Yaffa,

I agree with Pardee about not taking a young baby off the first breast to make
sure they take both, and also find that there seems to be less engorgement with
this.  My suggestions seem to be the same--let the baby go on the first breast
as long as he/she wants; pump a little off the second if it's uncomfortable and
use that breast next time.  It seems very reasonable to me that a baby that's
been getting 1/4 oz. or so at a feeding the first few days cannot all of a
sudden have the stomach capacity to hold what's being produced by both breasts!

However, I have changed what I recommend to mothers in the first few days before
their milk "comes in."  I had been seeing *way* too many mothers with damaged
nipples in the first few days, sometimes after the first feeding.  Now I suggest
that mothers not limit the length of feedings, but break the suction about every
10 minutes, *examine the shape of the nipple*, and switch sides.  Latches are
not always perfect as mother and baby are learning, and mothers have not always
interpreted what they are feeling as painful the first few times at breast.  If
the nipple is getting pinched, I'd rather know it after 10 minutes than after
30!  By the time the milk comes in, hopefully we know whether baby is latching
on correctly, and the increased milk flow decreases the negative pressure on the
nipple skin.

Becky Krumwiede, RN, IBCLC
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