Hi Gina,

It is not just about prolactin levels. It is about each woman's
sensitivity to the levels of various hormones in her body. It is about
how frequently a baby nurses throughout the day and how long the
longer stretches between nursing are. It is very individual. Some
mothers start their periods again even when the baby is nursing
exclusively and frequently. Others do not resume for several years,
even if the child has cut back on nursing quite a bit. Not sure how
PCOS would play into it, but again, it seems to be about about
hormonal triggers  With twins, I think that she is probably still
nursing quite frequently. It is actually a good thing to not be
menstruating any more than you have to be throughout a lifetime.
Unless this woman is terribly keen on getting pregnant again very
soon, I would say that she has nothing to worry about and her body is
behaving in a completely normal manner.

FWIW, I did not get my periods back for over two years and was nursing
only one child. It was wonderful. Then got pregnant again quite
quickly and went another two years post-partum. Got quite spoiled. The
biological norm is for women to be either pregnant or nursing for most
of their fertile years and not having very many periods at all. Not
saying that's what we all should be doing, just that's what probably
has been going on for most of human history where breastfeeding was
done until "natural" weaning took place.

Sharon Knorr, IBCLC, NY, USA

On Sun, Aug 1, 2010 at 12:21 PM, Gina Peterson
<[log in to unmask]> wrote:
> What is the connection between prolactin levels and lactational amenorrhea? A woman contacted me for her friend saying that she is breastfeeding 21 month twins, has not had a period yet and her prolactin level is normal. Her doctor is concerned that the level is normal but she has not menstruated yet. I have the book "Making More Milk" and based on the info in there, maybe the woman's level was not checked at the ideal time with respect to the last nursing session. The woman also has a history of PCOS. Any thoughts?
>
> Thank you so much,
> Gina Peterson, BS, IBCLC
>
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