In trying to understand the relationship between the delay in an engorgement
phase caused by this phenomenon, I've wondered if something about edema
"distracts" prolactin away from target receptors in the breast.  Prolactin
has
other "jobs and duties" in the body  such as control of homeostasis.  Do
these duties take precedent over lactation in a hypertensive crisis, for
instance?

Could the same type of reasoning also be applied to delayed lactogenesis
after a c-section. Not in the edema sense, but with the idea that having a
c-section is a real  (surgical)stress for the body. If you think about it,
with a c-section you have two stresses; removing the baby and placenta with
all the changes in haemodynamics plus the actual surgery and anaethesia. It
is well known that the body produces a stress response after surgery. Could
this (extra) stress response also be a reaon why lactogenesis can be delayed
after a c-section (so I've been told). Don't have a clue about the
specifics, it's only a theory and I appologise now if it's already written
in the bf text books! Could stress hormones be blocking the release of
prolactin or its actions? Maybe the edema also causes stresses to the body
like surgery and the result is ultimately the same  - prolactin resistance?

Here's another idea, which might be way of ball, but anyway. NIDDM patients
have insulin resistance. Once way of helping decrease insulin resistance in
tissues (i.e. muscle) is to exercise and train them, this also has to do
with insulin receptors. Could this work in the breasts - does training the
breast (i.e. pumping in Barbara's post) decrease prolactin resistance - if
it exists of course - by making the lactocytes more likely to bind
prolactin?

Sara Bernard - wishing I could remember all that physiology!
The Netherlands

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