>  where i get stuck is that if we continue to say.... the breast works on
>supply and demand and milk production can be created through stimulation...
>
>   if there is only a finite amount available from each breast we need to re
>look at some of our "standards" (!)......
>
>   is this finite amount set in the begining of lactation and therfore we
>MUST emphasize establish that supply now or for ever be without? (but we have
>cases the conadict this)
>
>  how do you expoain adopotive mothers milk supply? - one time only
>stimulation? then the receptors are gone...what about the mother with the
>slow or no gain whose milk supply is down and we with a box full of toys
>bring back he supply?

Patricia,
I think we need to look here at the difference between the quantity a baby
needs and the capacity of the breast to produce milk. As I understand it
from Peter Hartmann's talks, generally the breast has an enormous capacity
to produce milk, and at any one time during lactation usually has dormant
milk producing tissue. Also, it has the capacity to multiply existing
tissue to make more milk producing cells if the demand is great enough.
This explains how wet nurses of old could feed several children at once,
and mothers can feed triplets, etc. While a baby's need stays basically the
same from 1 to 6 months (except perhaps for short periods of growth spurts
- I liked Denise's analogy to her sons and their breakfast cereal intake),
the breast would be able to increase its production given long enough extra
stimulation. (By stimulation, I don't mean sensory on the nipple, but
removal of the milk frequently and efficiently.) Peter always asserts that
the amount of milk being made by a mother is directly controlled by the
baby's appetite, and not by her breasts' capacity to make it.

What was news to me with all this is that after growth spurts, the milk
volume is *not* reset at a higher level (ie the baby's appetite was not
increased), but returns to the basic level needed by the baby. We used to
think the intake (appetite) gradually rose.

Does this make it any clearer, or is it still confusing?

Joy Anderson IBCLC, NMAA Breastfeeding Counsellor
Perth, Western Australia
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