From what I have read of this research before, and what Cathy Fetherston
wrote, my understanding is this:
Women with greater storage capacity can breastfeed less frequently.  I
extrapolate that their babies may grow accustomed to taking larger amounts,
less often, because that is how their mother's breasts work.  Women with
lesser storage capacity must feed more frequently because their babies need
a higher number of servings to get the necessary volume to sustain normal
growth.

A breast that is frequently drained does not get as full between feeds as
does a breast with large storage capacity and a baby with a correspondingly
stretched out stomach.  We have all known those enviable mothers who could
rely on their babies to sleep for three or four hours between most feeds,
and mothers whose babies feed like windshield wipers, vacillating from one
breast to the other much more frequently, envied only by those who might
have a bumper sticker on their car that says 'I'd rather be breastfeeding'.


What Hartmann et al found was that the *difference* in fat content from the
first drop to the last drop in any given feeding, was less in women who feed
more often than in women who feed infrequently.  Another nail in the coffin
of foremilk/hindmilk as a useful notion for mothers and their breastfeeding
guardian angels, and none too soon if you ask me.

For me this knowledge means I don't always assume that a baby who prefers
frequent feeds and is unsatisfied and appears hungry a short time after a
feed, is suffering from overactive milk ejection reflex in the mother, nor
oversupply, nor what we used to refer to as foremilk/hindmilk imbalance.
This can also be the normal behavior of a hungry baby whose mother has
little storage capacity.  If you try to fix the perceived problem by keeping
the baby on one side over several feedings or several hours, and it gets
markedly better within a few feeds, it probably was oversupply and
overactive MER.  If this strategy makes the baby more unhappy, and the baby
clearly is displeased about being offered a recently drained breast, then
the problem may be that the baby needs to feed more frequently, or more
effectively, or both.

The truly great thing about this, is that Look at the Baby is the best
policy, once again, or still,  or whatever.

Rachel Myr
Kristiansand, Norway

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