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Subject:
From:
Rick Gagne & Elise Morse-Gagne <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 11 Dec 2003 09:28:29 -0500
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Lara writes,


>In other words, 5% of the population had genuine low milk supply that
>wouldn't necessarily be prevented with good postpartum support and
>information? That's "very common" in  my language, not "extremely
>rare".

While some cases of low milk supply are preventable (like retained
placental fragment or cosmetic breast surgery done w/o respect for breast
function) others may actually reflect health care successes, not
failures.  A woman with infertility problems which also impact lactation
might succeed in having a baby, with lots of medical help, and then need a
similar level of assistance for breastfeeding.  It's *good* news that some
breast cancer survivors go on to have babies, but some will be unable to
breastfeed.

It's kind of like saying more and more people are dying of heart
disease.  Once you've made sure most of the population lives to age 50 by
ensuring they aren't killed by accidents/overwork/starvation/childbirth*,
people are going to start having the opportunity of dying of old age instead.

Seems to me there are several intertwined questions to ask:
(1) Can a particular mother's low milk be increased through breastfeeding
management alone?
(2) Is it entirely *due* to breastfeeding *mis*management, or are there
physical factors causing all or part of it?
(3) Where physical factors underlie low milk supply, are they preventable
and deplorable, or are they unavoidable and maybe even reflect a medical
success? This is a complicated area (again, breast cancer rates are
themselves susceptible of improvement through many approaches incl.
breastfeeding) but I think it's worth pondering the relationship between
the different factors.  Bottom line, in one population there might really
and truly be 5 women in 100 who have insufficient milk, while in a
different population the number might really and truly be 1% or lower --
but I think it's worth questioning whether that *necessarily* means the
second group is doing everything better.

*Childbirth: I might have ruffled feathers by listing this.  In colonial
New England, childbirth was demonstrably a major cause of death, maybe
especially in frontier towns where midwives and even neighboring women were
few and far between, and women had staggering workloads.

Elise
LLLL, IBCLC
who had a homebirth and would do so again in a heartbeat.

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