My compliments to Karleen Gribble for thinking outside the box on the issue
of why Western women typically have difficulties in inducing full milk
supplies.  I HATE the "blame the victim" invectives that imply that either
these women didn't try hard enough, didn't believe deeply enough, or that
their helpers (us!)  didn't plant enough positive suggestions and in some
way undermined the process.  I've seen a lot of adoptive couples, prob. 5-10
each year pver the past 16 years that I've practiced (and in the 5 yrs prior
to that as a LLL Leader).  While I believe the reports I have read in the
lit about women elsewhere making full supplies,  I've NEVER seen a full milk
supply produced by an adoptive mother.  I've seen MANY mothers who tried
heroically, did everything they could, believed with all their hearts, and
had supportive cheerleaders (including me), and they generally made some,
but never all the milk their babies needed.

Some of these women had hormonal reasons for infertility, and I think those
issues impacted their ability to lactate fully.  This is perhaps makes them
different than the cases of re-and induced lactation in the developing
world.  Many of these descripptions may be perfectly of normal women (in
terms of hormonal status) who are adopting orphaned infants.  So that is
probably a confounding factor.

But I think Karleen is onto something with the issue of the body weight.  We
know that weight is an issue in terms of time of onset of menarche,
resumption of ovulation following pregnancy, and maybe it is even an issue
in when women enter menopause.  There was an article on the front page of
our local paper just yesterday reporting on the study linking obesity to
relative risk of developing cancer, and I found it interesting that the
effect was more striking in women than in men, and that the types of cancers
are those influenced by higher ciruculating levels of estrogen.  Excess body
weight increases estrogen levels, and estrogen is a lactation suppressant.
Perhaps there is not just an alteration of prolactin (which would influence
the number of target receptors in the breasts?) but also some sort of
over-ride by the higher estrogen levels.

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com

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