Many lactation consultants claim that milk goes over the mother's head. This phrase has a psychological meaning and a direct factor, since the hormone of lactation prolactin is actually produced in the part of the brain - the pituitary gland.

What is prolactin? What is prolactin for?

What is the hormone prolactin? This is the so-called "cook" hormone, which is responsible for the production of mother's milk. The amount of this hormone in the mother's body depends on how successful and long lactation will be. Of course, this is not the only condition for long-term breastfeeding, because in order for prolactin to be produced in the right amount, it is important for him to "feel" in demand, that is, the child must be more often applied to the breast and make sucking movements - in response to this action in the mother's brain a signal is received and prolactin is produced. The hormone is best produced at night and in the early morning hours, so it is very important that the mother does not restrict the child from feeding for longer than 4-6 hours and put the baby to the breast even at night, at least once.

Why else do you need prolactin? The function of the hormone is not limited only to the production of milk, prolactin has other purposes:

1. Stimulates the formation of maternal instinct - the production of the hormone "turns on" the mother's care for her baby and her desire to protect the baby.
2. Ovulation suppression - wise nature has made sure that a woman who has recently given birth and is breastfeeding a child does not become pregnant immediately after childbirth and has a margin of time to recuperate. Thus, a mother who breastfeeds on demand cannot easily become pregnant, at least in the first 6 months after childbirth. Further, with the introduction of complementary foods to the baby, it is less often applied to the breast, the level of prolactin decreases and pregnancy is possible, so if the couple does not plan a second baby, contraceptives should be used.
3. Regulation of the production of the hormone progesterone.

Norm of prolactin

The level of lactation hormone concentration in the body of a nursing mother directly depends on the individual characteristics of the body and the frequency of applying the baby to the breast, so there is no single norm for prolactin. If a newborn child from the first hours of life for some reason is fed with artificially adapted milk mixtures, then the concentration of the lactation hormone in the body of a young mother will not exceed 450-600 mU / l. When a child from the first minutes of life is applied to the mother's breast and makes active sucking movements, the concentration of prolactin increases with each feeding.

In the first six months of a child, when he is breastfed and does not receive any other food than mother's milk, the level of prolactin in a woman's body is 2500 mU / l. From the moment the child is introduced to complementary foods and replaces one or more feedings, the concentration of the hormone decreases to 1200 mU / l, and from the year when the child is gradually transferred to the general table and breastfeeding is left only for sleep, the prolactin level is no more than 600-800 mU / l l.

Deviation from the norm - causes

The reasons for the deviation from the norm of indicators of the lactation hormone are different and depend on many factors.

1. Reduced level:

• mixed feeding (feeding the baby with breast milk and an adapted mixture).
• premature birth in a woman.
• insufficiently frequent attachment of the baby to the breast.
• taking medications by the mother that affect the hormonal background.

2. Increased level:

• the birth of twins - natural feeding of 2 or more children requires more milk production in the body.
• benign or malignant tumors of the pituitary gland.
• autoimmune diseases.
• polycystic ovaries.

As a rule, nursing mothers suffer from a low level of prolactin in the blood, as a result of which the baby does not have enough milk.

How to increase prolactin for lactation?

If the baby is clearly not getting enough breast milk, he is not gaining weight well and is crying after feeding, there is no need to panic and immediately grab a jar of formula. In order to increase prolactin for lactation, you need to follow simple rules:

• avoid stress - worries and fears lead to vasospasm and block the production of hormones important for lactation.
• breastfeed more often - the more often the baby suckles, the more milk is produced.
• rest more - lack of sleep and chronic fatigue negatively affect lactation, therefore, in the first months of a child's life, it is very important that relatives help the mother around the house, and she is exclusively busy with the baby.
• eat fully - it is not uncommon for tired young mothers to neglect breakfast or a full meal in a hurry to do some household chores while the baby is asleep - this is absolutely impossible to do, since good nutrition is important for long-term lactation.

In some cases, young mothers can take natural biostimulants, for example, preparations based on royal jelly, to increase lactation, but it is important to remember that they can provoke severe allergies in the baby, so it is better to consult a pediatrician before using them.

An increase in the level of a hormone such as prolactin during feeding is the norm. Prolactin contributes to the growth and development of the secretory apparatus of the mammary gland during pregnancy. In addition to prolactin, progesterone, estrogen, cortisol, and placental lactogen are included in this process. When a woman is pregnant, the increased concentration of progesterone and estrogens prevent prolactin from affecting the breast cells, so milk synthesis does not occur. After childbirth, estrogen and progesterone levels drop sharply, the number of prolactin receptors in the glandular tissue increases, lactogenesis and lactation start. Stimulation of lactogenesis is accompanied by an increase in the synthesis of milk proteins, as well as fats. During the regulation of the secretion and excretion of milk, in addition to prolactin, insulin, cortisol and placental lactogen are involved.

No wonder prolactin is called the “hormone of motherhood”, because it is he who is responsible for the appearance of the so-called “maternal instinct” in both women and men. Thus, prolactin influences behavior and stimulates parental responses.

The norm of prolactin when planning pregnancy is 40 - 600 mIU / l (2 - 27 ng / l). Such a large range of values ​​depends on the individual characteristics of the organism.

Prolactin during breastfeeding, normal. Hyperprolactinemia during breastfeeding is always observed, since due to increased concentrations of prolactin, lactogenesis and lactation occur.

Prolactin during lactation, norm:

For the first time after childbirth, stimulation of the formation and release of milk occurs when the newborn is first attached to the nipple. It is the stimulation of the mechanoreceptors of the areola and nipple that is the trigger of this process.

Prolactin. The norm in lactating women depends on the duration of breastfeeding. The maximum amount of this hormone is determined in the blood in the first six months of lactation, the minimum - after a year. It is important to note that if a woman refuses to breastfeed, prolactin gradually returns to the physiological norm, the secretory tissue of the mammary gland, developed under the influence of prolactin, undergoes regression. In addition, the number of lactotrophs, the cells that are the main site for the formation of prolactin, decreases, because during pregnancy their number reaches 70%.

Prolactin while breastfeeding. The norm of this hormone in the postpartum period should remain elevated. Breast milk is an indispensable product for a newborn, because it is a perfectly balanced product, rich in all the substances necessary for the human body. But the main function of milk is the formation of the child's immunity.

The most famous reflexes, say, the one that makes us straighten our leg if we hit below the knee, are purely neurological in nature: the tendon has a sensory receptor - a nerve that transmits a signal to the spinal cord - the computing center that decides how to act; there is another nerve that sends back a response signal to the muscle, telling it to contract. The nipple and areola also have sensory receptors and nerves that transmit signals to the hypothalamus; however, the computer center does not respond through nerves, but through hormones reaching their destination through the bloodstream. Therefore, we are talking about the neuroendocrine reflex.

Prolactin

Pre-pregnancy prolactin levels are very low. It gradually increases from the first trimester, but there is no milk yet, because the progesterone and estrogens secreted by the placenta suppress the action of prolactin.

After the birth of the baby and the expulsion of the placenta, the level of estrogen and progesterone drops drastically in a day or two, which allows prolactin to begin to act. Milk production in the body starts with the birth of the placenta.

We have already said that prolactin levels remain high for several months in a row. But it grows even stronger (ten or twenty times) with each application of the child. These prolactin peaks appear exclusively in response to breast stimulation. If the baby suckles a lot, there will be a lot of prolactin and a lot of milk. If he suckles a little, there will be little milk. If he does not suckle at all, the milk is wasted.

There is an erroneous view, according to which it is necessary to withstand breaks of several hours between applications, so that the breast has time to fill up again during this time. This is not true. The chest is not like a cistern, where you have to wait for a while until it is full before it makes sense to pull the chain again. Rather, it is like a bathroom faucet: if you need more water, just open it again.

After feeding, the level of prolactin slowly decreases over two to three hours to a baseline level (which, recall, is quite high after childbirth). Imagine a baby who suckles for ten minutes every four hours. (How about ten minutes?! Why every four hours?! Well, it's an imaginary baby!) For one reason or another (maybe because it's growing), our baby wants more milk. What should he do? Suck for fifteen minutes every four hours? It is unlikely that this method will be particularly effective. If he starts to suck longer, prolactin will remain about the same - which means that there will be about the same amount of milk. But if he decides to suck for ten minutes every two hours, he will achieve that the peaks of prolactin per day will be twice as much. Moreover, since the prolactin level has not yet completely decreased, the new peak will be higher (say, instead of rising from 50 to 500, it will rise from 100 to 550). If you suck more often, the body will produce significantly more prolactin, and therefore milk.

Thus, there is no better way to spoil your lactation than to reduce the number of attachments. Anyone who advises a nursing mother to take a four- or three-hour break, or at least two and a half hours between feedings ("Wow! It can't be that he's hungry again! And if you give him breast now, she equally empty and of no use to her ... Yes, and the tummy should rest ... And at night you need to sleep, not eat ...”), prevents the mother from breastfeeding.

At night, both the basal level of prolactin and its peaks are more pronounced. This means that at night the breastfeeding baby will get more milk with less effort. So (among other things) the recommendation not to breastfeed at night is extremely stupid.

Oxytocin

Various aspects of a woman's sex life are controlled by oxytocin. This hormone is released during orgasm, during childbirth, and whenever the baby suckles. Its main effect is the contraction of various muscles: the muscles of the uterus, the vagina, as well as those that surround the lobes in the chest, and those that are located under the nipple and areola. Thus, all these episodes of sexual life have common features. During orgasm, the muscles of the uterus and vagina contract, and the nipples harden. During childbirth, the muscles of the uterus and vagina also contract; I will allow myself to assume that the nipples in this case also harden, although usually no one is looking at them at this moment. During feeding, the nipple also hardens and there are contractions of the uterine and vaginal muscles, very similar to contractions.

These uterine contractions, more or less painful, occur in the first days after birth whenever the baby is applied to the breast. They're uncomfortable, but think about it for your own good: the contractions help bring the uterus back to its normal size, which likely reduces the risk of bleeding or infection. It is said that with each birth these contractions are more and more painful (however, they also say that each subsequent birth is easier than the previous ones, so in general it turns out so).

Although the body always reacts to the release of oxytocin in a similar way, the sensations that it awakens in a woman's body differ radically from each other, since they depend not only on hormones, but also on mood. Most women do not experience sexual arousal from either childbirth or breastfeeding.

There are, however, also exceptions. Some mothers note in the process of feeding a child sexual sensations, sometimes reaching orgasm. Although this is rare, I will insert this paragraph in the book so that in case such a mother reads it, she can be sure that this is also a variant of the norm. No, no, you're not perverted, you don't think "anything nasty", you're not sexually exploiting your own child, you're not prone to incest, there's not the slightest reason to stop feeding! If you are so lucky that feeding gives you pleasant sensations, enjoy them to your health, there is no need to complain that life took and gave you a little joy.

Oxytocin not only causes various muscles to contract, but also affects behavior. If a newborn baby rat is placed in a cage with an adult rat that has never given birth, it will eat it. But if she is injected with a dose of oxytocin before that, she will try to care for the baby as if she were her own cub, and even intend to feed him with her milk (which she will not have for obvious reasons).

During the first months of nursing, most mothers notice the effects of oxytocin: something like contractions in the breasts, a feeling of goosebumps, a feeling that the milk is about to come; then droplets appear on the nipple or even a whole stream of milk appears ... This is a milk separation reflex, which is called differently in different places. We usually talk about the arrival of milk, referring to the feeling of fullness in the chest, which first occurs about the third day after childbirth, and about the flush, when talking about the feeling before feeding that the milk is about to flow. However, in most Latin American countries, they say the opposite: there the second word is used to indicate the feeling shortly after childbirth, and the first - to determine what happens in each feeding.

We are talking now about the first months of feeding and about most of the women. There are some women who have never noticed any hot flashes (or whatever you call them), but this does not mean that these women do not have milk or that it does not flow. And most mothers stop noticing hot flashes after two or three months and no longer feel anything special, although the milk continues to stand out perfectly. Do not be afraid, and you: this does not mean that you have lost or lost milk.

Those readers who notice the effect of oxytocin may also have noticed that often the flush occurs before the baby begins to suckle. It is enough to get ready to feed, or hear the cry of the baby, or even just think about him without seeing him, so that the breasts tense up and begin to ooze milk. What kind of reflex is this that manifests itself even without a stimulus?

The thing is, it's a conditioned reflex. Remember the famous Pavlov's dog, whose saliva dripped at the sound of a bell? By itself, the salivation reflex is triggered by the presence of a stimulus, namely food in the mouth. Each time he offered food to a dog at the sound of a bell, Pavlov ensured that the animal associated the two stimuli with each other, and now the sound of the bell was enough to make saliva drip from its mouth. In fact, all dogs have a conditioned salivation reflex: show them a juicy steak - and saliva will drip much before food gets into their mouths. We, too, fill our mouths with saliva at the sight of a delicious dish or even at the thought of it. The only original thing about Pavlov's experiment was that he used a bell instead of a steak; if he appeared before the Academy of Sciences in Moscow and said: “Look, look what my dog ​​does when I show her a steak!” - the wise professors would contemptuously answer: “So what? Mine does exactly the same. But the bell really interested them.

Just as the conditioned salivation reflex develops spontaneously in all dogs (and humans too), so the conditioned lactation reflex develops just as spontaneously in mothers. The effect remains even many years after the end of feeding; some women experience goosebumps when they hear a baby cry or see starving or sick children on TV. This phenomenon is called the “phantom milk flow reflex”, by analogy with “phantom pains” in a long-lost arm or leg.

Perhaps this conditioned reflex simply serves to make life easier: because of it, the baby does not have to first suck on the tide to get at least some milk. It is enough for him to take a nipple in his mouth - and the milk will begin to drip. However, Michael Woolridge, an English physiologist, believes that the main benefit of conditioning this reflex is not to activate it, but to suppress it - as a defense mechanism for female mammals. Since this is a conditioned reflex, it is no longer dependent on a physical stimulus through the sucking mouth; it starts when the mother sees the baby, hears it, thinks about it. Mother's thoughts can either trigger the reflex or suppress it. Hence the very typical story - "the milk was gone from the disorder."

Imagine a deer feeding a deer. Suddenly she smells a wolf. She hides the cub in the bushes, and she runs - the cub cannot run away yet. Since the cub does not smell of anything (it was not for nothing that the mother licked it all day) and lies very quietly, and the mother smells and moves noisily, the wolf will most likely rush after the mother, but will not find the cub. If he catches up with her - no luck, in the next few hours the cub will also die. If the mother manages to escape, she will soon return to the cub and will continue to feed him.

But if a doe had dripped milk on her way, no self-respecting wolf would have lost track of her. Since the milk ejection reflex is a conditioned reflex, the release of oxytocin stops if the deer is startled. Unlike prolactin, which gradually decreases over several hours, oxytocin is destroyed very quickly and remains in the blood for only a few minutes. That is why when using oxytocin to stimulate labor, it must be introduced into the body constantly, using a dropper; if a woman in labor were given an injection of oxytocin every three hours, it would not have any effect.

For greater reliability, adrenaline, which is produced by frightened animals, comes into play - it directly drowns out the action of oxytocin. It is likely that the same mechanism can stop labor if the mother is frightened. An adult hippo, rhinoceros or giraffe has every reason not to be afraid of hyenas; but a newborn cub would be easy prey for them. The obvious danger may be to stop the production of oxytocin and delay delivery for several hours until the mother is back in a safe environment. This may be why some births in the unfamiliar conditions of a hospital maternity ward, surrounded by strangers, are sometimes so difficult, and most women feel more comfortable if their husband or another family member accompanies them in childbirth, while others prefer to give birth at home with the help of a well-known midwife.

Forgive me for "spreading my thoughts along the tree" - maybe it's all the monkey ancestors that make themselves felt? Let's leave our deer for now, let him return to his deer. Since she is no longer afraid, adrenaline disappears from her blood, the conditioned reflex starts again, milk flows again, and the cub sucks calmly. But if a woman is in the place of the deer, additional difficulties may arise. In addition to the mother and the baby, a grandmother, a husband, a mother-in-law, a sister-in-law, a neighbor, a doctor and a nurse are present somewhere nearby. And then one of them (or even all in unison) burst into a stream of threats: “What, your milk is gone from grief, right? It was the same with one of my cousins, and the baby almost died of hunger; my husband had to run to look for a pharmacy on duty in order to buy the mixture - it was, as if on purpose, on Saturday evening ... "

Now it’s not the fear of the wolf, but the fear of lack of milk that leads to the fact that there is more adrenaline, and less oxytocin. The baby tries to suckle, but almost no milk comes out; the baby is indignant and protests, and then the finest hour of the mother-in-law comes: “You see? He only gets nervous from your milk. I told you that in this state you need to stop playing the fool and give him a bottle. The mother begins to cry and gets even more frightened.

Hormone inhibitor

For a long time it was believed that it was enough to know about prolactin and oxytocin to explain, at least in general terms, how lactation works. In general terms - because there are many other hormones involved in it, which we have not even mentioned yet.

Why, if the baby sucks more, then there is more milk? Because sucking increases the production of prolactin. Why does milk leak from one breast while the baby is suckling the other? Because with the blood flow, oxytocin simultaneously reaches both breasts. Why did women who tried to feed "every four hours for ten minutes" lose milk? Because there was not enough stimulation - and, as a result, there was not enough prolactin. Why does the mother of twins have enough milk for two, and the mother of triplets - for three? Because with three children, three times more prolactin is produced.

But there remained a strange phenomenon that could not be explained with the help of these two hormones. There is one ethnic group in Hong Kong where women traditionally fed from only one breast. All children suckle only the right breast, the left - never (well, yes, breast cancer is also more often found in them on the left). What an example to go far - and we sometimes meet children who, for one reason or another, stop sucking one of the breasts. Often this is a temporary phenomenon and after two or three days the mother ensures that the child takes both again. But sometimes it also happens that the child is determined and nothing can be done. There are women who feed like this for weeks or months in a row - only from one breast.

Since oxytocin and prolactin enter the bloodstream, since they reach both breasts in equal measure, both should seemingly respond in the same way and produce approximately the same volume of milk. Imagine that the breast produces half a liter of milk daily or even more, and the child does not want to suckle. In just a day, the pain would be unbearable, after three days the mother would have to be hospitalized, and after two weeks the poor thing would simply burst from excess milk. But nothing like this ever happens. If the baby refuses one of the breasts, it swells and hurts, sometimes the mother has to express some milk to relieve the pressure; but after two or three days everything passes, the milk disappears, and the breast remains soft and empty. One breast now produces twice as much milk (well, yes, twice: since the baby does not die of hunger, it means that he drinks as much from one breast as the others from both), while the second does not produce a drop, and so on for weeks and months. How can this be explained? There must be a local control mechanism, something that can affect each breast independently of the other.

Initially, it was believed that this is a purely mechanical process. The chest is so full that the milk squeezes the blood vessels. Therefore, neither oxytocin, nor prolactin, nor the nutrients that are necessary for the gland to continue producing milk are getting. There is a collapse in the chest - like at the airport, where the staff is on strike.

Of course, the mechanical process also works; but a few years ago, a special locally acting hormone was discovered that controls milk ejection. This is a peptide (that is, a compound similar to a protein, but with a smaller molecule) that was found in the milk of goats, humans and other mammals (as far as I know, if they were looking for it somewhere, they found it every time). This hormone is called FIL, from the English Feedback Inhibitor of Lactation. We could call it "lactation inhibitor factor" to keep the current acronym.

FIL is a perfect example of consumer control. Milk contains an inhibitor of the production of new milk, so if the child sucks a lot, then he will also suck out the inhibitor and more milk will be produced, and if he sucks a little, the inhibitor will remain in the breast and less milk will be produced.

This was proved by a group of Australian scientists, making a series of measurements of the volume of the breasts. The camera takes several pictures of the breasts from different angles, and the computer calculates the volume of the breasts based on these pictures (using a similar method, the weight of the baby in the womb is calculated on ultrasound). The method is harmless and quite convenient, it can be repeated as many times as needed, and even many times within an hour. The old method for measuring the volume of the chest was to bend over a container full of water, dip the chest into it and measure the volume of water displaced by it; The method turned out to be inaccurate and rather tedious. Thus, the Australians were able to prove that the volume of the mammary glands gradually increases from one feeding to another, while milk accumulates. Then the baby sucks, the volume of the breasts drops sharply - and everything starts from the beginning. If for some reason the child drank less during one of the feedings, milk is produced more slowly in the next few hours. If, on the other hand, the baby sucks more because, for example, he sucked less last time and is now hungry), milk is produced faster. If he suckled only one breast, then this one will produce a lot of milk, and the other, still full, will not produce it at all. Thus, milk production immediately adjusts to the needs of the baby, from feeding to feeding, in each breast this happens independently of the other. Of course, all this is true on one condition: the child is allowed to suckle as much as he wants, and when he wants. If one day he cannot attach to the breast, because the mother, for example, went out somewhere and she has to wait an hour or two, there will be no trouble: the mother will return, the child will suck longer, and everything will be fine. But if he is systematically denied breastfeeding when he asks for it, morning, afternoon and evening, day after day; if mothers have fooled their heads with all the familiar advice “feed for ten minutes every four hours” or “try to drag out the time between feedings”, then the child will not have the opportunity to “order” milk and the breast will not know how much it needs to be produced now. When a mother waits for hours for her breasts to fill up before giving it to her child - “what is it for him to poke an empty one now?” - the result is that she gradually becomes less and less milk, because the inhibitor accumulates at the same time as the breast fills up.

Even if we did not know anything about the existence of a lactation inhibitor, people have observed its effect for centuries. Every doctor, every nurse has seen it hundreds of times.

Why does breastfeeding usually end? If we are talking about Spain, then most often it is not at all because the mother and child want it that way. A survey was conducted in which the majority of mothers said they would like to breastfeed longer than they actually fed. But, alas, the milk is gone. How is this possible?

Here is a mother calmly breastfeeding. And suddenly, for one reason or another, it occurs to her (or someone puts this thought into her head) that the child is starving. Because it can't stand three-hour breaks. Because she's crying. Because he wakes up. Because he sucks fists. Because he doesn't poop. Because he sucks a lot ... Because he sucks a little ... The reason is not important, but in any case, the day comes when the baby is given a bottle for the first time. Many children, especially if they are already more than two or three months old, do not want to take it, because they are not hungry. But quite crumbs, poor fellow, sometimes it turns out to deceive. And sometimes the mother insists once or twice, or even she is advised not to give a breast in such cases, so that the child gets hungry more and agrees to a bottle.

If the baby took a bottle, which he really didn’t need for nothing, then he will eat up to the very ears. Every day he drank 500 ml of milk, and today he drank 50 or 100 ml more. That is, we are not talking about some increase in the usual volume, but about an extra 10-20%. Are you yourself very ready to move actively after Christmas dinner? If earlier the child woke up, now he will sleep like a groundhog for several hours in a row; if crying - stop; if he sucked his fists, then he won’t do that either. “Well, you see how he wanted to eat? For a long time it was necessary to give him a bottle, finally it became easier for the poor thing ... ”Easier, well, well. The baby obviously overeat.

Christmas holidays in Spain are a challenge to the digestive system. For at least two consecutive days, the family arranges a hearty meal (in some regions on Christmas Eve and Christmas, in others on Christmas and St. Stephen's Day). Remember what you do the next day? That's right, eat some fruit. Three Christmas meals in a row no one can bear. The same thing happens with our baby: if once he allowed himself to be deceived and overeat, he will not want to repeat this again. The next day he decides: “Since they feed me 100 ml from a bottle, I’d better drink only 400 ml from my chest, otherwise I’ll burst!” Maybe his mother will notice, maybe not; however, as a result, he will suckle the same number of times a day and for the same amount of time, but he will drink less milk in order to leave room in his stomach for the contents of the bottle. Thus, the magical effect of the mixture drunk from the bottle will not be repeated the next day: if the child cried, then he will cry, if he woke up, he would wake up, if he sucked his fist, he would suck him again. It was then that mom thought: “The milk is leaving, he will have to feed him another bottle.” In part, she is even right: there really is less milk - only she does not know that the reason for this is just in the bottle and that the solution to the problem will not be to add the second, but, on the contrary, to remove the first. So the second bottle appears, then the third, then the fourth ... Hundreds of times everything goes according to a familiar scenario: it is worth starting with bottles - and the breasts go to hell in a couple of weeks. Some famous doctor a century ago said so: the bottle is the grave of the breast.

So, the child used to suck out 500 ml, now only 400, 300, 200 ... If the mother continues to produce 500 ml of milk, where will this excess milk go? What, in two weeks, the mother in desperation will call an ambulance, complaining of inflammation in her chest, that each weighs several kilograms, and, in general, of her unfortunate fate? “Two weeks ago I started feeding him from a bottle, and of course, he didn’t drink milk, so look what happened to me!” Nothing like this happens, moreover, usually the opposite is true: “I started feeding him from a bottle - so now he doesn’t want breasts either, and my milk is gone.”

If the baby sucks less and less, the milk will also become less and less. Hormone-inhibitor works without misfires. There are no women in nature with bursting breasts, each of which has one, three or five liters of excess milk. So an inhibitor is like an elevator: it either works or it doesn't. If you can go down, then you can go up on it too. If you gradually reduce the amount of supplementary food, the baby will suck more and you will gradually increase the amount of milk. After a few days* you can just throw all the bottles in the trash can.

A few months after childbirth, prolactin loses its significance. Its base level is decreasing, and the peak level reached with each feeding is also decreasing. But the volume of milk does not decrease, but, on the contrary, continues to grow. It seems that for some unknown reason, the role of local control, that is, the hormone-inhibitor, over time becomes more and more significant in the regulation of lactation.

Complications of lactation (cracked nipples, milk stasis, mastitis)

What medications can be taken during lactation (antibiotics, antihistamines, antivirals, sedatives, activated charcoal)?

Treatment of cystitis, thrush, sinusitis, constipation, diarrhea, tonsillitis, cough and other diseases during lactation

What is lactation?

Lactation- this is the process of formation and excretion of breast milk in a woman in the postpartum period, which ensures the feeding of a newborn baby. The process of development and regulation of lactation is provided by complex mechanisms, among which the main role belongs to hormonal changes, as well as the central nervous system of a woman. In some diseases and pathological conditions, the lactation process may be disturbed, which will have characteristic clinical manifestations.

Physiology of lactation in women ( what hormones are responsible for lactation?)

To understand the mechanism of development of lactation, as well as the causes of the violation of this function, certain knowledge is needed from the field of physiology and anatomy of the female reproductive system.

The mammary gland consists of glandular tissue, which forms the so-called acini. The acini unite with each other to form lobules and larger lobes that share a common excretory duct. The excretory ducts of the lobes of the mammary gland come together and open at the nipple.

Under normal conditions ( outside of pregnancy) the weight of the mammary gland is about 150 - 200 grams ( data can vary significantly depending on the physique of a woman). When pregnancy occurs, under the influence of sex hormones ( estrogen and progesterone) there is an increase in the blood supply to the gland tissue, as well as its intensive development, as a result of which its mass can increase by 2 times. From about the middle of pregnancy, the mammary gland can already produce milk, but this is prevented by a high concentration of the hormone progesterone. 2 - 3 days before the onset of childbirth, the development of the mammary gland ends. In this case, its mass can reach 600 - 900 grams. The concentration of progesterone decreases, causing the secretory cells of the mammary gland ( lactocytes) begin to produce colostrum ( "immature" human milk).

After childbirth, there is an increase in the concentration of estrogen ( female sex hormones) in the blood, as well as an increase in the concentration of the hormone prolactin. It is the latter hormone that is responsible for the increased formation and accumulation of milk in the mammary glands. During breastfeeding under the influence of another hormone ( oxytocin) there is a contraction of the muscle cells surrounding the acini and excretory ducts of the glandular tissue, as a result of which the resulting milk is released outward through the openings in the nipple area.

How long does lactation last?

The regulation of lactation is determined by the frequency of feeding the child. The fact is that the attachment of a newborn to the breast and mechanical irritation of the receptors ( special nerve cells) triggers a reflex reaction that stimulates the production of the hormones prolactin and oxytocin and the production of breast milk. Therefore, the more often the baby is applied to the breast, the more milk is produced by lactocytes. In addition, together with breast milk, a so-called inhibitor substance is produced, which inhibits the further formation of milk ( that is, the more milk, the more inhibitor is produced and the slower new milk is secreted). This protects the mammary glands from overflow.

The main “stimulus” for stopping lactation is the disappearance of the sucking reflex in a child, which is observed at the age of 3-4 years. In the absence of a mechanical stimulus ( irritation of the nipple zone of the mammary gland) there is a decrease in the production of prolactin, as a result of which the process of milk formation slows down and fades away. The glandular tissue of the mammary gland is gradually destroyed, as a result of which it ( gland) may decrease in size.

It is worth noting that if the baby was weaned at an earlier date, lactation will also stop.

Can lactation occur without pregnancy?

The secretion of milk from the mammary glands in women outside of pregnancy and outside the period of breastfeeding ( galactorrhea) can be observed in diseases of the endocrine system and in some other pathological conditions.

The cause of galactorrhea can be:

• tumor of the pituitary prolactinoma). The pituitary gland is a gland that produces hormones that regulate the functions of almost all organs and tissues. If the pituitary tumor consists of cells that produce the hormone prolactin, an increased concentration of this hormone will be maintained in the patient's blood, which may be accompanied by the formation and release of milk from the mammary glands.
• Diseases of the hypothalamus. The hypothalamus is an organ that regulates the functions of the pituitary gland, as well as other endocrine glands. Under normal conditions, the hypothalamus secretes the substance dopamine, which inhibits the secretion of prolactin by the pituitary cells. When the hypothalamus is damaged with infection, trauma, tumor, and so on) this regulatory mechanism may be violated, as a result of which there will be an increased production of prolactin and the formation of milk in the mammary glands.
• Hypothyroidism. This is a disease of the thyroid gland, in which the concentration of hormones produced by it decreases ( thyroxine and triiodothyronine) in blood. This leads to increased production of the hormone thyroliberin by the hypothalamus, which can also stimulate the production of prolactin and galactorrhea.
• Kidney diseases. Under normal conditions, prolactin produced by the pituitary gland circulates in a woman's blood for a certain time, after which it is removed from the body through the kidneys. With a pronounced violation of kidney function, the process of removing prolactin may be disrupted, as a result of which galactorrhea may develop.
• The use of certain medications. Certain medicines ( for example, birth control pills containing estrogens) can also stimulate the formation of prolactin and the release of milk from the mammary glands outside of pregnancy. Another cause of galactorrhea may be the use of drugs that block the action of dopamine at the pituitary level, which will also be accompanied by increased production of prolactin.

Can men be lactating?

The reason for the appearance of milk from the mammary glands of a man may be prolactinoma - a tumor of the pituitary gland, accompanied by an increase in the concentration of prolactin in the blood. However, it is worth noting that this disease is not always accompanied by the formation of milk. The fact is that in the male body an extremely low concentration of estrogen is maintained ( female sex hormones), which are necessary for the growth and development of the mammary glands. This is why even with high levels of prolactin in the blood, galactorrhea in men may be absent.

It is worth noting that galactorrhea in men can be observed with tumors that secrete female sex hormones, as well as with the artificial introduction of these hormones into the body.

Can children be lactating?

The secretion of milk from the mammary glands in children can be observed during the first few days or weeks of their life. This is due to the increased concentration of estrogen in their blood ( female sex hormones), which entered their body from the mother's body through the placenta ( organ that maintains the life of the fetus during fetal development). Increased estrogen concentration can stimulate the production of prolactin ( both boys and girls), which may be accompanied by the release of milk. This phenomenon usually disappears on its own after a while, when excess estrogen is excreted from the body of a newborn baby.

Why does lactation disappear?

The reasons for the disappearance or reduction of lactation during breastfeeding may be some diseases and pathological conditions, as well as improper breastfeeding.

Violation ( weakening) lactation may be due to:

• Hormonal disorders. For normal growth and development of the mammary glands, female sex hormones are necessary ( estrogens), as well as progesterone. At the same time, for secretion ( workings) breast milk requires the hormone prolactin, and for the release of milk from the gland - the hormone oxytocin. If the process of formation or production of at least one of these hormones is disrupted ( what can be observed with infectious lesions of the pituitary gland, if it is damaged during an injury, or with other diseases of the endocrine system), the lactation process will also be disrupted.

• Mastitis. This is an inflammatory disease of the breast, which can be caused by infections, trauma, or other lesions. After suffering mastitis, connective tissue scars may remain in the mammary glands, which are not able to produce milk. This will lead to a weakening of lactation.
• Improper feeding of the child. As mentioned earlier, putting the baby to the breast stimulates the production of new milk. If you feed your baby irregularly, taking long breaks between two subsequent feedings, this can disrupt the process of hormone production ( prolactin and oxytocin) and the formation of breast milk.
• The introduction of complementary foods. Complementary foods are supplementary foods that are recommended for children over 6 months of age in addition to breast milk. If complementary foods are introduced too quickly, the baby will be satiated with it, as a result of which he will not require the breast or will suckle it too sluggishly. This will lead to a violation of the breastfeeding regimen and disrupt the hormonal regulation of lactation, which will be accompanied by a decrease in the amount of breast milk.
• Child diseases. If a child has a weakened sucking reflex, during breastfeeding, there is not enough pronounced irritation of the nipples of the mammary gland, which also disrupts the process of producing new milk.
• Aerophagy. The essence of this pathology lies in the fact that during sucking, along with breast milk, the child swallows a large amount of air. Air enters the baby's stomach and stretches its walls, as a result of which the baby feels full too quickly and stops suckling. According to the mechanisms described earlier, this reduces the production of prolactin, oxytocin and breast milk.
• Medicines. Some medicines ( diuretics, anesthetics, drugs containing male sex hormones and so on) can inhibit the process of milk production in the mammary glands.

How does smoking affect lactation?

It has been scientifically proven that women who smoke have problems with lactation ( that is, its weakening) are 20% more common than non-smokers. Scientists associate the mechanism of development of this phenomenon with the action of nicotine ( a substance that is part of almost all cigarettes, cigars, smoking tobacco, and so on) to the central nervous system. It is assumed that nicotine during smoking activates the production of the substance dopamine. Dopamine inhibits the formation of the hormone prolactin, thereby reducing the rate of milk production in the mammary glands during breastfeeding.

Are x-rays, fluorography, CT, MRI and ultrasound dangerous during lactation?

Performing diagnostic instrumental studies during breastfeeding is not contraindicated, since it cannot affect either the lactation process or the quality of breast milk.

During x-ray or CT scans ( computed tomography) radiation waves are transmitted through the human body, which are partially absorbed by the cells of tissues and organs. As a result of exposure to these waves, certain mutations can be observed in cells. In this regard, there is an opinion among the people that after performing an x-ray, you need to express milk, since it is impossible to feed a child with it. However, this assertion is erroneous. The point is that under normal conditions ( in a healthy woman) mutated cells are quickly destroyed by the body's immune system, as a result of which they do not cause any harm to the woman. Milk, on the other hand, does not contain cells at all, so a single X-ray or CT scan will not affect its composition in any way.

Medications to increase lactation

Name of medication	Mechanism of action	Method of application and dosage
lactogon	This is a dietary supplement based on herbal ingredients ( nettle, ginger, royal jelly, potassium iodide and so on). The drug stimulates the formation of breast milk and maintains lactation throughout the entire period of breastfeeding.	Inside, 1 tablet 3-4 times a day with meals, half an hour before feeding the baby. The course of treatment is 30 days.
Pulsatilla compositum	A complex preparation based on the grass of the lumbago, sulfur and other components. Stimulates the formation of milk during breastfeeding, and also has a moderate sedative effect.	The drug is prescribed 1 ampoule 3-4 times a week. It is administered intravenously, intramuscularly or taken orally ( for this, the solution from the ampoule should be drunk). The course of treatment is 15 - 20 days.
Mlecoin	A complex drug that can stimulate lactation. Produced in the form of granules.	Take orally, sucking 5 granules 30 minutes before meals twice a day ( in the morning and in the evening). Treatment is recommended to continue throughout the entire period of lactation.

Folic acid during lactation

Folic acid is a vitamin necessary for the normal course of cell division processes in the body. In other words, without this vitamin, the growth and renewal of tissues and organs is impossible. During pregnancy, part of the folic acid from the woman's body is transferred to the body of the growing fetus, as a result of which the mother may develop a deficiency of this vitamin. During lactation, part of folic acid is spent on increasing the size of the mammary glands, as well as on the production of breast milk, which also requires its additional intake into the body. This is why it is recommended that all breastfeeding mothers take 300 micrograms of folic acid daily ( in the form of tablets). The course of treatment is 1 month, but if necessary, it can be extended ( after consultation with a doctor).

Mixtures for nursing mothers to increase lactation ( milky way, lactamyl, femilac)

To date, there are many nutritional mixtures enriched with minerals, microelements and macronutrients, amino acids and other substances necessary to support the lactation process. The use of these mixtures in food provides abundant milk production, improves its composition, and also prevents the development of vitamin deficiency states, since they also include all the vitamins necessary for a nursing woman.

• Milky way blend. In addition to vitamins and microelements, the composition of the drug includes an extract of galega grass, which stimulates the formation of breast milk. To prepare the mixture, 1 tablespoon of dry matter should be poured into 150 - 200 ml of hot boiled water or milk ( not boiling water), stir and take orally within an hour after preparation. Take the drug in the indicated dosage should be 1 - 2 times a day for 2 - 4 weeks.
• Lactamyl blend. In addition to vitamins and minerals, this mixture contains components of plants that stimulate the formation of breast milk ( nettle, palm, soybean and other oils, anise, fennel and so on). To prepare a mixture of 50 grams of dry matter, pour 1 glass ( 200 ml) hot boiled water and mix thoroughly. The resulting mixture should be drunk within 40-60 minutes after preparation. The duration of the course of treatment is determined depending on the effectiveness of the drug, as well as on its tolerance by the patient.
• Femilac blend. To prepare the mixture, take 7 - 9 measuring spoons ( are included in the package) dry matter and pour 1 cup ( 200 ml) hot boiled water or milk. After thorough mixing, the mixture must be taken orally. Also dry matter can be added to tea ( 1 - 2 spoons 3 - 4 times a day).

Breast massage to increase lactation

Properly performed breast massage stimulates the production of milk ( by stimulating the receptors of the peripapillary zone and stimulating the production of prolactin). Massage also promotes the release of milk from the acini ( mammary glands), thereby preventing its stagnation.

Breast massage can be performed:

• 1 way. Slightly pressing on the upper sections of the mammary gland with your fingers, perform circular movements with them, gradually going down ( towards the nipple). The procedure should be performed for 20-30 seconds, and then repeated with the second mammary gland.
• 2 way. First, you should lightly press your fingers on the upper part of the mammary gland ( under the collarbone) and then swipe down ( to the nipple), while maintaining a slight pressure on the gland. Repeat the procedure 3-5 times, then move on to the second gland.
• 3 way. Take the nipple with two fingers and gently massage it for 5 to 30 seconds ( it will promote prolactin secretion and milk production).

Perform these simple exercises should be within 4 - 5 minutes after each feeding of the child, but not less than 5 - 6 times a day.

Does pumping and using a breast pump increase lactation?

Expressing breast milk allows you to maintain lactation at the right level or even stimulate it.

Pumping can be useful both for feeding a baby ( in this case, expressed milk is given to the child at regular intervals), and to remove milk from the mammary glands in cases where it accumulates in excess. For example, this can be observed with the introduction of complementary foods, when the child is satiated much faster than usual.

You can perform the pumping procedure manually or using a special device ( breast pump). In the first case, the essence of the procedure is as follows. The peripapillary zone of the gland should be clasped with all the fingers of the hand, and then slightly squeeze it ( gland) with fingertips, moving them to the braid. This procedure should be repeated several times until drops appear from the nipple area, and then streams of milk.

It is much easier to express milk with a breast pump. The essence of this device lies in the fact that it creates negative pressure around the nipple area, as a result of which the milk is “pulled out” from the lobules of the mammary gland, falling into a special reservoir.

Both with manual pumping and with the use of a breast pump, there is a maintenance or increase in breast milk production. The mechanism of development of this effect is that during pumping, the peripapillary zone of the mammary gland is irritated, which triggers the secretion of the hormone prolactin, which stimulates lactopoiesis ( milk production). In addition, the removal of milk from the lobules of the gland reduces the concentration of the inhibitor substance ( which inhibits the formation of new milk), which also stimulates lactation.

Is it possible to drink domperidone to stimulate lactation?

Domperidone is an antiemetic drug that is used to relieve nausea and prevent vomiting, and may also increase lactation.

The mechanism of antiemetic action of domperidone is that it blocks dopamine receptors at the level of the central nervous system ( CNS), thereby eliminating its inhibitory effect on the motility of the gastrointestinal tract. This increases the peristalsis of the stomach and intestines, which accelerates their emptying and eliminates the feeling of nausea.

As mentioned earlier, the secretion of the hormone prolactin responsible for lactation by pituitary cells also depends on the level of dopamine in the CNS ( dopamine slows down the production of prolactin). When using domperidone, the effect of dopamine on the pituitary gland is also blocked. This may increase the concentration of prolactin in the blood, which will stimulate the formation of milk. Some women use this effect of the drug to stimulate lactation. However, it is worth remembering that galactorrhea ( increased milk production) is not the main, but a side effect of domperidone. In addition, the use of this medication may be associated with a number of other adverse reactions ( irritability, headaches, allergic reactions and so on). That is why it can be used to stimulate lactation only after consultation with a gynecologist and only after they have been tested ( and turned out to be ineffective.) other methods.

Increased lactation with folk remedies and herbs ( nettle, dill, fennel) at home

To stimulate lactation, you can use folk recipes based on the use of various herbal ingredients ( herbs, berries and so on).

To improve lactation, you can take:

• Infusion of nettle leaves. To prepare the infusion, you need to grind 50 grams of fresh nettle leaves and pour 500 ml of boiling water over them. Insist for 2 hours, then strain and take 1 tablespoon orally half an hour before meals.
• Infusion of dill seeds. Chopped dill seeds ( 20 grams) should be poured with 200 ml of boiling water and infused for an hour. Strain and take orally 1 tablespoon 10-15 minutes before meals.
• Fennel infusion. To prepare the infusion, 1 tablespoon of fennel seeds should be poured with 1 cup of boiling water or boiled milk and infused for 2 hours. Then the resulting infusion must be filtered and taken orally for 3 doses ( morning, afternoon and evening 10-15 minutes before meals).

Teas for lactation ( hipp, humana, lactovite)

To increase lactation, you can use teas from various plants and herbs, which include components that enhance milk production.

To increase lactation, you can take:

• Tea with fennel and dill. To prepare this tea, you need to mix 10 grams ( half a tablespoon) fennel and dill seeds, pour boiling water over them, cover and leave for 10 - 15 minutes. The resulting tea can be drunk at a time or divided into several doses.
• Human tea. Tea can be purchased at the pharmacy. It consists of a collection of herbs and vitamins that stimulate milk production. To prepare 1 serving of tea, pour 3 teaspoons of granules with boiling water and insist for 10-15 minutes.
• Hippie tea. This is the commercial name of the drug, which includes extracts of many herbs that stimulate lactation ( in particular herbs of fennel, anise, galega, nettle and so on). The drug is produced in the form of granules. To prepare tea, 2 teaspoons of granules should be poured with 200 ml of boiling water and infused for 10-15 minutes.
• Tea is lactic. The composition of this tea also includes extracts of anise, cumin, dill, fennel and nettle. Tea is produced in convenient bags, which you just need to pour 200 ml of boiling water. Brewed tea should be taken 100 ml 2 times a day ( in the morning and in the evening).

It is worth noting that the listed teas practically do not affect the quality of breast milk and do not change its taste, so they will not harm the mother or baby in any way.

How to establish lactation after caesarean section?

A caesarean section is an operation during which the baby is removed from the mother's uterus by artificial means ( not through the natural birth canal). If the operation is performed on time ( that is, if the child is full-term), the mother should not have problems with lactation, since the mammary glands are already prepared to produce milk. It is extremely important that immediately after removing the child ( within the first 30 minutes) he was placed on his mother's breast ( at least for a few seconds). This will calm the woman, and also stimulates the production of the hormone prolactin and the formation of milk. In the future, the maintenance of lactation does not differ from that during natural childbirth.

If the caesarean section was performed earlier ( that is, if the baby is premature), a woman may experience problems with lactation, that is, a lack of milk. This is due to the fact that the mammary glands have not yet had time to prepare for the production of milk, since the child was removed from the womb prematurely. In this case, it is also recommended to attach the baby to the breast immediately after extraction from the uterus, which will contribute to the production of prolactin. In the future, the baby should be applied to the breast regularly ( several times a day). Even if there is no milk at the same time, such a procedure will speed up the process of preparing the mammary glands for lactation. In addition, these women may be prescribed medications, teas, or other lactation-stimulating drugs ( described earlier).

Is it possible to restore lactation after a break in feeding?

It is possible to restore lactation after a break, but this may require a lot of effort.

The reasons for a break in lactation can be:

• Mother's illnesses. Some diseases ( mastitis - inflammation of the mammary gland, hormonal disorders, pronounced nervous experiences, stress, and so on) may be accompanied by the disappearance of milk. In addition, with some infectious diseases, breastfeeding is also not recommended.
• Taking certain medications. When using a number of medicines, it is impossible to feed a child with breast milk, since with it medicines can enter the baby's body and cause a number of complications.
• Travel / work. During long business trips, it is impossible to regularly breastfeed a child, and therefore lactation disorders may develop.

If the break in feeding is not associated with lactation disorders, it is recommended to express milk regularly, which can then be given to the child ( if at this time the woman is not taking any medication) or just throw it away. This will help maintain lactation at the desired level and quickly restore it if necessary. If during the break there was a weakening or complete cessation of lactation, it may take some time to restore it.

The restoration of lactation after a break can be facilitated by:

• Regular breastfeeding. Even if the baby does not start suckling immediately, and when sucking milk is not released, it is necessary to continue to do this day after day, as this procedure will help normalize hormonal levels ( that is, the production of prolactin and oxytocin) and the development of lactation.
• Performing breast massage. Artificial irritation of the peripapillary zone receptors will also stimulate the production of hormones responsible for restoring lactation.
• Taking medications that increase lactation. It can be both pharmacological preparations and folk remedies ( herbal teas, teas, etc.).

How to properly stop stop) breast milk lactation?

Natural cessation of breastfeeding should occur when the child reaches the age of 1-5 years ( ideally - 2 - 4 years). In order to properly wean a child from the breast and avoid the development of complications, a number of rules should be followed when stopping lactation.

To properly stop lactation, it is recommended:

• Timely introduce complementary foods. After the child reaches the age of 6 months, he should begin to give complementary foods - various nutrient mixtures that will partially replace breast milk for him. At the same time, during breastfeeding, the baby will be satiated faster, as a result of which he will suckle less at the breast. This will be accompanied by a decrease in the production of the hormone prolactin and milk. After the child reaches the age of 12-18 months, he should be fed regular food ( nutritional mixtures, cereals and so on), but only as an additional source of nutrition to give breast milk ( no more than 2 - 3 times a day). In the future, the child should be breastfed less and less.

• Wean the baby off the breast. When breastfeeding is stopped, some children may become whiny, nervous, and regularly demand the breast. Feeding an older child older than a year) breast milk at his first request should not be, since in this case it will be extremely difficult to stop lactation. It is important to provide him with adequate nutrition through complementary foods or other food, and when the child requires a breast, give him a pacifier ( pacifier).
• Express "excess" milk. It is extremely important to prevent stagnation of milk in the mammary gland and the development of associated complications ( in particular severe pain, infection, and so on). This is why breast milk is sometimes recommended ( not often, no more than 1 - 2 times a day) express.
• Use medication to stop lactation. If the baby has already weaned from the breast, and milk continues to be produced, you can take special medications that will slow down or completely stop milk production by the mammary glands.

Rapid Discontinuation Tablets ( completion) lactation ( cabergoline, dostinex, bergolac, agalates, bromocriptine)

As mentioned earlier, to stop lactation, you can take special pills. Their mechanism of action is that they all stimulate dopamine receptors located at the level of the central nervous system ( in the pituitary gland). As a result, the production of the hormone prolactin is suppressed, which entails the inhibition of milk production by the mammary glands.

To stop lactation, you can use:

• Cabergoline ( dostinex, bergolak, agalates). To suppress lactation immediately after childbirth, take 2 tablets of 500 mg. To suppress lactation that has already begun, the drug should be taken 250 mg 2 times a day for 2 days in a row.
• Bromocriptine. Inside, 1.25 - 2.5 mg every 8 - 12 hours. The duration of treatment is determined by the doctor.

How to stop lactation without pills ( with the help of folk remedies - herbs of sage and mint)?

To reduce the amount of milk produced, it is not necessary to take drugs that have a large number of side effects. To do this, you can use folk recipes, that is, infusions and decoctions from various plants.

To reduce lactation, you can use:

• Infusion of sage herb. 2 full tablespoons of chopped sage herb should be poured with 500 ml of boiling water and infused for 3 to 4 hours. The cooled infusion should be filtered and taken orally 100 ml ( half a glass) 3 times a day, 15-20 minutes before meals. A decrease in lactation will be noticeable within 2 to 3 days after the start of using the infusion.
• Sage tea. 2 teaspoons of sage herb should be poured into 100 ml of boiling water, infused for 10-15 minutes and taken orally. This tea can be drunk up to 4-5 times a day ( at the same time, it is not recommended to combine the intake of tea with the intake of sage infusion).
• Infusion of mint leaves. 1 tablespoon chopped mint leaves should be poured into 1 cup ( 200 ml) boiling water and insist for 2 hours. Then the infusion should be filtered and taken orally 100 ml ( half a glass) 2 times a day ( in the morning and in the evening) after meal.

Camphor oil to stop lactation

During the interruption of lactation should be regularly ( 1 - 2 times a day) lubricate the nipple and peripapillary region of the mammary gland with camphor oil, rubbing it lightly for 1 to 2 minutes. Camphor oil allows you to wean a child from breastfeeding, and also alleviates the pain experienced by the mother during this period.

The mechanism of action of camphor oil is due to:

• Pungent smell. If you apply oil to the nipple area, the characteristic unpleasant odor will "scare" the child, as a result of which he will lose the desire to suckle the breast.
• Warming action. By irritating the skin receptors at the site of application, the oil creates a feeling of warmth in the peripapillary zone, which to a certain extent reduces the severity of pain in the mammary glands associated with milk stagnation observed during weaning.
• Antibacterial action. Applying oil to the nipple area helps prevent the development of infectious complications in the presence of nipple cracks, as well as with a predisposition to the development of mastitis ( breast inflammation).

Is it possible to bind drag) mammary glands to prevent lactation?

The essence of this procedure is that the mammary glands are tightly bandaged with elastic bandages, pressing them to the chest. This disrupts the process of outflow of breast milk from the lobules of the mammary glands, contributing to its stagnation. This increases the concentration of the so-called inhibitor substance, which partially inhibits the production of new milk. It should be noted that in the past this technique was very popular, as it allowed relatively quickly ( within 5 - 7 days) completely suppress lactation.

To date, gynecologists do not recommend bandaging the mammary glands, as this is associated with a number of side effects ( in particular, the risk of developing infectious complications and inflammation of the mammary gland increases). In addition, when performing this procedure, a woman may also experience severe pain associated with milk production and overflow of the breast lobules, which will also cause her some trouble. It is much easier and safer to stop lactation naturally, and if you need a quick result, you can take special pills or use the folk recipes described earlier.

Before use, you should consult with a specialist.

Prolactin is necessary for the development of the mammary glands and the production of breast milk after childbirth. The pituitary gland, the central organ of the endocrine system located in the brain, is responsible for the production of this compound. During the menstrual cycle, the rate of prolactin in women changes, and its amount in the blood also increases during pregnancy and breastfeeding.

A blood test to determine the concentration of this hormone helps in the diagnosis of certain diseases. The danger is an increased level of prolactin. This condition is often accompanied by disorders in the endocrine system and requires treatment.

Prolactin in the female body performs several functions:

• in adolescence, when puberty sets in, it takes part in the development of the mammary glands: it increases the number of estrogen receptors in them, the hormone responsible for the formation of secondary sexual characteristics;
• during the bearing of a child, it contributes to an increase in the glandular tissue of the breast;
• by the end of pregnancy and after childbirth, it starts and maintains the production of milk in the mammary glands;
• prevents the onset of pregnancy and the appearance of menstruation in the initial period of breastfeeding: inhibits the ovulatory cycle, prolongs the existence of the corpus luteum, reduces the production of progesterone;
• presumably reduces pain sensitivity, that is, it is a natural anesthetic;
• affects a woman's ability to experience orgasm.

The immunostimulatory function of prolactin is currently being studied. Scientists have determined that the surface of the cells involved in the formation of the body's defense reactions is covered with receptors for this hormone.

In which case it is necessary to take the analysis and how?

The concentration of prolactin in the blood increases with some serious pathologies. The analysis is prescribed when there are accompanying symptoms:

• the disappearance of menstruation, lasting longer than 2-3 months, not associated with pregnancy and lactation (amenorrhea);
• the appearance of breast milk in the absence of pregnancy and not in the postpartum period (galactorrhea);
• visual impairment of unknown origin;
• regular headache in the absence of visible disorders;
• inability to conceive (infertility).

For analysis, blood is taken from a vein. In order for the results of the study to be as reliable as possible, it is necessary to adhere to a number of rules when preparing for the procedure:

• refrain from sexual intercourse 24 hours before the analysis;
• avoid irritation of the nipples of the breast for several hours before blood sampling;
• donate blood between 8 and 10 in the morning, since the level of the hormone can change throughout the day;
• wake up 3 hours before the analysis;
• eliminate stressful situations, strong emotional experiences;
• to carry out blood sampling on the 5-8th day of the cycle (5-8 days after the onset of menstrual bleeding);
• do not eat before the procedure.

Hormone rate

Difficulties in the study of blood for the level of prolactin are associated with the determination of its norm. This indicator is not static, the variability is caused by several reasons.

First, there are several isoforms of the hormone: the usual monomeric, sulfide dimer, and macroprolactin. All these compounds have different activity and molecular weight. Normally, about 90% of all isoforms should be a common monomeric compound. But if macroprolactin predominates, the biological activity of which is lower, then a high concentration of the hormone in the blood will not be accompanied by the symptoms and disorders of the endocrine system characteristic of this condition.

Secondly, the limits of the norm depend on what methods and reagents the laboratory uses. Various immunochemical tests and units of measurement are used.

Despite all the difficulties, there is a range of normal values ​​\u200b\u200bfor healthy non-pregnant and non-lactating women. Depending on the phase of the cycle, the norm of prolactin in women is:

• follicular phase - from 4.1 to 30 ng / ml;
• ovulatory phase - from 6.5 to 50 ng / ml (indicators at which conception is possible);
• luteal phase - from 5 to 41 ng / ml.

Hormone levels during pregnancy and lactation

The norms of prolactin indicated above cannot be guided during pregnancy and breastfeeding. During the period of bearing a child, starting from the 2nd month, the concentration of the hormone is constantly increasing.

This is due to the general restructuring of the hormonal background, in particular, with increased production of estrogens. At the 20-25th week, the maximum amount of prolactin in the blood is determined, which is retained until the prenatal period, and then decreases slightly.

This hormone is very important for the unborn child. It is involved in the formation of the lungs and supports the activity of the immune system.

Irritation of the nipples during breastfeeding causes an increase in the level of prolactin in the blood and an increase in the amount of milk produced. This is where the ability of the mammary glands to “adjust” to the needs of the baby comes from: the more often the mother applies it to the breast, the more milk is produced.

Causes and treatments for elevated prolactin levels

If the norm of prolactin in women is significantly exceeded, this condition is called hyperprolactinemia. It is observed in pregnant and lactating women, as well as after severe stress. Since many factors can affect the results of the analysis (taking drugs, certain types of food, emotional stress, etc.), a control blood sample is often prescribed after a month.

If an elevated prolactin level is still determined during re-diagnosis, this may be a sign of the following diseases:

1. A neoplasm in the pituitary gland is a prolactinoma. Accompanied by amenorrhea, infertility, galactorrhea, headache, visual impairment, overweight. Requires neurosurgical diagnosis.
2. Lack of hormones produced by the thyroid gland - hypothyroidism. It is manifested by drowsiness, fatigue, a tendency to depression, anorexia and disruptions in the menstrual cycle. If symptoms are detected, an examination by an endocrinologist is necessary.
3. Eating disorders with refusal to eat - anorexia. It is accompanied by a pathological fear of weight gain and some other mental disorders.
4. Polycystic ovaries. Associated symptoms: violation of the regularity of menstruation, infertility, excessive growth of body hair.
5. Diseases leading to hormonal imbalance: diseases of the kidneys, liver, hypothalamus, etc.

To reduce the level of prolactin in the blood, you need to eliminate the underlying disease. Therefore, treatment depends on the data of a comprehensive examination and an established diagnosis. Medical methods are more commonly used. If malignant neoplasms are found, radiation therapy or surgery to remove them may be prescribed.