I would like to share some thoughts that I've had about a subject that Toby
Gish raised.  I work with a population of Orthodox Jewish women in New York
State who often also have large families.  In the past two years I have had
4 cases of, what I beleive to be, insufficient milk syndrome in this
community.  All three women successfully breastfed their first 5-7 children
but had milk supply problems with the last one or two.  One woman had
problems with her 15th child but never before.  One of these was a home
birth with the mother breastfeeding almost constantly for the first 6-7
days, all other children out of the home for the week, lots of reast and
good food.  She has had difficulties nursing her last child but felt it was
because of poor management in the hospital.   She has been using an SNS for
7 or 8 months, never having made a full supply.   Fortunately, her sister is
also bf a child and she is getting donated breastmilk for her baby.  Anyway,
I have also wondered about this.  I also see many women who nursed
successfully the first few children and then end up either breastfeeding a
short time with later children or completely weaning.  I often wonder if it
is management or true insufficiency.  Having so many pregnancies and nursing
must have some effect on the mother's body.  Is it hormonal-many times these
moms are older by this time, or perhaps just the effect of all the
pregnancies on one's body.  I'd love some feedback on this.
BTW-all of you in Israel.  I'll be in Jerusalem from 2/22 till 3/1-Wanna
have lunch?
Barbara Leshin-Zucker,IBCLC
Highland Mills, NY
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