Physiology and Endocrine Changes Underlying Human Lactogenesis II

Neville, Margaret C.; Morton, Jane

doi:10.1093/jn/131.11.3005s

Cited by 216 publications

(166 citation statements)

References 32 publications

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“…As the levels of gestational hormones rise, both structural and functional changes occur in the breasts during gestation, which can be observed by an increase in breast size (18). There was only one mother in the present study whose breasts were small and practically did not change in size (mammogenesis) during pregnancy.…”

Section: Discussionmentioning

confidence: 56%

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Risk factors for excess weight loss and hypernatremia in exclusively breast-fed infants

Cağlar

Özer

Altugan

2006

Braz J Med Biol Res

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Data were prospectively obtained from exclusively breast-fed healthy term neonates at birth and from healthy mothers with no obstetric complication to determine risk factors for excess weight loss and hypernatremia in exclusively breast-fed infants. Thirty-four neonates with a weight loss ≥10% were diagnosed between April 2001 and January 2005. Six of 18 infants who were eligible for the study had hypernatremia. Breast conditions associated with breast-feeding difficulties (P < 0.05), primiparity (P < 0.005), less than four stools (P < 0.001), pink diaper (P < 0.001), delay at initiation of first breast giving (P < 0.01), birth by cesarean section (P < 0.05), extra heater usage (P < 0.005), extra heater usage among mothers who had appropriate conditions associated with breast-feeding (P < 0.001), mean weight loss in neonates with pink diaper (P < 0.05), mean uric acid concentration in neonates with pink diaper (P < 0.0001), fever in hypernatremic neonates (P < 0.02), and the correlation of weight loss with both serum sodium and uric acid concentrations (P < 0.02) were determined. Excessive weight loss occurs in exclusively breast-fed infants and can be complicated by hypernatremia and other morbidities. Prompt initiation of breast-feeding after delivery and prompt intervention if problems occur with breast-feeding, in particular poor breast attachment, breast engorgement, delayed breast milk "coming in", and nipple problems will help promote successful breast-feeding. Careful follow-up of breast-feeding dyads after discharge from hospital, especially regarding infant weight, is important to help detect inadequate breast-feeding. Environmental factors such as heaters may exacerbate infant dehydration.

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Section: Discussionmentioning

confidence: 56%

“…Lactogenesis stage II, the onset of sufficient milk production, occurs during the first 4 days after delivery (18). It is possible for a suckling infant to get a volume of <100 mL/day on the first day of life while milk production rapidly increases to an average of 500 mL/day by the 4th day (19).…”

Section: Discussionmentioning

confidence: 99%

Risk factors for excess weight loss and hypernatremia in exclusively breast-fed infants

Cağlar

Özer

Altugan

2006

Braz J Med Biol Res

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“…Biological factors also play a role in the initiation of breast-feeding among overweight and obese women (37)(38)(39) . Biologically, lactation commences when prolactin is secreted and progesterone levels decrease after delivery of the placenta (40) . This process could be impaired in overweight and obese women due to elevated amounts of progesterone produced by excess adipose tissue.…”

Section: Discussionmentioning

confidence: 99%

“…This process could be impaired in overweight and obese women due to elevated amounts of progesterone produced by excess adipose tissue. Moreover, the physiology of obese women's breasts could impair proper latching of the baby to the breast and impede the commencement of the process of galactopoiesis (38)(39)(40) . It could thus be postulated that overweight and obese women are a population group to be targeted for breast-feeding education and support during the prenatal and postnatal period.…”

Section: Discussionmentioning

confidence: 99%

A study of early complementary feeding determinants in the Republic of Ireland based on a cross-sectional analysis of the Growing Up in Ireland infant cohort

Castro

Kearney²,

Layte

2014

Public Health Nutr.

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Objective: Early complementary feeding has been shown to increase the risk of overweight, obesity and chronic diseases later in life. Poor compliance with current guidelines on complementary feeding has been reported by Irish studies. The aim of the present paper is to identify predictors of early complementary feeding in order to help health professionals target population groups in greater need of dietary intervention as well as to provide effective advice. Design: Cross-sectional analysis of the national, longitudinal Growing Up in Ireland study. Setting: Data were derived from the first wave (2007)(2008) of the Growing Up in Ireland infant cohort. Subjects: A cohort of mothers (n 11 134) from the Republic of Ireland, interviewed when their infants were 9 months of age. Results: Of the infants, 1469 (13?5 %) had been regularly taking solids in the period between 12 and 16 weeks; this percentage increased to 47?0 % of the sample in the period between 16 and 20 weeks. Timing of formula feeding commencement, high maternal BMI and choosing a relative as the infant's minder were strongly associated with early introduction of solids both in bivariate and multivariate analysis. Those infants who started formula feeding at .4 months were 88?4% less likely to be introduced to solids early compared with those who started at ,2 months (OR 5 0?116; 95% CI 0?072, 0?186; P , 0?001).Conclusions: The results demonstrate that biological, social and behavioural aspects exert an important role in infant feeding practices. These findings are relevant to the design of policies and intervention programmes aimed at educating parents. Keywords Complementary feedingInfant's diet Early weaningThe European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) defines complementary foods as other solids and liquids introduced into the infant diet apart from breast milk or formula milk (1) . The introduction of complementary foods into an infant's diet is an important process not only for developmental and growth reasons, but also because of its potential long-term effects on health (2)(3)(4)(5)(6)(7)(8)(9)(10)(11) . Providing a balanced diet while adhering to introduction times recommended by guidelines is pivotal during this period of rapid growth, not only because of the high probability of nutritional deficiencies but also because early complementary feeding has been shown by some studies to increase the risk of overweight, obesity and chronic diseases later in life (5,6,(8)(9)(10) . Moreover, the transition from milk to solid foods is a crucial point to establish life-long feeding patterns (11)(12)(13) . However, poor adherence to recommendations on the introduction of complementary foods has been reported in the Republic of Ireland (ROI) as well as internationally (14)(15)(16)(17)(18) . WHO recommends exclusive breast-feeding during the first 6 months of life of the infant, with the gradual introduction of solids after 6 months (19) . The Department of Health and Children in the ROI updated its advice ...

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“…29 Administering progesterone too early can inhibit prolactin and thereby affect breast milk production. 30 The readiness to start medication was assessed with a self-report breastfeeding questionnaire. 31 If the participant reported delayed onset of lactation the medication start date was postponed.…”

Section: Methodsmentioning

confidence: 99%

Progesterone and Postpartum Smoking Relapse: A Pilot Double-Blind Placebo-Controlled Randomized Trial

Allen

Lunos

et al. 2016

NICTOB

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Introduction: Pregnancy is a strong motivator to quit smoking, yet postpartum relapse rates are high. Growing evidence suggests a role of sex hormones in drug abuse behavior and given the precipitous drop in sex hormones at delivery, they may play a role in postpartum relapse. This pilot study evaluates the feasibility and potential role of exogenous progesterone in postpartum smoking relapse. Methods: This 12-week double-blind placebo-controlled randomized pilot trial randomized 46 abstinent postpartum women to active progesterone (PRO; 200 mg twice a day) versus placebo (PBO) for 4 weeks. Participants were followed for relapse for 12 weeks. Main study outcomes include abstinence (point prevalence), feasibility (compliance per number of clinic visits attended, pill counts and Electronic Data Capture [EDC] completed) and self-reported acceptability. Safety was also measured by depressive symptom scores, adverse events, and breastfeeding. Results: Overall retention rate was 87% at week 12. At week 4, abstinence rates were 75% in the PRO group and 68.2% in the PBO group (p = .75). Medication adherence was 68% and clinic visit attendance was 80%, with no differences by randomization. Depressive symptom scores, adverse events, and breastfeeding did not vary by randomization. Conclusions: Although the study was not powered to evaluate abstinence rates, we did observe a higher prevalence of abstinence at week 4 in the PRO group. Further, exogenous progesterone was well tolerated and did not adversely affect depressive symptoms or breastfeeding. Thus, the results of this pilot study indicate further investigation into progesterone as a postpartum relapse prevention strategy is warranted. Implications: This innovative pilot trial determined the feasibility of delivering exogenous progesterone as a potential prevention of postpartum smoking relapse. We observed high retention and moderate adherence rates, as well as high acceptability among participants. Further, though not statistically significant, more women in the treatment group remained abstinent from smoking during follow-up. This project adds to the growing body of literature on the role of sex hormones in smoking relapse and also provides support for a fully powered clinical trial.

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Physiology and Endocrine Changes Underlying Human Lactogenesis II

Cited by 216 publications

References 32 publications

Risk factors for excess weight loss and hypernatremia in exclusively breast-fed infants

Risk factors for excess weight loss and hypernatremia in exclusively breast-fed infants

A study of early complementary feeding determinants in the Republic of Ireland based on a cross-sectional analysis of the Growing Up in Ireland infant cohort

Progesterone and Postpartum Smoking Relapse: A Pilot Double-Blind Placebo-Controlled Randomized Trial

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