THE ROLE OF ANTENATAL OESTROGEN IN POST‐PARTUM HUMAN LACTOGENESIS: EVIDENCE FROM OESTROGEN‐DEFICIENT PREGNANCIES

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Abstract
Five women with severe ante-partum estrogen deficiency (in 4 due to placental steroid sulfatase deficiency and in 1 due to an unknown cause) had low concentrations of PRL [prolactin] in peripheral plasma at delivery and in the puerperium. These women were unable to establish lactogenesis as assessed from plasam .alpha.-lactalbumin concentrations on day 4 post-partum. Ante-partum estrogen is required both to ensure adequate PRL secretion and to permit lactogenesis in breast tissue in response to PRL. A review of patients'' records in another 9 cases of placental steroid sulfatase deficiency indicates that failure to establish breast feeding is a common feature.