I have just read Michael Woolridge's article "Breast feeding:
physiology into practice", from "Nutrition in Child Health" (ed. DP Davies),
Royal College of Physicians, London, 1995.
        Woolridge, who is the director of the Baby Friendly Hospital
Initiative in the UK, states that initially milk production gets underway
without any reference to the baby's requirements, and during the following
4-6 weeks is adjusted up or down to the correct level. If I understand him
correctly, he feels that if the base-line is set too low during this period
(e.g. because the baby is receiving supplements, and does not take enough
from the breast), it may not be possible for the mother to increase her
production later on, even if she improves her breastfeeding management.
        I find this a very disturbing conclusion. I have always assumed that
every mother can improve her output if she encourages her baby to suck more,
even if she got off to a bad start. But Woolridge appears to be saying that
after a certain critical period, this may no longer be possible. Certainly,
this would explain cases of women who simply do not succeed in getting rid
of supplementary bottles, however hard they try.
        What do the rest of you think? Have you seen cases of women who did
not succeed in increasing their milk supply after giving too little for the
first 4-6 weeks? Or, conversely, have you seen women who went on to
establish full lactation, even though they had already passed this cut-off
point?
                                Anna Lowenstein
                                Zagarolo, Italy