SFEBES2022 Poster Presentations Reproductive Endocrinology (36 abstracts)
Investigating hormones triggering the onset of sustained lactation (INSIGHT) pilot study
Alexandria Fry 1 , Hussam Rostom 2 , Helen Price 2 , Amy Archer 2 , Emily Hilier 2 , Xin Meng 2 , Taha Elajnaf 2 , Robert Humphrey 3 , Nishan Guha 3 , Tim James 3 , Stephen Kennedy 2 & Fadil Hannan 2
1Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom; 2University of Oxford, Oxford, United Kingdom; 3John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
The onset of human lactation is characterised by increased breast fullness and the start of copious milk secretion. The process, which typically occurs 1-4 days postpartum, is triggered by a decrease in serum progesterone and high prolactin concentrations, although the exact levels are ill-defined. We aim to establish reference intervals for hormones triggering the onset of sustained lactation and understand how breastfeeding influences hormone secretion, so as to improve the clinical management of lactation insufficiency, which affects 5-15% of breastfeeding women. We therefore conducted a 3-month single centre pilot study to evaluate ease of recruitment and blood sampling during and after pregnancy. Women aged ³18 years with a singleton pregnancy were recruited with informed consent. Blood samples were obtained at 36 weeks’ gestation, and then before and after a breastfeed at a single home visit during days 3-5 postpartum. Lactation onset was ascertained using a validated breast fullness scale. Twenty-nine (94%) out of the 31 women recruited (age range 24-41 years) completed the study. All gave birth at term (37-42 weeks’ gestation) and reported lactation onset by day 4 postpartum. The mean±SEM serum progesterone concentration fell significantly from 491±25 pmo/l at 36 weeks’ gestation to 3.0±0.3 pmo/l (P<0.0001) on days 3-5 postpartum. The mean±SEM serum prolactin concentration did not significantly change between the same time-points (3535±209 versus 4080±300 mIU/l); however, prolactin levels rose significantly 45 min after breastfeeding started (4080±300 to 5229±283 mIU/l, P<0.01). In summary, we have demonstrated the feasibility of recruiting women for hormone measurements before and soon after childbirth to establish lactation hormone reference intervals.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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