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Subject:
From:
Magda Sachs <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 31 Jan 2002 09:04:45 -0000
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Interesting report from Canada:  >**** The most common reason for
discontinuing breastfeeding was perceived
insufficient milk, cited by 37% of women who breastfed for less than three
months (NPHS), <

Since this many women are not biologically likely to have insufficent milk,
the question is why the perception / the iatrogenic and cultural practices
which foster this belief/reality.  Pretty complicated, once you start
looking into it -- reasons ranging from misunderstandings about how milk is
made, the normal phsiology of lactation (eg that engorgement, and usually
leaking, subsides after a few weeks if things are going well ) and also a
cultural 'super-valuing' of charted weights of the baby (at least in the UK)
over any other understandings of infant well-being and embodied notions of
breastfeeding 'success', through yardsticks of breastfeeding success by the
clock devised 'in theory' by men of previous centuries, then supported by
mass feeding of infants with the sort of breastmilk subsitutes which would
be banned today.

Another thought about this report (a few years old, from 1998) -- they
consider early termination of breastfeeding to be before 4 months.  [Does
one assume termination of any bf before 4 months is meant?]  In line with
most recent WHO/WHA Resolution and thinking, surely early termination of
breastfeeding is termination of exclusive breastfeeding before 6 months, and
termination of any breastfeeding before 2 years?  This is the global
recommendation.

Despite articles in JHL over ten years old (1991) by Auerbach, Renfrew and
Minchin (now there's a trio of power!) and Helen Armstrong, and a
reminder in 2000 by Miriam Labbok, we are still not very precise about what
we mean when we talk about 'breastfeeding'. --Please insert long rant about
the damage to our understanding of breastfeeding done by the poor
definitions of breastfeeding in so many biomedical studies and even in
qualitative studies.  I will just cite in defense of this rant the
difference in  outcomes between the one study which examined breastfeeding
patterns of HIV+ women (Coutsoudis, et al 1999 and 2001) with all research
in that area which had gone before (and some that has come after).

Also, as health professionals and people interested in infant health and
nutrition, we should be lobbying our governements to enact with suitable
rigour the recommendations in the WHA Resolutions subsequent to the WHO
Code -- eg WHA 45.34 (1992) calls for the use of the common breastfeeding
idicators developed by WHO and other agencies and WHA 47.5 (1994)
reitierates this.

Magda Sachs
Breastfeeding Supporter, BfN, UK

Armstrong, H (1991) Interantional Recommendations for Consistent
Berastfeeding Definitions JHL 7(2) 51-94
Auerbach, K, Renfrew, M and Minchin, M (1991) Infant fFeeding Comparisons: a
hazard to infant health? JHL 7(2) 63-71
Labbok, M and Krasovec, K (1990) Toward Consistency in Breastfeedign
Definitions Studies in Family Planning 21(4) 226-30
Labbok, M (2000) What is the Definition of Breastfeeding? Breastfeeding
Abstracts, LLLI Feb, 19-20
Sokol, E (1997) The Code Handbook ICDC Penang

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