What might affect hormones starting lactation?
The start of lactation after childbirth is known as ‘secretory activation’ and is hormonally controlled. A delay in secretory activation is linked to excess infant weight loss, increased use of formula milk and early stopping of breastfeeding.
The mechanisms mediating secretory activation in healthy, term pregnancy are poorly understood, and even less is known about how maternal and fetal morbidity disrupt this process. This project will address biological mechanisms underlying delayed secretory activation in women with preterm, low birthweight and small-for-gestational-age infants.
The study
The term ‘small vulnerable newborn’ (SVNs) describes any baby that is born premature, low birthweight or small for its gestational age. More than 25% of all newborns worldwide fall under this category. Mothers with SVNs are at increased risk of delayed secretory activation and breastfeeding issues. This project aims to identify the mechanisms underlying this delay in secretory activation, with a particular focus on maternal hormones.
Our ongoing INSIGHT study investigates lactation hormone levels in healthy, term pregnancies, and aims to understand the effects of hormones on mammary gene expression, metabolism and milk composition in the early postpartum period. In collaboration with the Bode Lab, this new project will extend the scope of INSIGHT to advance knowledge about the biology of delayed secretory activation with a particular focus on SVNs.
Diagram outlining the project hypothesis
Research questions
Does maternal disease and infant prematurity impair early postpartum lactation hormone secretion?
Does reduced mammary gland development contribute to delayed secretory activation?
What is the impact of delayed secretory activation on the nutrients and bioactive compounds in milk?
Methods
This is a longitudinal study that will build on techniques established by the INSIGHT study. It will be sited in two centres: Women’s Centre, John Radcliffe Hospital, Oxford, UK and the Neonatal Unit, UC San Diego Health, California, USA.
Mothers with preterm infants (born at <37 gestational weeks) or those at risk of delayed secretory activation will be recruited (Fig 1). We aim to recruit ~100 participants from the John Radcliffe Hospital. In parallel, the Bode team will recruit preterm mothers from the San Diego Health Neonatal Unit.
Study Team
Bryony Davies, DPhil Candidate, NDWRH, University of Oxford, UK
Prof. Fadil Hannan, NDWRH, University of Oxford, UK (main supervisor)
Prof. Lars Bode, University of California San Diego, USA (co-supervisor)
Dr Taha Elajnaf, NDWRH, University of Oxford, UK (co-supervisor)
