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Chemical structure of progesterone, a key hormone in the onset of lactation. Clinically, obstetricians may look for biomarkers to determine the onset of lactation. Some common biomarkers for the determination of secretory activation include: A drop in progesterone levels; [8] Increase in blood flow, oxygen and glucose uptake; [8]
Estrogen, progesterone, and human chorionic gonadotropin (hCG) levels throughout pregnancy. Estrogen, progesterone, and 17α-hydroxyprogesterone (17α-OHP) levels during pregnancy in women. [ 1 ] The dashed vertical lines separate the trimesters .
After the luteal-placental shift, progesterone levels start to rise further and may reach 100 to 200 ng/mL at term. Whether a decrease in progesterone levels is critical for the initiation of labor has been argued and may be species-specific. After delivery of the placenta and during lactation, progesterone levels are very low. [citation needed]
After delivery, progesterone concentrations decrease, and prolactin levels drop. Only during nipple stimulation will prolactin levels rise, allowing for milk production. [22] At 6 weeks post-birth (postpartum), estradiol concentrations decrease, and prolactin concentrations return to normal even during breastfeeding.
Since uterine cramping may become more painful during breastfeeding, medications can be given half an hour before nursing. Pain control and comfort can be managed by anticipating the return of sensation and bodily reactions to bruises, tears, incisions and punctured sites.
High levels of prolactin during pregnancy and breastfeeding also increase insulin resistance, increase growth factor levels (IGF-1) and modify lipid metabolism in preparation for breastfeeding. During lactation, prolactin is the main factor maintaining tight junctions of the ductal epithelium and regulating milk production through osmotic balance.
A low level of estrogen can lead to a non-conception cycle, and a high level of estrogen when LH is at its peak, can lead to lower live birth rates and other complications. [13] During pregnancy, estrogen plays a role in supporting placentation through the modulation of angiogenic factor expression. [13]
The continuing of breastfeeding, while introducing solids after 6 months, to 12 months were shown to have an efficiency rate of 92.6 – 96.3 percent in pregnancy prevention. [13] Because of this some women find that breastfeeding interferes with fertility even after ovulation has resumed. The Seven Standards: Phase 1 of Ecological Breastfeeding