Hi ALl,
Have been reading the responses to the MER question.

Here is what my friend is thinking:  (If I can paraphrase her correctly.  I
wish she'd just type this in herself!)

We know that to get BF established there has to be an MER of some sort.  We
see babies all the time where the mom isn't having MERs and the baby gets
frustrated at the lack of plentiful flow and then refuses to BF.  We are
wondering about later in BF when mom starts having probs with no MERS (not
simply that she isn't feeling them anymore).  Is it neccessary to get the
MERs back so that BF can continue, or will the baby be able to draw the milk
from the breast on his/her own?  Granted they may have to work harder and
nurse longer to pull the hindmilk down from the alveoli, but is it
imperitive that the alveoli contract to push the hindmilk down?

Other thoughts my friend had were:

Are the alveoli in a constant state of contraction (to some degree) during
actual BF and that is what causes the hindmilk to be constantly coming to
the front of the breast for the baby to get?  OR do they contract and push
hindmilk forward sporadically (like a rhythmic pulse is what I am
envisioning here).  What about the pressure build-up inside the breast by
the alveoli when they contract (or when they don't and the milk is not
coming down?)?

How do we know just how these breast systems work?  What kind of research
has been done on the MER and how it actually functions within the breast to
push that milk forward?

How about moms who lose their milk supply, relactate, but don't have MERs?
The babies seem to get the milk OK, they just stay on the breast longer.

On a personal note:  I don't always have MERs when BF Patrick.  I feel mine
(they feel like someone has a vice-grip on the back of my breast and is
squeezing as hard as they can! OUCH!) and can tell when I am having a small
MER or a BIG MER.  When I do have an MER PJ slows to a nice rhythmic
suck/swallow...very typical, and BF ends within 15-20 min..  When I don't he
BF longer (30-45 one side) and doesn't get a really nice smooth pattern
going.  He seems to just BF longer to make up for what he didn't get easily
at the beginning.  Any thoughts on this?  I have talked to other moms with
the same situation.

Oh, if the baby is sucking away and gets all the available milk in the
lactiferous sinuses, but mom has had no MER, then what happens to the hind
milk in the back of the breast that hasn't come down?  Does the baby's
sucking action create pressure in the breast to pull that milk down or does
it just stay up there?  If the baby is able to pull that milk down on his
own (by creating neg(?) pressure) then why would MER be critical for BF
(after the intitial start-up period)?

Full of questions this AM!
THanks all!
Jay
Jay Simpson, CLE
Sacramento, CA
"No Miracles performed here, just a lot of love and hard work."