Pamela Edenfield asks "for some information on stress and it's
relationship to decreased milk supply."


The Pediatric Clinics of North America February 2001, Part I, The Evidence of
Breastfeeding has an entire section on this topic!  The Effects of Stress on
Lactation.
Pp. 221-234 with 4 1/2 pages of bibliography.

Here are some quotes:  Based on animal studies, stress may suppress lactation
directly by inhibiting prolactin and oxytocin or indirectly by action on
specific regions
in the CNS such as through activation of a sympathetic CNS. The peripheral
inhibition
of milk ejection through activation of the sympathoadrenomedullary system
also has
been demonstrated.  This likely occurs by vasoconstriction at the level of
the mammary glands, stimulation of the mammary myoepithelial cells, or potential
increase in
mammary ductal tone. Depending on the duration of the stress and its site(s)
of
action, suppression of lactation may result from a decrease in milk synthesis
or
ejection. These two components may be altered as a direct effect of the
stressor
on prolactin or oxytocin or secondary to the alteration of either of these
components.
For instance, if the acute stressor hampers milk synthesis, its suppressive
effect on lactation is apparent only later because a delay of 8 to 12 hours
exists between prolactin release and the resulting milk synthesis; however, if
the acute exposure to a stimulus is
inhibitory to milk ejection, an immediate decrease in milk release occurs
because
milk ejection may be suppressed by a decrease in oxytocin or activation of the
 central or peripheral sympathetic system. This effect is expected to be
short-lived
because milk synthesis is not affected. If an acute stressor acts on both
milk synthesis
and ejection, a rapid and prolonged decrease in milk release is expected
because of
the immediate suppression of milk ejection and the delayed suppression of
milk synthesis.
If exposure to a stressor is prolonged and the stimulus is inhibitory to milk
synthesis,
a decrease in milk release ensues as a consequence of decreased milk
availability.  Prolonged exposure to a stressor that affects milk ejection leads to
suppression of
lactation secondary to inhibition of milk synthesis as a result of incomplete
breast emptying.

Mardrey Swenson  IBCLC

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