RESUMO
Objective: To explore the regulatory effect of malt alkaloid on prolactin (PRL) secretion in the model rat with postpartum hypogalactia induced by bromocriptine based on dopamine D2 receptor, and determine the active fraction of the malt with galactogogue effect. Methods: The postpartum hypogalactia model was established by intragastric administration of bromocriptine mesylate. After the model was successfully established, all groups were given corresponding drug treatment. The concentration of serum PRL, estradiol (E2) and progesterone (P) in each group was detected by ELISA kits. HE staining was used to observe the pathologic changes of breast tissue. RT-PCR was used to determine the mRNA levels of prolactin receptor (PRLR) and dopamine D2 receptor (DRD2) in pituitary gland of rats. Results: Compared with the control group, the levels of serum PRL, P, and E2 were significantly decreased in the model group as well as the mRNA expression of the pituitary PRL cells. But the mRNA expression of the pituitary DRD2 in the model group was significantly increased compared with the control group. Compared with the model group, the malt total alkaloid significantly increased the volume of mammary lobule and dilated the duct. There was a lot of milk in the duct and acinar in the malt total alkaloid group. Besides, the total alkaloids increased the concentration of serum PRL, P, and E2 and the mRNA expression of the pituitary PRL cells, and decreased the mRNA expression of the pituitary DRD2. Conclusion: The primary the active fraction of malt for galactogogue action is total alkaloids, and its mechanism may be related to promoting PRL secretion, increasing serum PRL receptor level and decreasing the mRNA expression of dopamine D2 receptor.
RESUMO
INTRODUCTION@#Lactogenesis II (LaII) failure can be prevented in at-risk mothers with simple proactive interventions. In a randomised trial, we investigated the efficacy of early and regular breast milk expression in establishing LaII, using an electric double-breast pump.@*METHODS@#Mothers with uncomplicated singleton deliveries were randomised to intervention (n = 31) or control (n = 29) groups. The former commenced breast milk expression with an electric pump within one hour of delivery and maintained regular expression with direct breastfeeding. Control mothers directly breastfed without regular pump expression. Expressed milk volumes were analysed for citrate, lactose, sodium and protein.@*RESULTS@#Median time of LaII was Day 3 (interquartile range [IQR] 1 day) with intervention and on Day 4 (IQR 1 day) among controls (p = 0.03). Biochemical steady-state concentrations were achieved around early Day 4 (sodium, total protein) and Days 4-5 (citrate, lactose). Sodium, protein and lactose levels were similar in both groups over seven days, at 5.80 mM, 0.68 mM and -13.38 mM, respectively. Mean daily milk volume with intervention was 73.9 mL on Day 3 and 225.2 mL on Day 7, greater than controls (25.4 mL on Day 3 and 69.2 mL on Day 7; p < 0.2). Mean infant weights were similar on Day 8 at 3,477 g with intervention and 3,479 g among controls.@*CONCLUSION@#LaII is established by postnatal Day 3 with early initiation of regular breast milk expression, a useful intervention for mothers at risk of early-onset breastfeeding failure.
Assuntos
Adulto , Feminino , Humanos , Recém-Nascido , Adulto Jovem , Aleitamento Materno , Métodos , Extração de Leite , Métodos , Citratos , Fórmulas Infantis , Lactação , Fisiologia , Leite Humano , Química , Fisiologia , Mães , Proteínas , SódioRESUMO
A lactogênese é constituída pelas fases designadas como I e II. A transição entre essas fases é caracterizada pelo aumento da concentração de lactose no colostro. Este estudo teve como objetivo analisar a interferência do diabetes melito tipo 1 (DM1) na transição entre as fases da lactogênese. A concentração de lactose foi determinada em amostras de colostro de 11 puérperas portadoras de DM1 e de 19 puérperas sem a doença, durante os cinco primeiros dias do puerpério. A determinação da concentração da lactose foi feita pela reação com ácido pícrico. Em ambos os grupos houve aumento progressivo da concentração da lactose em função do tempo; entretanto, o aumento foi significativamente menor no terceiro e no quinto dia no grupo das portadoras de diabetes. A análise da transição de fases da lactogênese revelou que as puérperas portadoras de diabetes melito com controle glicêmico inadequado apresentaram atraso de 18 horas para alcançar a fase II da lactogênese, dificultando o estabelecimento do aleitamento materno.
Lactogenesis is constituted by phases I and II. The transition between those phases is characterized by an increase of the lactose concentration in the colostrum. This study aimed to evaluate the interference of type 1 Diabetes mellitus in the transition between phases I and II of the lactogenesis. The lactose concentration was determined in colostrum samples of 11 puerperal women with pre-gestational Diabetes mellitus and 19 without the disease, during the five first days of the puerperium. The lactose concentration was determined by reaction with picric acid. In both groups there were progressive increases in the lactose levels along the time; however, the increase was significantly lower in the 3rd and 5th days for the group of the women with diabetes. The analysis of the transition between the lactogenesis phases revealed that the puerperal diabetic women with inadequate glycemic control presented a time delay of 18 hours to reach phase II, making difficult the establishment of breastfeeding.