I did not see the research presented, and am definitely one of the slow to  
change folks.  Not that I don't accept change, I do, but my brain wants so  bad 
to hold onto 20 years of knowing. Haha.  SO, that said, are we  absolutely 
certain that the method of receiving milk for a baby is negative  pressure 
sucking only and that the tongue plays no part whatsoever in triggering  a let 
down, in compressing the breast ducts to release milk, etc.  I ask  because I hand 
express rather easily and there is zero vacuum happening for hand  
expression.  It seems to me we do not use our tongues much for sucking a  straw (of 
course adults and newborns are different creatures) and that perhaps a  baby 
sucking without the tongue being used properly at all should then provide  milk, 
but it doesn't really and it hurts like crazy.  If something causes  pain to 
signal us to change what we are doing there may be some evolutionary  reason for 
the stimulus to change our behavior.  Pain is less when the  tongue is in a 
certain spot and more milk is transferred then also.  I  know that great pump or 
not, if I hand express after not a single drop of milk  comes to the pump, I 
can get milk to come with compression.  
 
I am not doubting the research even though for the most part my  
understanding is it that in the past if not now it has been funded by a pump  company 
where it stands to reason proving vacuum is all we need makes  sense.  I wonder if 
zero milk was coming to the baby according to  ultrasound, of if in fact it 
was just less milk that compression brought until  the let down triggered. 
Knowing a larger bolus of milk comes during a let  down, but that milk can still 
come between let downs too, just not in so great  an amount.  
 
I guess I am going to have to get that panel on cd or something so I can  try 
to wrap my head around why all my videos and text books are so wrong.  Haha.  
The longer I do this work the more I am supposed to forget what I  know!  
Yikes. 

Thanks,
Pam MazzellaDiBosco IBCLC, RILC

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