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One theory behind delayed copious milk production is that progesterone stored in adipose tissue has led to elevated progesterone levels among obese or overweight women. [20] This interferes with progesterone withdrawal upon the delivery of the placenta and consequently disrupts the activation mechanism of lactogenesis II.
Normal histology of the breast during lactation. A woman's breasts change during pregnancy to prepare them for breastfeeding a baby. Normal changes include: Tenderness of the nipple or breast; An increase in breast size over the course of the pregnancy; Changes in the color or size of the nipples and areola
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]
The caloric requirement for a non-breastfeeding, non-pregnant woman changes from 1,800-2,000 kcal/day to 2,300 to 2500 kcal/day for the breastfeeding woman. Nutritional supplementation is often prescribed and recommended. In some instances women are encouraged to continue to take pre-natal vitamins. Increasing the intake of fluids is discussed.
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.
During pregnancy, pronounced breast growth and maturation occurs in preparation of lactation and breastfeeding. [20] [29] [30] Estrogen and progesterone levels increase dramatically, [20] reaching levels by late pregnancy that are several hundred-fold higher than usual menstrual cycle levels. [31]
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 .
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.