I would definitely agree that the vast majority of low supply situations are due to 
disruptive routines and misperceptions about infant needs.  In fact, in thinking about 
chaos theory --- it makes sense to me that an infant that is not allowed to get in sync 
with its mother would shut down.  

And I do talk about this in prenatal classes and try to arm parents with enough 
information to compensate for any disruption in the process of getting in sync with their 
infant after delivery.  I consider it now a necessity.

However, I have come to the point where I really don't like the term "perceived low 
supply" because of the dismissive way in which some care practitioners treat women over 
this issue.  It leads to either one of two perceptions of the woman, a) either she is too 
lazy to do the work of breastfeeding or b) she is just an overwraught new mom.  In fact, 
I've had my share of women who really did have low supply (regardless of the cause) and 
my share of women who had deep emotional issues that deserved attention.  You cannot 
distinguish between these two situations without really listening to the mother.  Labeling 
it "perceived low supply" is not enough.

I feel similarly about how some health care practitioners will look at a failure to thrive 
situation and immediately tell the mother she doesn't have enough milk.  We all know 
plenty of women for whom this is not true.  

And finally, when I talk about SOME patronizing health care practitioners, I am talking 
about my own experiences here with some very disappointing situations that could have 
been prevented.  There is no way any of us can understand how we all practice in our 
own settings merely by how we write on Lactnet. Writing on a computer is not interacting 
with a client.  

So, Karleen --- you just triggered my unhappiness with some of the situations I've faced 
with insufficient glandular tissue and breast reductions --- not a judgement on how YOU 
practice or interact with your own clients.  I still think an exchange program would be a 
fascinating education.

Best, Susan

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