hi ellen
I think when we have discussed this before that we pretty much came to the
conclusion that 'finish the first breast first' (which is still a valid
recommendation) has often been MISINTERPRETED to mean 'feed only on one
breast per feeding.' I counsel moms to bf from the first breast and let baby
finish, then offer the other one. Baby may or may not take it. If it feels
uncomfortably full, I advise mom to express to comfort. (Or she could
express completely if she is trying to increase or stockpile her milk.) I
also counsel moms that sometimes baby may take just one breast and other
times baby may take L, R, and L again. Or any other variable. I feel this is
good advice for normal healthy babies. Remember too that for all this to
work moms/babies should be together to respond to cues and for easy access
to the breasts. When there are premature babies involved, low birthweight,
or other problematic feeders, then I may give some other advice, for example
breast compression (which can be done for any couplet but which I don't
routinely recommend), or switch nursing. Hope this is helpful.

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA


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