Dear all:

I think that the research doesn't really change much beyond how parents may follow the 
rules.  Finish the first breast first is a good rule, but parents may sometimes need a little 
guidance into what "finish" means.  That's all.  I feel the research confirms the 
observations that have been made in the past, and really should push us beyond a rule-
based approach into a cue-based approach, which is probably what occurred before we 
had a worldwide experiment with artificial infant feeding.

Thanks to Cathy for putting some clarity on my fuzzy memories of the healthy proportion 
of milk drained from the research by Hartman's group.  Again, I don't think the specific 
proportion is as important as the fact that drainage stimulates supply, lack of drainage 
tamps it down.

Paula Mieier's work was done in a NICU setting with very tiny premature infants. She 
didn't specifically encourage breastfeeding, she did encourage pumping which actually led 
to some breastfeeding in mothers who would never otherwise have considered it.  That is 
very different from full tern infants whose mothers are breastfeeding and should not be 
extrapolated to that population.  The quantities that the mothers were pumping enabled 
them to "lactoengineer"  a very different milk than what one could accomplish merely by 
one sided versus two sided feedings.  

In fact, I'm hoping Nancy Wight might pipe up on this one.  I remember one of her one 
liners to the effect that merely increasing the fat content only created fat babies, not 
healthier babies.  Very premature infants need much more support to compensate for 
lack of uterine time.

Best, Susan Burger

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