Jay,
I have worked with a few moms who didn't have proper MER. Their babies
are unable to receive the calorie-rich hindmilk because of the failure
of oxytocin release. Two things happen:  1. The baby tends to be hungry
frequently, and 2. The baby fails to gain weight sufficiently.

If we define "successful breastfeeding" as a relationship which
satisfies babies physical and psychlogical needs, without the MER it
cannot occur. A mother could use a supplementer at the breast to help
the baby receive the calories he is not otherwise receiving. In this way
she could breastfeed successfully until she is able to experience
oxytocin release.

However, there are many moms who experience MER without ever feeling any
physical sensations. The only signs are the change in the suck/swallow
pattern, and perhaps milk leaking from the other breast.

I'll be interested to see the results of your survey.
Glenni Lorick, B.S.E., I.B.C.L.C.
San Jose, Costa Rica
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