In a message dated 1/4/2004 11:57:29 AM Central Standard Time,
[log in to unmask] writes:
<<I
also tell parents the object of pumping after a feeding is not necessarily
to get more milk but to tell the breasts that they need to make more.  The
emptier the breast is, the faster it makes milk even if none ends up in the
bottle.  If they get some milk, it is a bonus.>>


I've heard this line of reasoning before, and while I understand the theory,
I wonder if it really works in practice???  If you are not taking milk out of
the breast, how are we then telling the breasts to make more?  If we are in
the endocrine phase of lactogenesis, in which prolactin receptors are being laid
down, and milk production depends on surges of prolactin, then yes, I agree
that pumping after a feed may work.  However, if you aren't taking milk out of
the breast, how does it become emptier?  I guess I'm not quite following the
sentence that says "the emptier the breast the faster it makes milk [that part
I understand] even if none ends up in the bottle.  If none ends up in the
bottle, how are we emptying the breast?  Where is it going?

Not so many years ago mothers were being told that as long as the baby's
mouth was on the breast, it would stimulate milk production.  I've seen in my
practice mothers who are "breastfeeding" for an hour at a time every two hours,
and milk production is in the toilet.  Why?  Because the babies aren't suckling
effectively and aren't emptying the breast.  The mouth is on the nipple, but
the Milkmen are all on a coffee break because no milk is being removed.

Perhaps the question then becomes, is robust milk production dependent on
removing milk from the breast, or stimulating the breast even if no (or very
little) milk is removed?

I certainly hear what Linda is saying about moms who pump and then 15 minutes
later the baby wakes up and wants to eat so they don't breastfeed because
they think they don't have anything.  I try to circumvent this by telling mom to
go ahead and breastfeed anyway -- that the baby, if he is suckling effectively
is a much better pump than something made by man, and that the baby can get
milk out that the pump can't get.

All bets are off, however, in most cases of a preterm or ineffectively
suckling infant.

Good discussion -- other ideas?




Jan Barger, RN, MA, IBCLC, RLC
Wheaton, Illinois
www.lactationeducationconsultants.com

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