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Milk production is initiated in the breasts in the post-partum
period due to prolactin production and decreased estrogen
and progesterone after delivery of the placenta.
The onset of lactogenesis (the production of breast milk) has been
shown to be delayed by stressful events around delivery. Women who
underwent an urgent Cesarean section or had a long duration of labor
before vaginal deliveries were more likely to have a delayed onset of
breast fullness in the first days after delivery (
Dewey, 2001
).
By day 3 or 4 post-partum,
stimulation of the breast by suckling is required to continue
milk production.
Mothers produce milk between feedings due to elevated baseline levels
of prolactin.
They produce more milk during feedings due to the prolactin surge
caused by suckling
(
Lawrence, 2005
p79-86,
Daly (part 2), 1995
).
During continued lactation,
milk production is based on infant demand.
The average mother's ability to produce milk is much greater than the
average infant's appetite (
Daly, 1995
).
The rate of milk production varies over the day.
If a breast is not emptied at the end of the feeding,
that breast produces less milk prior to the next feeding
than it would have if the breast had been emptied completely
(
Daly (part 2), 1995
,
Wilde, 1998
,
Peaker, 1998
).
Suckling or any nipple or breast manipulation stimulates sensory nerves in
the areola and nipple.
These nerves stimulate the pituitary gland to release
oxytocin along with prolactin.
A conditioned milk ejection can occur when a woman hears her baby cry.
This is due to a conditioned release of oxytocin
without the release of prolactin
(
Lawrence, 2005
p79-86).
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