Regarding PPD and breastfeeding, and epidurals and
breastfeeding, and allergies and breastfeeding.....

I think that it can be counterproductive in these and many other
discussions to rush to the immediate conclusion that
breastfeeding/breastmilk can never have a negative bearing on the
outcome or, in the case of epidurals, that they are inherently evil
and to be avoided at all costs.  Yes, many potentially successful
breastfeeding experiences have been sacificed on the alter of
ignorance and it will always enrage me when that happens.  And
many bad things blamed on breastfeeding/breastmilk are due to
bad management, not the act or the milk itself.  This harkens back
to the ignorance factor as well.

That said....  Through these many years of working with so many
moms and babies, it is evident to me that the interaction between
mother and baby, mother and her own body, breastfeeding and
breastmilk - all remain extremely complicated and still, not well
understood.  I think that it is very likely, and I have seen it myself in
some moms, that breastfeeding does contribute to depressive and
other uncomfortable and sometimes debilitating symptoms -
sometimes through the hormones of MER, sometimes estrogen
levels, etc.  Just because the majority of moms find breastfeeding
to be a pleasurable experience, does not mean that we cannot
allow for the small majority that do not find it to be so, on a
physiological basis.  And we don't need to go around digging up
studies to prove that breastfeeding cannot possibly be causing
their problems (no offense to all who have done research showing
the physiologic benefits to breastfeeding - important information for
all of us to have).  I have also seen babies nursed under the best
management practices who definitely did better by almost any
parameter when switched to a predigested formula - again, a very
small group, but certainly known to any of us who have been in this
field for any length of time.  Why are some babies so sensitive to
any of the proteins or other substances in mother's milk, even
under extremely restricted diets?  I don't know and I hope that we
can someday find a way to alter mother's milk so these babies can
do well on it.  But to tell a doctor or mother that a baby is better off
breastfeeding even when he is screaming most of the time, not
gaining well, never content and the whole family is a disaster area
because of it.....  There is a reason why people think that some of
us are just plain unreasonable (not withstanding the other side of
that particular coin :-)

The more I learn, the less I know.  In some ways, I have become
much more stubborn and unyielding in the areas in which time,
experience and research have pointed me towards almost
inescapable conclusions.  But I am more willing to admit that there
are things about breastfeedling that I still really don't understand at
all and am open to all information and conjecture.  One of the best
things about Lactnet is that it has helped me to reach some of
these inescapable conclusions and opened my mind to the wide
range of normal and abnormal throughout the world, past and
present.

We continue to learn (and wonder) together.

Respectfully,
Sharon Knorr, BSMT, LLLL, IBCLC
Newark, New York (near Rochester)

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