Dear Karen, Megan, Cathy, Jennifer and Pamela,

Thanks for your replies to my question last Thursday about the feeding of widely discordant twins and the dictum some
have taken not to ever suggest that moms let them each have their own breasts. . I'm sorry after I asked that question I
then was unable to get to Lactnet and only now have caught up on your replies.

I do however feel a little misunderstood, I guess partly because of my unfortunate use of the word "assign" --which is
way too dictatorial than what we mean, and partly because in the post where I asked the question I did not repeat what I
had said in my earlier two posts two days before. As I said on Tuesday the 12th,

> The rigid assignment of *always* each baby to their own breast is where problems can arise, just as rigid switching to
>   *always* alternating babies and breasts can also cause problems. It is best to recognize the babies are different sizes,
>   will probably have different feeding patterns, give them each their "own" breasts, in general, but continue to adapt
>   flexibly to the situation of the moment, so that a rigid pattern doesn't replace comfort and ease.
>
>   Breastfeeding, like any physiologic process, works best without too many left-brained rules, but allowing homeostasis
>   to work, which means following mother's breast comfort, her instincts, the babies' behavior, etc.
>
and a little later I said:



> whether switching sides helps or not will depend on a lot of
>   factors. You can use your left brain to try to figure it all out for mom, and give her a set plan, which you then may have to
>   adjust over time, or you can give her a framework for understanding this, some tips to help her to follow the situation of
>   the moment, and then have her do whatever she thinks works best to help her baby feed better aat any given moment.
>
So, I did not mean to suggest that this is something that should be dictated to a mother. And certainly not before supply and feeding
are well established.

My question was the opposite, to those who always dictated that moms always switch breasts, did they never run into
problems with this? I was not talking about this suggestion in cases of a slight discordance (I would consider a10 oz
difference in weight between babies who are both over 6 lbs, or a 200 gm difference in babies over 2500 gm, both to
be relatively small differences). I was talking about offering this strategy as possible help to mothers in situations like
Jennifer Utley-Rosado's twins (3 3/4 lb and 4 3/4lb, a one pound difference here means the bigger twin weighs 25%
more than the smaller)-- In her case, on her own, she decided that her littler baby fed better on one breast than on the
other one. I wonder what would have happened if she had forced that baby to the alternate breast half the time.

Pamela-- your story, regarding your twins' handedness, is very interesting. Recent study on the neurobiology of the
development of handedness is fascinating and might be helpful to you in explaining what you have seen, but in a very
surprising way, not at all what one might think-- and in fact might suggest that both of your boys may have more talents
and flexibility than your ordinary right handed person (like me and my kids). I am not an expert on the neurobiology of
handedness at all, just a fascinated reader, and a pediatrician with some ordinary training in neurodevelopment, but I
will email you privately what I understand about this, as it's pretty off topic.

You also said that each child chose a side beginning as a toddler and continuing several years, which on the one hand
is not what I was actually talking about, although that may not have been clear, but on the other hand, this sticking with
only one breast business happens all the time with singletons who wean off one breast a year or more earlier than the
other. It's hard for me to understand how this can matter, neurodevelopmentally-- no matter how devoted a toddler is to
the breast, they still spend way more time NOT nursing than nursing, as well as interacting and socializing, manipulating
objects while not nursing, etc.

Also, as far as I understand it, the toddler/preschool years are not the time that the neurobiologists tell us that
handedness is developing.

As I understand it: While handedness is not "expressed" until after the toddler years, handedness is actually
neurologically determined much earlier, by genetics and, depending on certain factors, also by the prenatal
environment. It is in utero that the brain is most rapidly developing, and it is also in utero that twins have a prenatal
environment different from a singleton's. They are wrapped around each other, and each becomes part of the other's
environment, both stimulating each other's activity, as well as constraining each other's movements. As they were
locked in this tender and very long embrace, 24/7 for all those formative months, each may have had, perhaps, one
hand freer than the other.

(If indeed that kind of movement is the environmental variable that the neurobiologists are talking about-- I just don't
know the literature well enough to say)

Tina Smillie

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