NormalPuerperium6BreastsLactation can occur by 16 weeks'gestationLactogenesis is initially triggered by thedelivery of theplacenta (EPand prolactin)the prolactin levels decrease and return tonormal within 2-3 weeks (not breastfeeding)The colostrum初乳（thefirst2-4days)The milk continues to change throughout theperiod of breastfeeding to meet the changingdemands of the baby
Normal Puerperium 6) Breasts ✓ Lactation can occur by 16 weeks' gestation. ✓ Lactogenesis is initially triggered by the delivery of the placenta (E↓P↓and prolactin). ✓ the prolactin levels decrease and return to normal within 2-3 weeks (not breastfeeding) ✓ The colostrum初乳(the first 2-4 days) ✓ The milk continues to change throughout the period of breastfeeding to meet the changing demands of the baby
Normal Puerperium2Systemic changeCardiovascular systemBlood volume returns to nonpregnant levelsby the tenth days of puerperiumCardiac output ↑ (immediately after delivery)→ slowly declines-→reach latepregnancylevels 2days postpartum- normal 2-6 weeks.2）Hematologic changesHemoglobin concentration on the firstpostpartum daysSeveral clotting factors (fibrinogen) fon thefirst days
Normal Puerperium 2. Systemic change 1) Cardiovascular system ✓ Blood volume returns to nonpregnant levels by the tenth days of puerperium ✓ Cardiac output ↑(immediately after delivery) → slowly declines→ reach late pregnancy levels 2 days postpartum→ normal 2-6 weeks. 2) Hematologic changes ✓ Hemoglobin concentration↑on the first postpartum days ✓ Several clotting factors (fibrinogen) ↑on the first days