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Synthetic galactagogues such as domperidone and metoclopramide interact with the dopamine system in such a way to increase the production of prolactin; specifically, by blocking the D 2 receptor. [3] There is some evidence to suggest that mothers who are unable to meet their infants' breastfeeding needs may benefit from galactogogues.
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. Fluctuations in prolactin levels during menstrual cycles and menopause are inconclusive. [23]
Prolactin has a wide variety of effects. It stimulates the mammary glands to produce milk (): increased serum concentrations of prolactin during pregnancy cause enlargement of the mammary glands and prepare for milk production, which normally starts when levels of progesterone fall by the end of pregnancy and a suckling stimulus is present.
Scientific evidence for the efficacy of herbal galactagogues is insufficient or nonexistent. [21] The Academy of Breastfeeding Medicine protocol for low milk supply says that there is insufficient data to recommend specific medicinal or herbal galactagogues, but that some substances may be useful in some cases. [5]
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.
High levels of progesterone, which are associated with pregnancy, inhibits prolactin and therefore lactation. [30] Prolactin increases during the initial stages of lactation and can be stimulated by estrogen but not progesterone. [30] Research, however, focuses on the role of prolactin for breastfeeding and less on other behaviors. [30]
The anti-inflammatory components in breast milk are those bioactive substances that confer or increase the anti-inflammatory response in a breastfeeding infant. [ 1 ] Anti-inflammatory Components of Breastmilk
Mechanical detection of suckling increases prolactin levels in the body to increase milk synthesis. Excess prolactin may inhibit the menstrual cycle directly, by a suppressive effect on the ovary, or indirectly, by decreasing the release of GnRH. [2] Suckling is a pivotal factor in maintaining lactational amenorrhea postpartum.