the abode of two mansa- marma namely ‘Stana-Rohita’ and ‘Stana-Moola’ injury to which can lead to number of complications. [Su. Sa. Shareera Sthana 6/35]
Structural part of stana mainly comprises of mansa dhatu and consists of about 10 peshi (muscles), which are absent in males and undergo physiological hypertrophy during youth. [Su. Sa. Shareera Sthana 5/39] Two dhamani are present in stana of female according to Sushruta. [Su. Sa. Shareera Sthana 9/5] Charak has described normal anatomical positioning, shape and size of stana. [Cha. Sa. Shareera Sthana 8/14] Normal characteristics of stana sampat are not too highly positioned (na-atiurdhwa), not too elongated (na-ati lamba), not much emaciated (anati krisha), not overly nourished (anati peenau), nipples of appropriate size (yukta pippalikau) and nipples not retracted and easy for suckling (sukha prapannau). The description of stana is identical to that given by the modern science. Nipples situated at upper side of breasts (urdhwastana) can lead to visual abnormalities in child. While nipples at elongated side of breasts (lambastana) leads to covering of face of child, which might lead to suffocation. [Su. Sa. Shareera Sthana 10/25, Cha. Sa. Shareera Sthana 8/33] Thus the prenatal and antenatal examination of breast is important to avoid such complications.
Characteristics and diagnostic aspects concerning Stanya
The stanya dushti and its presentation in different neonates can be understood by the application of objective parameters like laboratory investigations and physico-chemical analysis along with the qualitative assessment. Sushruta has thus advised to examine the stanya by putting the drops of stanya in clear water. The appearance of shankha (conch) like white colour and homogeneity of mixture, absence of effervescence (phena), thread like appearance (tantumatva), does not float on the surface (no-utplavati), does not get precipitated) (na avasidati) is considered to be the features of shuddha stanya and keeps the child healthy (aarogya), gives proper growth and development (shareeropachaya) and improves strength (bala vriddhi) in child (kumara). [Su. Sa. Shareera Sthana 10/31]
The different diagnostic parameters concerning the metabolism of stanya are explained in the figure underneath (Figure no. 1)
Pharmacological properties of breast milk
- Rasa (taste): madhura (sweet) and slight astringent (kashaya)
- Veerya (potency): sheeta (cold)
- Guna (quality): light to digest (laghu)
- Useful in nasya (nasal therapy), aschyotana (eye drops), as wholesome (pathya) and vitalizer (jeevana) [Su. Sa. Sutra Sthana 45/57]
- It shall not be boiled [Su. Sa. Sutra Sthana 45/62]
- Curd made out of breast milk possesses unctuous (snigdha), heavy to digest (guru), sweet(madhura) properties. It has balya (strengthening), santarpana (satiating), chakshushya (beneficial for eyes) and doshaghna properties. [Su. Sa. Sutra Sthana 45/73]
- Ghrita (ghee) prepared out of stanya is easy to digest, chakshushya (beneficial for eyes) and anti-toxic (vishaghna) leading to enhancement of agni and nourishing to body.
It is used in the ocular therapies (prasadana putapaaka) for purpose of rejuvenation to eyes. [A.H. Sutra Sthana 24/16] It is also used as a medium for the proper attachment of jalauka(leech) during raktamokshana. [A.H. Sutra Sthana 26/41]
The vitiation of stanya leads to dosha vitiation in the child causing range of diseases. Dalhana mentions that the diseases occur due to consumption of vitiated stanya by the child. [Dalhana on Su. Sutra Sthana 1/7/5] The stana roga like stana-vidradhi (abscess), stana-granthi (cyst) predominantly occur after the development of stana or mammary glands according to the Sushrut Samhita. [Su. Sa. Sutra Sthana 10/17, 26, A.H. Chikitsa Sthana 13/28].
1) Dosha vaishamya (disequilibrium of dosha)
As mentioned earlier the pathology or the vitiation of normal physiology of stanya is the main reason behind the occurrence of diseases in the new-born. The basic dosha disequilibrium (vaishamya) can be understood as depletion (kshaya) and increase (vriddhi). It can be summarized in the table given below:(Table No. 1 – types of Vaishamya its features and understanding concerning Stanya)