Hello, Catherine.
       You wrote:
"Might this study actually reflect poorer MER in smokers?  Lower fat
content means that the breasts were not adequately emptied...."

       Since the smokers were *also* seen to have lower volume, then in this
case the lower fat content might indeed mean poorer MER.  But I would like to
suggest that lower fat content would not *automatically*, in all cases, mean
the breasts were not emptied well.
       I have been using a homeopathic remedy called Lactuca virosa with some
mothers who don't have enough milk.  One mother presented some very
interesting results.  Her baby would not latch, so she was exclusively pumping.  Before
she used the remedy, she got out a certain amount of milk (I've forgotten
just how much).  After it sat for a while, there would be a very thin layer of
cream on the top.  After using the remedy, she got out *exactly* the same amount
of milk BUT, after sitting, there was then a very thin layer of skim milk on
the bottom of the bottle and the rest was cream.  So even though there wasn't
any more volume, there was a lot more calories in that same volume, which is
what the baby needed anyway.  But because the volumes stayed the same, I would
not conclude that the difference in fat content was related to poorer/better
MER.  As with most things related to breastfeeding, it seems that there can be
more than one explanation for any particular symptom.
       Dee







Dee Kassing, BS, MLS, IBCLC
Collinsville, Illinois, in central USA

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