In a message dated 98-04-21 00:06:12 EDT, you write:

<< I also don't believe that producing milk is tiring.
 Taking care of children is tiring.  Breastfeeding can be tiring.  But
 producing milk is no more tiring than producing insulin.>>

 Well, I don't think I've ever produced insulin in the same quantities that I,
and most of us longtime bf'ers produce milk.  But maybe if I did it would make
me as tired as it has done to produce milk.  I do know that even though after
my daughters were weaned I had *more* work to feed them, fetch sippy cups of
milk, etc etc, than in the many happy months that I was breastfeeding them,  I
nonetheless needed an hour a night less sleep after each weaning than I had
throughout the periods when they were being breastfed.  Prolactin, that much
vaunted calming hormone, makes many people tired, period.

<<I would encourage her to nurse her baby and blame the fatigue on
 something else. >>

Dr. Jack, I don't mean to say that this woman should necessarily wean, and in
my great absence of medical knowledge I am sure that you are right about the
diagnosis of "adrenal exhaustion" being bullshit.  But I don't think it does a
service to breastfeeding mothers to ignore that there are real tradeoffs in
this important choice we make.  Our children won't need us this way forever,
and we love doing this important thing for them and for us.  But if this lady
has nursed her baby for 18 months and is tired, I don't see that supercilious
dismissal of that fact is going to help her much.

I feel a little terrified about disagreeing with you at all this way -- I know
as well as we all do how much help your work has given to so many mothers by
supporting them in the fact of other, unsupportive, medical practitioners.
But I do think the key here is support, not goading.

Elisheva Urbas
[log in to unmask]