>>I'm extremely interested in your comments regarding women who experience a
sudden drop in milk production at about 3-4 mos. pp. Lactnetters, what is
WITH this? I have spoken to at least three women recently, one of whom is my
neighbor and who is expecting her fourth child in March, who report that
their milk "suddenly went away" when their babies were anywhere from 4 - 8
months of age<<

My conclusions on this topic thus far start first with the theory of hormonal
and autocrine control of milk supply.  Latest research suggests that hormones
play a major part in sustaining lactation for approximately the first three
months, and then autocrine (local) control takes over the main controls. We
do know that prolactin surges and levels are highest immediately postpartum,
then slowly decrease and plateau at a lower level around three
mos..............   It is my theory that many mothers can get away with
nursing minimal intervals the first 3 mos, my definition of minimal being 7-8
times a day, but that they may not have laid the necessary foundation for
long term supply.  It would appear that the high level of hormones continue
to support milk supply initially, but that as they decrease, the milk supply
slowly slips and one day mom finds her supply inadequate.  Many babies also
experience growth spurts around the three month mark, and so the transition
from hormonal to autocrine control may also be coupled with an additional
increase in volume demand, exaggerating the deficit even more.

My limited personal observation is that women who have schedule fed from the
start, or who encouraged only 7-8 feedings a day early on and did not allow
or encourage baby to nurse more frequently during the early months are more
vulnerable to this sudden milk supply "loss".  (In fact, I find that most
mothers aim for 8X a day or every three hours from the start,  shying away
from the upper range of 12X a day or every 2 hours, without regard for infant
feedback) They are often apparently successful for the first 3 mos, but then
the bottom just seems to drop out one day. Concurring with my observation is
that of a former PREP moderator who noted that almost all of her moms "lost"
their milk supplies around the 3 to 4 mos mark.......... coincidentally, they
schedule their babies for no more than 8 feeds a day from the start and
reduce asap, believing that adequate milk removal is the most important, and
independent, variable.  I have read several individual stories of the same
also.

I am not expert enough in the fine points of breast physiology and
biochemistry to explain this at a detailed level (Dr. Hartmann, where are
you!), but it does seem apparent that the proper groundwork may need to be
laid during the first quarter, and when it isn't, supply can falter.  I would
be glad for someone to pick up on my thoughts and detail them out further.

RE: KA's comments about milk intake declining after 4 mos------ Kathleen, it
would take me a little longer than forever to dig out the articles. My
recollection is a little different than yours; perhaps someone else out there
can tell us for sure?  I have read that milk supply usually peaks at about 6
mos, then gradually declines. I have always assumed that the decline relates
in part to the introduction of solids.  It was also recently published-- and
mentioned here on Lactnet?--- that babies fed on formula may increase their
milk intake beyond 6 mos, while breastfed babies seem to plateau on their
intake, literally taking in less milk than their artificially fed
counterparts. They apparently become even more energy efficient, and so
working/pumping moms may notice that their older babies require less milk
than formula fed matches.   I'm still convinced that the phenomena that Jack
described does exist, and that it is real and not a misperception on the
parts of mothers or anyone else.

-Lisa Marasco, BA, LLLL, IBCLC