Marsha points out that babies do pretty well with 2-hour feeding intervals 
a lot of the time.  I agree.  And yes, babies are very adaptable!  But I 
think it's useful to have a sense of what adaptations involve the least 
"stretch" for the average baby.  Well, I guess maybe what Marsha's saying 
is, what if there is no reallly specific expectation at all on the baby's 
part?  Or if there's a wide range?  What if they are born simply 
"expecting" to have to change a lot, period, and many of the possible 
changes are pretty much equivalent to each other?  It's an intriguing 
question.

As Marsha says, the very frequent feeding pattern is probably because the 
baby is held next to the mother's bare breasts all the time.  In most 
hunter-gatherer societies (and these are the ones that most nearly reflect 
how humans operated when we evolved to more or less our current form), the 
baby is in fact always carried, usually by the mother.  And given what we 
know of infant physiological status when held skin to skin with the mother 
(vs set in a bassinet, held swaddled, etc.), it seems that they are in fact 
designed to be held skin-to-skin.  So, as far as I understand them, the 
anthropological and physiological studies seem to agree that infants are 
born expecting this constant contact.  So, I figure that a feeding pattern 
that develops naturally in those circumstances is probably "normal" as far 
as the baby's physiology is concerned and genuinely does involve less of a 
stretch.  This is borne out by what I've seen about infant crying being 
much less of a "given" in cultures where babies are held and nursed a 
lot.  In some societies, of course, the babies are carried on the mother's 
back (not at the breast) or are often carried by someone else, and I bet 
that in those cases feedings are less frequent because each feeding 
involves moving the baby to the breast.  I'd love to have more statistics 
on the range of possibilities.

Marsha, for what it's worth, the Toba women in this study were considered 
well-nourished and as a result started ovulating again relatively quickly 
considering their very very high breastfeeding frequency.  So, it doesn't 
work in this particular group to speculate that the mother's diet affects 
the milk composition in a way that necessitates super-frequent nursing.

Again, with birth -- to note that in some societies mothers give birth on 
their own and go straight back to physical labor is a way to challenge our 
assumptions that we "know" how a particular physiological process works and 
how it "has to" be managed.  I love cross-cultural observations because 
they help me perceive that there is a very wide range of solutions and 
strategies out there, and that things we thought were basic facts -- like 
that humans normally give birth lying down and experience several hours of 
dangerous labor -- are in fact not universal, so it might be worth 
investigating what factors produce such different experiences.

I think this discussion illustrates one of the points I get from the Toba 
study: what it means to the mother to nurse the baby is variable.  In our 
society it generally means you stop what you're doing, pick up the baby, 
bare your breast, and devote some one-on-one time to the baby.  No wonder 
we balk at the idea of doing that every 12 minutes or so.  In some other 
cultures it means nothing of the kind: you keep doing whatever you were 
already doing, just the baby happens to be latched on for a few 
minutes.  You were already carrying her.  Your breast was already 
bare.  You don't stop working.

I'm not suggesting American or European mothers should nurse several times 
every hour, but I do ask them to think about the reasons that is a 
startling idea to them.  And I do teach class wearing a 5-lb doll in a 
sling (my own baby is a second-grader), in order to make the point that we 
*assume* it's impossible to simultaneously breastfeed and get anything else 
done, so we are constantly making choices: teach class, or nurse the 
baby?  Cook supper, or nurse?  Clean house, or nurse?  Work for pay, or 
nurse?  Go to the store, or nurse?  Take care of the older children, or 
nurse the baby?  This does tend to put an enormous amount of pressure on 
the mother to wean so that she can resume her other obligations.  It's like 
if you have to choose between sleep and nursing, something's going to 
give.  If you learn to do both, there's more of a chance for long-term 
nursing.

If we try to understand how mothers in other societies manage to 
incorporate frequent or long-term breastfeeding into their lives, we might 
learn something about how our own cultural assumptions either facilitate 
breastfeeding or stand in its way.

--Elise
LLLL, IBCLC
New Hampshire, USA

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