Lisa Marasco writes:

>Subject: 5% number
>
>I am so glad to read the debunking of this myth, since I never really
>believed that nature messes up in 5% of humans but not other mammals. I am
>wondering, however, why we do have some legitimate problems. After all these
>years, you would think that natural selection would have bred these errors
>out, but we do have our share of women who have pituitary, thyroid, hormonal
>and hypomastia problems. Is it subtly iatrogenic? What should the real number
>be? (K. Dettwyler?)


I don't know what the "real" number would be if everything was done
properly.  I do believe there are some women with "primary mammary
insufficiency" -- all you LactNetters out there in the trenches have
convinced me of that, especially in the very similar descriptions you all
gave last summer about what these breasts looked like.  Could it be that
failure of the breast tissue to develop completely is due to lack of
breastfeeding in childhood?  In susceptible women?  An interesting thought.
Certainly in Mali, I never met anyone who didn't have enough milk, or who
knew of anyone else who couldn't breastfeed, but Mali was a country where
bottles had *not* caught on yet.  In many other countries that have been
influenced by the multinational infant formula companies, women seem to
think they have insufficient milk in droves.  I take back what I just said
-- I did know one woman in Mali who supplemented her breast milk with
bottles because she had been in a car accident 15 years previously and lost
a lot of blood.  And the Bambara people of Mali believe that milk is made
from the blood, and that the blood is irreplaceable -- so if you lose a lot,
you won't have enough for your babies.  This didn't stop her from
breastfeeding as much as she thought was possible.  Malian women say this is
why women who have had many children "get old faster and look dried up"  --
they've turned all their blood into milk!

I think Linda Smith is definitely onto something when she asks how many of
the cases of "lactation failure" come from children who have weak,
ineffective sucks.  And how many of those are iatrogenic, from drugs during
labor, deep suctioning, mother-infant separation after birth, etc.  Our
standard practice in modern U.S. hospitals is so fundamentally foreign to
what the baby-mother pair have evolved to expect, that it is amazing how
often it does work well!  I would think that prolonged mother-infant
separation and lack of stimulation of the nipples in that critical hour
after birth might send a message to the mother's physiological systems that
"this birth didn't result in a baby -- put a halt to the gearing up of the
milk producing system."  Then when baby is put to breast, hours later, full
of drugs so sucking ineffectively, etc., it may be too late for full
lactation.  In other words (and I'm truly just speculating here) there may
be a window of opportunity in the first hour(s) after birth during which
stimulation of the nipples by the baby, with strong effective sucks, has to
occur in order for the *normal* progression of milk production to take
place).  I'm not sure how one would test this....

Interesting to think about.

Kathy D.