Ellen, I am confused. Were you referring to the article I mentioned in an earlier post with the same heading? Evans K, Evans R, Simmer K, Effect of the method of breastfeeding on breast engorgement, mastitis and infantile colic, Acta Paediatr 84:849-52. 1995. If so, are you going on the abstract only, the whole article, or just the discussion on LN? <blank recommendation of bfg from one side only each meal, from birth. = This reference does refer to engorgement, mastitis and colic, but it = does not refer to FTT and insufficient milk production.> In one paragraph, the article itself states "However, concerns are often expressed that the practice of prolonged nursing on one breast may lead to an insufficient milk supply for the infant, and that longer intervals between feeds may lead to a higher incidence of mastitis. . . . . .We attempted to address these issues objectively in large groups of mothers allocated to one of two methods of breastfeeding. The first method was based on prolonged emptying of one breast at each feed while the second method involved using both breasts at each feed to facilitate equal drainage of both breasts.. . . . . Mothers in the experimental group were asked to empty one breast, and only place the infant on the second breast if the infant still showed signs of hunger." The main thing that caught my eye was that there was significantly less engorgement in the experimental group (prolonged emptying of one breast at each feeding) and there was no difference in infant weight loss/gain between the groups on days 3,5 and 8. Since I volunteer for WIC doing follow-up phone calls after the mother has left the hospital, this is the time period that my concerns zero in on. So many of our clients just plain give up during that time. If we can't get them through that time perod, we are certainly never going to have them reach long term breastfeeding. Despite our encouragement and explanation of our services (for office consults, etc.) so many don't call for help. They are vulnerable to the suggestions of family and friends and less-than-informed HCP's, and so often, the "supplement cascade" starts there, because the baby can't latch successfully and the frantic crying and/or nipple pain and damage does them in. (I know just how they feel. That's exactly what happened with my first three, 4-5 decades ago.) I have been thinking "if we could just alter the occurrence of engorgement (and its effect on nipple pain and damage) in the first place, maybe they would not be so discouraged before we even get much of a chance to follow them up with phone calls and consults." I was surprised to find that in both the control group and the experimental group, 8 out of each group,150 & 152 mothers, also used formula after discharge from the hospital and through the first 6 months. Also, solids were introduced at a mean age of 4.5 months in each group. Perhaps that is part of the reason no FTT was noted. "Only 37% of mothers in the experimental group were able to satisfy their infants' hunger with one breast per feed, with 63% offering the other breast after emptying the first breast." So nearly 2/3 of the mothers in the experimental group did eventually make a judgement to switch to using both breasts. So I think the authors were just reporting what happened with each approach, and certainly did not "forbid" the mothers to use their own minds to decide to do otherwise as time went on. I don't believe they were trying to give any blanket recommendations to use one breast only at each feeding-"period." It seems to me their focus was on "prolonged emptying on one breast at a feeding" rather than trying to equalize the amount removed from both breasts each feeding. To anyone interested, I would recommend reading the entire article, rather than just the abstract. The study itself was done in Australia. I expected to have to appeal to someone on LN in Scandinavia to locate the journal for me, but I was very surprised to find my own local medical school library stocked the journal. Jean ********* K. Jean Cotterman RNC, IBCLC Dayton, Ohio USA *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html