Karleen has been asking such wonderful questions. Wish I had tiem to digest this information into a clearcut format - it would make a nice book on how and when to use supplementing devices on the breast and when not to!! Another project I'd love to do, but don't have time for - at least not yet. So... catching up on all her postings - She stated: "I often wonder about the usefulness of breastfeeding supplementers. The places where we have the most studies on relactation (and the most women...the Indian study frm last year with 1000 women for eg!) have not had any gadgets at all, no pumps no supplementer and have just concentrated on breastfeeding and supplement after breastfeeds." So, I've been pondering the differences between the population I and my colleagues see and the India population. The population we see is predominantly primips, typically older women, I'd say 15-20% have fertility problems (some of those with PCOS). Often, there has been some interference in stimulation of the supply while in the hospital. I have seen two women that got a kick out of handexpressed - most of the rest will do it for a while, but are not truly comfortable with it. How many of the women in the India study had achieved full lactation with a previous child? Another question Karlene asks is: "but just how useful are they in cases where mothers are concentrating on increasing milk supply??" The answer to this is variable. That's why I always check milk transfer with the device. I had one baby take 5.6 oz from the breast with the small tube SNS in place and 2.0 oz from the SNS. This was an exceptional case because we caught the baby at 6 weeks, 4 oz above birth weight. The baby had frank marasmus - as obvious as any baby I'd seen back when I was working in International Nutrition. And that avid hunger that led her to take in 7.6 oz, also promptly led to the obvious - a copious upchuck. But she was completely unfazed and looked quite satisfied after that ravenous feed and did slow down once she got it that she could get enough to satisfy herself. I've had some babies who take nothing from the breast and then I look to why they aren't able to transfer from the breast and often will adopt other strategies - or use the SNS to get some breast time in if the baby isn't latching. Best, Susan Burger, MHS, PhD, IBCLC *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html