Yes--most of the time poor milk removal leads to low supply...BUT

sometimes, if mom has a large storage capacity, and her baby can take out 
SOME milk with a shallow latch, what she will learn is that in order to get 
a feeding to last less than an hour she needs to offer the baby both 
breasts.  So say the mom can "store" 6 oz at a time in each breast, and 
optimally "should" be feeding 4 hours per side...but she is feeding both 
sides every two hours in order to get her baby fed, because he only gets 
what she "lets-down" into his mouth.

We know milk production only stops if a breast's ductwork is completely 
full.  If some milk is taken "off the top" of each breast every two hours, 
in moms like this it will cause them to never really stop production, and 
their breasts are never "emptied".  This tends to lead to discomfort from 
being mostly "full" all of the time, plugged milk ducts and leaking.

If baby gets on the breast correctly, and is able to get plenty from one 
side at a feeding (or 2 or 3 in a row!) then the other side finally has a 
chance to decrease production.

I would agree that by far most of the oversupply situations I see are a 
result of the mom offering too many breasts too frequently, rather than a 
primary baby shallow latch problem.  (although we see a LOT of babies who 
learn to bite down to slow the flow from an oversupply mom...but that is 
another topic!)

Kathy Leeper, MD, IBCLC
MilkWorks- Lincoln, NE

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