> The schema does not ask whether the breastmilk is given by
>feeding at the breast or as pumped milk via bottle, cup, or other means.

This was written about the Labbok and Krasovec schema.  In fact, the Labbok
an Krasovec schema assumes that all feedings are at the breast -- in fact, %
of feeds "at the breast" is the primary way you distinguish among the
different levels of full (exclusive and almost exclusive), and partial
(high, medium, low).

The best place to find the two current schema (Labbok and Krasovec and WHO)
is in the WHO report "WHO Global Data Bank on Breastfeeding" published in
1996 -- it includes both schema, plus an explanation of all the different
questions WHO asks.  You can probably get one by sending an e-mail request
to James Akre at [log in to unmask] -- but please don't all 1200 of you ask for
one!  Check your local university library first.

Both of these schema, plus a new one supposed being developed by Paula Meier
and associates for use with premature babies who aren't getting their breast
milk directly from the breast, have many ambiguous aspects and
inconsistencies that lead to strange associations.  For example, since the
WHO focuses in part on the produce (breast milk or something else) and in
part on the process (from the breast or in a bottle) you can get a child who
is 100% fed on expressed breast milk in a bottle being categorized as
"bottle-fed" and placed in the same category as someone who is bottle-fed
with formula and someone who is bottle-fed with goat's milk and chamomile
tea.  The Labbok and Krasovec system is based on % of feeds at the breast,
with no consideration of what the rest of the feeds are -- they could be
expressed breast milk, tea, formula, Kool-Aid, bourbon, or turpentine!

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