Prolactin - Keep It Up!!

What is Prolactin?

Prolactin is a hormone produced by the pituitary gland, a small gland located at the base of the brain, and its primary function is to promote milk production. We all have a little bit of prolactin roaming around, but prolactin levels increase significantly during pregnancy to prepare the mammary glands (breast tissue) to produce milk. After childbirth, prolactin stimulates the alveoli (milk-producing cells) in the breasts to produce and secrete milk.

How does Prolactin work?

During pregnancy and immediately after, prolactin levels are high. The hormone travels from your brain, through your blood, and tells your breasts to make milk. As a baby suckles the nipple (or with a pump), the nerves in your breast will signal back to the brain. This feedback tells the brain - there's a hungry baby! we need milk! and prolactin is secreted again.

Prolactin levels will fall (and so will your milk supply) after childbirth... UNLESS there is a baby suckling to tell your body that more milk is needed. The pump works the same way - nipple stimulation and milk removal will both increase you prolactin levels and milk supply. In fact, after every breastfeeding session, the prolactin levels fall until the next session.

Prolactin is like a volleyball - you need to keep it up. If prolactin levels fall, your milk supply will decrease. 

Why is my Prolactin LOW?

Infrequent Milk Removal

If your are not nursing or pumping, your body doesn't realize that there is a baby to feed. The nerves in your breast will not signal your brain to secrete prolactin. As prolactin levels fall, so does your milk supply. This can happen soon after birth. Tongue-tie might be playing a role here because milk is not being removed effectively.

Breast Surgery

If the nerves that signal from the breast to the brain have been cut, the brain won't realize there is a baby to feed, and prolactin will be low. Moms who have had lumpectomy, breast reduction or breast lifts are at risk. Nipple numbness can be an indicator that your breasts are not sensitive enough to signal prolactin secretion. 

Medications

Cabergoline? Abilify? Lactating moms who have taken these medications might have low prolactin levels, and they need a medical evaluation at Woven Pediatrics.

Life Stuff

There are a few normal occurences that can affect prolactin levels. Is your baby older and sleeping longer stretches? Are you back to work and unable to pump frequently? (This is illegal, BTW - call me!) Are you menstruating again? 

Tips for Increasing Prolactin

Nurse or Pump Frequently

Regular breastfeeding stimulates prolactin release and supports milk production. Dr. Stephanie recommendes 8-12 feedings per day, especially in the early weeks postpartum. Do not take more than a 4 hour break. As your baby gets older, your prolactin levels are not so sensitive, and milk production is on auto-pilot... you'll be able to go longer without nursing. 

Schedule a Medical Evaluation at Woven Pediatrics

If you suspect your prolactin is low, please schedule a medical evaluation with skilled lactation provider. Remember, IBCLCs canNOT check labs, make diagnoses, or prescribe medications - you need a provider (like an MD) to help here. In many cases, there are prescription medications, supplements or herbs that can help increase prolactin levels.