<Milk supply on the left side should be unaffected, as should MER as it is smooth muscle and under autonomic control. > I agree that milk supply should not be limited by the aftereffects of the stroke. But I respectfully submit that myoepithelial cells are not muscle cells. They are not ennervated by nerves. They are a specialized individual type of cell developing from the epithelial layer that begins formation of the breast in the embryonic/fetal period. The MER is a neurohormonal reflex. The afferent signals from the chest wall and/or nipple take the message TO the brain to stimulate the cascade of hormones that will then reach the myoepithelial cells through the circulation. Each individual myoepithelial cell contracts in response to oxytocin reaching it through the blood stream. Both sides receive the hormone no matter which side the neural stimulus originated from. Stress hormones, if present in sufficient amounts during stimulation of the nipple can block or minimize the MER by interfering with the release of oxytocin. I agree that positioning would seem to be the biggest challenge. And if positioning at the breast on the affected side is more difficult, and therefore that breast is not used as often, or not drained as thoroughly, the lack of milk removal, as in any mammal, would be a limiting factor. Jean ****************** K. Jean Cotterman RNc, IBCLC Dayton, Ohio USA ________________________________________________________________ YOU'RE PAYING TOO MUCH FOR THE INTERNET! Juno now offers FREE Internet Access! Try it today - there's no risk! For your FREE software, visit: http://dl.www.juno.com/get/tagj. *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html