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Subject:
From:
Denise Fisher <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 9 Jul 1998 13:18:48 +1000
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Elisheva - being an Aussie and the main researcher in this field also being
Australian it's become one of my favourites.  Peter hartmann has done
extensive work in this field.

<< Without a wide enough gape, there isn't good drainage, although there is
lots of nipple stimulation to make an enormous milk supply. >>

>But I thought that milk is always produced at a constant rate, except for the
slow-down effect of having milk in the breast?  If I have that right, then
shouldn't poor drainage *rule out*  oversupply, nipple stimulation or no?

Yes, you're right - the 'enormous milk supply' is caused by the initiation
of lactation post delivery. And by its not being efficiently removed it
causes engorgement, which is actually the problem, not ongoing milk synthesis.

 Milk synthesis initially comes under endocrine control and prolactin has
for some years been the hormone most often talked about - I think the
emphasis is diverisfying a bit now, though certainly drugs like
bromocriptine which inhibit prolactin will also inhibit lactation JUST AFTER
DELIVERY.
Within a few weeks the shift to autocrine control happens, which, as you
mentioned, is dependant on how much milk is in the breast.  Milk synthesis
depends on the removal of milk from the breast, and therefore the removal of
the local negative feedback mechanism.  ie the fuller the breast the slower
the milk synthesis, the emptier the breast the faster the milk synthesis -
so no, it is never really 'at a constant rate'.
Can I refer you to an online paper by Peter et al
http://mammary.nih.gov/reviews/lactation_(Hartmann).html
Happy reading

Denise
Brisbane, Qld

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