The Postpartum Dance of Estrogen, Insulin, and Cortisol, for Milk Production

The Postpartum Dance of Estrogen, Insulin, and Cortisol, for Milk Production

The Postpartum Dance of Estrogen, Insulin, and Cortisol, for Milk Production


To understand common lactation difficulties, we need to investigate the sensitive dance of estrogen, insulin, and cortisol after childbirth and during lactation.

How we use Energy – It Matters

All living beings are able to absorb energy from outside sources and to use that energy to fuel their life. Plants get their energy from sunlight on leaves. The sunlight is metabolized into starch in the cells of leaves and is then used by the plant to fuel its further growth. This process is called photosynthesis.

Animals and insects eat the leaves and then use the plant’s starch for their own energy needs. These starches are changed into a form of sugar called glucose, which is transported around the body in the blood (blood glucose) and used to fuel the muscles and organs. Excess glucose is put into storage in the liver and muscles. When a burst of energy is needed, the stored glucose is mobilized for rapid use.

Animals and insects eat plants, but they also eat other animals and insects. This allows the eater to absorb types of tissues, vitamins, proteins, minerals and fats that the predator does not easily produce itself. For instance, humans do not produce vitamin C or vitamin B12 in our bodies. We depend on food sources. We also have a hard time producing important fatty-acids that are needed for the brain and the nerves. We get these fatty acids from certain leaves, seeds, nuts, and fish. Humans are less able to produce vitamin D in our body as we age and need to absorb it from food sources.

Human women store excess glucose in our fat pads for the specific use of having extra energy for pregnancy and lactation. In fact, fertility typically only turns on when there is enough stored fat to support a pregnancy.

The Dance of Postpartum Hormones     

Insulin and cortisol are hormones that orchestrate the uses of energy (calories) that we derive from food. Insulin tells the blood glucose where to go. Cortisol dictates how our stored fat will be used.

After childbirth, insulin levels sink to an all-time low and they remain that way throughout the first long phase of exclusive lactation. With these lower levels of insulin, the body does not use blood-glucose to fuel the needs of muscles or organs. Instead, the breastfeeding hormone, prolactin, makes the breast tissue highly sensitive to even these lower amounts of insulin, so that blood-glucose can be directed into the breasts and the milk.

In this dance, the priority is on milk production. At the same time that insulin levels are kept low, the hormone cortisol is kept high. Cortisol tells the mother’s body to take its energy from stored fat. The fat is now metabolized and used for a mother’s daily energy needs. This is why, after childbirth, a mother gradually loses her excess weight: higher levels of cortisol tell her body to access its calories from her stored fat pads.

Estrogen, a hormone of fertility, is the dance partner of insulin. When insulin goes low, estrogen also goes low. This is why women no longer have menstrual cycles while breastfeeding.

When, after months of exclusive breastfeeding, a baby begins eat solids and to gradually wean, the mother’s body increases her levels of insulin. Now she begins to use her own blood-glucose for energy during daily life, and no longer her fat reserves. She begins to gain weight and to build fat reserves in preparation for the next pregnancy. When her insulin levels are high enough, and she has gained enough weight to support another pregnancy, her estrogen levels also increase. This turns on her menstrual cycle. She is ready to conceive.  

Scroll down past the summary and the science extract to read how our present-day blood-sugar and insulin imbalances interfere with the hormonal dance of lactation, leading to the many lactation difficulties that are widely experienced.

Summary of the Hormone Dance

This, then, is the unique dance of hormones that is supposed to occur after childbirth. 

Insulin low, estrogen low, cortisol high.

But the mammary cells are particularly sensitive to even low levels of insulin. This allows the breasts to be fully active.

We see this postpartum pattern in studies on animals and primates (gorillas, chimpanzees and orangutans). This pattern also emerges in a set of studies from the 2000s, in which postpartum insulin levels were measured in Toba women who lived a Paleolithic lifestyle in the forests of Argentina.[1] 

The Problem of Insulin Resistance

Most people today have some degree of a condition called “Insulin Resistance.” It typically develops throughout our formative years in response to a diet with foods that are high on the glycemic index, such as French fries, potato chips, bread, packaged breakfast cereal, candy, cookies, ice-cream, soda, pizza and so on. On this diet, the hormone insulin is constantly in demand. It becomes so active and “loud,” so “nagging,” that the cells of the body stop listening to it. They “resist” responding to insulin’s signals. They are now “insulin resistant.”

Lifestyle factors also play a role: certain medications, chemicals around the house and garden, lack of good sleep, and chemicals in the soaps and cosmetics that we use on our body: anything that causes further inflammation in the body contributes to the furthering of insulin resistance. 

Insulin resistance leads to a vicious circle. When the cells of the body resist accepting energy from blood-glucose, we are actually in danger of death. Too much sugar in the blood is that dangerous. 

Accordingly, the levels of insulin in the blood increase dramatically, more and more. This is called hyperinsulinemia. Higher levels of insulin produce a stronger signal so that eventually the cells do accept the signal and open up to absorb the excess glucose. But the underlying condition remains. As the body produces more and more insulin, the stage is being set for diabetes, a serious illness. 

Gestational Diabetes, often dismissed as being just temporary, is a clear risk factor for diabetes and it is also a red flag for a potentially difficult start to breastfeeding. 

Symptoms of Insulin Resistance

Feeling hungry throughout the day, easily gaining weight, experiencing sudden drops in energy, loss of concentration and fatigue, are signs of progressing insulin resistance. 

Insulin Resistance and Lactation

Now that you understand the Dance of the Hormones, imagine the body attempting to create this dance pattern in the presence of Insulin Resistance and with perpetually higher levels of insulin in the body. It is not possible.

The result can be a lack of full maturation of the mammary tissue during pregnancy, delayed onset of lactation after childbirth, an unreliable supply, and early return of menstruation.

There are other results, such as mothers being unable to lose weight while breastfeeding, even needing to eat more calories to maintain their supply: they are in a struggle with their body’s insulin resistance. Drinking a sugar-laden “sports drink” is one way to force insulin to peak so its signal can get through all the resistance, and this is surely one reason that sports drinks are so popular for supply-challenged mothers.

As well, insulin resistance during our teen years, especially in combination with health problems such as eating disorders (not allowing the body to develop its normal fat pads at the onset of puberty, or being too thin to have menstrual cycles), or a hormonal condition called PCOS (polycystic ovarian syndrome – present in approximately 10% of women), can lead to a condition where the mammary glands do not fully develop at this time. This condition is known as insufficient glandular tissue, IGT.

Yet, even in the face of all this, most mothers are able to produce their personal, optimal supply. Her supply may not cover all of her baby’s needs, and she may have to top it off with donor milk or formula, but she and her baby will have that special and unique time together.

To navigate these breastfeeding hurdles, families require patience, understanding, and the guidance of a knowledgeable lactation consultant. 

We pass Insulin Resistance to our Babies in the Womb

Sadly, insulin resistance is passed from mother to baby in the womb. Our children gain weight more easily and are at risk to develop health problems linked to insulin resistance earlier in life. 

This cross-generational increase in insulin resistance is manifestly seen across the world in quickly rising levels of obesity, diabetes, kidney disease, heart disease and dementia. Because insulin resistance also increases what is called “systemic inflammation,” it promotes the development of inflammatory or autoimmune conditions, which can include depression and anxiety. 

The cross-generational passing of insulin resistance is a world-health tragedy. Yet it is never described in mainstream sources and very little research—on humans—has focused on ways that we might correct it. 

Solving Cross-Generational Insulin Resistance

On animals, however, a plethora of research exists. From these studies, we know that one way to turn it around is to eat foods and take supplements that are high in antioxidants.

In animal studies, antioxidants reduce and even eliminate the impact of a mother’s insulin resistance on her unborn children. These same antioxidants protect the delicate mammary and placental tissue, and thus support the maturation of the mammary glands during lactation. 

Insulin Resistance, Dehydration, and Lactation

One of the mechanisms that the body uses to get rid of excess blood-glucose is to pee it out. It does this by extracting water from the deeper tissues of the body and directing this moisture into the blood, diluting the sugar in the blood so it is less damaging as it passes out in the urine.

To do this, the body takes water first from the areas between the cells (the extracellular matrix), and then from within the cells. 

Only a fully hydrated extracellular matrix allows for fully functional cells and a fully developed mammary gland complex. By not addressing deep hydration, the problem remains. 

It is no coincidence that traditional postpartum soups and gruels, without exception, have deep-hydrating ingredients that maintain the extracellular matrix and keep the cells fully functional. We’ll talk about this in class. 

Additionally, extracts from lactogenic foods and herbs are frequently used in high-end cosmetic products because of their hydrating and moisturizing properties.

To summarize, the lactogenic diet is: 

  • Deeply hydrating
  • Uses herbs and foods and are anti-inflammatory
  • Contains herbs and foods that are used in traditional medicine to treat insulin imbalances.
  • Contains herbs and foods that are anti-anxiety and anti-depressant.
  • Contains herbs and foods that support immune health.
  • On top of this, uses kitchen spices and herbal galactagogues to positively influence the hormones of lactation: prolactin and oxytocin.


1) Valeggia, C. and Ellison, P.T. (2009), Interactions between metabolic and reproductive functions in the resumption of postpartum fecundity. Am. J. Hum. Biol., 21: 559-566.

Once upon a time… Girls Fairytales Retold

Once upon a time… Girls Fairytales Retold

For information on our classes for mothers, IBCLCs, and postpartum caregivers, go HERE.

Once upon a time… Girls Fairytales Retold

Once upon a time, my 11-year-old daughter begged me to tell her fairytales, just like when she was still little. That got me thinking. The Grimm’s Girls’ stories, aka “Fairytales,” are familiar to us as Cinderella, Snow White, Red Riding Hood, the Frog Princess, Rapunzel, and more. These stories typically feature a conflict between an adolescent girl and an older woman, be it her stepmother, older step-sister, an evil fairy, sorceress or a witch.

I asked myself: just what is this fascination with the “evil mother” all about? And why did my pre-pubescent daughter suddenly demand to hear these stories?

I started researching and re-writing traditional girls’ fairytales. In my re-told stories, rather than girls being oppressed by older, evil women, the girl and her mother come to understand each other better.

The Grimm’s Girls’ fairytales have their origins in Eurasian shamanism, a world-view that existed for tens of thousands of years. It pre-dates all modern religions, yet contains elements of all religions as well. Thinking about this, I decided that the perfect person to narrate these tales would be an elderly shamanic woman, a “Grand Mother,” living thousands of years ago. 

In my re-told Girls’ Stories, we meet the original characters of the Red Riding Hood story: a wise shamanic Grandmother, her young Girl-Apprentice, and their companion, a Half-Wolf named Fahrwa. Together, they ascend a hill. Sitting beneath a tree, they peer into the future in a shared vision quest. As they behold future times and stories, Grandmother shares the meanings of the “Old Songs.”

Each story works on several levels. (For a more in-depth discussion, see this post.) They are first of all literary narratives for adults that are told in a fairytale style. Another level is a simplified arc of European history that is embedded in the stories, and that revolves around the rarely-told suppression of women’s medicine (including herbs for lactation). The stories also represent archetypal situations: passages of life when an individual must either grow in skills and wisdom or flounder and lose their way. Such “skills and wisdom” are the “Initiations” that Grandmother reveals in the “Old Songs.”

A Book Discussion Group for my Newsletter Members

In late August and through September, I’ll hold weekly zoom meetings so that everyone who has read the book and who is a member of my newsletter can meet to talk about the stories. I am looking forward to these meetings and hope you will join!

The kindle sale ($0.99) is this week, July 12 – 16.

If you would like the paperback with black and white illustrations, it is here.

(It’s less expensive than the paperback with color illustrations, here, which costs more to print and therefore has a higher price.)

Several controversial subjects are neatly woven into the stories, so softly and subtly that you may not even notice them. I wonder, will you notice them? We’ll talk about it all in our meetings.

Join my info and course newsletter (below) to get updates on the book-discussion meetings and on classes.

Mother Food, a breastfeeding diet guide with lactogenic food and herbs

Mother's Garden of Galactagogues Cover

A Mother's Garden of Galactagogues: growing and using milk-boosting herbs and foods

Healing Breastfeeding Grief: how mothers feel and heal when breastfeeding does not go as hoped

Red Madder Root, Tales of Initiations: A Novel of Fairytales and Forgotten Histories (color illustrations)

Red Madder Root, Tales of Initiations: A Novel of Fairytales and Forgotten Histories (b&w illustrations)

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Red Madder Root: Reflections and Intentions of the Author

Red Madder Root: Reflections and Intentions of the Author

Red Madder Root: Reflections and Intentions of the Author

For ten long years while writing the tome Mother Food I took part in a professional writers’ group where we shared short stories, novels, and poems. This creative outlet helped me keep some balance while writing chapters on infant colic, food allergy and nipple thrush.

After Mother Food’s publication, I considered writing a novel. I knew that good ideas take years to ripen, and sometimes decades. I challenged myself to come up with a grand and unique concept, and then sat back and waited for inspiration to hit. But would it?

One of my strengths is my ability to see large historic trends and to think in terms of symbols and archetypes. Maybe I could do something with that. 

When my eleven-year-old daughter pleaded with me to tell her “Old Stories” like Snow White, Red Riding Hood, and Cinderella, I felt a spark, the lighting of an ignition, deep in my brain. My daughter was entering puberty, yet she wanted to hear “Old Stories” that are told to young children. What could it mean?

I soon learned that these stories go back 50,000 years or longer. Their origins are in Eurasian shamanism. I was intrigued. 


Before I dig in further, let me say that this book, Red Madder Root, Tales of Initiation is not about shamanism or the use of hallucinogens or other similar phenomenon. Rather, these aspects are touched upon lightly, more like sketching the scenery, providing a background or framework where the main characters live and communicate.

Also, although the plant called Red Madder Root is an abortifacient as well has having other properties and uses, and although this use is mentioned in the book, this book is not about abortifacients or abortion. Rather, it is about the suppression of women’s knowledge, medicine and traditions, of which the suppression of herbal abortifacients is but one aspect. 


Shamanism derives from humanity’s Paleolithic past but it lives on today in many indigenous societies. Although in the US we equate shamanism with Native American peoples, Eurasian shamanic societies pre-date peoples arriving in the Americas.

Simply put: I believe that shamanism is in all of our pasts. There is no genetic line that does not spring from humanity’s Paleolithic origins or that has not at one time embraced a shamanic world-view. It behooves us to rediscover its living principles – our capacity to feel a connection to the natural world, to intuit unseen realities, to use natural forms of medicine.


Enhanced Cognition

Until just recently, shamanistic experiences were deemed “New Age” and “woo” by mainstream scientists. Now, studies on psilocybin and ayahuasca (psychoactive plant “medicines”) shine a positive light on this “therapy.” It turns out that in many cases, one intense spiritual “awakening” on a mind-altering drug can resolve a lifetime of depression and addiction. It is clear that these experiences reinforce a strong sense-of-self and build ownership of purpose and empowerment. We have seen the same hold true for strong religious experience.

Humans crave and need embodied experiences of purpose and meaning. Such feelings and knowings give us strength to carry on in the face of harsh realities. In shamanism, such truths and insights reveal themselves through altered states of consciousness that might be evoked by mind-altering plants, but also by breath work, fasting, isolation, sweating, and rhythmically induced trance with drumming and dance. Such experiences may be used to convey, enhance and ingrain the sacred teachings, rites and initiations. 

Shamanic skills are passed by a mentor to an apprentice through years of specialized training. This idea of generational teaching is at the heart of Red Madder Root.  


Archetypes were first described by the Swiss psychologist Carl Gustav Jung. He believed that all human societies draw from a pool of shared but forgotten memories which express themselves in our stories and dreams. An example would be the story of a great flood that is survived by a family in a boat. We find variations of this story around the world and, most likely, it was a true historic event. It is familiar to us as the Biblical story of Noah’s Ark. 

Archetypes also represent biological imprints and patterns: they are keys to a network of instincts, responses and behaviors that guide us from the time we are born to the moment we die. The mothering instinct, for example, relates to patterns of the brain and body that condition a woman to nourish and protect children. These patterns are also referred to as genetic memories.

The concept of genetic memories and of biological memory is central to the Tales of Initiations and the Red Madder Root stories. 

Mother Goddesses

When humans transitioned from Paleolithic (hunting and gathering) to Neolithic culture (agriculture, domesticated animals, living in settlements), our beliefs also changed. Instead of worshipping powerful animals, we worshipped a Mother Goddess. She gave birth to all that exists: stars, earth, rivers, mountains, plants, animals, and humans. She also controlled the weather and the seasons, enabling plants to come alive in spring and to die and disappear in winter.

In researching herbal medicine for mothers, I discovered that ancient peoples associated Mother Goddesses with specific plants with specific medical uses. The association took various forms. Sometimes, the goddess’s name is the same as the plant, for instance: Padma, which means “lily,” Demeter, which means “Mother of Grain,” or Hel, the goddess of the “Elder tree.”

Other clues appear in sculptures or engraved images, such as the goddess of Crete who is shown with poppy-flowers in her hair. Along with plants that support fertility and milk production, mother goddesses are associated with plants that end pregnancy, so-called “abortifacients.”  Evidently, women’s desire to control their reproductive functions is as old as culture itself.

It appears that our foremothers encoded medical plants in stories, myths, iconography and statues, to remind us to pass this information forward on from generation to generation.

By the way, animals, too, use plants for reproductive means, especially primates and elephants. But that’s a story for another time.

Thou shallt not speak of Red Madder Root

The title “Red Madder Root” refers to Rubia tinctoria, a plant used from ancient times to impart a deep red color to fabric, wool, leather, and fur. Just three centuries ago, it went without saying that Red Riding Hood’s cloak had been dyed red with the madder root, as synthetic dyes did not yet exist. And so, although the madder root is not explicitly named in the tale, it is smack-dab in the center of the story. And while you and I might think that this connection doesn’t matter very much, the parents who told the story to their children understood its meaning and importance.

The madder root was a known abortifacient.

Perhaps the message of the story was this: When a girl comes of age and embarks on a journey of sexuality—leaving the narrow path and being tempted by the wolf—the properties of the madder root protect her. This interpretation may be too on-the-nose, but it certainly fits. One might also suppose that the message of the story is “cloaked” or “hidden” in the red dye of the girl’s protective mantel.

Again, woman’s medicine had been hidden or encoded in a story that was passed on from one generation to the next.

To my mind, discovering women’s medicine in the tale of Red Riding Hood and in other traditional girls’ stories was just as important as discovering plants associated with ancient goddesses. Women were preserving, hiding, or cloaking their use of plants in the stories they created about women, girls, and goddesses.

Goddesses and Transcendence 

I mentioned that the Goddess’s plants support fertility and milk production and that some were abortifacients.

There was one other important use for a goddess’s herbs: as a mind-altering medicine. Indeed, we discover a remnant of shamanism in the cultic and religious practices of Mother Goddesses.

Truth be told, I was dumbfounded when I realized that “barley water,” the beverage used to support milk production in ancient Greece and around the world today, would be mixed with hallucinogenic plants and used in Demeter’s Rites of Eleusis to produce visions of the afterlife. 

The same holds true for other goddess cults/religions: the northern goddess Hel offers an infusion of elder flowers to support milk supply and a hallucinogenic beer made with elder flowers for her ceremonies. In Mesoamerica, the traditional milk-supporting drink is pulque, and the Mesoamerican Great Mother Goddess offered her initiates a hallucinogenic beverage based on pulque.

Witches and Witchcraft – Women’s Herbs

The link between women’s lactation herbs and mind-altering brews is not trivial. Across centuries of witch-burnings, laws punished both the use of mind-altering plants and the use of herbs, especially abortifacients. These two areas of medicine must have been viewed as being similar in their degree of evilness.

In fact, we know that mind-altering medicines and plants can mimic the chemistry of lactation, and that a person addicted to heroin or cocaine may begin to (involuntarily) produce milk. (Galactorrhea.) The same is true for certain sedatives and psychopharmica.

Was this connection (between mind-altering drugs and onset of milk production) observed ages ago? And did it leave our society with an unconscious sense of abhorrence and taboo for both milk supporting herbs and mind-altering plants?

Why it matters: Red Madder Root Revealed

This novel is not a story about herbal abortifacients, and it is also not about shamanism. Rather, it is about the general suppression of women’s medical knowledge from ancient times to modern times, and the attempts of women to maintain some semblance of that knowledge throughout changing cultures. While that suppression did aim to curb the use of abortifacients, it extended far beyond them to include herbs such as those to protect pregnancy, to speed childbirth, to help with healing after childbirth, and to bring in and support a mother’s best milk supply.

In suppressing abortifacients, the entire range of women’s medicine was under pressure. It became more and more difficult for women to recall and pass on their ancient knowledge.

We feel the consequences of this today in humanity’s widespread ignorance about natural medicine and lack of immune-supporting measures, in our subservience to and reliance upon modern medicine with its poor outcomes in birth and breastfeeding, rising numbers of C-Section births, and an increasing inability of women to produce a sufficient milk supply.

My Thoughts Today

My millennia-spanning short novel, Red Madder Root, Tales of Initiation, encompasses forgotten history that underlies many of the terrible societal problems we have today.

Through the Initiations, the girl Mayana receives insights and absorbs knowledge. While facing her crushing recognition of life’s harsh realities, she accepts the madder-root-cloak of purpose and responsibility. As it passes to her shoulders, it also passes to the heart and shoulders of the reader. 

I worked on this book from 2003-2010 and then forgot about it for more than a decade. Today, I feel gratitude and pride. I feel as though I was honored in some cross-dimensional way to receive these ideas and create this unique and somewhat grand little novel that breaks open the hearts of some readers and encourages them to keep on keeping on, even as our times become darker. 

Artwork by Ruta Ciutaite @blueruedesigns on Instagram.