Just wanted to comment on the information here that states milk supply will drop at 3 months without effective nipple stimulation due to a decrease in prolactin. From what I have read (and I recently confirmed this with breastmilk synthesis researcher Dr. Hartmann in Australia) this is not accurate. The change from endocrine (hormonal) control of milk syntheses to control at the breast (autocrine) does not occur at 3 months rather in the first week following delivery. Here are a couple quick references:
"The onset of copious milk secretion after birth is lactogenesis, stage II (days 2 or 3 to 8 postpartum ) ." p. 73; "Following lactogenesis II, milk production shifts from endocrine to autocrine control." p. 91; From "Breastfeeding and Human Lactation, 3rd Ed. by Jan Riordan.
Breastfeeding Answers Made Simple, pp. 393-394:"After the hormonal chain of events that occurs during the first days after birth, it appears hormones play only a minor role in establishing and maintaining milk production (Cox, Owen, & Hartmann, 1996Íž De Coopman, 1993). The hormonal influence on milk production is sometimes referred to as "endocrine control." After that, the most important aspect of establishing ample milk production is draining the breast often and well, which is sometimes referred to as "autocrine" or local control."
There's also a nice diagram on the kellymom website: http://kellymom.com/pregnancy/bf-prep/milkproduction/
In addition, from what I have read prolactin is permissive rather than regulatory, so the fact that prolactin drops at 3 months should not impact milk supply. This permissiveness of prolactin rather than regulatory is written here, http://www.ncbi.nlm.nih.gov/m/pubmed/8960706/,
"In summary, our investigations show that changes in the concentration of prolactin in the blood could not directly regulate milk synthesis in women. They do not, however, preclude prolactin from having a permissive role in milk synthesis. The variations in the rate of milk synthesis, both unilaterally and bilaterally, are indicative of autocrine control mechanisms regulating milk synthesis."
Ellen Rubin, MA, IBCLC
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