So sorry to have been gone for so long from LACTNET.  I found Dettwyler's
post about the 5% figure of women unable to breastfeed too compelling not
to add to.

It is potnetially quite dangerous to extrapolate to the general population
from a particular lactation clinic population.  I will use myh own practice
as an example.  In 1995, close to 30% of the women I saw (nearly always
"last resort referrals, i.e, if you can't fix it I'm quitting") had
insufficient milk. Some due to poor infant suckling patterns, some due to
primary breast insufficiency.  In 1996 in the first two weeks, I ahve seen
7 women for visits unrelated to pump rentals or other equipment concerns.
Of those 7 women, 3 (42%!) were referred to verify primary breast
insufficiency.

Does this mean that 30-45% of women have this particular problem? Of course
not. It simply reflects that I receive referrals for this particular
problem to a (probably) greater extent than others in their practices.

For Neifert to extrapolate from her clinic population (surely also one that
receives referrals from other LCs and MDs, etc for serious difficulties) is
inappropriate and not a true picture of the general population at all. The
only way to generalize from any clinic population is to VERIFY that it
truly reflects the general bf popuatlion from which that clinic population
derives.  I do not know of any data published by Neifert and colleagues
that verifies such a closeness of fit.

PS another 30% of the mothers I see are attempting to induce lactaiton.
Does this mean all kinds of adoptive mothers are breastfeeding? maybe,
maybe not. Again, it simply relfects one of my areas of specialization.




Def. of LC service: "We are all faced with a series of great opportunities
brilliantly disguised as impossible situations."
Kathleen G. Auerbach,PhD, IBCLC (Homewood, IL)- [log in to unmask]
WEB PAGE: http://www.mcs.com/~auerbach/lactation.html