Dear Dr Jack

When you are right you are right! I think that there has been enough
research to show that in a moderately malnourished mother her milk supply
and its nutrient quality is still maintained. Isn't breastfeeding as a
physiological process just marvellous!

However in the developing country scenario, some of these women are severly
malnourished and their ability to stay healthy,function and care for their
children is greatly reduced. Ultimately their ability to reproduce and/or
breastfeed will also be compromised. One has only to look at the tragic
pictures of starving women in Ethiopia and the subsequent infant mortality
rate to see this. Often it is an insidious process. My point is that one
needs to correct the maternal situation rapidly, so things do not detoriate
to this extent. Do not blame the naturally progressive infant situation on
breastfeeding.

After all who is going to sustain a bottlefed baby with a with a dead
mother.

There is also this tendency to look at child and infant nutritional status
in developing countries and then propose that because there is malnutrition
it is due to breastfeeding not being enough. Often one only needs to look
closely at the breastfeeding stats and it becomes apparent that the
situation is as it is because breastfeeding is not being done enough. Couple
this with poor weaning practices and you have a recipe for disaster.

Kind Regards

Mandy O'Reilly
IBCLE
nurse midwife

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