Denise,
You asked a really good question.  Though the Milk Ejection Reflex makes
milk available to the baby by pushing it out of the milk-producing
alveolar cells and into the ductal structure where the baby can remove
it, efficiency of removal affects the volume the baby consumes.  Proper
positioning and attachment to the breast are vital for infant stability,
and stability is vital for motor functioning.  (See yesterday's post on
sucking the lower lip for details of how positioning the nipple
incorrectly in the front of the mouth destabilizes the tongue).  A baby
who is not stable at breast will take in less milk per suck, and will
fatigue faster, because their effort of feeding is far greater.  This
means that baby stops feeding before they have gotten as much milk as
they really want.  Because the fat content of the milk ingested
increases with the length of the feeding, the milk missed out on is the
higher fat milk.  So proper positioning and latch on is important in the
infant's obtaining the 'hindmilk'.
--
Catherine Watson Genna, IBCLC  NYC  mailto:[log in to unmask]