The PRL response to suckling was studied during the first week of the puerperium. Mean basal levels of PRL showed no significant changing during the first week of the puerperium, but there were progressive rises in both the maximum suckling-induced response and the total area under the response curve, which reached peak values on the fourth day after delivery. Despite large variations between individuals in basal PRL levels (range, 0.3-7.0 U/liter), peak suckling-induced response (range, 0.1-9.9 U/liter), and total response (range, 0.6-63.0 arbitrary units), there was much less variability within individuals between consecutive feeds. Using an electronic balance, 20 patients on days 5 and 6 were classified either as good feeders (greater than 60 g milk/feed) or poor feeders (less than or equal to 60 g milk/feed) on the basis of 2 consecutive test weights. The mean PRL response to suckling in 11 good feeders was no different from that in 9 poor feeders, and there was no significant correlation between milk yield and PRL response. Six patients whose infants were in the special care nursery had lactation initiated and maintained by breast pump for an average of 5.6 days. Although the PRL response to the breast pump was very small, these patients also had satisfactory milk yields (mean, 86 g). Although the presence of PRL is essential for lactation, the data in this paper suggest that there is no close temporal correlation between PRL concentrations and milk yield.

Substance use and levels of cohesion and adaptability were assessed in three consecutive high school freshman classes in a small midwestern city. As predicted, adolescents who perceived their families to be extreme on cohesion and adaptability (measured by FACES II) were more likely than adolescents from balanced and midrange families to use marijuana, alcohol, tobacco, depressants, and psychedelics. Inconsistent results were found for cocaine use. Adolescents from extreme families were especially vulnerable to substance use when a family member was perceived as having a drinking problem.

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Few studies have examined the therapeutic helping relationship within married couples, and those that have done so have considered stressor events that affect one spouse more than the other. This qualitative study of couples who experienced pregnancy loss and infant death explores the emotional support that spouses give to their partner. A minority of couples did not provide support to each other. In most couples, however, the support was described by both partners as mutual. Among all couples who provided mutual support, most of these perceived a fairly even exchange; some saw the husband as providing more support than he received, and one couple felt that the wife had been the primary helper. Couples who provided very little support to each other were helped by attending a peer support group.

Contemporary bereaved parents who usually lack prior experience with the death of an infant or young child also lack understanding of how parents reacted in previous centuries when a child died. This article reviews social science writing on parental bereavement in Anglo-American history, concluding that parents as early as the early seventeenth century have left records of their grief. Cultural understanding and customs surrounding death have changed, and around 1800 women began to leave records of their grief in letters and diaries. Emotional expressiveness following infant death was greatest during the nineteenth century, but decreased toward the end of the century and became taboo in the twentieth. Compared to men's, expressions of grief by women and writings directed toward women have been more expressive of emotion. Relatively little has been written about parental bereavement in the early and mid-twentieth century.