I'll bet a million dollars that research in human (as in bovine) lactation
will demonstrate that genetics, and  hormone balance and health at the time
of delivery play a huge role in milk production.  I agree that breastfeeding
is a 'confidence' game up to a point, but there are all sorts of perfectly
confidant women with whom I've worked (of many nationalities) who have had
issues regarding milk production that had nothing to do with their attitudes
or with their management. Converesly, I've seen some women who were nervous
as cats who had great milk supplies.  It's the underlying physiology that
varies from individual to individual that is more to the point.  My
grandfather (the dairy farmer) called his better producing cows "easy
keepers".  They didn't require special handling, feeding, or extra vet care
to outproduce every other cow in the barn.

I think we keep looking to the "system" for explanations of all that goes
amiss (and don't get me wrong; I agree that there is plenty that needs
fixing in birthing institutions with regard to lactation support). But look
at birth itself. Each individual is going to give birth differently (for
some birth is relatively easy, for others, it may be fatal). Similarly, each
woman is going to lactate as an individual and deserves to be assessed as an
individual.  We have to give individuated care to lactating women just as in
other aspects of health care.  To blame their attitudes seems like a blame
the victim mentality to me.  I would rather understand more clearly what
their specific challenge is and deal with it.  It's been my experience that
attitudes quickly improve if people feel their care givers have some clue as
to how to help improve their problem.

Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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