Here on Pohnpei, it is not unusual for a women to use ABM rather than
breastfeed because she believes she is not getting enough to eat and is
concerned that her baby will suffer.

I reassure her that this is not the case, that the baby will do just fine.

What are the implications for the mother's health? I'm referring to women
who have pregnancy after pregnancy (6,7,8,9+) often without the spacing
benefits of LAM. These women typically have given up the  traditional diet
of fish, taro, mango, lime, banana, coconut and so on, for rice, Spam,
ramen, soy sauce, soda pop, ice cream.

Of course, I recommend breast as best and suggest local foods that she likes
to eat.

But I do wonder, will her body become depleted from the stress of
lactogenesis and breastfeeding?

I am not in any way suggesting that not to breastfeed is better. I do not
believe that. I'm just wondering what happens to a malnourished woman's body
with subsequent pregnancies and nursing. And if she is nursing, there is
ususally more than one child at the breast as children do nurse here for
many years.


Lisa Boisvert-Mackenzie, Midwife
East Caroline Islands, Pacific Ocean

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