I just reread my own post and I clearly wrote it too early in the morning, typos, unclosed quotes, etc.,but the one thing I really want to correct is in that last paragraph about "sucking" milk out in the presumed (but incorrect) "absence" of MER: > Also somebody asked if a mom doesn't feel an MER (or get one, as it was > misunderstood) does the baby just suck that milk out all the way from > the alveoli? NO! BF babies do not suck the milk out at all, they use > just enought suction to stay on the breast and then use the peristaltic > action of the tongue to strip the milk out ("milk" it out) by pressing > the tongue against the roof of the mouth. The milk has to be in the > lactiferous sinuses (which are then inside the infant's mouth) for this > to happen, which means the mom has had an MER to get it from the alveoli > to the ducts. No suction. And everyone has MERs. What I want to correct is this line from my post: > and then use the peristaltic action of the tongue to strip the milk out ("milk" it out) by pressing the tongue against the roof of the mouth. Should be: "by using the tongue to press the lactiferous sinuses against the roof of the mouth." That is, the tongue should not be pressed alone against the roof of the mouth (that's when you would get that clicking sound, and no milk transfer), the breast is in there, too, with the sinuses between the tongue and the hard palate (and the nipple back at the soft palate), and the tongue then strips the milk out by pressing those lactiferous sinuses (aka milk ducts), full of milk after MER, against the roof of the mouth. The peristaltic wave action of the tongue presses first anteriorly, ie. close to the end of the tongue and then the wave movement of the tongue moves further and further back, pushing the milk in the sinuses within the mouth toward the nipple in the back of the mouth. I hope that's more clear. A video would be worth a thousand words. No suction. Babies suckle, they do not suck. Tina Smillie MD IBCLC