Hi All,

I am late chiming in on this subject, however I have puzzled on it for many
years.  As a hospital based lactation consultant and a previous home birth
midwife, I would like to address some observations.  Most of the
supplementation on our unit comes from mothers' request.  The most frequent
statements from mothers are:  "He/She is still hungry" and "I don't have
enough."  These are made with great concern.  The mothers really want to
exclusively breastfeed but do not feel secure that they adequately meet
their babys' needs.  I find that reassurance rarely works, nor does hand
expression of several drops.  On the other hand, I don't recall any of my
home birth mothers fretting like this.  Mothers who delivered at home
rarely supplemented. Those that did did so when baby was not able to latch,
not because they thought "She/he's starving!" They were mostly confident of
their production.

I am wondering if the use of synthetic oxytocin intrapartum may inhibit
maternal oxytocin release in the early postpartum period.  Synthetic
oxytocin was never used intrapartum in the home births I attended and it
was only rarely during 3rd stage or after.

Do you think it's also possible that women who deliver in the hospital less
sure of their bodies and its ability to produce milk because the birth
process has been handled by others? Is it simply a emotional reaction?  Do
hospitalized mothers have difficulty with oxytocin release?

I have a hard time not believing the mother's gut instincts when they fear
that they are not providing one of  the most basic instincts of mothering.
But the feelings could be a by-product of a really neurotic culture.

These are some questions which I can't answer and hoping others have
thoughts or perhaps answers.

Grieving today for my friends and relatives in France,

Mary Westra RN, IBCLC

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