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Subject:
From:
Chris Mulford <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 10 Apr 2001 15:12:58 EDT
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Rose asked
<<And hence my question - how do we apply the knowledge of breast storage
capacity when each baby seems to have a pattern of feeding that is unique
unto itself? Could the storage capacity of the mother change to fit the
needs of the baby rather than the storage capacity dictate how the mother
needs to feed the baby? If I had visited Perth with each baby, would the 24
hour computerised breast measurements have shown different readings ?>>

I remember hearing Mike Woolridge describe the case of a mother who had
trouble with a low supply on one breast.  When they looked in her records
from nursing her previous baby, they found that that low-performing breast
had been the main producer.  The lesson to draw here was that each lactation
is different.  Most women have enough excess production capacity that their
breasts can adjust to a new baby's nursing patterns to tailor-make the right
supply for that baby, provided that the baby has sufficient access to the
breasts in the terms of timing, position, and latch-on.

But at the end of each lactation, we have breast involution and loss of many
of our alveoli. With the next pregnancy we re-establish lactation capacity by
growing new alveoli.  Then when the new baby arrives, the baby tells this
"new" set of breasts what the "new baby" will require.

I wonder how much change there is with each pregnancy in total duct length,
as opposed to total number of alveoli.  Don't you recall learning in every
lactation A&P lesson that estrogen stimulates duct growth and progesterone
stimulates alveolar formation?  That never was anything more than an odd
lacto-factoid for me, but today I'm realizing that if the balance between the
two hormones changes, it might account for breasts' being significantly
different in production or storage capacity from one lactation to the next.

How this relates to volume I'm not sure.  But as we all know, breasts are a
"morphing" body part, subject to rapid changes in size and shape and texture
more than most other external structures---noses, for instance,   And as I
understand it, breast volume is measured by changes in appearance and then
correlated to output as measured by pre- and post- feeding weights.  [I
wonder whether Peter Hartman's group has explored the effect of breast edema
on the ability to measure breast volume.  Can Cathy Fetherston or anyone else
comment?]

Anyway, my point is that our breasts, that we think we "know" pretty well,
can keep surprising us with each new baby, partly because we grow a new set
of breasts the way we grow a new placenta during each pregnancy, and partly
because the baby shapes them to his or her own ends---and some babies are
better able to do this than others.

I wonder if the early anatomists had any more fun figuring out how bodies
work than we do, in this collective pursuit of the True Story of Lactation!
Well, at least we don't have to rob graves to get our subjects.

Chris Mulford, RN, IBCLC
pondering in Swarthmore PPA, eastern USA

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