Endocrinology of milk production

The physiology of lactation includes development of the mammary gland from the foetal to the adult stage, further development during pregnancy and onset of lactation, with the accompanying metabolic and behavioural adaptation. At the onset of pregnancy the endocrine system undergoes dramatic changes. The growth of the mammary gland is stimulated by growth hormone and prolactin, adrenocortical steroids, oestrogens and progesterone, and that of the gastrointestinal (GI) tract by gastrin, CCK and secretin. The onset of lactation is accompanied by increases in the blood volume, cardiac output, mammary blood flow and blood flow through the GI-tract and liver, aiming to provide the udder with nutrients and hormones for regulation of milk synthesis. Food intake and distribution of nutrients to the mammary gland are partially regulated by hormones as well as the repartitioning of nutrients away from body stores towards the udder. To improve milk production, administration of growth hormone has been practised, but also much discussed. Besides central mechanisms, local mechanisms within the mammary gland regulate initiation of lactation, maintenance, regulation of blood flow and mammary gland cell apoptosis. Most of the milk in a filled dairy cow udder is stored in the alveolar compartments. The milk ejection reflex must be activated to gain access to the udder milk, i.e. oxytocin contracts the myoepithelial cells. Recent studies show that vasopressin may also elicit milk ejection. More efficient oxytocin release is achieved if the cows are fed during milking. Beyond milk let down, oxytocin influences maternal behaviour and metabolism. Furthermore, it has been indicated that suckling or milking activates a vagal reflex, which may link the milk production to the endocrine system of the GI-tract. The question has been raised whether the mammary gland is a supporting or consuming organ.