Greetings from a Stockholm finally emerging from its dark winter (but where winters are hardly colder than, say, New York and less so than St. Louis where I was born). I have been on LACTNET for only a few days but look forward to this means of contact with a growing group of experts on breastfeeding. For 10 years I have commuted 90 minutes each way to Uppsala University (over 500 years old!) where I have a position somewhat equivalent to an assistant professor in the US, doing a bit of teaching and research in International (developing country) Nutrition, but mainly consultancy work for the Swedish International Development Authority and various UN agencies once in a while, travelling a lot to Tanzania and Zimbabwe and occasionally to Bangladesh and elsewhere (recently to Sri Lanka and Brazil). I have been on the ILCA Professional Advisory Board since its inception. My masters degree at Cornell University was based on research in St. Vincent, West Indies on the impact of infant food advertising on infant feeding patterns and on infant health. My wife, Stina Almroth, and I then did research for the UN Food and Agriculture Organization on the economics of breastfeeding in West Africa and later I did my PhD on a breastfeeding promotion program in Yemen. At the Unit for International Child Health within the Pediatric Department of the Uppsala University Medical School, we have recently formed a group of Swedish and developing country graduate students interested in breastfeeding research and are trying to simultaneously learn about key issues, what is going on in the world in breastfeeding promotion, and research methodology. The Innocenti Declaration says women should be "enabled and empowered" to breast feed. The International Code and Baby Friendly Hospital Initiative as well as lactation management training centers and various health worker training courses have made a lot of progress and will continue doing so in the "enablement" department. But what has been achieved in empowerment? I became convinced of the importance of this aspect when I read an article and eventually the PhD dissertation by Datha Brack "Why women breast-feed: the influence of cultural values and pernatal care on choice of infant feeding methods and sucess and breast-feeding," City University of New York, 1979. The recent WHO book "Breastfeeding: the Technical Basis" identifies two areas of breastfeeding protection, support and promotion that should be relevant: mother-to-mother suppport and support to working women. Research is needed to develop "success stories" and eventually models of how to work on these aspects in various cultural/economic settings. This is part of what our group hopes to work on in coming years. I see the type of work lactation consultants do as a sort of hybrid, with each individual consultant having better possibilities of empowering clients than, say, a physician has (who belongs to a professional tradntage), but being more at risk of taking on a disempowering style than, say a LLL advisor. (A "Brave New World" view of what can happen when male physicians gain complete power over women's reproductive health can be seen in Brazil where 65% of deliveries are now caesarian sections --the others take place mainly in areas where the health care services do not reach. A modern, educated Brazilian woman would be frightened and worried if informed that she were to be delivered naturally.) But in all cases, personal awareness of empowerment as an important issue and makiving within. After many years of contact with the Swedish culture I have become convinced that human effort can make conscious change in culture--albeit much easier in Sweden than in a big heterogenous country like the USA. In a democracy where women haal party, the Social Democrats, ran out of excuses and agreed to fill half of all political posts with women. What a shame that the job as head of UNICEF just went to an American woman (good though she may be) instead of her main competitor for the job,n a family bed until they were 7 and 10. For a couple years after that we always laid with them at night until they went to sleep. Now of course they do so on their own and are delightful, independent young teenagers. For the past three years we three trition, based on research in Lesotho, partly dealing with exclusive breastfeeding. Some of you may have seen her recent article in Lancet (March 18) on why home management of diarrhea, including use of ORS to prevent dehydration, was poorly thought through and perhaps has been harmful on the whole (my words) compared to what could have been--encouragement of the use of home fluids to prevent dehydration. Our first child was born in a small hospital on the coast of Finland and we spent his first weeks in a cabin on a nearby island. Lik output--but I realize this will achieve little more than smiles for some years to come... Ted Greiner, PhD Senior Lecturer in International Nutrition Unit for International Child Health, Entrance 11 Uppsala University 751 85 Uppsala Sweden pho5198 fax +46 - 18 515380 home phone +46 - 8 191397 (can be used as fax also)