Karleen gave us some info on study in Karnataka, India -
"A survey was done in a remote rural area of Karnataka with a questionnaire.
Overall 274 lactating mothers from a population of 10,000 were interviewed,
to know the practices of breast-feeding with special reference to lactation
failure. It was found that the majority of the mothers (97.09%) in rural
areas breast-feed. Lactation failure is not a problem."

As I like to remind moms in my breastfeeding class - we're mammals and this
is supposed to work.  

However, and this has been brought up before, some of us work with that
population of moms that (in nature) would not have become pregnant.  Altho'
fertility specialists can now work miracles for pregnancy, the same effort
has not been put into lactation, of course.  And maternal fertility problems
may well predict lactation insuffiency.

If you add to that a cultural overlay that may prevent optimal stim
(presumably if you're in Karnataka you can't hire a night nanny, buy a pack
of cute pacifiers, and no-one tells you to get your baby on a schedule or
you'll regret it!) it's no wonder we see too much chronic low supply.

These days I'm delighted and a bit surprised each time I meet a mom with a
lovely flow.  They must think I'm a bit batty as I flap around excited about
all that lovely milk. Age of typical mom that I see is late 30's.  Lots of
40+ primips.  One day I'll sort out the % that had fertility tx but will
guess close to 10% in that age group.   

To quote Ruth Lawrence MD (p.318 Breastfeeding, a guide for the medical
profession, 6th edition) "Insufficient milk is a problem in Western cultures
and rarely in developing countries."  

In Breastfeeding Abstracts, Summer 1985 Vol 5 No. 1 Marianne Neifert MD
states "Generalizing that every woman can breastfeed was helpful to all
women when many unfounded contraindications to breastfeeding
existed...Perpetuating this myth today is no longer useful."  It is in this
same article she comments "Probably 95% of women are fully capable of
successful lactation...". 

I am still waiting for someone to come out with "Milkagra" (sorry - bad take
on Viagra).  One of my peeves is having to watch ads for various erectile
dysfunctions meds on the 6 o'clock news (loved explaining that to my little
ones) - and having nothing comparable to deal with lactation dysfunction.  

Cheers,
Joanna Koch, IBCLC, N Ca    

 

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