If you are a couple new to adult nursing or a nursing couple looking for useful tricks then this discussion was written for you. It contains information about adult nursing in general and specific tricks that allow you, as a nursing couple, to be more successful with less stress. As I write this, my wife and I have been nursing for about five years. During that time we have made a ton of mistakes and have paid for them with both physical and emotional stress. This could have been avoided had we known the information presented here first. I suggest you read this discussion twice, first to get an overview, then again more slowly to absorb most of the information.

Why nurse? Adult nursing is incredibly intimate and loving, much more so than sex. It is hard to describe but there is simply no comparison to the deep, primal emotions generated within a nursing relationship. We have become emotionally and physically closer to each other then we ever imagined possible. If you become a nursing couple your nursing relationship will impact every aspect of your lives, from where and how much you work to how you schedule errands, vacations, and visits with family. Almost every decision you make will be judged by how it will affect your life together as a nursing couple.

Adult nursing is extremely intimate and loving but it also creates needs and obligations for each of you that are very real and serious. Physical discomfort and embarrassment may result if your obligations to each other are denied. Entering a nursing relationship together will create a high level of physical and emotional dependency between you that many people would be uncomfortable with, and therefore must not be taken lightly! Once you reach a certain response level, postponing your obligations to each other for a day or two is NOT an option! Adult nursing is not for every one. It means adjusting your daily lives to put your relationship with each other first, above all other relationships and obligations, and this is not an easy task in our fast-paced and complex society. It means physically offering yourselves to each other daily, within an intimate setting, with built in reprimands if you don't! It means providing for each other's day-to-day physical and emotional comfort in a very real and tangible way.

In some ways adult nursing sounds pretty horrible, doesn't it? It really is not because the positive benefits of nursing together far outweigh the negative aspects, and the negatives are easy to avoid if you know how. One day you will realize that you would prefer to spend time together, alone with each other, rather than do almost anything else. Adult nursing is a lot like riding a bike. When you first try you fall, then one day you get your balance and you hardly ever fall again. Just remember a few simple tricks and together the two of you will become a successful nursing couple.

How do you, as a nursing couple, measure your success? If you read some of the posts on this site and others you might get the idea that success is ONLY achieved if a measurable quantity of milk is produced. To this end some people are using drugs and pumps and working overtime to reach their goal. This is fine if that is what you wish to do, but why work that hard if it is not necessary to be successful? It all depends on how you measure your success.

Remember, it is about commitment and intimacy, not about milk. If you are a nursing couple and you measure your success in intimacy and loving commitment to each other, then you can be successful without producing a single drop of milk. You can be committed to each other, have a closer & more intimate relationship with each other, and have a physical NEED for each other by nursing up to a state of partial lactation, rather than full lactation. This will give you most of the positive effects of nursing together without some of the negatives.

When my wife and I started nursing she was very concerned that she might leak. She is a businesswoman and didn't want the possibility of embarrassment. I also work a lot of hours more than 30 miles from home, so nursing 3 or 4 times a day was not an option. Our social schedule varies too, and there are times when nursing twice a day is not practical for more than a few days. We decided that pumping was also undesirable because we are doing this for us, not for a pump! So with these realities in place what did we do? Our schedule dictated nursing only once or twice a day, depending on our activities. We made a lot of mistakes, but we learned a lot by trial and error.

We have found that it is relatively easy to reach a level of partial lactation and maintain that state. The primary requirement is REGULARITY over time. Together, you must pick a regular schedule you can stick to and stick to it like glue. Do not vary this schedule more than 10% and you will be pleasantly surprised with the results. Gauge her state of lactation by being aware of her physical responses. Here are 10 lactation indicators in roughly the order they will occur.

Each of these items is a measure, or level, of her lactation response. Level 4 is a major milestone that demands a higher level of commitment from each of you. If she becomes physically uncomfortable if a nursing session is skipped, then he must be more readily available to her, and she to him, to maintain her comfort. At this time she will be unable to express milk on her own so she cannot relieve herself even if she tries. This, by itself, means that partial lactation is in some ways more demanding than full lactation. Level 8 is another milestone because it adds the possibility of embarrassment and inconvenience to your relationship and you must be even more committed to each other to keep your private life private.

If her response reaches level 10, then she is fully lactated and now has the option of expressing or pumping occasionally instead of nursing if she chooses. This will give you more flexibility and perhaps allow adding sessions to your schedule that you couldn't support at lower levels because you could not be together every time she would need relief. Be careful! Skipping a session now will mean completely soaked clothing and could also contribute to very painful engorgement!

We now nurse once a day on a limited schedule so how are we doing? We are currently at level 6 but we were at level 4 for a long time. Level 4 is a good place to be. It gives you all of the closeness of adult nursing along with a physical need to be together. We could stay at level 4 forever and be happy together but recently we learned the tricks necessary to move up without working too hard. These tricks are simple and they work well, but you have to understand why they work for them to be useful.

Trick 1. Pick a schedule you can stick to and stick to it like glue! This is the single most important step to success on a limited schedule. Do not vary from this schedule more than 10%! If you nurse once a day that means 24 +/- 2.4 hours. So, if you nurse at 7:00 am then you must nurse again between the hours of 4:40 am and 9:20 am the next day. If you nurse twice a day that means 12 +/- 1.2 hours. So, if you nurse at 7:00 am then you must nurse again between the hours of 5:50 pm and 8:10 pm that night. You also must nurse 9 or 10 out of every 10 scheduled nursing sessions. If the schedule you are on cannot be maintained in this manner for at least 30 days then pick a new schedule and stick to it!

Trick 2. Do nurse outside of the schedule if necessary for her comfort! She must be as comfortable as possible so if you miss a scheduled session and she becomes uncomfortable then nurse outside of the schedule as necessary for her comfort if you can. If you cannot she will probably bounce, meaning she will become engorged to the point where she will be too uncomfortable to be nursed for a few days until her breasts "turn off". Her response will drop at least 2 levels and it might be a week or more before she can be nursed again. Bouncing is very discouraging and stressful for both of you.

Trick 3. Do NOT nurse outside of the schedule UNLESS it is necessary for her comfort! This is by far the hardest thing to do. The two of you lead busy lives and have established a schedule you can stick to. Suddenly you have a day or two alone together and add one or more sessions outside of the schedule. When you resume your regular schedule she becomes engorged and bounces because you cannot be together the additional time now that she needs it. This is one of the hard realities of adult nursing and it has happened to us many times. We have just recently identified the cause of this problem and are still learning about it. If she is partially lactating then she can accommodate increased nursing frequency easily, but decreased frequency is especially difficult because she cannot relieve herself. If you must decrease the nursing frequency then you must be together for a few days.

Trick 4. Nurse in sets. Nurse for about 5 minutes on each breast, then rest 5 or 10 minutes for each set. Do 1, 2, or 3 sets in 30 to 60 minutes, then stop until the next scheduled session. A fourth set is usually not productive unless she is very engorged. It is not necessary to do the same number of sets every session, but try to "empty" the breast every time, judging by the softness after nursing. We usually do 2 sets every day during the week and 3 on the weekends. Always snuggle for 5 or 10 minutes afterward; it is about intimacy, not milk.

Trick 5. Suckle gently. Sucking hard collapses the milk ducts near the front of the breast. This can happen anytime you are trying to draw out faster than the breast will release. The idea is to stimulate the breast to "let go" of the milk it is holding, not to suck it out through a straw. Time any suction with the opening of your jaw so that the nipple is pulled open around its' circumference instead of out, away from the breast. Use only enough suction to hold the nipple and areola in your mouth, and learn how to massage her nipple with your lips and tongue to create a rhythmical open/close motion that will stimulate the breast to release milk into your mouth, rather than trying to suck it out through the nipple.

Trick 6. Modify set time if she is engorged. If her breast is stubborn about releasing any milk, then nurse the breast for a total of 3 to 5 minutes, if no milk flows, then stop. If a stubborn breast begins to release milk, then keep nursing this breast until it JUST stops, then stop. If a breast that is giving milk suddenly stops while nursing, then stop also. Once you have stopped for any of these reasons, wait for the next set and try again. If the breast is still stubborn after the second set, then increase the rest time on the third and fourth sets. This technique gives the breast time to respond and dilate milk ducts that may be plugged or collapsed. This also helps to release milk from deeper inside the breast. Don't be surprised if you feel a mouth full of solids (and maybe a bit of nipple pain) when the breast decides to release. If no milk at all is released by the third set, stop until the next scheduled nursing session unless she asks to be nursed.

Trick 7. Don't get discouraged if she seems to dry up for 3 to 5 days each month near her period. Her body is holding onto fluid in preparation for menses and our experience is her breasts do not seem to be engorged or otherwise in distress. This can be stressful if he feels he is not relieving her properly. Nurse her one or two sets each session following the rules in trick 6. Do not skip sessions because you want her breasts to "know" when it is time to nurse.

I hope you now have a better understanding of how to be successful as a nursing couple on a limited schedule. You might be asking how far you can go if you limit your schedule to only once or twice a day? We are currently nursing every morning once a day and have been following the +/- 10% rule faithfully for about 4 months. Since then we have stopped bouncing between level 3 and 5 and are now at level 6 and holding steady. We are both much more comfortable without all that bouncing! Last summer we were able to nurse twice a day on schedule for about two weeks. We nursed one or two sets in the morning and three every night and on the weekends for that time. We went to level 7 briefly before we went on vacation with family and had to alter the schedule, when we did she bounced. We have not gotten to level 7 again but we are confident we can reach any level we want. We are not in a hurry because we have the rest of our lives together to get there. I hope this discussion helps you both.

What does the term "fully lactated" mean as used in "Successful Adult Nursing"? I based the answer on what I have seen and know about nursing mothers. I know that some mothers leak drops of milk when they hear a baby cry, and/or can spray streams of milk during a letdown. "Full lactation" can be defined as a level of response that produces a visible flow of milk that she can initiate without the help of her nursing partner. If she can trigger a visible letdown without his assistance, then she is fully lactated. At this level of response she has taken the lactation process about as far as it can go.

There are several stories in the files section that illustrate this. While these stories may not be true I believe much of the information presented to be correct. Stories like "Desperate at 30,000 feet", "Dewdrops", and "Give Me Your Milk" are all good examples, but the one I prefer is "Dinner Party Disaster". In this story a nursing couple hosts an evening with some close friends, and the evening ends up with the hostess wetting her shirt in front of them. There is a lot of information in this story. They nurse 4 times a day on a regular schedule. When the schedule gets disrupted, she relieves herself with a breast-pump, which drains her enough to last until he is available to finish the job. The pump is slower and less effective than he is, but she uses it successfully when she has to. They often nurse together at lunch but he was supposed to leave work early, so perhaps he worked through lunch figuring they would have plenty of time to nurse, and drain her completely, before their guests arrived. When he got home late because of traffic, the stage was set for the disaster. After you read this story you will see that she is fully lactated.

Can she be fully lactated without quite such a high response? Yes. Full lactation also implies that her milk production cannot be stopped simply because her nursing partner is not available to her when she needs him. Her release of milk is no longer optional but is now a basic necessity, similar to urination. When her breasts become full, she MUST letdown. If he is not available to help her, then she must find another way to relieve herself. She must release her milk because she has no other choice. She is fully lactated… even if she cannot initiate the release of milk without help. This type of response is one of the cornerstones that makes Adult Nursing so demanding, so rewarding, and so powerful.

Does she need to be fully lactated to be successful at Adult Nursing? No. Full lactation is not required and is often undesirable. You and your partner can be successful without ever seeing a drop and skip the larger burdens that full lactation would place on you. Every couple can reach a level of partial lactation that will fit into their lifestyle without pushing the envelope so far as to be overly burdensome. The beauty is that you can decide how much is enough and how much is too much. You can also adjust your lactation response as your life together progresses and your lifestyle changes over the years. The main thing to remember is not to be in a hurry. You have plenty of time to enjoy the lactation experience together. All you have to do is stick to your schedule, pay attention, and apply the techniques.

In the early stages of inducing lactation how do you know for sure when she is producing milk? Her fluid is often at a slightly different temperature than the inside of his mouth. Be alert to temperature changes while suckling, especially when the fluid volume is small. Her nipples can also leak without producing a visible flow of milk. If her nipples are cooler, or much cooler, than the surrounding skin of the breasts, then her nipples are leaking even if they are dry to the touch. The liquid is evaporating into the air, thus cooling her nipples and enhancing the formation of butter within. This so-called "dry leak" will not leave a wet spot, but it will produce temperature changes, as compared to skin of the breasts, as butter is formed, dissolved, and re-formed in her nipples. Of course, if she releases butter or milk solids she is definitely producing milk. Learn more about how the breast produces milk and butter in Successful Nursing Techniques. Sometimes he will be able to feel the coolness of her nipples through her top when they hug or caress. It can be very stimulating when you feel it and you know what it is.

When I wrote Successful Adult Nursing I felt there was more to be said, but I still had much to learn and couldn't add anything more meaningful at that time. It was written to increase awareness among nursing partners, allowing each of them to see and understand the various physical responses she will experience as lactation is induced. It included 10 lactation indicators to use as a progress guide, in addition to any milk produced. These indicators allow the partners to experience the success of their efforts as it happens, even before any measurable milk is seen. Successful Adult Nursing stressed the importance of a regular nursing schedule and identified the regular nursing schedule as the most important variable to successful induction of lactation. I still believe all of this to be true, but there is more.

Today I can say that I have additional information that can help you and your partner refine your techniques and become more successful as a nursing couple. These methods should provide more positive results faster, with fewer negatives, allowing you to better induce and maintain lactation sooner. It may even be possible to start from scratch and bring about full lactation in as little as six weeks. These techniques and methods do not use drugs or artificial pumps so put them away, you don't need them.

What you are about to learn may not agree with what you have learned about breast anatomy. I am not a medical person, just a guy in a nursing relationship who can pay attention, observe, and reason. I believe adult nursing is very old, dating back to the Stone Age and the early development of the human species. If you look at the differences between men and women it will become clear that they are by design, not by coincidence. The differences compliment each other's weaknesses, making the man-woman team much stronger. Human females are also the only mammals that can lactate indefinitely throughout their adult life. This is not an accident of nature. Adult nursing is another tool in our biological toolbox to help bond men and women together and insure their survival under extreme conditions. With a little bit of time and applied effort, your success as an adult nursing couple is almost guaranteed.

Lets get started with the right foundation for success. Every day you need to know what you are doing right and what you are doing wrong, then make corrections as necessary. Print a copy of Successful Adult Nursing (SAN) and Successful Nursing Techniques (SNT) and put them on your bedside table. Try to read one of them every day and compare what you are reading to your own nursing experiences. You will find that as your nursing experience changes, so does your interpretation of what you read. After I wrote SAN I kept a copy at my bedside and re-read it several times a week for almost a year. Every time I read it, something new would click with a recent nursing experience. There is a lot of imbedded information that your brain will tend to glaze over unless the experience is close at hand. Periodically re-reading the material will help you stay focused and on track.

Success at adult nursing depends on a successful suckling technique. Stimulate the breast properly and it will "let go" of the milk it is holding and release it, allowing room to make more. Stimulate the breast improperly and it will not release its milk but hold on to it, causing the breast to lock up, tight! Why? Because the breast not only makes milk, it also makes butter. Milk production is the pro-lactation process and butter production is the anti-lactation process. If the breast is not suckled properly, the butter will build-up and stop the lactation process before it can get off to a good start.

Milk is produced in milk sacs within the breast mound and is made up of liquid and dissolved solids. The milk travels from the sacs through tube-like ducts to sinuses in the areola. The sinuses are flexible cavities, or bladders, that collect milk from the sacs and funnel it toward the nipple. The nipple contains many very small capillary tubes that connect from the sinuses to the outside world. The nipple is a sort of valve that stops the flow of milk, holding it within the breast, until it is needed. After nursing, milk left in the breast ducts, sinuses, and capillaries is re-absorbed over time by osmosis through the tube walls. This process reduces the liquid part of the milk, leaving the solids behind in the tubes. As more milk is made some of it trickles into the tubes bringing more dissolved solids and liquid to be absorbed. The process causes the solids to concentrate within the tubes, forming butter. This butter can eventually build up and block the capillaries and ducts, stopping the lactation process because the breast can no longer get rid of the milk it is making and has no room to make more.

The more milk the breast can make and get rid of, the less the production of butter will affect it. If she is fully lactated and nursing regularly, there will be so much liquid passing through the breast that the solids will remain dissolved and very little or no butter will be formed. However, the less milk the breast can get rid of, and the more time it sits in the tubes, the more butter it will produce. In the early stages of inducing lactation the breast produces only small amounts of milk, much of which stays in the tubes, the ideal situation for making butter. The first time new milk is made, it can easily flow through the empty tubes of the breast. When he stops nursing the flow stops at the nipple, but the sacs still ooze milk for a few minutes, until they can transition from releasing milk to storing it. Once the flow stops the milk sits in the tubes and is subjected to osmosis thickening. As time approaches the next nursing session, the milk sacs become nearly full and again begin to ooze some milk into the tubes. This helps to dilute the thickened milk in the tubes in preparation for nursing, but the farther down the tubes away from the sacs the less effective this is. One of the goals during nursing is to remove all of the thickened milk from the breast. If all of the thickened milk cannot be brought out of the nipple at each nursing, the nipple will close on pre-thickened milk, making it easier for butter to form before the next nursing session.

Butter can form anywhere in the breast, but it forms faster in the capillaries of the nipple than elsewhere. This is because the smaller the tube, the more wall area is exposed to a given quantity of milk and the milk near the end of the nipple is subjected to evaporation to the air which can hasten the process. The nipple is also farthest away from the milk sacs, with the sinuses in between, so it is unlikely to receive any new milk from the sacs to help dilute the butter. Add up all these factors it is very likely that there will be breast butter in the nipple when it is time to nurse. Once formed, the butter helps keep the nipple from leaking, enhancing its tightness, but it also makes it harder to start a new flow of milk when you nurse again. This means that in order to successfully induce lactation the nursing technique must be able to remove butter from the breast. If the butter cannot be removed, neither can the milk, and lactation cannot be sustained. This is probably why so many couples bounce back to zero right after they see their first drops. The suckling technique he is using cannot remove the butter from the breast.

He can remove the butter by rhythmically squeezing the nipple around its circumference for the nipple's entire length, followed by a short release, then repeat. He should purse his lips forward, placing the face of his lips on the areola, and use the inside of his upper and lower lips to squeeze the nipple. His jaw should open partly on the release and close on the squeeze, creating a chewing motion that is transmitted to the nipple. This technique mimics the size and action of a baby's mouth. The nipple remains in front of his teeth and he can place the tip of his tongue between them to ensure against biting. He should start by gently and evenly squeezing for about 1 second, followed by a 1/4 second release, thus repeating every 1 1/4 seconds. The rhythmic action signals the nipple to loosen and the milk sacs to release new milk into the ducts. The squeezing compresses and stretches the butter, making it longer and narrower. Some of the butter will be forced out, into his mouth, and some will be pushed back toward the sinuses. As the nipple loosens and the butter narrows, liquid milk from the sinuses can surround and lubricate the butter in the capillaries of the nipple. Soon he will feel the butter flowing out of the nipple in strands.

The faces of his lips are also massaging the areola, mixing the milk and butter in the sinuses, making the butter softer and easier to flow. He can now pick up the tempo slightly and adjust the cadence by squeezing for about 1/2 second with a 1/4 second rest, thus repeating every 3/4 second. The cadence is now squeeze 2/3, rest 1/3, or 67/33. As the flow of milk increases he should adjust his rhythm and cadence to keep up, but not draw the milk too fast. If she is fully lactated with a strong letdown, he may receive a mouth-full of milk at a time, squeezing only briefly to swallow. However, in the earlier stages of inducing lactation he should stick to the 67/33 cadence and adjust his rhythm only. As her response level increases over time, he can move up to a 1/2 second rhythm and a 50/50 cadence. When she becomes fully lactated the cadence will vary widely to include 33/67, 25/75 20/80 or more. He should be constantly aware of the flow and learn to make adjustments automatically.

As new milk is released from the sacs and travels through the ducts to the areola, it dilutes and loosens the remaining butter and flushes it into the sinuses. This butter could suddenly cause the milk flow through the nipple to stop. A short rest of about 1/2 minute (10 breaths in and out) will close the nipple and allow more milk to accumulate behind the butter in the sinuses. You can actually see the sinuses swell as they fill with milk. Start nursing again slowly with an 80/20 cadence as before, thinning and reshaping the butter and purging it through the nipple. As the flow increases, adjust the rhythm and cadence to match. If she has butter deep in the breast, he may need to apply a short rest several times. When the flow of milk has slowed sufficiently, or if the breast will not release any milk at all, apply a long rest of about 10-15 minutes. This will allow new milk to trickle into the ducts, helping them to dilate, and soften the butter that has formed. As the ducts dilate some of the liquid milk will make its way into the sinuses, making it easier to remove butter from the nipple after the rest.

The long rest also gives the milk sacs a chance to relax and prepare for another release of milk. If you think of each milk sac as a small round ball of spongy tissue encased in a thin layer of muscle tissue, then it is easy to visualize what happens within the breast as milk is produced and released. Rhythmic stimulation of the nipple signals the milk sac muscles to contract thus pressing milk from the crevices of the spongy tissue, where the milk is synthesized and stored. The longer the nipple is stimulated the longer the sac muscles contract. This leads to the tiring of the sac muscles and a loss of compression on the spongy tissue. The long rest lets the tired sac muscles relax, improving their blood flow and re-supplying them with energy. The improved blood flow to the milk sacs stimulate the spongy tissue to produce milk and helps to re-hydrate the tissue that has been dried, causing expansion of the sac and dilution of the remaining milk left behind. This process is somewhat slow, but when nursing is resumed after the rest a new contraction of the milk sac muscles begin thus pressing the thinner milk from the crevices of the spongy tissue and again tiring the sac muscle as the milk is drained. Multiple contractions of the milk sacs during a single nursing session is very effective at improving blood flow, muscle strength, spongy tissue growth, and (of course) milk production. This means that nursing each breast for 10 minutes is less effective than nursing each breast for 5 minutes once, waiting 15 minutes, and then nursing each breast for 5 minutes again.

This model of a milk sac also sheds light on the ability of the breasts to supply milk as needed by demand and to induce lactation without pregnancy. Before lactation is induced the ball of spongy tissue is dormant and tiny, surrounded by a relatively thick layer of weak muscle. As the muscle is exercised it demands more blood flow, which passes through to the inner circumference to nourish the spongy tissue and provide raw materials to synthesize milk. The increased blood flow acts like a wakeup call, telling the spongy tissue to produce milk. As milk production increases milk storage needs also increase, stretching the sac muscle and making it thinner. As it stretches a little bit more each day, more room is opened up for the formation of blood vessels and more spongy tissue on the inner circumference. More milk, more room, more blood, more tissue, more milk. Gradually the milk sacs will thus grow in size and capacity.

Each day the milk sac muscle can easily stretch a little, but it will resist stretching a lot. After lactation or partial lactation is induced if a nursing session is skipped the continued milk production and added milk volume causes the milk sac muscle to stretch too much, thus overflowing milk into the breast and raising the pressure on the milk sac as the muscle resists. As the pressure rises and the sac muscle resists, the forced thinning of the muscle tissue restricts the flow of blood, thus starving the spongy tissue of nourishment and raw materials and slowing the production of milk. In the early stages of inducing lactation, this starvation process can halt the production of milk altogether in a relatively short period of time, but if she is fully lactated and nursing regularly the milk sacs are more powerful and have developed a plentiful blood supply that is much more difficult to cut off. Milk production will slow but it will be nearly impossible to stop. The milk sacs and the entire breast will eventually become very tight and painful as the pressure builds behind the nipple. The nipple will remain tight to contain the milk (or try to) until it receives the proper stimulation needed to signal a release.

The release of milk, or letdown, is triggered by physical stimulation of the nipple but can also be affected by mood, stress or anxiety. The ease of release is also partly tied to her lactation response level because the more milk she is producing the easier the release becomes. This is why some lactating women can trigger the release of milk easier than others. Some women can release with digital stimulation and some cannot. Some women can release with the use of a breast pump and some cannot. A few women can even signal the release spontaneously without physical stimulation on the nipple. While various nipple stimulation techniques produce varied results on different women, every woman will respond positively to the use of the proper suckling technique regardless of how much or how little milk she is producing. The other release methods may not get the job done, but her body is hard-wired to respond to a well-trained pair of lips. This is the best way to ensure the breast is properly stimulated and fully drained at each nursing session.

The long rest can be applied more than once during a nursing session, but overuse can lead to diminishing returns. In the early stages of inducing lactation, it is actually possible for the milk sac muscle to force out some of the spongy tissue and expel it from the sac. This can happen because the sac muscle quickly strengthens each time you nurse, but it takes more time to generate spongy tissue, stimulate the production of milk, and expand the milk sac, thus stretching and thinning the sac muscle tissue. As the spongy tissue grows and milk production increases over time, the sac muscle stretches, thinning it and reducing its overall strength relative to the ball of spongy tissue. If the sac muscle is strengthened too fast, before the ball of spongy tissue is large enough, the milk sac can squeeze out its own insides. If this happens it will feel similar to foamy toothpaste in your mouth and it will set back your lactation induction efforts at least a week. As time passes and her response level increases multiple use of the long rest can be very effective at totally draining the breast thus later resulting in an increase of her milk production. This technique can be handy to empty the breast right before a mammogram, but can also be used to "bump up" her milk production at a time of your choosing.

I have presented a lot of information up to this point. That is because, like many aspects of adult nursing, it is much easier to actually do it than it is to explain how and why. Everything we have learned can be restated simply as follows: The lactating breast makes milk in the milk sacs that will be converted to butter as it sits stagnant in the ducts and tubes. The nursing technique must remove the butter from the breast or the lactation process will be stopped! Butter must be reshaped and lubricated to pass through the capillaries of the nipple. Butter must be softened and diluted to be flushed from the breast ducts into the sinuses of the areola. Proper grip of the nipple, proper squeezing technique, use of rhythm, cadence, the short rest, and the long rest are the primary tools used to manipulate the milk and butter and remove it from the breast. Being aware of her responses is the best way to gauge the use of these tools so there is no substitute for an observant partner with a well-trained pair of lips!

Earlier I promised full lactation in six weeks. I think this is a realistic goal for a dedicated nursing couple on a strict twice a day +/- 10% schedule using the techniques I have outlined. It will require a plan, some patience, some discipline, some observation, and intelligent use of the primary tools. To start: Nurse 1 minute, 1 short rest, 1 minute, next breast, long rest, next breast, last breast for the first 2 weeks. This regime will take about 25 minutes, leaving five minutes to snuggle in a 1/2-hour allotment of time. Start using longer nursing intervals and more short rests as needed above response level 3 and allow a full hour for each nursing session. Begin using 2 long rests occasionally above level 4. You may add multiple long rests as her response level approaches level 6 and allow 1-2 hours of time. At this level don't worry about how long you nurse at each session so long as you always begin nursing on schedule. If you have a lazy day and you want to "bump up" then nurse long in the morning, maybe a little short in the evening, and perhaps long again the next day. Always nurse on time every time! If she hasn't fully recovered from a long session then nurse short, but do nurse. Don't skip any sessions for the first six weeks. Get a calendar and mark off the schedule up front, so you both know what you are getting into.

Many couples cannot maintain a strict twice a day +/- 10% schedule. So start nursing once a day on schedule for 4 to 8 months or until she is stable and comfortable at level 6. Then take a 2-week vacation together and begin nursing three times a day. After 4 days begin "bump up" techniques to bring her up to level 10. At least 4 days before you return from vacation start using a good quality breast pump at the mid-day session. He is still with her every day and can help her get used to the pump. When you get back to your regular routine, he can nurse early each morning and late each evening, and she can pump in the afternoon. I don't like a breast pump, but in this instance it makes good sense. Three times a day with full lactation means no butter in the breast! Don't try this plan unless you both committed to see it through. If she bounces after the "bump up" it will be very bad.

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