The question Kathy Leeper poses about what happened in the past to babies
with a poor latch is provocative. In my opinion, it is an enormously
romantic notion to think that breastfeeding in the past (due to lack of any
alternatives but wet-nursing) was always successful and provided
consistently good outcomes.  Historically high infant mortality figures
belie this.  Many complicated public health, general hygiene, and infectious
disease issues interplay, but I believe that just as in animals early
feeding problems are tantamount to a death sentence unless there is skillful
intervention to prevent it, so this is also true in human populations.  When
you read historical records, there certainly are reports of weakly feeding
babies who didn't survive. Additionally, so many historical periods are
marked by seriously uncertain food supplies that many women had barely
enough milk for one baby, let alone enough to spare for another woman's.

 I see a lot of babies who I am convinced would die if they were in a more
marginal setting.  The ability to feed robustly is (in my opinion and
experience) the definitive way to distinguish between a functional and a
non-viable organism.  We live in an era where we have recognized that
sometimes there are very TEMPORARY reasons why an infant might fall into the
"non-viable" column (like birth trauma or treatable infection or rapidly
elevating jaundice, etc).  Assisting newborns beyond this point with
rational interventions moves most babies into the viable category.  But
looking at some poorly feeding infants down the road, many of those early
feeding problems are predictive of other issues.

Ogg,HL:  Oral-Pharyngeal Development and Evaluation, Phys Ther 1975,
55:235-241.



"Often the earliest and only signs that reflect central nervous system
deficits in babies are related to feeding.  Difficulties such as weak
sucking, choking, and regurgitation may be symptoms of central nervous
deficit.  "


Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com

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