Hormones involved in Lactation and milk supply

For many women breastfeeding is not as easy as it sounds and takes some practice. It's a learning curve for both you and your baby. Here this article explains how breastmilk is made and if you are struggling with your milk supply there are a few useful tips to help increase this.

There are 2 hormones involved in the production of breast milk

Prolactin

When a baby sucks at the breast, impulses that are fed to your brain secretes prolactin, this is then transported in the blood to the breast where it tells the cells in the breast to start producing milk.

The milk producing cells in the breast have 'magnets' or receptors that attract the prolactin to them, but they need to be primed first in order for more milk to be produced. They are most sensitive immediately following the birth and that's why it is most important for baby to initiate breastfeeding or skin to skin contact immediately after delivery.

If these 'magnets' are not primed the resultant milk supply will remain at a low level for the duration of breastfeeding so early and frequent breastfeeding in the first few days is important to ensure a good milk supply, both then and later.

Prolactin levels remain high for 90 mins after a feed and make the breast produce more milk for the next feed.

  • If baby suckles more then the breasts will produce more milk.
  • If baby suckles less then she will produce less milk.
  • If baby stops sucking then your breasts will soon stop making any milk.

It is quite normal for the first 24 hours to produce minimum amounts of colostrum, it may only be a few drops initially but the more you feed your baby the more milk will start to come through with correct positioning and attachment.


Breast Anatomy and the Lactation cycle

Oxytocin

Think of this hormone acting upon muscles in your body, it is the same hormone that acts upon your uterus to contract in labour (contractions). It is also known as the let down reflex.

In breastfeeding, the milk producing cells are surrounded by very small muscles, when baby suckles on the breast the sensory impulses from the nipple is sent to the brain which releases oxytocin into the blood stream.

This then acts upon the muscles that surround the milk producing cells to contract. This propels the milk out of the breast when the baby suckles.

  • Oxytocin is produced more quickly than prolactin but enough is stored in the breast for each feed.
  • The oxytocin reflex (or let down reflex) is easily triggered off and affected by other factors not only breastfeeding.
  • The mothers thoughts, feelings and emotions can affect the flow of milk.
  • If mum is feeling positive towards her baby, thinking lovingly and feeling confident that her breast milk is good for her baby, then this will help get a really good flow of milk.
  • Sometimes even a crying baby or the thoughts of feeding a baby can trigger off the Oxytocin reflex, therefore mums that are separated from their babies in Neonatal care can express their milk with a photo of their baby next to them.

It is very important to have your baby with you at all times so that the production of milk is maximised.


How to overcome a fall in milk supply

Frequent feeding or expression will speed up the milk production by removing the protein each time, whereas infrequent or restricted suckling will slow it down.


The following points about how breast milk is produced is important for the mother to know:

  1. Early and frequent feeding in the first few days will encourage the prolactin magnets to become primed, ensuring a good milk supply.
  2. Prolactin levels are higher at night, and a breastfeed during the night will produce a larger surge of prolactin than one given during the day so night feeding is important to keep the milk supply going.
  3. Being near to baby will keep the mothers milk flow going.
  4. Allowing baby to feed as long as he wants will ensure effective removal of milk and maintain milk supply.

Other Factors affecting milk supply

  1. Breast milk production is mainly controlled by hormones from the brain but each breast can control the amounts of milk is made.
  2. It is possible for one breast to stop making milk and the other to continue, even though the same amounts of hormones are being produced. This is down to a protein contained within the milk in each breast that can reduce or even stop milk production.
  3. If the breast contains a lot of milk, this protein acts to slow down further production so that the breasts don't become too full. If breast milk is removed by feeding or expressing then the levels of this protein falls and more milk is made.


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