Here is the website http://www.nwparent.com/scripts/northwest/paper/index.asp?ColumnID=35 Here is my letter: 1-30-99 I read the article by Susan Garrett in Family Matters entitled "Is the baby getting enough milk?" The information on the amount of wet and dirty diapers and the scenario about how poor latch/suck can cause milk supplies to dwindle are great. However I must comment on some of the things that lactation consultant L. Running reports. “We frequently see babies who are 4 to 5 days old who are starving.” If this is true, this is very scary. Someone should look at the hospital practices that might be contributing to this problem. One shouldn't be seeing this problem frequently. Running says the breasts begin making milk "but only if the baby is sucking effectively and nursing frequently (on the average, four times in the first 24 hours)". This is VERY INFREQUENT and perhaps this is the problem. If immediate skin to skin contact is allowed and encouraged and the first breastfeed takes place within the first hour, the baby should be then continuously rooming or bedding in, and encouraged to nurse 8-9x minimum per 24hrs. I hope parents don't think that 4x in a day is ok. [Note to lactnuts- I think some babies bedding in would be ok with 4 the first day, but she makes it sound like this is the norm. Comments?] I also disagree with this paragraph: "In her experience, breast surgery of any kind, especially breast reduction surgery, makes it difficult, if not impossible, to breastfeed. Also, if a woman's breasts don't change—i.e., if they don't become larger and more sensitive during pregnancy—this may also mean breastfeeding will be difficult or impossible. Some other instances where breastfeeding may be difficult are when the women's nipples are inverted, the breasts are unusually shaped, or the baby is born before 38 weeks." [note to lactnuts- doesn't this sound like if you have the above, don't even try bf?] I work with women all the time with these conditions and I would not say that breastfeeding will be difficult or impossible for them. Occassionally it is a challenge, but not to the extent that Running implies. With breast reduction surgery, I agree, this is a high risk situation for insufficient milk, but moms can still breastfeed with supplementation. It is not an all or none situation. Thank you for the opportunity to share my comments. Laurie Wheeler, RN, MN, IBCLC ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com