Dear Cathy, I wanted to personally thank you for adding so much to our 
discussions here on Lactnet. Your patience, thoughtfulness, and 
scholarship, along with teaching ability, are much appreciated.  The 
message of accepting new information, and questioning the arrangement and 
purpose of each fact or puzzle piece...as it were, is very helpful to those 
of us who are trying to be more the scientist in this work. Many thanks.

Warmly, Kathleen

At 11:47 AM 05/11/2002 +0800, you wrote:
> > The idea of "stimulation to let breast know it needs to make the milk" 
> which
> > was previous reason for nipple stim and pumping is now outdated?  And 
> this is
> > because we have now accepted Hartman's study as "the new truth" and it is
> > volume, emptying, etc. that determines production and stimulation is no
> > longer "the" issue?
>
>I would really like to give a longer and more considered comment to this
>thread on milk production and stimulation however at the moment time does
>not permit:-)  - We could spend a semester teaching this stuff. But I just
>want to quickly comment that we shouldn't fall into the trap of mistaking "a
>new truth" for "the (only and) absolute truth". We do now know that milk
>removal stimulates the autocrine response to produce milk production (and
>this is not an "all or nothing issue", there are degrees of emptying and
>concomitant degrees of increase in milk synthesis. We have learned that
>SERUM prolactin is not related to changes in milk production (although milk
>prolactin levels do appear to be). Because we know nipple stimulation is
>related to prolactin release there has been a "leap of assumption" that
>nipple stimulation is not important in the lactation process if milk is not
>being removed. I do think its important to work with what we have learnt (ie
>milk removal is very important) but equally so - not to make assumptions
>about knowledge we have not yet discerned. Clinical experience is important
>to our practice when we don¹t have researched "truths" to help us out - and
>they provide us with a basis to discover new knowledge. But the entire
>picture is a long way off. I think its always important to change our
>practice as learn new things and to continue with what seems to work until
>we learn otherwise (if this practice always falls within the premise of "do
>no harm").
>
>Cathy Fetherston
>Perth, Western Australia
>
>              ***********************************************
>The LACTNET mailing list is powered by L-Soft's renowned
>LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
>mailer for lightning fast mail delivery. For more information, go to:
>http://www.lsoft.com/LISTSERV-powered.html


Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
http://together.net/~kbruce/kbbspin.html
LACTNET Archives http://peach.ease.lsoft.com/archives/lactnet.html

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html