Jan Aken wrote:

<My thinking was always that the weight of the fat on the mammary ducts
caused an almost tight binder or crushing effect the in the breast
secretory cells and thus causing the breast to go into a pseudo weaning
mode. Just my opinion.>

Another opinion. I wonder if it might not be partially connected with
insufficient stimulation of the nerves that cause prolactin secretion,
due to overall shallower latch? And or reduced frequency of
breastfeeding? While there is no fat between the skin and the glandular
tissue of the nipple-areolar complex, previous deposition of fat in very
large breasts is said to be a contributing factor to the degree of nipple
inversion or at least, less eversion.
Schwager RG, Smith JW, Fray GF, Goulian D Jr., Inversion of the Human
Female Nipple, With a Simple Method of Treatment, Plastic &
Reconstructive Surgery, Nov. 1974, Vol. 54, No. 5 pp. 564-569.
Actually, to provide space for the expanding alveolar system, the fatty
cells around the milk-making tissue itself are to some appreciable degree
reabsorbed for raw material during lactation. The process reverses during
involution between pregnancies and/or menopause. Fascinating to read
about:
Russo J, lRusso IH Development of the Human Mammary Gland in: The Mammary
Gland, Development, Regulation, and Function ed. by Neville MC, Daniels
CW 1987 Plenum Press, NY. pp 67-93.
Interesting pie chart of differing amounts of different types of tissue
depending on age/parity (p. 89).  Also, more info on fat cells around the
secretory tissues of the breast:
Neville MC, Physiology of Lactation, In: Clinical Aspects of Human Milk
and Lactation In: Clinics in Perinatology, ed. by Wagner CL and Purohit
DM, WB Saunders, Philadelphia, 1999, 26(2):251-279.
I believe this article, or the one preceding it in 1997, was discussed
several weeks ago on LN, and someone very astute (Valerie??) pointed out
that the study did not seem to have any information about who (just the
mother's word for it?) was observing the actual breastfeeding process to
assess the effectiveness of the latch, the feeding patterns, frequencies
etc. etc., all of which could impact the prolactin level, which is what
was actually reported on in the original article.

<The researchers found that the overweight and obese women produced
dramatically less prolactin 48 hours after birth and moderately less
seven days after birth compared with the women who were not overweight.>

<Rasmussen says that although obese women might have trouble
breast-feeding for a combination of physical reasons, the new study is
the first to find a biological reason. >

However, the physical reasons may have a direct connection to the
biological reasons. One possible physical reason might be connected with
the fact that obesity often complicates the course of pregnancy and
labor, leading to more interventions, which lead to more postpartum
breast swelling, which might conceivably result in less prolactin
stimulation, and more possible complication to the initiation of
breastfeeding associated with distortion of the nipple-areolar complex
leading to less-than-optimal latch, as well as the slower delivery of
hormones from the blood stream through edematous intersitial tissue to
the alveoli. Whew! (Reminds me of the song about "The headbone connected
to the neckbone . . . . .legbone connected to the thigh bone .. . . .)

Inquiring minds also wonder where insulin resistance might factor into
all of this.

This article makes a good springboard for further research. So much more
fascinating informatiion yet to learn! Just my opinion.

Jean
************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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