The various observations expressed on this phenomenon have had me
fascinated.  I was especially interested in Dr Jack Newman's observations
that the baby nurses, then pulls away, then sucks hand, cries, baby's weight
may remain static, or even decrease, etc.  And Lisa Marasco's theory that
early "routine" breastfeeding (7 - 8 times per day) may lead to a reduced
breastmilk supply later, say at 4 months.  I'm convinced that these are all
tied in together.  That it is the *management* of the early period of
lactation that sets the "tone" for later lactation, and that this is tied up
with the whole mother-baby relationship.

I see quite a lot of what could be termed *potential* nursing strikes" at
around the 3 - 4 month mark, and recently one at 2 months.  If the mother
was less sensitive it seems that they could become full-blown, but at this
stage there are only "soft" signs, as Dr Jack describes.  A history reveals
that the mother may have been breastfeeding with long-ish intervals (say 8
times/24 hours) right from the beginning - she may have been concerned with
establishing a "routine", there may be use of a dummy (pacifier), she may
lead a busy life or have many other commitments on her time, other children
to run to school etc. It's as if the baby becomes programmed to comfort
himself in other ways - rather than at the breast;  he will *feed* at the
breast, but pulls away and cries when the flow slows down, he treats the
breast almost as a cup, only drinking when the let-down is fast and gives up
when it stops, and will not comfort-suck (which would trigger another
let-down etc.)  My theory is that this causes less-than-optimal drainage
over time, leading to a reduced breastmilk supply, leading to lowered weight
gain etc etc   It may take quite a while to develop into a "problem", but
eventually the mother realizes that something is up, and seeks assistance -
or starts introducing solids or supplements as the case may be.

To reverse this I explore with the mother ways that she can find to give the
baby her undivided attention for a long block of time, several days to a
week, and then we go through all the strategies for resolving a nursing
strike, "wearing" the baby while she's doing other things, keeping him in
close body contact, playing with him a lot, sleeping with him, and offering
the breast very frequently - any time he wants to suck, dark quiet room,
favourite position etc. keeping him as *happy* as possible.  I see that
others have mentioned this too, so we're all having similar gut-feelings
here.   I stress the need for frequent and efficient drainage to stimulate
increased breastmilk production and point out that this is very manipulative
- she is working towards "seducing" the baby into thinking that she is just
one large delicious comfort-object.  I find that the whole mother-baby thing
undergoes a metamorphosis because the mother becomes so sensitive to the
baby's needs AND the baby starts breastfeeding well again including
comfort-sucking to go to sleep with.  The mother often realizes to her
horror all the small ways that their relationship was being sabotaged
before.  At the end of it I urge her to treat him like Dresden China for a
while and to be alert to signs that the baby is drawing away from her again.

One last thought - I think that Peter Hartmann's fascinating studies on
storage capacity of the breasts - are also relevant.  We were lucky enough
to have Peter here in Zimbabwe a few years ago and I asked him if he had
done any studies on the relationship between engorgement and later storage
capacity and he said he hadn't.  But my observation is that it is the very
frequent and very thorough drainage of the breasts in the early weeks (and
very prompt attention to potential/actual engorgement) that leads to a large
storage capacity later.  Those mothers who dive right in at the deep end in
those crucial early few weeks and feed the baby "every time he squeaks" seem
to have babies who may go much longer intervals between breastfeeds in the
later months because they obtain *so much* milk at each breastfeed.  If I
have the chance early on I urge them to treat the early weeks as an
"investment" in their future breastfeeding success.

Sorry so long, hope others will contribute to this thread too.

Pamela, Zimbabwe