I've been following the discussion of growth spurts and the language used to
describe the degree of fullness/emptiness of breasts with some interest. I
think these topics are connected.
Firstly my impression/interpretation is that growth spurts are not caused by
an increase in the baby's appetite - rather they are a manifestation of a
drop in the mother's milk production. The consequence is that the baby
receives less milk at each nursing and therefore needs to nurse more
frequently to "get enough". The increased frequency and more thorough
emptying of the breasts during "growth spurts" cause the breasts to make
more milk again (get back to normal), and the baby becomes less demanding
once again.
Someone also mentioned that she sees fewer stools during a growth spurt, and
concluded that this was because the milk was being absorbed more
efficiently. My interpretation would be that fewer stools are a reflection
of a lower milk supply (as above).
I think the discussion about whether mothers need to "empty" the breasts, or
need to pump/express after breastfeeding in the early days is relevant.
IMHO mothers *do* definitely need to drain the breasts "to comfort" any time
they feel too full. Why? Because overfull breasts today will cause a drop
in milk production the day after tomorrow. And *very* full, engorged
breasts, will result in such damage to the milk producing cells that whole
lobes of breast tissue may become non-functional at some time in the future.
My observation is that overfullness, particularly in the first couple of
weeks after delivery, is the single most damaging thing that can happen.
And that if just this one condition is taken care of, then we would see
fewer mothers with "not enough milk" and fewer babies who appear to be going
through growth spurts.
Consequently, I *always* recommend that any mother who feels that her
breasts are overfull or even slightly tight should pump or express "to
comfort". They always ask how much milk to pump, but it's impossible to say
- every mother varies in her milk production, but sufficient milk needs to
be drained off (baby, pump, manual expression) so that the breasts feel
uniformly soft and "comfortable" - for some mothers this will be 450 ml
(really bad engorgement). For others it may just be about 60 ml. Each mom
needs to be very subjective. But I believe that the mother's comfort is
vital to continued easy breastmilk production, and I tell them that although
it's a hassle at the time, draining to comfort now will turn out to be a
good investment in the future - avoiding damage to the milk producing cells
will increase their storage capacity for next month, and the month after that.
Refs: Peter Hartmann's work on breastmilk synthesis, and the LC Series unit
on Inadequate Weight Gain (the domino effect of lactation failure).
Pamela Morrison IBCLC, Zimbabwe
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