Ah Karleen has blown another of my Lactopia delusions.  

When I looked up the figures for exclusive breastfeeding in West Africa and discovered the 
shockingly low rates of exclusive breastfeeding among infants under six months of around 20% it 
was incredibly depressing.

Hopefully Rachel will confirm that Norway is still the Lactopia of the world.

Also, I must thank Karleen for her wonderful discovery of the odds ratio error in the mortality 
study.  I went to a wonderful conference where Thomas Hale was speaking and he too just used 
the figure of the 21% increase in death rates among nonbreastfed infants.  So, I pointed out the 
epidemiology of the odds ratio and how many of us had missed what she alone spotted, that the 
increase in the death rate is really 26.6% when you flip the odds ratio.  I gave her full credit for this 
when I took Thomas Hale aside to explain it to him.

As a weird cultural phenomenon, I just saw a mother who grew up in the Netherlands.  Her mother 
has been pressuring her to buy a scale because apparently EVERYONE had a scale and weighed 
their babies all the time to see what their babies got.  I forgot to ask where in the Netherlands. 

This was one of those hot sticky days in Manhattan and going up and down the steps I really was 
resenting the scale.  Anyway, when I got there and discovered that she was an oversupplier I was 
really annoyed at the scale because it was unecessary, but she the mother was pleased because we 
used the scale to get the numbers to convince her mother that she really didn't need to buy or 
rent a scale.  The price alone was another good bit of data that she will give to her mother to get 
her off her back.

Gonneke, aren't you in the Netherlands?  If you are and that is how scales were or are used I 
certainly can see why you feel the way you do about scales.  

Finally, I had one of those zebra moments in Rachel's comments about weighing our food all the 
time.  Of course it would be absurd.  But we do sometimes step on the scale to check out whether 
we need to cut back a bit in our consumption. And no one who properly uses a scale or has any 
common sense at all would ever recommend that kind of obsessive weighing for any purpose but 
research and then it would be informed consent.

Then I remembered how irritated I was feeling about 16 mm nipple shields because I have to mop 
up after their misuse all the time with failing to thrive babies and induced low supply.  I was 
thinking why would anyone ever use them for any purpose let alone before the milk came in.  But I 
dutifully read some of the posts from people who did find those situations when they were useful.  
The same week I actually had one of those cases where a mom had been given a 16 mm nipple 
shield and I had to eat crow about my previous attitude about those 16 mm nipple shields as the 
root of all evil.

So, please take this one in the light it is meant.  When Rachel mentioned the obsessive weighing 
scenario, I remembered a very intuitive LC that I had trained with.  La Leche League background.  
Flexible in many areas of her life and certainly flexible with her clients.  She had a severe problem 
with obesity and went to Gray Sheeters - a program similar to overeaters anonymous.  Amazingly, 
she did weigh every bit of food before she ate it.  If you saw her you would never ever think she 
had ever been obese.  She had maintained a normal weight for many many years.  While many of 
us would think this was the height of insanity, it clearly worked very well for her.

Best, Susan

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