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From:
Carlos Gonzalez <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 14 Jun 1996 18:13:51 +0200
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Hello
Anna's suggestion that "babies will compensate for oversupply and accompanying rapid, forceful milk ejection. Some babies cope by backing off areola to nipple-feed, others clamp their jaws causing compression of nipple, and others still cope by weakly sucking and essentially waiting for mother to let-down milk" is interesting. I had, however, been taugth by Chloe Fisher just the opposite: incorrect possitioning or improper sucking causes some mothers to compensate, let's make LOTS of foremilk and eject it into this poor baby's mouth, because he cannot suck well and obtain the hindmilk!
I have seen at least a case in wich this was true: a mother suffered for 3 months from sore nipples, engorgement and blocked ducts; her baby was fed for more than 30 minutes at a breast, almost every 90 minutes. Mother experienced 2 or 3 let downs at each feed. She was asking how to wean the baby. Baby was fed with his head in the mother's elbow, so he had to flex the neck to reach the nipple, and was unable to make a good latch. Slightly changing position (baby's head in the middle of the forearm, and not in the mother's elbow) allowed the baby to suck properly; he left spontaneously the breast (for the first time, to his mother's great amazement) in 7 minutes; from then on he breastfed for a normal time and with longer interval, and gained 500 g in only a week. Soreness and engorgement dissapeared inmediately, and the mother no longer experienced a let-down at each fed. She breastfed for five more months.
Surprisingly, both positions are depicted as "good" in page 248 of the Riordan-Auerbach handbook. In Fig. 9-10 A, mouth is in front of the nipple (in a normal baby, mouth is in line with the ear); but in Fig. 9-9 A, even when mother is clearly compelling her arm into the middle line, baby's mouth is far from the center of the breast, where nipple should be. Only mothers with large, flexible breasts can breastfed easily in this position. The question is: your elbow is at your side, but your nipple is in your front!
I know this is one major difference between the American and the British schools; Fisher not even believes there is such a thing as primary "strong ejection reflex". I am with the British school (did you ever notice I write English with an Oxford accent? :-)
If you reply to Lactnet, please email me privately also. I am going nomail at this moment. As a sequencing househusband, and having left my job as a pediatrician for a while, I am expected to take care of my children and house, instead of digesting digests for hours and hours.  I am no longer able to deceive myself, considering Lactnet as a free English course (my political vocabulary has improved quite a lot :-). I will miss all of you, and hope to receive private emails from time to time. After raising my children and my grand-children, I hope to be online again (c. 2025 AD).
Breast wishes!          Carlos Gonzalez
                        Barcelona

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