<<As Marsha says, the very frequent feeding pattern is probably because the 
baby is held next to the mother's bare breasts all the time.  In most 
hunter-gatherer societies (and these are the ones that most nearly reflect 
how humans operated when we evolved to more or less our current form), the 
baby is in fact always carried, usually by the mother.  And given what we 
know of infant physiological status when held skin to skin with the mother 
(vs set in a bassinet, held swaddled, etc.), it seems that they are in fact 
designed to be held skin-to-skin.>>

This presumes that all our ancestors lived in a tropical climate where s2s
CAN be done 24/7.  In cooler climes, this isn't possible for at least part
of the year, therefore, what were those babies "designed" for?  (I ask
because I personally don't believe we ever evolved from any significantly
different form than the one we currently occupy).

My, this has been quite a thread that has evolved (sorry, no pun intended!)
from a discussion on feeding frequency, through breast anatomy and milk
composition and on to research and the influence of money on outcomes!!!  I
hear Rachel's concern over this, and I agree that one lab, one person, one
company or one group of lactation professionals for that matter, do not have
the ONE RIGHT WAY to explain, manage or teach breastfeeding.  *That is
precisely my point!*  We are all so varied, it is hard for me to believe
that one size fits all!  For those who think I am advocating intervals of
two hours between feeds, I am not.  I could advocate two per hour feeds and
be extending the interval by more than twice what was originally mentioned
as our biological norm(5/hour).  What I see typically are cluster feeds.
Sometimes they feed every hour for 30 minutes several times in a row, then
take a looong nap, say 2-3 hours.  That is not feeding every hour 24/7.
Someone emailed me privately and said that as an anthropology major, they
are taught to beware of the "noble savage" phenomenon, that just because a
more primitive people behaves a certain way, doesn't make it the way we are
supposed to: do things/eat/feed our children/sleep...etc, etc.  I think
parents should allow for clusters of feeds, but after the first few days,
that tends to happen more on a cyclical basis, not a continuous one.

As for the Hartmann team, my hats off to them, and I applaud Medela for
"putting their money where their mouth is" as someone said!  I am as
uncomfortable as Rachel is with a hard sell and would prefer something less
ostentatious and 'in-your-face' at conferences, but sometimes we have to
take the bad with the good, and I think the research is sound.  We should
take it for what it's worth, evaluate and apply it where needed.  I saw
their presentation at the conference in Boca a few years ago, where they
ultrasounded women on stage while they pumped, and it was impressive.  I
hope that we don't "bite the hand that feeds us" (or the researchers and
pump companies who invest in something from which we and they stand to
benefit) just because they don't do it for nothing, like many of us do
(though most of us do get paid in our jobs).  And like Rachel, I am just
thinking critically when I question the idea that all babies should be
attached at the breast continuously for the first x months because a tribe
in a primitive culture does it that way.  And I wasn't talking about how
rich the milk was.  Perhaps it was quantity that is smaller because of their
diet.  These mothers are not usually overweight, in fact they are often on
the verge of malnutrition, with slender frames and smaller breasts (we all
know that breast size is related to amount of body fat).  In that case, baby
would have to nurse often to get enough.  There are many possible variables
that could cause a baby to feed in a given pattern, whether 5x/hr, 2x/hr or
every other hour.  It is, as someone said, the baby we should watch for
cues.  If they are thriving and happy, then I say whatever works!

Marsha, who has nursed some of her babies more often (they required it) and
some less, some on just one side per feed (d/t reflux) and some on both.
All gained well enough, with dd #2 being "no bigger than a minute" still at
age 2 (she's tall and slender now), and ds on his way to being a "hoss" by
one week of age (he's just plain tall now!)

~~~~~~~~~~~~~~~~~Marsha Glass RN, BSN, IBCLC~~~~~~~~~~~~~~~~~~~~~
Mothers have as powerful an influence over the welfare of future generations
as all other earthly causes combined.
~~~~~~~~~~~~~~~~~~~~~~~~~John S. C. Abbot~~~~~~~~~~~~~~~~~~~~~~~~~




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