I'm just composing a letter to the nursing unit manager of the hospital where my sister in law had her baby and had such difficulty getting someone to help her begin expressing. Before finish writing I want to know that I know what I am talking about, if you know what I mean, and so I have some questions. Everything I have read says that breastfeeding should begin as soon as possible after birth or if mother and baby are separated, expression should also begin asap. However, if I understand rightly, Lactogenesis II is driven purely hormonally and the switch from hormonally driven lactation to autocrine driven lactation (ie Galactopoiesis) doesn't occur until 3 or so days after birth. If this is the case, why is early breast stimulation/milk removal (in the 1st 3 days) so important? Why are there studies that show that the sooner after birth that breastfeeding is initiated the greater the probable length of breastfeeding duration? Can lack of stimulation of the breast delay galactopoiesis or depress the magnitude? Is this why delaying breastfeeding is potentially detrimental to the breastfeeding relationship or is it more to do with the baby than the breast? I'm just trying to puzzle out why it is best for someone in my sils situation to "begin milk expression with a hospital grade breast pump as soon as possible after delivery"- Riordan and Auerbach. Why would waiting a couple of days matter? Hope my questions are not too stupid. I'm trying to learn. Karleen Gribble Australia _ ---_l\ / \ \_ ----- __/* o *********************************************** 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