Nina, Respectfully, this is not a new discussion. There are quite a few posts on this very issue in the archives. I see your point exactly, though, and I do believe there is merit to informing and supporting mothers to breastfeed many, many times a day to ensure both adequate production and adequate intake. Certainly, where there has been restriction of feeds, in any way, this will not drive the demand/supply system appropriately. Now that I've had 25 yrs of working with breastfeeding mothers, I would have to say that it is not rare for mothers to have insufficient supply. I can often predict which ones, based on their body type and breast shape. Since we have a followup clinic in 1-2 days post hospital discharge, I don't say anything to the mother, but often it bears out. I have seen enough cases of PCOS (because we have an OB doc on staff who sort of specializes in this, and infertility), that I believe it is definitely associated with lowered milk production. Certainly, lowered production is often multifactorial, and so when a mom has PCOS, diabetes, conceived with fertility drugs, twin premies, we will be very worried about her supply. On the other hand, sometimes it's the baby (we have alot of premies and near-term infants) who is just not driving the system. In that case, a good hospital grade pump, used frequently, will drive the system. I also believe that many mothers don't give it enough time, and after a week, or even two weeks of doing supply-enhancing interventions, they stop bf altogether because they expected better results. I know a mother who had her 5th baby, and had breastfed all others long-term, attachment parenting style. For some reason, she had a serious problem with milk supply and had the help of 2 excellent IBCLC's at another hospital. (I was consulted by the 2 LCs by phone) She had help with the latching, and all that, took herbs, domperidone, and secretly (from the doctors) used donor milk because formula use was so distasteful to her. It was so devastating to her, that I do believe it contributed to her hospitalization for major depressive episode. It was soon after Hurricane Katrina and that certainly added to the severe stress she was under. What I am saying, is that no matter how often the baby nursed, the mother was not making enough milk to sustain the baby. I definitely believe we need to examine this issue, what we say to mothers, how we support them etc. So I do welcome any discussion on this, as the last discussion was very enlightening. Laurie Wheeler, RN, MN, IBCLC Mississippi USA *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome