On Thu, 27 Mar 2003 Karleen Gribble wrote:
.... I was thinking about application of programs encouraging relactation and wondering whether you could provide some history into the relactation programs that existed in outback Aboriginal Australia in the 60s/70s? ....
Hi Karleen,
The only such program I am aware of, despite a lot of research, was in the 1980s in Alice Springs. The other instances you referred to were isolated cases, from anthropological sources (anecdotal) and other sources, certainly not programs.
When in Alice Springs in Central Australia in September or October 1985 for some speaking engagements for ABA, I was invited to meet with the staff at an Aboriginal child health facility that had some residential accommodation. Babies from distant communities who had started bottle-feeding in very basic camp conditions, and had contracted gastroenteritis, were flown in to Alice Springs to the Base Hospital with their mothers. While the babies were rehydrated in the busy "gastro" ward at the hospital, the mothers lived at the child health facility where the staff started them on relactating. Positive factors were that they weren't alone as other mothers may have been in at the same time, and the staff working with them had regularly helped other women to relactate fully. The nurses laughed when I asked about timeframe - apparently it would have been a luxury to have had as much as 4-5 days, as the mothers were keen to get out of town and back home to their own communities. So they did it in less.
The Alice Springs program used: frequent breastfeeding, confidence boosting, a supplemental tube device, and metaclopramide (maxolon, reglan), "the latter as much for the placebo effect as its prolactin-enhancing properties". This is from my Feb 1993 report, under my previous surname:
Phillips V: Relactation in mothers of children over 12 months. J Trop Pediatr 1993;39(1):45-48.
When checking the proofs before publication, I accidentally left in an incorrect reference number (to someone else) along with the correct citation, i.e. my personal observation. This should be the only citation for that information.
Remember that, in this paper, I was reporting only on cases where the child was over 12 months. I could have had a lot more cases in the 7-12-month age range, but chose to make 12 months the lower age limit. My case series involved 6 Caucasian Australian women, preceded by a literature review. Some of these Caucasian Australian women relactated for a biological child accidentally - the mother reluctant but the child very insistent. My 1969 case report (child of 2-3 years) that I cited in the lit. review, was an anecdotal account provided me by letter by anthropologist Catherine Berndt, observed by her in an Aboriginal settlement in about 1942 and used with her permission. It involved a reluctant grandmother and an insistent child.
I hope this information clarifies these issues. I have been convinced, for years, that lactation is something that women can come in and out of, rather than a progression from exclusive breastfeeding, to mixed feeding, to weaning. Weaning doesn't have to be final. If the child wants to resume breastfeeding, or if the mother has some reason for doing so (and an emergency situation is a darn good reason!), they can go back in and out of it. Of course, in the presence of a determined and willing child who remembers what to do, what hope has the unmotivated mother of preventing relactation! (As you are aware, my 1993 case series has examples and a discussion on this.)
Virginia
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