Doreen wrote:

<It is mentioned that "drugs, too, can affect the delivery of milk.
Pitocin (used to induce labor) and ergot (used to control uterine
bleeding after delivery) can both act on the ducts to effectively block
milk production." I have heard about the ergot, but had never heard that
Pitocin could block milk production. Can anyone explain this to me? Could
this be the reason we (in our hospital breastfeeding clinic) are seeing
so many cases of low milk supply, with no other risk factors other than
having been induced for various reasons>

This is my understanding as I have pieced it together. Linda Smith and
others may certainly be able to add more. Drugs in the ergot family
apparently have a blocking effect on prolactin secretion, thus
interfering with stimulation at the level of alveolar cells. Pitocin has
a molecule very similar to anti-diuretic hormone (ADH). It can attach to
ADH binding sites in the kidney. When the amount is large enough, it can
delay prompt elimination of excess fluid from the circulatory system.
This in turn may delay the return of excess interstitial fluid from the
connective tissue compartment into the circulatory vessels for
elimination.

Unrelieved excess swelling in these two compartments of the breast.can
cause pressure on the glandular compartment, potentially interfering with
milk production in two ways 1) Pressure on the ducts may mechanically
delay forward transfer of initial colostum/milk, while any swelling in
the areola may delay colostrum/milk removal due to interference with
latch. Delay in milk removal may eventually allow feedback inhibition at
the alveolar membrane..2) Excess interstitial fluid may dilute raw
materials, slowing osmotic transfer to the alveoli, while pressure on the
outside of the alveoli from excess intersitial fluid or any source such
as tight binders, etc., may also cause a potential mechanical delay in
actual secretion by the alveolar cells.

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

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