Submitted to: Book Chapter
Publication Type: Book / chapter
Publication Acceptance Date: 10/15/2006
Publication Date: 12/1/2006
Citation: Hopkinson, J.M., Berens, P.D., Reece, E.F. 2007. Puerperium and lactation: physiology of the reproductive system. In: Reece E.A., Hobbins, J.R., editors. Clinical Obstetrics: The Fetus and Mother. 3rd edition. Oxford, UK: Blackwell Publishing Ltd. p. 1206-1218. Interpretive Summary:
Technical Abstract: This chapter describes changes in the physiology of the female reproductive system during the period of recovery from childbirth and throughout lactation. Normal and abnormal clinical findings are described, together with evidence-based treatment options for normal care and problem management. Uterine resorption following vaginal and cesarean birth; appearance, volume and duration of vaginal discharge; typical and atypical characteristics of the postpartum cervix and vagina; and normal course for resumption of menses in formula feeding and breastfeeding women are reviewed, along with underlying hormonal control mechanisms. Breast anatomy and development during and following gestation are characterized, along with the physiologic basis for onset and maintenance of milk production. Underlying causes for early lactation failure are reviewed. Optimal support for breastfeeding initiation and strategies for management of a variety of breastfeeding difficulties are detailed. Appropriate advice regarding maternal diet, exercise, and weight loss during lactation are included, together with a table of 6 key items of breastfeeding information for new parents and a list of 20 key points summarizing the chapter.