What is prolactin?
Prolactin is a hormone that helps your breasts grow while you are pregnant and in the first few weeks after giving birth. It also helps stimulate milk production for as long as you are breastfeeding. Breastfeeding frequently in the first few weeks after giving birth is important in setting up your long term milk supply. If for any reason your baby is unable to breastfeed, hand expression and pumping should be used as a way to stimulate your milk supply.
Why, you ask?
In the first few weeks, frequent feedings help stimulate the production of prolactin receptor cells in your breasts. Prolactin receptor cells are important in determining your long term supply. Right after birth your prolactin levels are high, but these slowly come down over the following months, and the more prolactin receptor cells you have, the better they can work with the lower prolactin levels. If you don’t have enough prolactin receptor cells, then your supply will decrease along with your prolactin levels. Increasing your prolactin levels can be done, but isn’t easy and in the U.S.A, the drug of choice to do this is not readily available. Your best bet for a great long term milk supply is for your baby to breastfeed frequently and effectively in the first few weeks. If your baby is unable to breastfeed for any reason, pump and hand express as if your baby was breastfeeding, 8 to 12 times a day.
What about engorged breasts?
Just to make matters a bit more complicated, very full breasts aren’t good either, unless we can relieve the fullness fairly quickly. When your breasts are too full, the shape of the prolactin receptor cells changes, and they can’t pick up the prolactin that is there. This means that less milk will be made. It makes sense, if your breasts are full, why would your body want to make more milk. Softer breasts make milk at a much faster rate than firm breasts. However, if this happens for too long, then the result is that your body will slow down milk production to an extent that you may end up with a lower supply.
What should you do?
The best line of defense is still a good offense. Start on the right path with lots of breastfeeding. I know that in those first few
overwhelming weeks it seems like a reasonable thing to offer your baby some formula so you can sleep. The truth is that you aren’t doing yourself any favors in the long run. Even one bottle can lead to less prolactin receptor cells being made, and if your breasts get overly full, can change the shape of those you do have so they can no longer do the work they are meant to do.
If you have done all you can and still feel your supply is low, low levels of prolactin can be the cause and you should consider getting your levels checked. Also consider making an appointment with a MilkOnTap IBCLC to discuss other options.