Kathy, I appreciate your comments and I do understand the problem with women
assuming that they "just don't have enough milk."

<<We get up in arms because most of the people promoting this 5%
figure *don't* realize/admit that any of it is iatrogenic or culturally
based.  They insist that 5% of women everywhere just can't produce enough
milk, and that is has nothing to do with management or drugs or anything
else.>>

However, as I see it, the danger with not wanting to recognize that a problem
may exist is that no one is looking into the reasons *why*.  It frustrates me to
no end to have no answers for women who really want to breastfeed, never had any
reason to doubt that they'd be successful (after all, everybody can breastfeed)
and end up not being able to produce a full milk supply.  I guess I've always
assumed lactational capacity was kind of a bell curve (at least in our
society)--most women do just fine, a few are major overproducers causing
problems for their babies, a few make milk but not enough to sustain their
babies, and only a tiny fraction don't make any or just drops.  Looking at my
population, we have about 65 breastfeeders/month at my hospital.  5% would mean
3/month unable to produce enough milk.  I'm sure I deal with 1-2/month on an
average, and not all mothers are motivated enough to seek help if things aren't
going well, so I could easily believe there's another 1-2/month that I'm not
seeing.  Like I said, my clients have access to easy, early help, so I feel like
I can most often rule out mismanagement or lack of stimulation as a cause (not
that I don't see those, too).  I'd really like to have some answers for these
women, not pretend they don't exist.

Regards,

Becky Krumwiede, RN, IBCLC (looking forward to reading your book that came today
in the mail)
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