What I haven't yet seen reflected in our discussions is the notion 
that there is no distinct line between 'can produce suffcient milk' 
and 'cannot produce sufficient milk'.

There is no clear definition of 'sufficient milk' I am aware of, 
beyond the idea that 'sufficient' milk enables the baby to survive, 
thrive and grow.

How fast do we'demand' that babies grow? We have all seen and heard 
of babies being supplemented with formula because their growth rate 
did not match what they were 'supposed' to be achieving....maybe that 
growth rate was physiological to them? Does that mean the mother did 
not have sufficient milk? Or what about mothers whose supply always 
sees to be low, no matter what she does, and her baby seems to be 
growing slowly and even looks skinny? The baby may be basically ok, 
but admittedly undernourished. His weight may correct itself later, 
when he's not relying on breastmilk alone. Maybe the mother did not 
make sufficient milk for the baby to 'thrive' but would she be 
classed as not being 'able' to breastfeed?

There's got to be a continuum, surely? Mothers at one end making vast 
amounts of milk whatever happens, because of some underlying 
physiological 'generosity' of cells, glands, hormones, leading to the 
majority of mothers who happily make sufficient for their infants to 
thrive and who regulate their supply to 'fit' the requirement, with a 
few mothers struggling but managing to do this with 
help/intervention/treatment, and with these blending into the smaller 
number who are struggling even more.

In addition to all this you have the other half of the partnership - 
you can never have 'just' the mother's physiology, 'cos you have the 
baby's as well, exerting his own influence on her lactation 
performance.

Oh, and the environment they are both in - supportive and informed, 
or rigid and uninformed - which has an effect on the whole thing, too.

I have no idea how anyone can draw a line. Some of the '1/3/5per 
cent' of mothers who 'can't' make sufficient milk might be able to 
make sufficient if (for example) they had a baby who was not 
pre-term, not tongue tied, not jaundiced etc or an environment which 
'allowed' uninterrupted contact, or a more effecive 
expression/pumping regime, or higher levels of self-belief and 
confidence, or a mother/partner/friend who did not sabotage her 
efforts, or a great midwife, or a wonderful postnatal breastfeeding 
supporter, or access to quality info from the internet.

Too, too many variables for dogmatic percentages!

Heather Welford Neil
NCT bfc, tutor, UK
-- 
http://www.heatherwelford.co.uk

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