Dysphoric milk ejection reflex among Japanese mothers: a self-administered survey.

BACKGROUND: The dysphoric milk ejection reflex (D-MER) is a reflex that causes temporary discomfort during milk ejection. D-MER develops due to the effects of hormones involved in lactation, and it has been reported that it is a physiological symptom different from postpartum depression, but the actual situation is unknown in Japan. METHODS: This study was conducted using a self-administered, anonymous survey of mothers of children who had undergone health checkups at three years of age at five health centers in Kagoshima city and aimed to clarify the reality and perceptions of mothers regarding D-MER. The survey period was from May to September, 2022. The questionnaires were distributed to 389 mothers, and 216 (55.5% recovery rate) responses were received, of which 202 (valid response rate 93.5%) were included in the analysis. RESULTS: Regarding the experience of D-MER, 202 mothers in the study population had given birth to a total of 403 children and experienced D-MER when breastfeeding 62 children (15.4%). Of the 202 mothers included in the analysis, 47 (23.3%) answered that they had experienced D-MER with at least one child while breastfeeding. Sixty-six mothers (32.7%) knew about D-MER. Compared to those who had not experienced D-MER, those who had experienced D-MER had significantly higher scores on the items related to having had trouble breastfeeding (odds ratio (OR]: 3.78; 95% confidence interval (CI]: 1.57, 9.09) and knowing about D-MER (OR 2.41; 95% CI 1.20, 4.84). Regarding symptoms, irritability (n = 24, 51.1%), anxiety (n = 22, 46.8%), and sadness (n = 18, 38.3%) ranked high. Coping strategies included distraction, focusing on the child, and, in some cases, cessation of breastfeeding. Thirty mothers (63.8%) answered that they did not consult anyone, citing reasons such as a belief that no one would be likely to understand their symptoms, and that they could not sufficiently explain their symptoms. CONCLUSION: The low level of awareness of D-MER suggests that it is necessary to inform and educate mothers and the public about the physiological symptoms of D-MER. Moreover, it is necessary to listen to the feelings of mothers with D-MER and support them in coping with their symptoms.

Dysphoric Milk Ejection Reflex in Human Lactation: An Integrative Literature Review.

BACKGROUND: Dysphoric Milk Ejection Reflex is an understudied condition of lactation involving emotional dysregulation during letdown or milk ejection. Affected individuals may experience transient feelings of helplessness, melancholy, and general unhappiness. RESEARCH AIM: To evaluate the scope of published literature on Dysphoric Milk Ejection Reflex. METHOD: Whittemore and Knafl's methodology guided this integrative review. Five databases were searched for primary research, summaries, and editorials on Dysphoric Milk Ejection Reflex in lactating individuals. Literature searched also included websites, pamphlets, and conference proceedings via Google and Google Scholar. A total of 11 articles, from five different countries, met inclusion criteria for review. RESULTS: Studies on Dysphoric Milk Ejection Reflex and negative emotional sensations during lactation were synthesized under five conceptual umbrellas: (1) Experiences, Sensations, and Symptom Management; (2) Biological Underpinnings; (3) Influence on Maternal Role and Breastfeeding Self-Efficacy; (4) Support, Understanding, and Awareness; and (5) Reduction and Cessation of Breastfeeding. CONCLUSION: Dysphoric Milk Ejection Reflex is a neurobiological condition characterized by low mood and negative feelings during milk ejection throughout lactation. Dysphoric Milk Ejection Reflex is linked to maternal psychological distress and breastfeeding discontinuation. Priority areas for future research include biological origins and interventions aimed at prevention, symptom control, and greater awareness of the condition on a more international scope.

Effects of 2 gradual debonding strategies on machine milk yield, flow, and composition in a cow-driven cow-calf contact system.

This controlled study compared the effects of 2 different gradual debonding strategies on machine milk yield, flow, and composition in a cow-driven cow-calf contact (CCC) system with automatic milking. Cows had 24 h/d access to their calves during the first weeks of lactation. In the long debonding (LDB) treatment (n = 16), a gradual reduction of cows' access to their calves was initiated 4 wk after calving over a total period of 28 d; first to 12 h/d (14 d), and then to 6 h/d (14 d). In the short debonding (SDB) treatment (n = 14), gradual reduction was initiated 6.5 wk after calving over a total period of 10 d; first to 12 h/d (5 d), and then to 6 h/d (5 d). From 6 h/d, access was finally reduced to 0 h/d for 7 d for both treatments. Machine milk yield, somatic cell count, and peak and average milk flow were automatically registered at milking. During the 9-wk study period, composite samples were analyzed for milk composition. Data were analyzed with linear mixed effect models. Results showed that machine milk yield during 24 h/d access varied between cows (range 1.2-49.9 kg/d, average ± standard deviation 13.2 ± 7.82 kg/d). The LDB cows had a higher daily machine milk yield than SDB cows at the end of and after access reduction was completed (+5.0 ± 1.63 and +5.1 ± 1.55 kg during the last 5 d of 6 h/d access, and 0 h/d access, respectively). Somatic cell count was on a healthy level, with no difference between treatments. Milk fat content increased with reduction in access, regardless of treatment. Short debonding cows tended to show higher milk protein content and lower milk lactose content than cows with a longer debonding. This study has shown that a longer debonding initiated earlier may give a higher milk yield in the short term. The variation in machine milk yield may indicate differences in milk ejection, suckling, and visiting patterns and preferences among cows.

Dysphoric Milk Ejection Reflex: Report of Two Cases and Postulated Mechanisms and Treatment.

Background: The symptoms of Dysphoric Milk Ejection Reflex (D-MER) occur just before milk release, last no more than a few minutes, and then subside spontaneously, which are characterized by a sudden and transient feeling of dysphoria, depression, sadness, or other negative emotions. These emotions may adversely affect the mother's lactation behavior and mental health, negatively influence the mother-child relationship, and even result in self-harm or suicidal tendencies in lactating women. Case Presentation: We reported two cases of breastfeeding mothers with D-MER who experienced unpleasant emotions during lactation. Severely affected by D-MER symptoms, the mother in the first case chose to wean prematurely after struggling for 6 months, and her symptoms disappeared after weaning. With the help of professional guidance, the mother with D-MER in the second case actively adjusted and persisted in breastfeeding until her daughter was 18 months old, after that her symptoms vanished. Discussion: Awareness and knowledge of D-MER are insufficient among the public and health care professionals. D-MER is not a psychological disorder but a physiological issue caused by hormones, which is different from postpartum depression. The severity of D-MER symptoms can be evaluated by the assessment tool of the D-MER spectrum. Lactating women can relieve their symptoms through self-regulation, lifestyle changes, and professional guidance and treatments. Conclusions: The two cases studies about Chinese women with D-MER will enrich the knowledge of D-MER, and it might suggest some directions to health care workers for exploring scientific guidance and treatments for lactating women. Because the literature and published empirical studies about D-MER are scarce, further researches on the theory and interventions of D-MER are necessary.

The interplay of continuous milk ejection and milking system with and without prestimulation at different vacuum settings.

Efficient machine milking requires an optimal interaction of alveolar milk ejection in the udder and milk removal by the milking machine. The aim of the present study was to test whether the equilibrium between continuous milk ejection and milk removal can also be maintained at very fast milking through a particularly high vacuum. Eight Holstein dairy cows were milked at 42, 52, or 60 kPa, with (PS) or without (nPS) prestimulation. Each of the 6 treatments was conducted at 2 afternoon milkings in each animal. The prestimulation lasted 40 s and consisted of forestripping and teat cleaning. The cluster attachment followed after a 20-s latency period. Throughout each milking, B-mode ultrasound videos of the gland cistern of 1 front quarter as well as milk flow and claw vacuum curves were recorded. Total milk yield was neither affected by nPS or PS nor by the vacuum level. Milk removed within the first minute and the first 2 min of milking and average milk flow were higher, and the duration of incline and time until peak milk flow were shorter at PS than at nPS milkings at all vacuum levels. Machine-on time was shorter at PS than at nPS milkings, although only at 42 and 52 kPa vacuum, obviously caused by the high percentage of bimodalities occurring in nPS milkings (17% bimodalities in PS vs. 92% bimodalities in nPS milkings). The frequency of bimodalities was higher at high than at low vacuum both in PS and nPS milkings. Peak flow rate and average milk flow were both higher at higher vacuum levels. The duration of milk flow plateau was shorter at 60 kPa than at 42 kPa milkings. At the highest vacuum (60 kPa), the shorter plateau phase indicated a declining milk ejection rate toward the end of the plateau phase, and milk ejection could no longer keep up with the fast milk removal; hence, a higher milking efficiency at a higher vacuum level could only be achieved as long as the gland cistern remained sufficiently filled by the continuous milk ejection. The ultrasound imaging confirmed this finding as the duration of cisternal area plateau in the recorded front quarter was shorter at high than at low vacuum. Thus, the highest vacuum of 60 kPa did not cause a shorter machine-on time than 52 kPa. In conclusion, milking at a very high vacuum can increase milking efficiency compared with a low vacuum. However, a vacuum reduction at the start and toward the end of milking is required to prevent overmilking if milking is performed at a very high vacuum.

Dysphoric milk ejection reflex (D-MER) and its implications for mental health nursing.

Dysphoric milk ejection reflect (D-MER) is a dysphoria which women may experience within seconds of commencing breastfeeding. It is only recently gaining recognition in the academic literature and may have important implications for breastfeeding continuation, differential diagnosis and perinatal mental health. This perspective piece introduces the topic, sets out the physiological processes underpinning the experience and outlines why increased awareness of D-MER is important for the profession of mental health nursing.

Effect of mechanical premilking stimulation on milking duration in late lactation.

This study documents the effect of mechanical prestimulation on the milking duration of pasture-based cows in late lactation to better harness increased capacity of automation in the milk harvesting process. Premilking stimulation, provided via manual or mechanical means, has been shown to promote the milk letdown reflex and assist in achieving quick, comfortable, and complete milk removal from the udder. The literature is lacking knowledge on the effect of mechanical premilking stimulation on milking duration, especially in late lactation and in pasture-based systems, and many pasture-based farms do not practice a full premilking routine because of a lack of labor availability. The current study addresses this gap in knowledge. In this study, we tested 2 treatments: (1) the No Stim treatment used normal farm milking settings with no premilking preparation and (2) the Stim treatment used 60 s of mechanical premilking stimulation, with a rate of 120 cycles per minute and a pulsator ratio of 30:70 on cluster attachment. Once the 60 s of stimulation had elapsed, normal milking settings resumed for the remainder of the milking. Sixty cows were enrolled in the study, which ran for 20 d. The effect of treatment on a.m. milking duration was significant, a.m. milking duration for Stim was 12 s shorter than that of No Stim. The effect of treatment on p.m. milk duration was not significant. Treatment had no effect on a.m./p.m. milk yields, average milk flowrates or peak milk flowrates. Significant differences emerged between treatments on a.m. and p.m. dead time (time from cluster attachment to reach a milk flowrate of 0.2 kg/min). The a.m. and p.m. dead times were 6 s shorter for Stim compared with No Stim. The time taken to achieve peak milk flowrate (time to peak) at morning milking was 7 s shorter for Stim compared with No Stim, and treatment yielded no significant effects on time to peak at p.m. milkings. Treatment also had no significant effect on log10 somatic cell count. Although the percentage of congested teat-ends and teat-barrels was numerically lower for Stim versus No Stim, no statistical differences were detected across these measures. Based on the results of the study, we found merit in applying 60 s of mechanical pre-stimulation at a.m. milking from a milking duration perspective. However, the strategy was not as successful for the p.m. milking. Analysis of the milk flowrate profiles recorded during the study suggest potential utility in employing different machine settings for various milkings based on anticipated yield and level of udder fill.

Is sleep critical for lactation in rat?

Sleep deprivation is a feature shared by most studied mammals at some point during the postpartum period. Unlike the rabbit, the pig, or the human mother, sleep has been claimed as an essential state for milk ejection in mother rats, where sleep deprivation using gentle handling (GH) prevents milk ejection and pup weight gain. Though sleep deprivation is a stressful situation itself, most common methodologies used in laboratory animals, including GH, usually involve aversive stimulus to prevent sleep, adding further stress to the animal. Deep brain electrical stimulation (DBES) of the brainstem reticular formation is a less common technique used to prevent sleep, and while this methodology may also carry unwanted effects, it avoids stressful conditions. In the present study, we examined the relationship between sleep and nursing, and how different sleep deprivation methodologies impact nursing and lactation. For this purpose, we carried out two sets of experiments. First, we correlated sleep and waking states with different nursing parameters of lactating rats under undisturbed conditions. Second, we slept deprived another group of mother rats using two different techniques: GH and DBES. Our main findings show that sleeping time was positively correlated with the time devote to nurse the pups, but not either with milk ejection or pup weight gain. When mother rats were sleep deprived, maternal behavior was fragmented using both methods, but was substantially more disrupted when using GH. Additionally, lactating dams were capable of ejecting milk and their pups gained weight despite of being sleep deprived using both techniques, but these parameters were significantly reduced using GH compared to control values, while DBES did not differ from control group. Overall, these results suggest that sleep and nursing are behaviorally compatible, but in disagreement with previous findings, we concluded that sleep is not necessary for milk ejection. These observations have critical implications for using the rat as a model to explore sleep loss during the postpartum period.

Risk factors for delayed milk ejection in Holstein dairy cows milked 3 times per day.

Delayed milk ejection, manifested most often as bimodal milk flow, occurs when the cisternal milk fraction is removed before the alveolar milk reaches the gland cistern. It is thought to be a consequence of not meeting cows' physiological needs, due to insufficient premilking teat stimulation, inadequate timing of milking unit attachment, or both. It has been associated with decreased milking efficiency, reduced milk yield, and impaired teat and udder health. Traditionally, portable electronic milk meters have been used to assess the presence of delayed milk ejection in dairy cows. By contrast, incremental milk flow rates from on-farm milk meters and their suitability as a measure to assess delayed milk ejection have not been studied by rigorous methods. The objectives were (1) to describe a protocol for identification of cows with chronically delayed milk ejection (CDME) and (2) to investigate risk factors for CDME using incremental milk flow rates obtained from automated on-farm milk meters. In a retrospective case control study, milk flow data from a 4,300-cow dairy with a thrice-daily milking schedule were obtained over a 1-wk period. Incremental milk flow rates (0-15 s, 15-30 s, 30-60 s, and 60-120 s) were used to identify cows with delayed milk ejection. Cases of CDME were defined as presence of delayed milk ejection at all 21 milking observations. Cows that had no delayed milk ejection at any of the same 21 milking observations were included as controls. A total of 171 cases and 393 controls were included in the study based on these criteria. A logistic regression model was used to evaluate associations of the following risk factors with CDME: parity (1, 2, ≥3), stage of lactation (<100, 101-200, >200 DIM), presence of a nonlactating quarter, milk somatic cell count, average daily milk production, and health and management events. Parity and CDME were associated such that compared with cows in their third or greater lactation, the odds (95% confidence intervals, 95% CI) of CDME were 1.27 (0.71-2.25) for cows in their first and 4.77 (2.47-9.22) for animals in their second lactation. The odds of CDME increased with increasing stage of lactation, with an odds ratio of 0.20 (0.11-0.36) for early and 0.28 (0.15-0.52) for mid-lactation animals, respectively, compared with late lactation cows. A 1-kg increase in average daily milk production was associated with decreased odds of CDME [odds ratio (95% CI): 0.89 (0.87-0.92)]. A lameness event during the study period increased the odds of CDME [odds ratio (95% CI): 8.04 (1.20-53.83)], as did a vaccination event 1 wk before the study period [odds ratio (95% CI): 4.07 (0.99-16.71)]. This study confirmed associations between CDME and previously reported risk factors and identified several previously less rigorously investigated health and management events that could be associated with CDME. Incremental milk flow rates from individual cows serve as an automated tool to evaluate milk flow dynamics. This information could be used to improve individual premilking udder preparation to meet the animal's physiological requirements, improve teat and udder health, and enhance parlor efficiency.

Reduced liner-open phase and vacuum instead of prestimulation increase parlor efficiency in dairy cows.

Adequate prestimulation is considered a requirement for a fast, gentle, and complete udder emptying at machine milking. Reduced vacuum or reduced liner-open phase of pulsation (or both) may replace prestimulation and consequently reduce work load of the milker and increase parlor efficiency. In the present study we compared 2 milking routines (MR) with manual prestimulation (LPrep = long preparation: 15 s of forestripping, teat cleaning, and stimulation; SPrep = short preparation: 5 s of teat cleaning) followed by 1-min latency period and milking at standard vacuum and pulsation settings (claw vacuum 44 kPa, pulsation rate 60 cycles/min, pulsation ratio 65/35) with 2 MR consisting of 5 s of teat cleaning, immediate cluster attachment and milking at reduced vacuum with or without shortened liner-open phase of pulsation until milk flow exceeded 400 g/min (RP = reduced pulsation: pulsation ratio 30/70, pulsation rate 50 cycles/min, claw vacuum 44 kPa; RPV = reduced pulsation and vacuum: pulsation ratio 30/70, pulsation rate 50 cycles/min, claw vacuum 34 kPa). Cluster detachment was performed at 400 g/min in all MR. Ten Holstein dairy cows were milked twice daily at 14-h and 10-h milking intervals. Milk flow and electrical conductivity (EC) were recorded throughout milking. During the first 2 min of each milking ultrasound cross-section images of the gland cistern of one front quarter were recorded, and 5 min after the end of milking teat tissue thickness of both front teats was measured by using a cutimeter. Most milking characteristics such as total milk yield, average milk flow, and machine-on time reached higher values at 14-h than 10-h milking intervals, but did not differ among MR. However, the occupancy time (time from the first touch of the udder until cluster detachment) was considerably shorter in RP and RPV compared with LPrep and SPrep. Ultrasound cross section areas of the gland cistern were larger in LPrep than in RP and RPV indicating that milk ejection already occurred at cluster attachment in LPrep. This assumption is also supported by the lower EC at cluster attachment in LPrep than in RP and RPV, which was caused by the presence of alveolar milk in the gland cistern after milk ejection. The MR RP and RPV increase parlor efficiency and are work-saving alternatives to MR, which include an adequate prestimulation (LPrep). However, shortening prestimulation to a 5-s teat cleaning followed by a latency period and milking at regular vacuum and pulsation is not adequate to save occupancy time. Because milking was performed at a relatively low vacuum (44 kPa) and at a detachment level of 400 g/min, teat tissue thickness did not differ among MR, and the vacuum reduction in RPV did not cause an additional advantage for teat condition compared with RP.

Milk let-down in goats can be influenced by the type of stimuli applied or to which goats are exposed during suckling and hand milking.

The present experiments on goats were conducted with the aim of verifying (a) whether the identity of the goat kids can affect the characteristics of milk let-down during suckling (Study 1) and (b) whether the presence of the goat kids may improve the milk let-down during hand milking (Study 2). In Study 1, 16 lactating goats with twins and 12 with single kids were used. Dams with single goat kids ejected more milk when suckling their kids at Days 5 and 20 of lactation, than when suckling aliens. Dams with twins ejected more milk when suckling their own kids than aliens only at Day 5 of lactation. Taking into account all the dams, they ejected more milk with more fat, protein, and lactose during suckling their own litter than when suckling aliens. In Study 2, when dams (n = 13) were hand milked in the presence of their own litter or in its absence, they ejected more milk with more fat, protein, and lactose than when milked in the presence of alien kids. We conclude that milk let-down in goats can be influenced by the type of stimuli applied or to which they are exposed to during suckling and milking.

Oxytocin and cortisol release during suckling, hand-milking and machine milking in camels.

This research paper addresses the hypothesis that oxytocin (OT) could be released during suckling and during milking with and without the presence of a calf and that this release could be regulated by maternal behaviour. Plasma concentration patterns of OT and cortisol (CORT) were measured in six Tunisian dromedary camels during 2 suckling episodes, 2 manual milking episodes with calves beside the mother and 2 machine milking episodes without calves present. Various patterns of OT release were observed between each camel including specific two peak release patterns. Higher plasma OT concentrations were found during the suckling and hand-milking episodes with simultaneous suckling of calves, than during the machine milking episodes without calves. Exclusive mechanical milking episodes also evoked significant mean OT release, although greatly reduced compared to suckling and hand milking. The low basal levels and classical CORT release patterns suggested non-stressful management practices were used and there were very limited differences in udder stimulation between managements. The OT release induced by exclusive suckling and suckling together with hand-milking gives a reference point for what a good milk ejection stimulation is in camels. The important and specific reduction of OT release during machine milking without the calf present could be a physiological consequence of the maternal behaviour (selectivity for the own young) and to a lesser extent explained by a lower stimulation by machine milking.

Plasticity in Intrinsic Excitability of Hypothalamic Magnocellular Neurosecretory Neurons in Late-Pregnant and Lactating Rats.

Oxytocin and vasopressin secretion from the posterior pituitary gland are required for normal pregnancy and lactation. Oxytocin secretion is relatively low and constant under basal conditions but becomes pulsatile during birth and lactation to stimulate episodic contraction of the uterus for delivery of the fetus and milk ejection during suckling. Vasopressin secretion is maintained in pregnancy and lactation despite reduced osmolality (the principal stimulus for vasopressin secretion) to increase water retention to cope with the cardiovascular demands of pregnancy and lactation. Oxytocin and vasopressin secretion are determined by the action potential (spike) firing of magnocellular neurosecretory neurons of the hypothalamic supraoptic and paraventricular nuclei. In addition to synaptic input activity, spike firing depends on intrinsic excitability conferred by the suite of channels expressed by the neurons. Therefore, we analysed oxytocin and vasopressin neuron activity in anaesthetised non-pregnant, late-pregnant, and lactating rats to test the hypothesis that intrinsic excitability of oxytocin and vasopressin neurons is increased in late pregnancy and lactation to promote oxytocin and vasopressin secretion required for successful pregnancy and lactation. Hazard analysis of spike firing revealed a higher incidence of post-spike hyperexcitability immediately following each spike in oxytocin neurons, but not in vasopressin neurons, in late pregnancy and lactation, which is expected to facilitate high frequency firing during bursts. Despite lower osmolality in late-pregnant and lactating rats, vasopressin neuron activity was not different between non-pregnant, late-pregnant, and lactating rats, and blockade of osmosensitive ΔN-TRPV1 channels inhibited vasopressin neurons to a similar extent in non-pregnant, late-pregnant, and lactating rats. Furthermore, supraoptic nucleus ΔN-TRPV1 mRNA expression was not different between non-pregnant and late-pregnant rats, suggesting that sustained activity of ΔN-TRPV1 channels might maintain vasopressin neuron activity to increase water retention during pregnancy and lactation.

Visualising oxytocin neurone activity in vivo: The key to unlocking central regulation of parturition and lactation.

During parturition and lactation, oxytocin neurones in the supraoptic and paraventricular nuclei fire high-frequency bursts of action potentials that are coordinated across the entire population. Each burst generates a large pulse of oxytocin release into the circulation to induce uterine contraction for parturition and mammary duct contraction for milk ejection. Bursts are stimulated by cervical stretch during parturition and by suckling during lactation. However, the mechanisms by which these stimuli are translated into episodic bursts are poorly understood, as are the mechanisms that coordinate bursts across the oxytocin neurone population. An elegant series of experiments conducted in the 1980s and 1990s used serial paired recordings to show that oxytocin neurones do not act as a syncytium during bursts; rather, they start each burst within a few hundred milliseconds of each other but with no distinct "leaders" or "followers". In addition to afferent noradrenergic inputs that relay the systemic stimuli to oxytocin neurones, bursts depend on somato-dendritic oxytocin release within the hypothalamus. Hence, bursts are considered to be an emergent property of oxytocin neurones that is bootstrapped by appropriate afferent stimulation. Although much progress was made using traditional electrophysiological recordings in head-fixed anaesthetised animals, research has effectively stalled in the last few decades. However, the emergence of new technologies to monitor neuronal activity in freely-behaving animals has reinvigorated efforts to understand the biology underpinning burst firing in oxytocin neurones. Here, we report the use of fibre photometry to monitor the dynamics of milk ejection bursts in the oxytocin neurone population of freely-behaving mice. This approach will shed light on the neural mechanisms that control the oxytocin bursts underpinning parturition and lactation.

Impact of expression mode and timing of sample collection, relative to milk ejection, on human milk bacterial DNA profiles.

AIM: To investigate the impact of expression mode: electric breast pump or hand expression, and timing of sample collection: pre- and post-milk ejection on human milk (HM) bacterial DNA profiles. METHODS AND RESULTS: Three HM samples from the same breast were collected from 30 breastfeeding mothers: a pre-milk ejection pump-expressed sample (pre-pump), a post-milk ejection pump-expressed sample (post-pump) and a post-milk ejection hand-expressed sample (post-hand). Full-length 16S rRNA gene sequencing was used to assess milk bacterial DNA profiles. Bacterial profiles did not differ significantly based on mode of expression nor timing of sample collection. No significant differences were detected in the relative abundance of any OTUs based on expression condition (pre-pump/ post-pump and post-pump/post-hand) with univariate linear mixed-effects regression analyses (all P-values > 0·01; α = 0·01). Similarly, no difference in richness was observed between sample types (number of observed OTUs: post-pump/post-hand P = 0·13; pre-pump/post-pump P = 0. 45). CONCLUSION: Bacterial DNA profiles of HM did not differ according to either expression method or timing of sample collection. SIGNIFICANCE AND IMPACT OF THE STUDY: Hand or pump expression can be utilized to collect samples for microbiome studies. This has implications for the design of future HM microbiome studies.

Homocysteine Hypothesis on the Impaired Peripheral but Not Central Nervous System Oxytocin Responses in Cystathionine γ-Lyase-Deficient Dam Mice.

An elevated plasma homocysteine level is an independent risk factor for cardiovascular diseases, neurological disorders, and pregnancy complications. We recently demonstrated partial lactation failure in cystathionine γ-lyase-deficient (Cth-/-) dam mice and their defective oxytocin responses in peripheral tissues: uterine (ex vivo) and mammary gland (in vivo). We reasoned that elevated levels of circulatory homocysteine in Cth-/- dam mice counteract with oxytocin-dependent milk ejection from the mammary gland. Based on our observation that those mice displayed normal maternal behaviors against their pups and adult Cth-/- male mice exhibited normal social behaviors against adult wild-type female mice, both of which are regulated by oxytocin in the central nervous system (CNS), we conducted the present study to investigate the amino acid profiles, including total homocysteine, in both blood and cerebrospinal fluid (CSF) of wild-type and Cth-/- female mice before pregnancy and at day 1 of lactation (L1). Serum levels of total homocysteine in wild-type and Cth-/- L1 dam mice were 9.44 and 188 µmol/L, respectively, whereas their CSF levels were below 0.21 (limit of quantification) and 3.62 µmol/L, respectively. Their CSF/serum level ratio was the lowest (1/51.9) among all 20 proteinogenic amino acids, sulfur-containing amino acids, and citrulline/ornithine in Cth-/- mice. Therefore, we hypothesize that the blood-brain barrier protects the CNS from high levels of circulatory homocysteine in Cth-/- dam mice, thereby conferring normal oxytocin-dependent maternal behaviors.

Mex3c mutation affects lactation through impairing milk ejection in female mice.

Mouse Mex3c encodes RNA-binding proteins of variant length through alternative splicing. Its mutation results in multiple defects including growth retardation, perturbed energy balance, and defective antiviral innate immunity. Here we report that Mex3c mutation affects mammary gland development and lactation in female mice. Pups of Mex3c mutant dams die of starvation soon after birth. Milk contents are present in the alveoli but deficient in the ducts of the mammary glands in mutant mice. Mutant mice do not show prolactin or oxytocin deficiency. They also develop myoepithelial cells in the mammary glands. Mex3c is expressed in the mammary gland epithelium. Our data suggest that functional defects in mammary gland epithelium or myoepithelial cells could cause lactation defects.

Multiscale imaging of basal cell dynamics in the functionally mature mammary gland.

The mammary epithelium is indispensable for the continued survival of more than 5,000 mammalian species. For some, the volume of milk ejected in a single day exceeds their entire blood volume. Here, we unveil the spatiotemporal properties of physiological signals that orchestrate the ejection of milk from alveolar units and its passage along the mammary ductal network. Using quantitative, multidimensional imaging of mammary cell ensembles from GCaMP6 transgenic mice, we reveal how stimulus evoked Ca2+ oscillations couple to contractions in basal epithelial cells. Moreover, we show that Ca2+-dependent contractions generate the requisite force to physically deform the innermost layer of luminal cells, compelling them to discharge the fluid that they produced and housed. Through the collective action of thousands of these biological positive-displacement pumps, each linked to a contractile ductal network, milk begins its passage toward the dependent neonate, seconds after the command.