The Lancet 1979 "Pattern of Milk Flow in Breast-Fed Infants" by A.Lucas,JD
Baum and P.J. Lucas:July 14,1979

122 six day old infants were test weighed during breastfeeding.Milk flow
conformed to a definite pattern: a mean of 50% of the feed from each breast
was taken in the first 2 minutes of sucking and a mean of 80-90% was taken
by four minutes.The second half of a 10 minute feed from eighter breast was
almost non-nutritive.Preliminary studies suggest that the pattern is the
same after ONE month of lactation.
You can see from the above that there are some problems with the method of
study..."Cross-sectional data were built up in the following manner.Infants
were weighed before the feed and at either TWO minutes(n=20),four minutes
(n=13),or seven minutes (n=12) after the beginning of the feed. 3 other
groups were wighed at the same times during feeding on the second
breast.Another was wighed before the start of the feed on the first
breast,again during the change over to the second side,and finally after
the end of the feed on the second breast N=33.

In the 7 groups studied the infants' sex ratio 62M / 60 F,birth-weight
(overall mean 3368 grams),and distribution of maternal palrity was
similar--overall primipara/multipara 2/1 ratio.

My question is:who ended the feeding?baby or mom?and how was the feeding
determined to be over,after babe fell asleep(and when the test-weighing
person left babe woke up to finish the feeding maybe) or at the
pre-determined time of 10 minutes???

           "our observations are supported by videotape studies in this
department(M.W.Woolridge and R.F. Drewett) which show that the
           pattern of suckling ina group of breast-fed infants changes
after four minutes' feeding froma predominance of short suck-to-suck
           intervals to a substantial proportion of long intervals between
bursts of sucking.This independently suggests that there is a
            major physiological change in a feed at about four minutes
which might relate toa change in milk composition or flow or both."

"It should not be assumed,for example,that mothers are underfeeding their
infants if they elect to feed them for periods of time shorter than is
recommended by the obstetric unit."

         This was a 2 page(barely) write up of the study which I have saved
since working in Alabama where in 1988 women were instructed by their
pre-printed(formula company authors)Md's instructions to scrub breasts with
BETADINE prior to each feed and where there was no electric breast pump
until I repeatedly questioned the powers that were,the rest is history.We
got the OB's to write their OWN instructions up-to-date,but the 4 minute
breast is empty feeding is complete rule in the Peds remained printed by
the formula companies til the day we moved to Indiana in 1991....I haven't
checked on that but the instructions were horrendous:"3 minutes per side
for the first day,4 minutes per side on day 2     etc,etc   (I have copies
I think,if anyone would like some historical fiction)

Denise Ferrell,       I guess this didn't really help the problem. But the
methodology has a lot to be improved upon.
Requests for reprints should be addressed to A.L.