On Thu, 13 Nov 2003 Kate Hallberg wrote, re: c-section and lactogenesis:

"in part, the delivery of the placenta starts
lactogenesis, but possibly more important is the
stretching of the perineum.  This upregulates the
oxytocin and prolactin receptors.  with this
upregulation, the hormones present can be much more
effective.  To my mind, the need for perineal
stretching is an argument against episiotomies and
birthing positions that can cause, or are more likely
to cause, tearing.  We *need* that stretching, that
ring of fire.  without it, lactogenesis can be
delayed.":

May I contribute a recent reference to this discussion.  In no way to I intend it to be the last word.  In fact, Kate, perhaps you'd like to contribute your comments (above) to the authors, who did not (on my reading of it) come up with a clear reason for the slight delay.  The article was in the fetal edition of Archives of Disease in Childhood.

1) Evans KC, Evans RG, Royal R, et al. Effect of caesarean section on breat milk transfer to thenormal term newborn over the first week of life.  Arch Dis Child 2003;88(5):F380-382.

I'm going 'no mail' in a couple of hours, Kate, and so can only continue this discussion off list.
    Virginia Thorley
     in Brisbane

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html