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SUMMARY
The
most important factors in initiation of the cascade of changes in
the mammary epithelium that constitute lactogenesis stage II seem to
be a prepared mammary epithelium, withrawal, maintained plasma
prolactin (in most species), and removal of milk from the breast
within an underfined interval after birth. Although the molecular
mechanisms by which prolactin regulates milk protein synthesis are
the subject of intense and productive studies, the specific
mechanisms by which progesterone and milk removal interact with the
mammary epithelial cell at parturition have not been studied,
perhaps because no in vitro model system exists that lactogensis
stage II, or because of the complexity of the changes that must be
coordinated during this process, or because of a lack of general
understanding of the complex progression of changes in the function
of the breast as it goes from the quiescent state of pregnancy to
the active secretory state of lactation.
With new technologies designed to
investigate the biology of complex systems arising from the growing
knowledge of the genome of human and animal species and the growing
availability of animal and tissue culture models for these
processes, physicians can expect a rapid increase in the molecular
understanding of lactogebsis in the near future. These fundamental
studies must be coupled with good prospective clinical studies if
physicians are to obtain a useful, comprehensive understanding of
lactogenesis in women.
(The Pediatric Clinic of North America)
BREASTFEEDING 2001, PART I:
THE EVIDENCE FOR BREASTFEEDING
Volume 48.Number1.February 2001
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