The let-down reflex during breast feeding is influenced by the hormone?

Appeared in: SCTIMST Staff Nurse - 2015 (Set-A)

Explanation

Oxytocin is released from the posterior pituitary gland in response to the infant's suckling.
It stimulates the contraction of myoepithelial cells surrounding the alveoli and milk ducts in the breast.
This contraction forces milk out of the alveoli and into the ducts, making it available to the infant—a process known as the milk ejection or 'let-down' reflex.

Option A: Progesterone, along with estrogen, inhibits the actual secretion of milk during pregnancy. Its levels must fall after delivery for lactation to begin.
Option B: Oestrogen inhibits milk secretion during pregnancy. High levels of oestrogen prevent prolactin from initiating milk production.
Option C: Prolactin is responsible for milk production (synthesis) within the alveolar cells, not milk ejection (let-down).

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Hormonal regulation of lactation, specifically the milk let-down reflex as background academic context rather than a clinical decision trigger.
Nurses play a key role in educating and supporting new mothers, explaining that the let-down reflex can be conditioned by the baby's cry or even the thought of the baby.
It is important to create a calm, relaxed environment for breastfeeding, as stress, pain, or anxiety can inhibit the release of oxytocin and interfere with the let-down reflex.
What if? If a mother is having difficulty with the let-down reflex due to stress, the nurse should first provide reassurance and suggest relaxation techniques like deep breathing, a warm compress on the breast, or gentle massage. If problems persist, a synthetic oxytocin nasal spray may be prescribed in some cases to help trigger the reflex.

How to Approach the Question

First, identify the key term in the question: 'let-down reflex'.
This is a factual recall question requiring knowledge of the endocrinology of lactation.
Differentiate between the two main hormones involved in the process: Prolactin and Oxytocin.
Recall that 'Prolactin' is for the production of milk.
Recall that 'Oxytocin' is for the ejection or 'let-down' of milk.
Eliminate Oestrogen and Progesterone, as their primary role during pregnancy is to develop the breast tissue while inhibiting milk secretion.

Concept Tested & Keywords

Concept Tested: Hormonal regulation of lactation, specifically the milk let-down reflex.
Stem keywords: let-down reflex, breast feeding, hormone
Lead-in keywords: BEST, MOST RELEVANT CLUE
Negative lead-in flag: false

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E6 Physiology Guyton 4SAE Part 3 p. 69-71

E6 Nutrition Kumud Khanna 2e p. 99-101

E6 Obstetrics Williams p. 48-68

Practise the full SCTIMST Staff Nurse - 2015 (Set-A)

Attempt every question from this paper in a timed mock, then review the full solution for each one.