What may affect the process of lactogenesis? A comprehensive review

Abstract

Introduction: Breastfeeding provides babies with numerous benefits, such as strengthening of the immune system, protection against gastrointestinal diseases, correction of the stomatognathic system development and prevention of caries. In this context, the WHO recommends exclusive breastfeeding until 6 months and non-exclusive at least until 2 years age. However, lactogenesis can be impaired by some local and systemic factors. Objective: This study aimed to review the literature on the main factors that can affect lactogenesis. Case presentation: For this purpose, a search was carried out in the journals PubMed, Scielo and Periódicos Capes, using the DeCS/MeSH descriptor “lactation disorders” and the keywords “delayed” and “lactogenisis” with the boolean operators AND/OR, in English and Portuguese, and published in the last 5 years. A total of 218 articles were found and, after their title and abstract review, 17 were selected for full reading. The factors that can impair lactogenesis can occur at three stages: pre-glandular, glandular and post-glandular. Pre-glandular diseases include diabetes mellitus, obesity, hypertension and polycystic ovary syndrome. Among the glandular ones are breasts surgery and hypoplasia. In turn, some medications used, as well as smoking and alcohol, are among the factors related to impaired lactogenesis in the post-glandular phase. Also in this phase, characteristics related to the baby, such as the presence of a cleft lip and palate, ankyloglossia and prematurity, can also affect lactogenesis. Therefore, it is important for dentists to have expertise in those conditions and to be able to advise families on how to prevent early weaning.