Lactation hormones - in simple words about complex processes. Lactation hormones: the hormone responsible for lactation Are hormones released during breastfeeding

98% of women are physiologically able to breastfeed for as long as they want. The World Health Organization recommends exclusive breastfeeding for infants under 6 months of age, and continued breastfeeding up to 2 years of age or beyond.

Each of them was originally laid down for hyperlactation - that is, for the production of a very large amount of milk. Therefore, it is important to know and understand how the chest actually “works”.

2 hormones are responsible for the production and excretion of milk, which are produced by the pituitary gland: oxytocin and prolactin.

Prolactin

Prolactin is directly responsible for milk production. It is produced ONLY in response to the baby sucking at the breast. Moreover, if the baby is attached to the breast incorrectly or sucks inefficiently (weakly), then it will be poorly developed. It looks something like this: the child begins to suckle the breast - a signal about this enters the brain - the pituitary gland of the brain begins to produce prolactin - prolactin enters the bloodstream - thanks to this, milk is produced between feedings. When the baby starts to suck again, it is this prolactin produced in the previous feeding that causes the mammary glands to produce milk.

Those. every time we feed a baby, we “order” milk for the next feeding. Prolactin does not live in the blood for long, about an hour and a half, so feeding once every 3-4 hours reduces milk production approximately exponentially. It is necessary to feed the child at his request, but at least 2 hours during the first 3 months.

Oxytocin

The second hormone - oxytocin - is responsible for the release of milk from the breast.. A lot of things influence its production: the suckling of the baby at the breast, the sight, the smell, the crying, thoughts about the baby. Various enjoyment. Drinks to increase lactation. This hormone suppresses stress, fatigue and self-doubt.

Its production during feeding looks like this: the baby sucks the breast - the pituitary gland produces oxytocin - oxytocin causes the breast muscles to contract, helping to squeeze milk out of the milk ducts - the woman feels this as a tightening, tingling and buzzing in the chest, calling it "milk rush". As successful lactation is established, these “tides” cease to be felt, but this does not mean that oxytocin is not produced.

Colostrum

In the first days after the birth of a child, the mammary glands of the mother produce the so-called colostrum., i.e. immature breast milk. Colostrum contains 3-5 times more protein than mature breast milk. The level of lactose is 1.5-2 times less than in mature milk. Colostrum also surpasses it in the content of fat-soluble vitamins (A, E, K), ascorbic acid, mineral elements - sodium, phosphorus, zinc, as well as class A immunoglobulins.

The amount of fat in colostrum is approximately the same as in mature breast milk, but colostrum fat contains a large amount of phospholipids, cholesterol, linoleic (essential polyunsaturated) acid, saturated fatty acids (myristic, palmitic, stearic) necessary for building cell membranes at this age .The activity of the hydrolytic enzymes included in colostrum - trypsin, triacylglycerol-lipase and alpha-amylase - stimulates the digestive process in the gastrointestinal tract of the newborn. Its calorie content is 1500 kcal / l on the first day, then it decreases by day 5 to 700 kcal / l.

The proximity of colostrum proteins to blood serum proteins and high calorie content make it especially suitable for feeding newborns and premature babies. Therefore, colostrum is called "white blood". Colostrum has an immunological protection function, which interprets the expediency of putting the baby to the breast immediately after birth.

mature milk

Mature milk is divided into "front" and "hind". The anterior is produced between feedings and accumulates in the expansion of the ducts in front of the nipple. It is very rich in carbohydrates, the main of which is lactose. This milk is very thin and not fat at all. many women believe that they have poor quality milk because it is "clear". But this is the correct "front" milk. It's a drink for a child. "Hinder" milk is produced ONLY at the time of feeding. It does not "spout" like the "front", but is squeezed out drop by drop.

It is rich in proteins and fats. It contains enzymes that help digest lactose, namely lactase and lipase.

If the child is limited in attachments, often change the breast and take it away, then the child may begin lactase deficiency, which is treated very simply - it is enough to establish proper breastfeeding. Also, a baby may not get enough milk if he does not latch correctly, for example, if he suckles only the nipple or a small part of the areola.

The effect of breastfeeding on the baby

The baby needs to suck on the breast not only for food, but also for calming, bodily contact with the mother. etc. Don't be afraid to breastfeed your baby as often as he asks. He won't eat more than he needs. Spitting up is also not something to be afraid of. Normally, the child has the right to spit up every time after feeding 1-2 tbsp. and once a day with a "fountain" -3 tbsp. l. Whether or not the baby has enough milk is checked by the “wet diaper” test.

We remove the diaper for a day and count urination. Normally, there should be 8 or more. If there are less than 8, but more than 5, contact a lactation consultant. The stomach is not actually involved in the digestion of milk. Milk passes through it in transit, stays in it for 15-20 minutes, and then enters the intestines, where it digests itself and is absorbed by the intestinal walls.

With frequent feeding, the stomach DOES NOT stretch, and at night it should not rest, it almost does not work anyway.

After 6 weeks of life, the child begins to poop less often than in the first weeks of life.. This happens due to the establishment of lactation - colostrum contains laxative components, while mature milk does not. Therefore, the child can poop as 3-4 times a day (a little bit) and once every few days. Milk is well absorbed by the body and its "waste" gradually accumulates in the intestines and "comes out" once every few days.

Their color is yellow or light brown, inclusions of white lumps (fat) are possible, the consistency is mushy, the smell of cottage cheese. If all the characteristics of the stool are normal, then the child does not have constipation and does not need laxatives. Please note that pediatric norms are designed for artificial babies, for whom constipation is a common and very harmful phenomenon, so they must poop every day. A nursing mother needs to consume as much liquid as she wants.

Now it's time for us to talk about what other recommendations can be given for those women who are in the period of completion of breastfeeding. There are several nuances in this matter, in addition to nutrition and the possibility of weight gain, in particular, it is the stabilization of the hormonal background, the alignment of the psycho-emotional background and the return to the usual, non-nursing life. Let's start with the question of stabilizing the hormonal background of a woman, as a guarantee of her health and normal well-being.

Questions about hormones

We all remember very well that lactation is a hormonally dependent process, and it will be directly determined by a stable amount of prolactin and oxytocin. What recommendations should be taken into account by mothers who complete the process of breastfeeding so that all the functions of the female body can return to normal as soon as possible? It must be remembered that the hormonal background of the body can depend on many factors, sometimes seeming quite insignificant, and the production of hormones by the body in the required quantities and ratios is a very delicate and sensitive system. The production of hormones is directly related both to the diet and the general daily routine, as well as to the influence of the environmental environment, work, and household factors. Significantly, the level of hormones can change due to viral infections, severe diseases of the body, or many other processes. As a result, a woman's menstrual cycle can go astray and lactation is disturbed, seemingly from very insignificant factors, especially if these are psycho-emotional experiences.

When you need some time to return to normal life again - you don’t need to actively change everything in your life on the very first day without breastfeeding - you are still in a special state of physiological stress. You need to part with your image of a nursing woman gradually, without sudden jumps and distortions. Having finished breastfeeding, you do not need to immediately go to work on the same day (if there is, of course, such an opportunity), you need to give your body time to adapt to the new living conditions for it. And remember the recommendations that existed for you earlier - if lactating women need to rest more, eat properly and fully, be more in the fresh air, then you will need the same regimen in the first two to three months after breastfeeding is completed - you are still enough vulnerable and fragile. And in general - a woman needs to take care of herself at any age - if her mother gets sick, who will take care of all family members?

How long will the restructuring of hormones last in a recently lactating female body? On average, it takes at least three months for a full hormonal adjustment, on average it is from two to six months, based on the initial characteristics of a woman's body. And this is true for all areas where hormones are involved - for example, for those women who take hormonal contraceptives, it is also worth missing at least three months from cancellation in order to start a full conception. This is necessary to stabilize and equalize the hormonal background. And the same applies to the issue of using hormonal contraception after the end of the lactation period - it is worth letting the body adjust to a new stage of work for it and give the body a rest for at least three to six months, and not take pills immediately after the end of feeding. You need to give your body time to recover and rest from feeding, and only then use hormonal contraceptives.

However, in the vast majority of cases, everything turns out just the opposite - the mother goes to work at the same time as the end of the breastfeeding period, and begins to take hormonal contraceptives to protect herself from a new unwanted pregnancy. And what's more, many young women look forward to the end of the breastfeeding period in order to go on diets and lose weight immediately. They are engaged in all kinds of fasting and “therapeutic” cleansing, fasting days are used, and so on. In general, they stress their still very vulnerable body with increased loads. Stop girls - don't torture yourself like that. Breastfeeding a child is a very serious and big job for the body for more than one year, it requires a lot of expenses for the body, not only in terms of calories, but also in terms of resources of the woman's body. Therefore, after the end of breastfeeding, you fully deserve rest and recovery. Take care of yourself and your body seriously!

Signs of completion and possible problems

But by what signs of the body can a woman understand that her completion of lactation was quite successful and that the function of breastfeeding has already curtailed painlessly, and the body has already rebuilt its normal life? First of all, with the early termination of lactation, this is the formation of regular menstruation, although many long-term lactating women note that they do not have menstruation all the time of lactation. So, from the moment of the abolition of breastfeeding, menstruation should fully recover within six months. If, during the formation of menstruation or without it, signs of pathological premenstrual syndrome appear - PMS, pain occurs in the mammary glands or psycho-emotional instability is formed - this indicates that the correct hormonal adjustment of the body has gone astray. In such cases, it is necessary to contact specialists to find out why such changes occur in the body and how to help your body fully adjust its previous functions.

But what kind of doctor should a woman who has recently completed feeding and is worried about her hormonal levels go to? The question is complicated - it seems that this is not quite the task of a gynecologist, and not a mammologist either. And this can sometimes become a problem, because it seems that your well-being does not suffer much, practically does not bother you, except for a few days in a month, and you don’t really want to go to doctors and sit in lines, leave a child with someone. Many women do not consider it a big problem at all that menstruation does not come after the end of the breastfeeding period - and live with it for a long time, not finding time for themselves and accumulating a load of problems, which can then result in serious health problems. By the way, normal menstruation after a period of breastfeeding may not come due to a deficiency in a woman’s body of certain substances and trace elements - it can be protein, iodine or iron, it’s just that hormones simply have nothing to produce for the normal functioning of the body! The basis of hormones for the female body is proteins and fats, and often no hormonal correction is needed for the onset of menstruation - it is enough to adjust the diet and drink a course of multivitamin-mineral supplements.

It also happens that against the background of breastfeeding, menstruation can occur quite early - and earlier than six months too. This can be taken as body signals that lactation is beginning to come to an end, because it is prolactin that blocks menstrual functions? Can the appearance of menstruation be taken as a signal of a decrease in the amount of prolactin and a danger to breastfeeding? This statement is not entirely true - there is no direct relationship between the occurrence of menstruation after childbirth and lactation. Of course, as the number of applications decreases, the level of prolactin decreases and it may no longer be enough to block menstruation in a woman. But, at the same time, it may well be enough for a woman to produce enough milk to feed a child for another year, or two, or even three years. And even after a woman has stopped breastfeeding and she has full regular menstruation, a certain amount of free prolactin is still circulating in the blood - a woman's body cannot abruptly stop its production the very next day after the end of feeding.

Therefore, for some time there may be slight rushes of milk in the breast, and rather not even rushes, but breast fullness. And if suddenly the child is attached to the breast - milk can appear in a fairly large amount. But if an increased amount of prolactin persists in a woman for a sufficiently long period after the end of lactation, this can lead to irregular menstruation, irritability and emotionality. This condition outside lactation must be corrected. With an increased level of prolactin after lactation, doctors talk about psychogenic "not letting go" from the baby's breast. This is a kind of manifestation of hyper-custody and increased maternal instinct. This is already work on oneself - after all, lactation is not eternal and someday the baby will still refuse to breastfeed!

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.

Changing the ratio of hormones in a woman's body during the period of bearing a child is a natural process. All physiological systems are rebuilt to ensure the full development of the unborn child.

During pregnancy, the balance of hormones changes. The leading role belongs to progesterone, estradiol.

For nine months the body works in an enhanced mode, changes occur at all levels - biochemical and cellular. Restoring hormonal balance after childbirth takes time. During lactation, the level of prolactin is high, which lowers. During the period of breastfeeding, their concentration is below normal values.

Avoid severe forms of hormonal failure:

With a successful postpartum recovery period, the level of hormones stabilizes no earlier than 1-2 months after the end of breastfeeding. Many factors affect the body of a woman in labor, so cases of hormonal failure are not uncommon.

Causes of postpartum hormonal imbalance

Difficult pregnancy, difficult childbirth with complications, caesarean section cause hormonal imbalance. For the same reasons, the recovery period for normal hormone levels will be longer than after natural labor. Other factors also delay rehabilitation:

breast milk is not produced;
malnutrition;
lack of rest;
lack of postpartum activity not related to the child;
stress and anxiety;
diseases immediately after the birth of a child;
taking medications;
drinking alcohol;
smoking;
unfavorable environmental conditions.

The hormonal background after childbirth normalizes slowly.

Symptoms

With the advent of a baby in the house, a young mother experiences physical overload. Deterioration of well-being, frequent mood swings, jumps in blood pressure, the appearance of edema, the occurrence of dizziness are signs of negative changes in the body.

Symptoms of hormonal imbalance after childbirth include:

low performance, frequent depression, unexplained outbursts of aggression, decreased libido are associated with insufficient estrogen production;
painful, profuse, prolonged menstruation - an indicator of a low concentration of the main;
the cause of insomnia, superficial sleep is a lack of progesterone;
low concentration of prolactin causes a violation of the production of breast milk;
excess excess weight or its decrease with normal nutrition is associated with a violation of the concentration of thyroid hormones.

Hormonal failure is reflected in the external state of a woman - hair falls out, skin rashes appear, tooth enamel is destroyed, excessive sweating occurs. With these symptoms, you should consult a doctor to prevent complications..

Violation of the ratio of estrogens and progesterone leads to postpartum depression. It inevitably causes discord in the work of internal organs and their systems.

For the treatment of severe hormonal failure after childbirth, qualified medical assistance is needed.

Restoration of menstruation

During breastfeeding, a woman does not have maturation of follicles (eggs). It suppresses the secretion of progesterone, which directly regulates the uterine cycle. The first menstruation should be expected after the complete end of lactation. Each attachment of the baby to the breast stimulates the secretion of prolactin.

Hormonal adjustment , the resumption of the menstrual cycle is directly related to lactation:

Normalization of the uterine cycle after childbirth indicates a complete restoration of hormone levels.

Treatment of hormonal disorders

To clarify the diagnosis, the doctor prescribes, finds out the reasons that provoked the failure. Perhaps the cause of excess weight, depression, poor health is related to the woman's lifestyle, stressful situation or other external factors. If the deterioration is associated with hormonal disorders, special treatment is carried out..

Several specialists are involved in restoring the hormonal background after childbirth - a gynecologist, an endocrinologist, a therapist. Laboratory studies of urine and blood reveal a hormone whose level needs to be regulated. With timely access to specialists, strict implementation of their recommendations, the concentration and ratio of hormones is restored.

Medically

An endocrinologist (therapist, gynecologist) prescribes drugs to stabilize the hormonal balance based on laboratory tests and individual characteristics. Among the medications for the treatment of postpartum hormonal disorders:

Esstrinol;
Cordyceps;
Cyclodinone;
Biozinc;
Biocalcium;
Anti-lipid tea;
Cellulose.

Folk methods

The hormonal background in the postpartum period is normalized with the use of decoctions:

sage;
cinquefoil;
oregano;
hops;
fenugreek;
nettles.

The active substances of these plants help the body cope with the lack of estrogen. During breastfeeding, prolactin production is activated. The use of medicinal herbs must be agreed with the doctor.

To stabilize the condition of a woman after childbirth, products will help:

sea fish, black cumin seed oil, olive oil, linseed oil, nuts (rich in useful omega-3 fatty acids and cholesterol, necessary for the synthesis of sex hormones);
chicken meat, turkey, beef, eggs, hard cheese, tomatoes, bananas, dates (sources of the amino acids tryptophan, phenylalanine, which are important for the synthesis of endorphins and stabilization of the emotional state).

External and internal factors cause hormonal failure after childbirth. This condition has severe symptoms. When they appear, it is necessary to seek the help of specialists to clarify the diagnosis and conduct adequate treatment.

Medicines, medicinal plants, proper nutrition, adherence to the daily routine will help to recover after childbirth.

You have already got used to a new role for you - the role of mother. It's time to remember that you are a woman and take some time for yourself. The raging hormones return to normal only after the woman stops breastfeeding her baby. Not only the quantity and quality of milk, but also the intensity of production of other hormones depends on the concentration of prolactin responsible for lactation - if more than one, then less than others.

When breastfeeding ends, the level of prolactin decreases, and a signal goes to the brain that allows the production of other biologically active substances. The body immediately increases the amount of progesterone and estrogens, on which the menstrual cycle depends. The woman's body is being rebuilt in accordance with the tasks that become relevant, in particular, it will hasten to restore its reproductive function.

For everything to go smoothly

Prolactin levels rise gradually throughout pregnancy. By the time the baby is born, when milk becomes in demand, this hormone in the body of the expectant mother is enough to start breastfeeding immediately after birth. Accordingly, by the end of lactation with a gradual reduction in the number of feedings, the level of prolactin also gradually decreases. From this point of view, in order for the process of completing lactation to be painless for the body, with less stress, it is important to introduce complementary foods into the baby's diet in time. As a result, the number of feedings will gradually decrease.

By the end of lactation (a year and a half after childbirth), the mother feeds not 12 times a day, as at first, but 2-3 times. But sooner or later there comes a time when even rare breastfeeding must be stopped altogether. Then it is better to curtail lactation function at once. It will be difficult for the body to rebuild if the end of natural feeding occurs in parts, and episodic attachment of the baby to the breast continues. Each such “unscheduled” feeding of the crumbs can cause jumps in prolactin, and as a result, a violation of the hormonal background.

IMPORTANT! It is advisable to start protecting yourself from unwanted pregnancy with the help of hormonal drugs three, and preferably six months after a regular cycle of menstruation is established, interrupted by pregnancy and lactation.

No sudden movements

The restoration of the hormonal background depends on many factors, and the production of hormones in the right ratio is a very delicate mechanism. It is associated with the daily routine, diet, psycho-emotional state, environmental situation, past viral infections. Completion of breastfeeding is a difficult period for a woman. Do not rush to radically change your lifestyle immediately. Let your body adjust to the new conditions. At the end of lactation, you should still observe the same “sanatorium-resort” regimen for some time - more rest, be in the fresh air. It is very important to continue to eat well. Indeed, often the hormonal background fails simply due to the fact that the body of a young mother lacks some elements - iodine, iron or even protein. Hormones are ready to be produced, but there is no building material for them ... To normalize the hormonal background, hormone therapy is not required - it is enough to adjust the diet and daily routine. At the same time, pay attention to the beneficial properties of pineapple and some other exotics.

Almost all young mothers in our country are deficient in iodine. In this regard, during pregnancy, all women are advised to take drugs with iodine. A lack of iodine in a future mother can increase the level of thyroid hormones, in particular the hormone TSH. This can lead to the development of heart defects in the fetus. It is advisable to take tests for hormone levels even before conception. After all, it also happens that a woman already has some kind of endocrine pathology before pregnancy. It gets worse during pregnancy. As a result, after birth, the hormonal background does not return to normal, and drug treatment is required.

Restoration of menstruation

Every woman who has given birth is interested in the question of when she should expect the return of "critical days". The rate of recovery of the menstrual cycle directly depends on the hormonal background. And it is closely related to lactation.

✓ If a child eats only breast milk and receives mother's breast at any time of the day, as they say, on demand, then the resumption of menstruation should be expected not earlier than the end of the baby's first year of life, approximately by the end of the lactation period.

✓ With the introduction of complementary foods, the child receives less breast milk during the day, and then the restoration of the menstrual cycle after childbirth can begin before the end of the breastfeeding period.

✓ If the baby was supplemented with milk formula from birth, i.e. he was on a mixed diet, then the restoration of menstruation after childbirth occurs, as a rule, at 3-4 months of the baby's life.

✓ When the baby is bottle-fed from birth and does not receive breast milk at all, ovulation begins approximately 10-12 weeks after the baby is born.

FACT! The formation of a regular menstrual cycle no later than six months after the end of breastfeeding indicates that the woman's body has been hormonally rebuilt.

Something is wrong

It happens that the lactation period is over, but the long-awaited hormonal balance in the body does not occur. In this case, do not delay visiting an endocrinologist and take a blood test for hormones. Pregnancy can be a kind of trigger for various diseases, including endocrine ones. What symptoms should alert you?

✓ INSSONNESS. You cannot fall asleep for a long time or the dream is short, disturbing, with frequent awakenings. This may be due to a sharp drop in progesterone levels. It has a relaxing effect, so when the amount of this hormone decreases, you experience overexcitation.

✓ SAD MOOD. This condition can be caused by low levels of estrogen in the body - a hormone that keeps you young and positive in life.

✓ APPEARANCE CHANGES. If symptoms such as hair loss, weight gain, constipation, tachycardia, dry skin appear, thyroid hormones should be checked.

✓ SUDDEN FLUSHES OF MILK, IRREGULARITY OF MONTHLY can be caused by the so-called "free prolactin" circulating in the blood, when the body does not stop its production even after the end of lactation.

* * *

The hormonal background of a young mother is restored after the cessation of lactation, on average after 1-2 months, in some cases, menstruation can resume even during breastfeeding. While a woman is lactating, it is best to refuse to take combined oral contraceptives. If, after stopping breastfeeding, the menstrual cycle is not restored for more than 1 month, consult a gynecologist or gynecologist-endocrinologist. There is no need to specifically take blood tests for hormones after pregnancy. From contraception after the end of lactation, it is best to use combined oral contraceptives (COCs). Modern COCs contain in their composition natural estrogen - estradiol, identical to the hormone that is produced in the body of a woman in the ovaries.