Karleen, don't you think that this speaks volumes about the value of reading the actual paper? I think the study brings some good information to the table, but not necessarily what is going to be useful. The study was done with women who pumped and the "stage of lactation" was 6 months (plus or minus  2 months)

My experience has been that if there is going to be a question about supply, it is going to occur long before 6 months. Without further studies, we just don't know if we can generalize results to the typical mom of a six week old.

I also admit to having a distrust of procedures that I cannot explain in a sentence or two. If you've been following the "4 hour pump test" thread you can tell that the directions have evolved like a good rousing game of "Telephone".

Important info,yes. Valid for my population, possibly-we'll have to see more studies. Useful clinically, no. Standard of care, not for me.

Gail Hertz MD, IBCLC, FABM  Author of the Little Green Book of Breastfeeding Management
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On Jul 13, 2013, at 7:42 PM, Karleen Gribble <[log in to unmask]> wrote:

> OMG! I've just read the full paper. The test is proposed as a solution to the problem of perceived insufficient milk. I too cannot see how this research could be extrapolated from women who are breastfeeding without any problems to women experiencing difficulties. I'm just in the process of writing up more research on milk sharing and 4 (out of 41) of the milk recipients were women who were separated from their infants for prolonged periods of time because they were working and who had no problem with low milk supply but who were unable to express milk. Some women are not very responsive to a pump. I can see that if women do this test and perform well that it could potentially rule out low milk production. However, for women who do not express much milk it says nothing. I doubt that this it how it would be interpreted by most.
> Karleen Gribble
> Australia
>> With the assistance of an email off list I was able to track down one peer reviewed article.  The cost of over $50 for 24 hour access was prohibitive so I have only looked at the abstract. Ching Tat Lai, Thomas W. Hale, Karen Simmer, and Peter E. Hartmann. Breastfeeding Medicine. June 2010, 5(3): 103-107. doi:10.1089/bfm.2009.0074. 
> 
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