Kathy and Barbara

Thank you for your exchange discussing infant mortality as it might relate
to breastfeeding problems in times gone by.  The points you raise are right
on the button.  I think this was what I was trying to say a few weeks ago
to refute the misconception that women in unsophisticated societies always
breastfeed easily and without difficulty.  They do not.  Any more than than
all women breastfed successfully in now-industrialized countries a century
or two ago.  Not only do breastfeeding problems occasionally identify those
babies who have *other* problems, but I'm also convinced that there may be
a brief 2 or 3 day period even for healthy full-term babies, probably at
about 4 or 5 or 6 days after birth, where they seem to reach a critical
point.  If the mother knows how to manage the baby's intake then the baby
goes on to thrive.  If not, then it's these babies who seem to hover for a
bit and then start a quick slide downhill, and I have a strong suspicion
that these babies are very much at risk unless an intervention is made.

Somehow it is accepted that all women will need assistance during
childbirth.  But it is not yet accepted that all women will need assistance
initiating and maintaining breastfeeding, and in fact, I suspect that one
of the reasons why breastfeeding is not given more support in developing
countries ( by national and international agencies) is that there is the
naive belief that all mothers need is minimal intervention and it will
happen almost by magic.

Thank you both for identifying that infant mortality can, and does, occur
as a consequence of breastfeeding difficulties in all societies.

Pamela Morrison, IBCLC
Harare, Zimbabwe

Barbara wrote, "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....."

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