hi all

I am finding the discussion about Dr Hartmann's research concerning. 
Concerning because so many of us here on Lactnet openly say that we welcome
and encourage scientific research in regard to lactation issues.  Here is a
man who has done more research on the anatomy of the breast than anyone else
 has posed more questions about our understanding of the lactating breast,
is taking steps to answer many of the questions that are proposed and yet
because he challenges long established ideas, there are some of us who
appear to be disregarding what he has found.

Of all the research of his that I have read, it does in fact support what we
know clinically - no- one can diactate how long, how often, whether to feed
one side or two.  His findings highlight that there are measurable
differences between the lactating breasts of women and the differences
between the two breasts of a lactating woman.  He stresses that his findings
illustrate the need of a mother to respond to the cues of her baby as the
best way to establish and maintain supply.   He has shed new light on what
happens to the fat content of milk in any given time frame.  I have even had
the privilage of listening to and meeting the LC who coined the terms 
foremilk" and "hindmilk".  She has said that in light of what we now know,
these terms should not be used as our understanding of lactation has moved
on.

Surely we need to be prepared to let go of some of our old ideas.  To let
them go, to be open to new ideas (no matter how radical) is a sign of
maturity.  Often what we think we know turns out not to be quite true. 
Often our understandings need to honed.  If we hold onto old ideas simply
because this is what I thought, then lactation as a profession will not move
ahead.  

I remember when I started nursing, Pressure Area Care involved turning
patients, washing their backs and boney areas with soap and water and drying
these areas briskly with a towel every 2 hours.  We now know that frequent
washing can break down skin and dry skin out.  Now we simply turn the
patient and sometimes gently massage the skin.  Another area of change has
been wound care.  What I did - even though my understanding was correct for
the day, is now seen as poor practice.

Please do not be so quick to judge.  Please be open to radical ideas - even
if they shake the foundations of what you think and what you know.  Many
discoveries and thoughts have been rejected because they were too radical at
the time, only to be hailed as break throughs down the track.  Even Pro.
Hartmann admits that the understanding he has is changing and unexpected. 
He admits that as our understanding increases the textbooks will have to be
re-written many times.

Lets move on.  Sure, ask questions.  Be wary but do not be afraid to find
out that old understandings need to change.

Off the soap box

Ruth  Fiedler
Australia

 
 

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