Given this "mental factor", it is understandable that a bitch who is not comfortable with motherhood, whose choice of nest has been overruled, or who has been anesthetized for a Cesarean can show a clear delay in milk production. This condition can be treated by a change in environment, by homeopathic herbs or by administering certain antiemetics that stimulate secretion of prolactin by the central nervous system.
Once the first puppies have been born, milk secretion continues on its own by a neurohormonal reflex action. Nursing or massage of the teats stimulates the secretion of another hormone, oxytocin, which causes the milk to move into the milk ducts. This mechanism is proportional to the number of nursing puppies, and so allows milk production to adapt to the puppies'appetites, which in a sense take priority over the mother's health.
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