I have been catching up on the posts that came in while I was on my way
home from vacation. (I had a delightful opportunity to meet some of the
members of the Central Arizona LCA while there.) I also had lots of time
to read on the plane, including every last little jot and tittle of the
new JHL.
I find Barbara Wilson-Clay's idea of an anticipatory guidance sheet for
mothers in regard to any delay in their milk coming in very thought
provoking. I was waiting to see if someone else would mention the
interesting article in the current (February) issue of JHL:
Hilson JA, KM Rasmussen, CL Kjolhede. "High Prepregnant Body Mass Index
Is Associated with Poor Lactation Outcomes Among White, Rural Women
Independent of Psychosocial and Demographic Correlates"
One of these outcomes is later onset of lactogenesis II. (That in itself
may be associated with a shorter duration of breastfeeding.)
One statement was "This process may be impaired in obese women, as they
may experience a delay in the fall of progesterone resulting from an
elevated amount of this hormone produced by excess adipose tissue."
I wondered whether this was a grammatical mix-up, that actually meant to
say that the delay (in release) was produced by the adipose tissue which
caused a slow fall of the level. (I had heard many years ago that
progesterone is stored in adipose tissue and that the level falls more
slowly in women with more fatty tissue."
However, later in the article, it states: "In particular, the post-partum
fall in progesterone concentration that occurs after the delivery of the
placenta is the trigger for lactogenesis. Maintenance of prolactin and
cortisol concentarations is required for this trigger to be effective.
What is not known is how obesity may modify this hormonal cascade.
Possibilities might include a delay in reduction of estrogen and
progesterone concentrations because they are produced in adipose tissue .
. . . . . ."
This is hard for me to believe, that fat tissue has an actual endocrine
secretory function. I can't wait to get to the library to find the
article that is cited:
Nevill, MC, Morton J. Physiology and endocrine changes underlying human
lactogenesis II. J Nutr. 2001;131:30055-30085.
I have several other articles whose primary author is Peggy Neville, so I
feel like a little "homework time" is coming on! Anyone else curious, or
have further references???
Jean
**********
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA
Jean
************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA
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