Hi Rhonda

I'm hoping that Pam and Barb will respond, too, re your question on
breastfeeding difficulties in developing countries.  I am responding
from the tip of Africa and most of my information comes from IBFAN
Africa, based in Swaziland, and from working with Community Health
Workers and others in Khayelitsha.

Yes, we see mastitis and occasionally thrush in "non Western" cultures.
I have heard of mastitis being caused as a result of a mother being
warned not to feed on the breast that baby had burped on.   In
travelling through Africa one is likely to see mothers breastfeeding
almost everywhere, but the sad reality is that less than 5 percent (or
is it one percent, Pam?) of breastfeeding is exclusive.  In two studies
here in South Africa (Soweto and Khayelitsha) most babies received
complementary foods/fluids by 4 weeks of age.  Breastfeeding initiation
is high, but what we would consider as optimum breastfeeding practice is
extremely rare.

The two most common reasons for early supplementation or cessation of
breastfeeding - the same the world over - too little milk, pain.

Urbanization, advertising, and now the HIV issue are further
impacting on breastfeeding.

Jean Ridler  RN  RM  IBCLC
Cape Town, South Africa
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