Hello. I have been lurking for a week or two, and learning a lot from all
the discussions. I am an LLL member, also treasurer of our local group,
nursing a 17-month old. I am working on a Masters of Education in
Instructional Design -- did my class project last semester for LLL. Hope
to take my electives in Maternal and Child Health.

I wanted to respond to 2 items:

First, Jane Squires wondered about a link between nursing a baby flat on
its back and ear infections. In "Pregnancy, Children, and the Vegan
Diet," Michael Klaper, MD says in big bold type: "Never let your baby
nurse from the breast or bottle while lying flat on his/her back." He
explains that: "The nasal cavity and the mouth both share a common
passage at the back of the throat. When the baby is lying on its back,
and fluids are swallowed, the liquid can be forced up into the back of
the nasal cavity...Such a supine position will permit the back of the
nose, including the openings into the canals leading to the middle ear,
to fill with milk, fruit juice, or other liquid. This subtle, but
important mechachism is one of the greatest sources of recurring middle
ear infections and chronic nasal discharges and allergies in children."
(This book is copyright 1987 by Gentle World, Inc., ISBN 0-9614248-2-6)

This book is the only place I have seen this information. In fact, I've
seen some breastfeeding/baby books that described the flat-back
position as an OK alternative. I followed Dr. Klaper's advice, and I must
say that my baby has never had an ear infection (knock on wood) -- but he
is also not in day-care, and we don't do dairy, so that might have
something to do with it also.

Next, Jon Ahrendsen mentioned a study showing that the mother's diet must
be near starvation levels before it affects breastmilk quality. LLL's
1996 Facts About Breastfeeding lists two abstracts related to this:

" Lactation performance is not primarily determined by maternal
anthropometric status (with the possible exception of severely
malnourished women) but is regulated to a large extent by the infant."
   -Perez-Escamilla, R. et al. Maternal anthropometric status and
lactation performance in a low-income Honduran population: evidence for
the role of infants. Am J Clin Nutr 1995; 61(3):528-34

"Human lactation performance is extremely robust and body mass index does
not provide a useful indicator of function at the levels studies so far.
Lactation performance becomes compromised when undernutrition is
sufficiently severe, but it appears that this occurs only in famine or
near famine conditions."
   -Prentice, A.M. et al. Body mass index and lactation performance. Eur
J Clin Nutr 1994; 48(suppl3):S78-S89.


    Betty Meeler
    Durham, NC
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