Breastfeeding Counseling
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Interactions between metabolic and rep... [Am J Hum Biol. 2009 Jul-Aug] - PubMed - NCBI

Interactions between metabolic and rep... [Am J Hum Biol. 2009 Jul-Aug] - PubMed - NCBI | Breastfeeding Counseling | Scoop.it

Lactation has long been recognized as a major determinant of interbirth intervals. The temporal pattern of nursing has been proposed as the mechanism behind lactational amenorrhea. We present a new model of the dynamic regulation of lactational amenorrhea that identifies maternal energy availability as the main determinant of ovarian resumption. Variation in the intensity of lactation remains a component of the model as a determinant of the absolute energetic cost of milk production. However, maternal energy supply determines net energy availability; a larger energy supply leaves a greater net energy surplus than a smaller energy supply (lactation costs being equal). We characterize the hormonal postpartum profile of 70 lactating Toba women of Argentina. We use C-peptide, which reflects maternal insulin production, as a measure of energy availability. Initially low, insulin production rises as the postpartum period progresses, reflecting the declining metabolic load of lactation. A short period of supernormal insulin production precedes menstrual resumption. The high levels of insulin may play a role in stimulating the resumption of ovarian activity, which in turn may help to resolve the transient period of insulin resistance. The dynamics of insulin sensitivity during lactation would aid in synchronizing the resumption of ovarian function with a reduction in the energy demands of milk production. This hypothesis is supported by the sustained weight gain experienced by lactating women during the months preceding the first postpartum menses. The link between fecundity and energy balance could serve as a mechanism for adjusting the duration of lactational amenorrhea to the relative metabolic load of lactation.

2009 Wiley-Liss, Inc.

PMID: 19298003 [PubMed - indexed for MEDLINE] PMCID: PMC3305908 Free PMC Article

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Rescooped by Camille Freeman from F'ing Cool Physiology
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Lactation Education Resources - Resources for Professionals

Lactation Education Resources provides online lactation courses following the IBLCE blueprint designed to prepare students to sit for the IBLCE exam to achieve certification or recertification as lactation consultants.
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Camille Freeman's curator insight, September 2, 2013 11:22 PM

This Resources page has links to great info, see esp. the nipple shields information.