The earliest research that I'm aware of on the subject of inhibited MER - in lactating women specifically, earlier work had been done on cows for the dairy industry - was done by Michael and Niles Newton (J. Pediatrics, 33, 698, 1948). Now I'm reading this from secondary sources (authored by Niles and Michael, though), but what they did was to define two groups of breastfeeding women: successful (those not needing to supplement with artificial human milk after day 4 postpartum), and unsuccessful (those still dependent on artificial human milk beyond day 4 postpartum).In querying the women, the *successful* group reported more of the symptoms of MER (leaking prior to brfdg, opposite side leaking while brfdg, uterine cramping while brfdg, and cessation of nipple discomfort while brfdg) than did those women in the *unsuccessful* group. Further, they had the women pump immediately following a breastfeeding, then injected the women with oxytocin and pump again. They found that the unsuccessful breastfeeders delivered significantly more breastmilk to the pump following the oxytocin injection than the *successful* breastfeeders - the thought was to show that more residual milk was left in the breasts of those women in the *unsuccessful group, suggesting that they had poorer MERs. They figured this post-injection pumped volume (for this *unsuccessful group) to be 47% of the total amount delivered to: baby, first pumping and second pumping after the injection. The Newtons also did research on lactating women measuring the volume of milk received by the baby: under normal conditions, while distracted both physically and mentally, and after injections with saline and oxytocin. In quick summary, there is strong evidence that distraction inhibits the MER (in some cases cutting the volume by almost half) and an artificial boost of oxytocin (via injection) will augment the MER. There are a few other non-dairy-industry studies mentioned in Auerbach and Riordan's book. Fiona, in looking through my breastfeeding *stuff*, I bumped into a compilation of Newton's (Niles, that is) work on breastfeeding done by the former Birth and Life Bookstore (1987) of Seattle, WA, USA - it was great to re-read this, Thanks for the motivation! Newton, in several pieces, suggests that coitus, birth and breastfeeding have several commonalities, one is the release of oxytocin, and influence of that hormone on behavior. So, if one considers one' s reaction while involved in intercourse and something unexpected happens - say a small child wanders into the room - you can begin to understand a new mother's reaction as several relatively unknown medical staff of mixed gender, hover over her as she attempts to breastfeed her new baby, just having labored and birth US style, the first few times. As for the stress levels of those women who breastfed through the bombings of England in WWII - there is a survival strategy *built-in* to us (humans), that allows us to acclimate to most newly imposed levels of stress, given enough time. What I suspect happened is that the initial air raid sirens caused some inhibition of some MERs but with daily living falling into a pattern of unexpected bombings and sirens, the women's bodies accommodated the increased stress and performed despite the situation. I also know, both personally and professionally, about the high level of engagement between infant and mother while breastfeeding, along with the prolactin release during the early months of breastfeeding; I can well imagine a mother attempting to block out much of the world to focus on just breastfeeding her baby in those difficult times - especially if she knows that artificial human milk is in precarious supply. When working with a woman who we suspect has a poor MER, I prefer to have the woman identify: ways that she relaxes, places in her environment where her privacy is protected, methods for overcoming any semiconscious obstacle to allowing breastfeeding to succeed, etc., rather than to suggest her emotions don't play a part. Possibly an apt analogy might be: how do we counsel women to achieve orgasm? Could these techniques be modified for the breastfeeding mother with a poor MER? Just a captured stray thought!! Jeanine Klaus, MS, IBCLC Oakville, Ontario [log in to unmask]