Lactation suppression. 1980

N K Kochenour

In spite of a very recent upsurge in breast-feeding in industrialized countries, approximately one-half of parturients are candidates for postpartum lactation suppression. The mechanisms controlling lactation are complex and involve preparation of the breast during pregnancy, stimulation of secretion of milk in the immediate postpartum period, ejection of milk from the alveolar cells, and maintenance of milk production during the period od lactation. The local effects of estrogen and progesterone in the breast prevent milk secretion during pregnancy. With their withdrawal in the postpartum period, the stimulating effect of the anterior pituitary hormone prolactin dominates and milk secretion is initiated and maintained. Milk ejection is accomplished by a neurohormonal reflex resulting in stimulation of the myoepithelial cells of the breast by the posterior pituitary hormone oxytocin. Local stimulation of the breast by suckling is important in initiating the release of oxytocin and also the secretion of prolactin. The suppression of lactation in the postpartum period can be accomplished in approximately 60--70% of females by the use of a tight brassiere and avoidance of stimulation of the nipples. An additional 10% or so of females can be helped with the use of estrogens during the postpartum period. The addition of an androgen to the estrogen increases the success rate of lactation suppression to about 90%. Unfortunately, the use of estrogen alone or in combination with an androgen is accompanied by rebound lactation in a significant number of patients and has been associated with an increased incidence of postpartum thromboembolic disease. Lactation suppression by inhibiting prolactin secretion with synthetic ergot alkaloids such as bromocriptine has been shown to be safe and highly effective both immediately post partum and after lactation has been established. The 2 week period of therapy required with this drug may be unsatisfactory for some patients. If given immediately at delivery, a single injection of testosterone enanthate and estradiol valerate is equally effective in suppressing lactation and, in the young patient who has delivered vaginally, is not associated with significant risk.

UI MeSH Term Description Entries
D007774 Lactation The processes of milk secretion by the maternal MAMMARY GLANDS after PARTURITION. The proliferation of the mammary glandular tissue, milk synthesis, and milk expulsion or let down are regulated by the interactions of several hormones including ESTRADIOL; PROGESTERONE; PROLACTIN; and OXYTOCIN. Lactation, Prolonged,Milk Secretion,Lactations, Prolonged,Milk Secretions,Prolonged Lactation,Prolonged Lactations
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011388 Prolactin A lactogenic hormone secreted by the adenohypophysis (PITUITARY GLAND, ANTERIOR). It is a polypeptide of approximately 23 kD. Besides its major action on lactation, in some species prolactin exerts effects on reproduction, maternal behavior, fat metabolism, immunomodulation and osmoregulation. Prolactin receptors are present in the mammary gland, hypothalamus, liver, ovary, testis, and prostate. Lactogenic Hormone, Pituitary,Mammotropic Hormone, Pituitary,Mammotropin,PRL (Prolactin),Hormone, Pituitary Lactogenic,Hormone, Pituitary Mammotropic,Pituitary Lactogenic Hormone,Pituitary Mammotropic Hormone
D001940 Breast In humans, one of the paired regions in the anterior portion of the THORAX. The breasts consist of the MAMMARY GLANDS, the SKIN, the MUSCLES, the ADIPOSE TISSUE, and the CONNECTIVE TISSUES. Breasts
D004338 Drug Combinations Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture. Drug Combination,Combination, Drug,Combinations, Drug
D004876 Ergot Alkaloids Alkaloids originally isolated from the ergot fungus Claviceps purpurea (Hypocreaceae). They include compounds that are structurally related to ergoline (ERGOLINES) and ergotamine (ERGOTAMINES). Many of the ergot alkaloids act as alpha-adrenergic antagonists. Clavine Alkaloids,Alkaloids, Clavine,Alkaloids, Ergot
D004967 Estrogens Compounds that interact with ESTROGEN RECEPTORS in target tissues to bring about the effects similar to those of ESTRADIOL. Estrogens stimulate the female reproductive organs, and the development of secondary female SEX CHARACTERISTICS. Estrogenic chemicals include natural, synthetic, steroidal, or non-steroidal compounds. Estrogen,Estrogen Effect,Estrogen Effects,Estrogen Receptor Agonists,Estrogenic Agents,Estrogenic Compounds,Estrogenic Effect,Estrogenic Effects,Agents, Estrogenic,Agonists, Estrogen Receptor,Compounds, Estrogenic,Effects, Estrogen,Effects, Estrogenic,Receptor Agonists, Estrogen
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000728 Androgens Compounds that interact with ANDROGEN RECEPTORS in target tissues to bring about the effects similar to those of TESTOSTERONE. Depending on the target tissues, androgenic effects can be on SEX DIFFERENTIATION; male reproductive organs, SPERMATOGENESIS; secondary male SEX CHARACTERISTICS; LIBIDO; development of muscle mass, strength, and power. Androgen,Androgen Receptor Agonist,Androgen Effect,Androgen Effects,Androgen Receptor Agonists,Androgenic Agents,Androgenic Compounds,Agents, Androgenic,Agonist, Androgen Receptor,Agonists, Androgen Receptor,Compounds, Androgenic,Effect, Androgen,Effects, Androgen,Receptor Agonist, Androgen,Receptor Agonists, Androgen

Related Publications

N K Kochenour
September 1967, Canadian Medical Association journal,
N K Kochenour
June 1968, Rivista di ostetricia e ginecologia,
N K Kochenour
April 1969, British medical journal,
N K Kochenour
January 1986, The Medical journal of Australia,
N K Kochenour
April 1986, The Medical journal of Australia,
N K Kochenour
November 1969, British medical journal,
N K Kochenour
July 1979, Seminars in perinatology,
N K Kochenour
November 1964, [Sanfujinka chiryo] Obstetrical and gynecological therapy,
N K Kochenour
January 1997, Oncology reports,
N K Kochenour
October 1981, The New Zealand medical journal,
Copied contents to your clipboard!