Chris,
I agree that an MRI is non-invasive, and at the very least, might be
reassuring.
I found my reference, a detailed one 44 pages long, containing 199
citations in the bib.
Ostroni, KM, A Review of the Hormone Prolactin, Progress in Food and
Nutrition Science, vol. 14, pp. 1-44, 1990 Pergamon Press
In this quote, I am unable to make the proper symbol for part of the
prolactin measurement, so I will substitute "ug/L"
"The measurement of prolactin is hindered by the natural reactivity of
the hormone in circulation. Prolactin release is episodic, follows a
circadian rhythm and is responsive to stress. The hormone has a
relatively short half-life in blood of 15-20 minutes. Factors which
affect prolactin release are pregnancy, lactation, stress, sleep,
hypothyroiism, estrogen, exercise hypoglycemia and breast stimulation, in
order of their effect. . . . . . . ."
"The timimg and method of withdrawal can be critical factors when
collecting blood samples for prolactin measurement and comparison.
Prolactin secretion varies diurnally with increased levels during aleep
and basal levels are not re-established before 8:00 a.m. . . . . .Thus,
blood samples collected in the morning have higher prolactin levels than
afternoon samples. . . . . ."
"The consumption of food appears to have a rapid and pronounced effect on
prolactin release. . . . . Greater control of results can be obtained by
having patients fast and rest to relieve stress before sampling. . . . .
."
"Battin et al conducted a study of prolonged lactation up to six months
in eight women. Basal serum prolactin at day ten was 90.1ug/L; at day
180, 44.2 ug/L. Suckling doubled the baseline values to 188.9 +/- 33.1
and 80.1+/- 8.5 ug/L, respectively. Peak prolactin values were always
greater than 45 ug/L Baseline prolactin remained elevated throughout the
first six months postpartum when reguar nursing occurred every three to
four hours. Baseline values were still doubled in response to nursing at
six months."
In a nutshell, it seems to show that deciding when to collect the
prolactin level in relation to time of day, fasting/fed state of mother,
age of baby, number of breastfeedings in 24 hours, time since last
breastfeeding, etc. must make a great deal of difference in how to
interpret the results in a lactating woman.
Jean
*************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA
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