Linda's explanation of when/how milk is made was brilliant.  Bonny's mention
of light studies was interesting.  When Prof Peter Hartmann was here a
couple of years ago he gave some wonderful lectures to our medical students
about his research on breastmilk synthesis. I seem to remember that there
was a graph showing that because of the variable breastmilk storage capacity
between individual mothers, some babies needed to breastfeed 20 times per
day in order to obtain sufficient breastmilk to grow and thrive, whereas
other babies needed to feed only a few times to obtain the same volume of
milk.  One mother in his study was able to store 750 ml in her breasts at
any one time, so that her baby would only have needed to breastfeed once per
day, thus for this baby it was the storage capacity of his stomach which
determined feeding frequency.  I really liked this research because it
confirms what we have intuitively known all along;  that if each mother
responds to her own baby's feeding cues (assuming the baby is healthy and
the mother has an adequate amount of glandular tissue, and fully functioning
hormones, of course) rather than trying to follow some arbitrarily imposed
"routine", then each baby would "get enough".

It would be interesting to know if any work has been done on the effect of
early postpartum engorgement on an individual mother's subsequent storage
capacity.  At that time this particular aspect had not been studied, but my
personal hunch is that engorgement which is not resolved promptly can
seriously impair the breasts' ability to store larger quantities of milk
later in lactation.  In practical terms this means that the mother who may
initially over-produce may be the very one who complains of "not enough
milk" within a couple of weeks unless she is encouraged to drain her breasts
*very* well during the time of over-supply.  So that Linda's new year Wish
is very relevant.  The mother of any baby who for any reason is not able to
drain the breasts frequently and efficiently needs prompt assistance to
ensure good drainage, or risk "the domino effect of lactation failure" shown
so well in the LC Series 8.

Pamela Morrison IBCLC, Zimbabwe