Came across this recently and had not seen it discussed on LN:
Evans K, Evans R, Simmer K, Effect of the method of breastfeeding on
breast engorgement, mastitis and infantile colic, Acta Paediatr 1995;
84: 849-52.
"This exploratory study compared the effect of two methods of
breastfeeding on breast engorgement, mastitis, infantile colic and
duration of breastfeeding. An opportunity sample of subjects was assigned
either to the experimental group (prolonged emptying of one breast at
each feed) (n=150) or to the control group (both breasts equally drained
at each feed) (n=152) and both groups were followed prospectively to 6
months after delivery. The experimental group had a lower incidence of
breast engorgement in the first week (61.4% versus 74.3%; p<0.02) and
colic over the first 6 months (12% versus 23.4%; p<0.02). There was no
significant difference between the two groups in the incidence of
mastitis over 6 months and the length of breastfeeding (16.5% +/- 10.3
weeks versus 17.5 =/- 10 weeks experimental versus control group). The
majority of mothers in the experimental group (63%) felt it necessary to
offer the second breast at the end of a feed to satisfy their infant's
hunger. The "perceived insufficient milk suppy syndrome" was the main
reason given for cessation of breastfeeding in both groups. This study
provides data to advise nursing mothers about these two methods of
breastfeeding."
I like that last sentence. Advising mothers of both ways and letting them
decide from their infant's cues. No hard and fast rules and "You musts"
pontificated by the staff. And good info to feed back to the
grandmothers, aunts, etc. who frequently pontificate this same point to
new mothers.
Maybe this would be good for staff education, so the staff could give
some evidence based guidance instead of blithely telling the mother "Well
they used to say . . . . . but now they're saying . . . . . . . . so it
doesn't seem to matter much which way you do it, just do what you want
to do."
Despite our lack of control over pitocin inductions, IV's, & epidurals,
we might be able to reduce the incidence and severity of engorgement
somewhat simply because of this variable, which uses the influence of
the nursing/LC staff.
Maybe a little more emphasis on reducing chances of severe engorgement by
using what ended up seeming to be the "First breast first" principle,
might be worth a try.
The mother is still in charge, and always has the second breast to offer
if she thinks the baby needs it.
Jean
******************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA
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