I had always wondered about the notion that pain inhibits the milk ejection
reflex, especially when I saw women literally writhing from nipple pain
while spraying milk across their laps. Now I may have a notion of where the
connection might have come from.
Niles Newton was one of our earliest trailblazers, and we owe her a great
deal. She felt her work in the late 1940s and early 1950s linking pain to
inhibited let-down was among her most important work. The only subject in
her actual research was herself. That's a sample of one. But she certainly
found ample corroboration, among over a hundred women observed, that there
was a connection between women with nipple pain and women who weren't
letting down, and between women who were unsuccessful breastfeeders and an
unreliable MER.
Interestingly, she never - that I could find in skimming a collection of her
writings - addressed the correlation between latch and nipple pain, a
correlation that we would probably put above everything else today. She
addressed, soap, topical alcohol, ointments, diet, clothing attitude,
previous breastfeeding experience... nothing at all about latch. (She may
also be the reason we became so paranoid about soap, to the detriment of
women with infected nipples; thank you, Barbara Wilson-Clay.)
Seems to me Newton's "mothers in pain don't let down well" and "poor
breastfeeders have a poorly conditioned let-down" philosophies make more
sense today as "poorly-latched babies cause pain and can't trigger let-downs
well.." In my experience (far more limited than many of you), pain and
let-downs are utterly unrelated, so long as the latch is good.
And if we're going to rely on studies with a sample size of one... I once
let down during a heated discussion with an electrician. It felt very much
like a natural consequence of the stress I was feeling. Hey, it's oxytocin,
right? And we release oxytocin during stress, right? My sample of one says
stress *enhances* let-down, not the other way around. Have others actually
*observed* a correlation either way between stress and MER?
Do others feel we need to bury the idea that let-downs are unreliable, need
to be conditioned, and are readily suppressed by stress and pain? Is it
just that I don't see babies in the early days? It strikes me as a notion
that fit what was known at the time (before we understood much about the
links between latch and pain, and latch and intake) but that no longer fits
what we know...
--
Diane Wiessinger, MS, IBCLC Ithaca, NY
www.wiessinger.baka.com
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