I find that some women with a history of a prolactinoma make a normal 
amount of milk, and some make very little milk. Theoretically, it is 
possible that the high prolactin level in some of these women causes 
down-regulation of their prolactin receptors, such that the breasts no 
longer 'listen' to changes in prolactin levels that occur with nipple stim.
The breasts and other parts of the body become 'numb' to the prolactin. 
This happens with medications, and a good example is caffeine. If a 
person drinks a lot of caffeine for a long time, he/she may not notice 
much of an effect from it. People who normally don't drink caffeine tend 
to react strongly to just one cup.
We certainly need to learn more about this.
Anne

Anne Eglash MD, FABM, IBCLC
Clinical Professor
Dept of Family Medicine
University of Wisconsin School of Medicine and Public Health
600 N. 8th St.
Mount Horeb, WI, 53572
608-437-3064 (O)
608-437-4542 (fax)
608-550-3054 (pager)

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