Why are women not getting enough breast milk?

(why do many women after having a baby often do not have enough milk to breastfeed? A new study by scientists at the Cincinnati Children's Hospital Medical Center, University of California Davis adds, their previous study of the effect of insulin on breast milk intake in lactating women .

This is the first study to describe how human mammary glands become very sensitive to insulin during lactation. This is the first study to show which gene is 'turned on' in the period of breastfeeding.

Researchers have used the new generation of gene sequencing technology, RNA sequences, to study in detail what genes plan for breast milk production in human mammary glands, according to Dr. Laurie Nommsen. -Rivers, a scientist at the Cincinnati Children's Hospital and information author, published online in the journal PLOS ONE, a journal of the Public Library of Science.

Previous research by Nommsen-Rivers has shown that mothers who have signs of glucose metabolism near the extreme, such as being obese, pregnant when they are older or having a big weight, will take time. longer for milk after childbirth, showing the role of insulin in the mammary gland. This new study shows that the mammary gland becomes sensitive to insulin during a woman's lactation.

For a long time, it was not thought that insulin played a direct role in regulating milk-producing cells in the mother, because insulin is not necessary for these cells to absorb sugars, such as glucose. Now, however, scientists evaluate insulin to play more than facilitate the uptake of sugars.

"This new study shows, a strong switch on insulin receptors and its pro-signaling signals during the transition of the chest so that the chest becomes a biological organ that produces enormous amounts of proteins," he said. Fat and carbohydrates to nourish newborn babies , 'revealed Dr. Nommsen-Rivers.

'We find that 20% of women between the ages of 20 and 44 are pre-diabetic, so imagine that about 20% of mothers in the US are at risk for insulin-induced milk disorders'.

Dr. Nommsen-River and her colleagues were able to use a non-invasive method to capture mammary RNA - a sequence of molecules that these molecules determine to make specific proteins - in Breast milk samples. Then they first created a publicly accessible library of genes expressing at the mammary gland based on RNA sequence technology.

This approach shows that a very sensitive portrait of genes is expressed in human milk-producing cells. They discovered a muted and off-link of many genes in the transition, the mammary gland secreted a small amount of immune colostrum increased in the first few days after birth until abundant milk production for babies. matured.

In particular, the gene PTPRF - known to be a gene to block intracellular signals that are normally triggered by insulin binds to its receptors on the cell surface, can serve as a biological marker. insulin resistance with milk deficiency. These results lay the foundation for future research, which will focus on the study of physiological factors that adversely affect breast milk intake.

Now that scientists have demonstrated the importance of insulin markers in the mammary gland in humans, they are planning a phase I / II clinical trial, with a drug used to control blood sugar in In patients with type 2 diabetes to determine if this drug can improve the insulin activity in the mammary gland, it may therefore improve the milk supply of the mammary gland.

While a drug is not an ideal way to solve the problem for lactating women with optimal pre-glucose metabolism, this is very good, Dr. Nommsen-Rivers said. evidence of the concept through the use of placebo controlled randomized clinical trials.

"The ideal approach is a preventive therapy ," she said. "Changing diets and increasing exercise are more powerful therapies than any other drug. This clinical trial, we hope to study interventions ".

Dr. Nommsen-Rivers has begun to study the cause behind many modern American mothers, having suffered from low milk levels since she was a doctoral student at the University of California Davis.

The lead author of this study is Dr. Danielle Lemay, California Davis University Research Center.