The issue of timed feedings makes me nuts!  It was the first issue I
attacked when I first started this job as a hospital LC 4 yrs. ago and
it died a very long, slow death.  It still raises its ugly head from
time to time as we get new staff or nurses float from other areas.  It
doesn't make sense that the rules about times will fit all babies.  We
need to teach parents that babies get their meals at the breast in very
different lengths of time.  Milk transfer depends on supply, quality of
latch, force of MER, strength of suck, among other things.  Some
babies will finish quickly, others need a long time.  It is SO important
to let the baby pace himself and finish one breast before offering the
second.  When I explain to parents about each breast being a 3 course
meal and how, when she has had enough of dessert (or when she has had
her slice of cheesecake), she will come off the breast and look relaxed
and full.  Baby body language is an important thing to teach parents
about, too.   An anecdote: The first week I was on the job I was paged
to the emergency room.  I thought it was a mistake but, sure enough, it
was for me.  A 41 y.o. primip with a 12 day old infant had read 6 books
on BRF before delivery and they had all said "babies should nurse for at
least 10 mins. on each side".  This day she was determined to make her
baby nurse that long.  Up to this time she had only nursed 5-7 mins. per
breast before pulling off herself.  The mother pushed her and got her to
do 10 mins on each side after which she projectile vomited and the
mother panicked and dialed 911.  She was brought in by emergency vehicle
around lunchtime.  Luckily she had an enlightened pediatrician who knew
what had happened and asked them to page me.  The baby's weight gain was
fantastic and my job was to put my arm around this sobbing mother and
tell her what a great job she was doing!  So much for 10 minutes on each
side!
Edie Armstrong BSN, IBCLC, Fairfax, Va.