Hi Kika,

The question you are asking is right up my alley of interest/research, and I have listed a couple of articles below. While estrogen can stimulate prolactin, it appears to interfere with lactation at the local level of the breast.  Even with high prolactin levels, estrogen can interfere with milk synthesis.  



The Nedkova study is in Bulgarian but I have a rough English translation that I'd be happy to share with you. 



From the Ingram study which looked at various hormones at two time points postpartum: "At 4 wk, higher postpartum oestradiol levels had a negative association and antenatal progesterone levels a positive association with milk output."



The two Stuebe articles discuss normal/abnormal hormones, but not estradiol levels specifically. I include them below in case you are still interested in that information. 



I also ran across the interesting Valdes article on prolactin & estrogen levels at month 3 pp & relationship to return of menses. It is in Spanish (except for English abstract) and I had to use google translate to read. Unfortunately, the tables did not translate. I am sure there is someone on Lactnet who is more fluent in Spanish who could peruse for useful information.



I would be very interested to hear what you deduce from this information.



~Lisa Marasco





Nedkova, V., & Tanchev, S. (1995). [Serum levels of prolactin, progesterone and estradiol in nursing mothers]. Akush Ginekol (Sofiia), 34(3), 22-23.  Retrieved from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8743840



Ingram, J. C., Woolridge, M. W., Greenwood, R. J., & McGrath, L. (1999). Maternal predictors of early breast milk output. Acta Paediatr, 88(5), 493-499.  Retrieved from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10426170  



Valdes, P., & Orellana, J. J. (2007). [Post suckling prolactin and estradiol levels as predictors of the time of appearance of the first post partum menstruation]. Rev Med Chil, 135(4), 419-426. doi:/S0034-98872007000400002



Stuebe, A. M., Grewen, K., Pedersen, C. A., Propper, C., & Meltzer-Brody, S. (2012). Failed lactation and perinatal depression: common problems with shared neuroendocrine mechanisms? J Womens Health (Larchmt), 21(3), 264-272. doi:10.1089/jwh.2011.3083



Stuebe, A. M., Meltzer-Brody, S., Pearson, B., Pedersen, C., & Grewen, K. (2015). Maternal Neuroendocrine Serum Levels in Exclusively Breastfeeding Mothers. Breastfeeding Medicine, 10(4), 197-202.



********************

I am working with the mother of a preemie who is having big time production issues, and I am at a loss as to what to do next.



The beginning was a disaster because she received no support at all the first days so she did not start pumping until the third day after her child was born. I started working with her two weeks after birth, when she was pumping four times a day with a hand pump and getting about 5 ml per session.



Production has not gone above 60 ml per day. She is pumping ten times a day, good double hospital grade pump, right flanges, has support from her husband and personnel, is doing skin to skin several hours a day. She is on domperidone. The baby is doing well, she has had no major complications and is thriving. She is now 34 weeks, and will be discharged next week.



She had a hormone test last week and she has just sent me the results. I am having a very hard time finding information to interpret them and yes, I´m a doctor!!!! I cannot find normal levels of some hormones during lactation in the literature.



The blood was drawn 4 days before her period, so pre-mentrual (end of lutheal phase). FSH is low (2 mUI/ml), LH is also low (0.4 mUI/ml), 17-beta estradiol is high (170.2 pg/ml) and prolactin is high (176.3 ng/ml).

Thyroid function is normal.



It seems to me that LH should be higher and that estradiol should be low...

but, as I said, I cannot find normal values in breastfeeding women.





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