Jennifer writes:

<I rarely suggest switch nursing anymore, b/c breast compression works so
well.>

I recently had an "A-ha" moment while reading references. 50% of the
glandular tissue is in the upper outer quadrant (UOQ) of the breast
(where nature has made it convenient to place all 4 fingers of the
opposite hand!) 75% of the lymphatic drainage of the breast goes through
the axilla.

Perhaps teaching compression of the UOQ of the breast during every feed
from the very beginning might "kill several birds with one stone". It
would:

* stimulate MER's promptly, as direct pressure on the myoepithelial cells
is another way to stimulate them to contract, without oxytocin even
entering the situation. (ever see a calf butting its mother's udder?)

* move already secreted colostrum forward promptly right from the
beginning due to this myoepithelial cell activity, plus the force of the
manual compression on the ducts.

* thereby get more calories into the baby sooner, which would avoid a
whole lot of baby-associated problems.

* avoid back pressure of secretion buildup on the alveolar membranes,
thereby speeding early production.

* keep glandular tissue in the UOQ from getting full enough at any one
time to crowd the many lymphatic channels in the same vicinity, thereby
encouraging efficient lymphatic drainage of what might otherwise back up
in the interstitial tissue as edema.

* thereby reduce the "onslaught" of engorgement by the 3rd day by
avoiding much of the viscious cycle of edema crowding the ducts and the
ducts crowding lymphatic pathways ad infinitum.

* without "verbal information overloading", kinesthetically teach the
mother a valuable skill she will be able to use at home during subsequent
nursing situations of all kinds. (I teach moms with the familiar analogy
"that it's a little like compressing the far end of a giant toothpaste
tube.)

* subtlely reveal to her in a way that is simpler for the personnel and
that might be less threatening to her than fingertip expression, that
it's "ok" to touch her breast, if that is a problem with her.

* thereby familiarizes her with tactile sensations of what is a "full"
UOQ, and what is an "emptier" UOQ.

Does this make sense to anyone else? Is anyone hospital based willing to
try it, and perhaps even do a little research?? Maybe even recruit
experienced LLL moms to participate by starting to do it on one breast
every feeding from the beginning and avoid doing it on the other breast,
at least until she might feel she needs to do it for comfort?

Jean
**************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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