My question to Katherine, or anyone else, is: Why do so many babies =
nurse for long periods, then sleep for a few hours?  This seems to =
happen without any conscious manipulation on the part of the mother.  We =
know that with good attachment at the breast, a healthy infant can =
ingest a large volume of milk in the first few minutes of the feed,

This is true IF it has been several hours since the last feed.  If it's only
been a few minutes since the last feed there isn't "a large volume of milk"
to be ingested.  In many cultures, the most typical pattern is for the baby
to nurse for a few minutes at a time, several times an hour -- and this
pattern can persist for 2-3 years.  These babies also sleep in much shorter
"catnaps" than American babies -- 10 minutes here, 15 minutes there, an
occasional 30 minutes asleep.  One of the major differences, I believe, is
that these babies are almost constantly physically in their mother's arms or
on her back.  They are not laid down in a crib or bassinet -- they are
constantly being moved and jostled, and shifted around to meet the mother's
needs for freedom of movement.  If she needs to pound millet or hoe the
sweet potato field, she puts the baby on her back.  If she needs to wash
clothes, or go to the market, she puts the baby on her back.  She seldom has
30 minutes to sit and nurse a baby uninterruptedly -- she lets the baby
nurse a few minutes and then takes it off the breast to go stir the cooking
pot, or whatever.  The baby doesn't complain the was a US baby might because
it "knows" it will be getting another chance to breastfeeding in just a few
minutes.

Although American mothers may not be "consciously" encouraging their babies
to wait many hours between meals, I think there are many subtle cues they
use, such as trying every other comforting measure they know before nursing,
encouraging baby to sleep longer by rocking the cradle or rubbing baby's
back and singing to it, rather than just letting it wake up after a 10
minute snooze -- plus the lack of physical stimulation from lying on a crib
or mattress (non-moving surface) in a quiet room, perhaps even with the
lights out and the curtains drawn to make the room as dark as possible.
This "sensory deprivation" may encourage longer sleep times.  All of this
sets up a positive feedback pattern -- the longer between feeds, the
hungrier baby is when it does get to nurse, and it wants to nurse a long
time to get its hunger/thirst/sucking needs met, and it is upset when pulled
off too soon because it "knows" it will be many hours before it gets another
chance.  That belly full of milk contains beta casomorphins that cause the
baby to feel sleepy, so it gets 3-4 hourly blasts of sleep-inducing drugs.
That means the baby sleeps a long time, so next time it wakes up really
hungry and needing to nurse -- and the cycle repeats itself.

I'm not saying one is better than the other.  Just that the more frequent
feeds, and the constant contact with mother's body (NOT being laid down in a
dark quiet room with no movement) is more typical both of all the other
primate species and of most children's experience in the world today.  I may
be totally wrong about the possibility of there being a link between
frequent nursing and mastitis.  I also saw only one yeast infection in Mali
in 2.5 years of studying breastfeeding -- so maybe it's the climate or the
lack of antibiotics that keeps the yeast in check.





Katherine A. Dettwyler, Ph.D.
Associate Professor of Anthropology and Nutrition
Texas A&M University
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