First, I want to underscore Nikki Lee's important point:  women have 
breastfed successfully throughout millenia of stress of all kinds.

Second, malnutrition and stress can occur together, but are two separate 
variables. For malnutrition, there are decades of research 
papers--starvation used to be an unavoidable part of the natural cycle. 
Unfortunately, it is now perpetuated for different reasons, but still, 
it is happening, and the data is there to support successful 
breastfeeding up to the point of maternal starvation. I would like to 
believe that our clients will not be faced with actual unavoidable 
starvation, except in the most unusual circumstances.

For stress, an examination of human endocrinology convinces me that it 
is both our behavior changes in response to stress, and our beliefs 
about stress and its impact on breastfeeding, that adversely impact milk 
supply, rather than the stress itself. In the "picture is worth a 
thousand words" category, recall the magazine cover in which a Balkan 
woman is fleeing tanks and bombs, and breastfeeding as she runs.

Arly Helm, MS, IBCLC

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