"My observation is that overfullness, particularly in the first couple of
weeks after delivery, is the single most damaging thing that can happen.
And that if just this one condition is taken care of, then we would see
fewer mothers with "not enough milk" and fewer babies who appear to be going
through growth spurts."

I quite agree - and I think that while our language *is* important, we
shouldn't tie ourselves up in knots over it, in terms of "empty" breasts or
"growth spurts". If I'm talking with a woman who seems pretty with-it in
terms of information & comprehension, I might (after I've reviewed the
basics of production, etc. with her) say something like, "We know your
breasts are never *really* 'empty', but...". And I also agree with putting
guidelines for expressing in terms of the mother's comfort, rather than
length of time or amounts obtained.

Some women are uncomfortable with that - they find it too vague - but it's
one of the very few things I'm pretty adamant about. I can't tell them how
much they "should" be getting, and they really need to learn what they
themselves feel like when the baby's had a good fdg, or when he's dozed off
on the job, or when she's getting the signal from her breasts that it's time
to wake that baby up to nurse, or whatever it is. As long as she's doing it
"by the book, clock, amount, whatever, it will never be an automatic, easy,
spontaneous thing for her to do.

Cathy Bargar, RN, IBCLC Ithaca NY

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