Hi, all!  I wrote up a summary of the lecture that I attended last week. It
was fascinating, and also left many of us confused as to how to integrate his
research into our current knowledge. The fact is, we may need to *again*
change some of our understanding and theories, at least as soon as we figure
it all out!  I know that our Australian sisters are more familiar with Peter,
and I would call upon them to clarify anything that I may have misunderstood
or misstated. In the meantime, I am most interested in your feedback, and
your thoughts to my own questions.  My mind has been working overtime since
then!
Thanks,
Lisa Marasco, IBCLC
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Peter Hartmann Lecture on Milk Supply


On Thursday, Feb. 9, I heard Peter Hartmann lecture on the results of his
studies on milk supply. Peter does his research with the help of graduate
assistants at a University in Perth, Australia, and has been studying the
subject for several years. He has developed equipment specific to the study
of breasts; his research involves taking pictures of breasts before and after
feedings and using the information obtained to analyze through the computer
the change in volume and the rate of synthesis. This involves a method of
topographical study and analysis, made possible by stripes projected onto the
mother's breast by a third source before the pictures are taken. Peter has
found that, in his protocol, mothers are able to align themselves properly
for follow-up pictures to within 1-2% accuracy, an excellent rate for
reliability. Some of his information represents new thoughts in the theory of
milk production and storage, and raises some interesting questions, which I
am going to briefly address:

Theory of Milk Synthesis-- Peter has found that milk volume is quite often
highest in the morning, and that babies often do not take all of that volume,
leaving some milk in the breast. The amount of milk left in the breast
decreases with subsequent feeds throughout the day until it is all taken at
every feeding; in the meantime, as the volume left decreases, the *rate* of
synthesis, or milk production, increases. Peter also noted that the fat
content of the milk rose as the volume decreased; this seems to occur as the
left over milk becomes more concentrated with fat over time, and may explain
why babies might take higher volume feeds earlier in the day but come back
soon for more!  Also, that later feeds may be higher in fat content and
therefore satisfying, though possibly less in volume.

Theory of effect of storage capacity on breastfeeding frequency:  Peter
Hartmann noted that there is great variation in the amount of milk that a
woman was able to store at one time.  In direct relationship, he found that
women with smaller storage capacities had need to nurse their babies more
frequently because less milk was available at any given time. Thus, a
possible explanation for why some babies are "snackers" while others are
"feasters"! I see a great application for this re: Prep for
Parenting/Babywise: could it be that the mothers who "fail" on the prescribed
schedule do so because they physiologically *cannot* provide enough milk at
his intervals, though they can do so over 24 hours? And are the "success
stories" of those women who have large storage capacities?

Of course, by embracing this aspect of Peter's research and applying it this
way, I am excluding other research that has noted minimum #'s of breastfeeds
per day as apparent necessity for guaranteeing milk supply. Or are they
really an average of all of Peter's women? I'm wondering.