Puerperal alactogenesis with normal prolactin dynamics: is prolactin resistance the cause?

OBJECTIVE: To determine the cause of puerperal alactogenesis in a young woman.

DESIGN: After proper clinical assessment, a definitive investigative protocol was followed to determine the cause of alactogenesis.

SETTING: Tertiary care medical center in Kashmir, India.

PATIENT(S): A young married woman with three full-term deliveries, all characterized by puerperal alactogenesis.

INTERVENTION(S): An investigative protocol to document prolactin reserve and mammography to demonstrate presence of normal breast tissue.

MAIN OUTCOME MEASURE(S): Prolactin secretory reserve.

RESULT(S): The patient had normal breast development and an adequate pituitary prolactin reserve.

CONCLUSION(S): Prolactin resistance may have caused alactogenesis.