Laurie asks when you can tell that endocrine control of milk synthesis has
been taken over by autocrine control.  In my clinical observations I used
to say it was around 6 to 8 weeks, when the breasts stopped feeling full
before every feed, responding more closely to the infant's needs.  This
also seemed to correlate with the published data for when the falling
prolactin levels reached near baseline.
HOWEVER, in my discussions with Prof Peter Hartmann he feels that as soon
as the initial endocrine melee which occurs at birth has happened and
caused Lactogenesis II then autocrine control begins.  I can see the
scientific rationale here.
Prolactin, while we know that it doesn't control milk synthesis, is very
important for the production of breastmilk ... those levels still being
high seem to have an effect (in my clinical experience) on milk production.
What are others thoughts on the science and the art of this part of lactation?

Denise

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Denise Fisher MMP, BN, IBCLC
BreastEd Online Lactation Studies
http://www.health-e-learning.com

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