Elisheva - being an Aussie and the main researcher in this field also being Australian it's become one of my favourites. Peter hartmann has done extensive work in this field. << Without a wide enough gape, there isn't good drainage, although there is lots of nipple stimulation to make an enormous milk supply. >> >But I thought that milk is always produced at a constant rate, except for the slow-down effect of having milk in the breast? If I have that right, then shouldn't poor drainage *rule out* oversupply, nipple stimulation or no? Yes, you're right - the 'enormous milk supply' is caused by the initiation of lactation post delivery. And by its not being efficiently removed it causes engorgement, which is actually the problem, not ongoing milk synthesis. Milk synthesis initially comes under endocrine control and prolactin has for some years been the hormone most often talked about - I think the emphasis is diverisfying a bit now, though certainly drugs like bromocriptine which inhibit prolactin will also inhibit lactation JUST AFTER DELIVERY. Within a few weeks the shift to autocrine control happens, which, as you mentioned, is dependant on how much milk is in the breast. Milk synthesis depends on the removal of milk from the breast, and therefore the removal of the local negative feedback mechanism. ie the fuller the breast the slower the milk synthesis, the emptier the breast the faster the milk synthesis - so no, it is never really 'at a constant rate'. Can I refer you to an online paper by Peter et al http://mammary.nih.gov/reviews/lactation_(Hartmann).html Happy reading Denise Brisbane, Qld ****************************