Catherine and/or Denise,

I am admittedy not well-read on the newer prolactin literature, but a
question came to my mind when I read this sentence:

<It
is the immediate rise in prolactin after birth that stimulates the
increase
in lactose production which in turn through osmotic effects cause the
initial changes in volume ("coming in" of milk).>

I remember reading in early prolactin literature that prolactin levels
actually rise to their highest pregnancy levels toward the end of
gestation, but that the progesterone levels keep prolactin from being
very active at the cellular level (beyond helping with the production of
colostrum, I suppose.)

From memory of articles I read years ago, I seem to remember that the
delivery of the placenta, and the subsquent gradual release of remaining
progesterone stored in fatty tissue, brings about the declining blood
level of progesterone. It is this decline that gradually removes the
inhibition effect so the prolactin becomes free to "do its thing" at the
cellular level.

This is the reason for milk coming in in those mothers who do not even
breast feed. And for those who do, at each suckling stimulus, for at
least the first few weeks, there is a temporary 8-fold rise in prolactin,
which goes down between nursings.

I can see it is time to seriously update my reading on the subject, but
still, I had to raise the question.

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

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