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Subject:
From:
"Catherine Watson Genna, IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 23 Aug 2009 09:23:45 -0400
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Some surprising research findings about how milk is made that have not 
been covered yet:

One thing we've learned is that milk goes back up the ducts to the area 
outside the milk glands (alveoli), allowing feedback to the breast about 
how much milk the baby didn't take. This is Donna Geddes discovery, and 
it is in agreement with other research findings, i.e. that germs ascend 
from the nipple to cause mastitis, and now that cells from baby's saliva 
are found in the breast.

We also found that it's how much milk the baby takes, not the fat 
content that leads to growth. The citation for this study that Jean 
Riddler mentioned:
Effect of sucking characteristics on breast milk creamatocrit.
Paediatric and Perinatal Epidemiology. 16(4):355-360, October 2002.
Aksit, Sadik; Ozkayin, Nese; Caglayan, Suat

It's well worth reading. Remember the "lack of fat/hindmilk" dx was a 
hypothesis. In my experience, babies who are getting relative lactose 
overloads are FAT, not skinny. Skinny babies are usually not getting 
enough volume.

Peter Hartmann and people working in his lab found that babies 
breastfeeding well take about 75-79% of the stored milk from mom's 
breast (from their topographic analysis studies measuring breast volume 
with a computer). Susan Burger mentions one of their studies of mothers 
pumping with the research pump (Symphony) that showed a significant 
proportion of successfully breastfeeding mothers did not remove 50% of 
their milk with that pump. That's NOT a good thing for their future milk 
production if they were to rely on that pump. Research is obviously 
ongoing to try to improve that performance. In my work with tongue-tied 
babies, some of them only take half or less than the milk mom can then 
immediately pump.

We keep learning, and it's fascinating. For now, I advise moms to offer 
both breasts, especially in the early weeks, unless baby is gaining more 
than 2 lb per month, is miserable, and has gi symptoms.

Catherine Watson Genna, BS, IBCLC  NYC

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