>I would like to explore this further, particularly in the first few =
>weeks of the baby's life, when most mothers will not be engaged in =
>physically demanding chores.

I'm not sure which cultural context you are referring to.  In some places,
moms only get 3 days, in other 8 days, in others 40 days of respite from the
birth of a child, and then it's back to working in the fields, hauling
water, collecting firewood, pounding millet, etc..  In Mali, it is 8 days.


 So I can't really imagine how =
>this type of feeding - a brief suck several times an hour, round the =
>clock- happens.

Baby is in mother's arms or on her back, and baby just nurses whenever it
wants.  Mother stops what she is doing to assist the baby in the early days,
but by several months, baby is expected to do a lot of the work of finding
and holding the breast on its own.  In Mali, the case with which I am most
familiar, a lot of a mother's work -- including selling in the market place,
and processing and cooking food, braiding each other's hair, beadwork,
basketry, etc. -- is done while she is sitting on a low stool.  Her knees
are higher than her butt.  Baby lays on her lap, but isn't "held" so her
arms are free.  Her breasts are readily available to the baby.


  The ''noble savage'' myths don't tell of high =
>maternal and infant mortality rates from preventable causes.  What =
>happens to the babies in these cultures, where frequent feeding is the =
>norm, in the establishment of breastfeeding?

Of course there is more maternal and infant mortality in Mali than in the
US.  In terms of the establishment of breastfeeding, if it doesn't go well
and there is no one to wet-nurse the baby, then the baby dies.  Some babies
die of neonatal tetanus and other diseases.  But the vast majority of babies
have no trouble at all "establishing breastfeeding" -- it isn't even an
issue.  The baby is born, it nurses.  Women have grown up seeing hundreds if
not thousands of women nurse their babies and everyone knows all about it.

>That was 1972.  Within 6 months of finishing midwifery training I gave =
>birth to my first child.  My memory of the first breastfeed, within =
>minutes of the birth, are quite clear - the baby wanted to nurse, and =
>had no knowledge of "3 minutes''.  At that point I discarded the timed =
>feed routine, and let the baby lead.  I have seen the same process many =
>times, in several countries.  Then a long sleep, eager feeding, followed =
>by sleeping which is deep and no amount of prodding would make the baby =
>take the breast.

I suspect, but have no proof, that the long and deep sleep that some/many US
babies engage in during the first few days of life *may* be the result of
more prolonged and traumatic labors than most babies experience in many
other cultures.  We do a lot of interventions that prolong labor, including
just taking the mother into a situation which is totally foreign and
surrounding her with strangers and taking away all or almost all of her
control -- then we put her on her back, do invasive procedures such as
vaginal checks, IV's, fetal monitors, etc.  Surely there must be research
out there documenting differences in labor times in hospital vs. home births
in the US.  So you hae a stressed baby, sometimes even a drugged baby at
birth.  Add to that the fact that there is much more cephalo-pelvic
disproportion in First World births, due to the better health and diet of
the mother during pregnancy, leading to really big babies with really big
heads, so the baby takes a longer time to be born and perhaps is more
squished/stressed during the delivery process than a smaller Malian baby
would be.  Women in Mali mostly give birth at the local clinic.  They stay
at home until almost time to deliver.  At the clinic they walk or sit until
delivery is imminent, then they deliver lying down, and then they get up and
walk up the stairs to a bed.  They get no labor drugs, no IVs, no fetal
monitoring, and after the first time, they are used to the context -- even
though it isn't at home as their mothers probably did it, they have many
children each, so most of the children are born to experienced, multiparous
mothers.

My last baby was 9 lb. 2.5 oz, and had major shoulder dystocia.  He nursed
soon after delivery and then fell into a very deep sleep for many hours.  He
had a very traumatic birth.  I suspect that sort of situation is rare for
birth in many traditional societies.


>When a woman lives in a society which does not allow long periods (such =
>as 30 minutes) for the mother of a baby (say 2 weeks old) to nurse, it =
>must be the mother who says "that's enough for now" and take her baby =
>off her breast so that she can get up and stir the pot, or whatever.

Yes, but just as US mothers and babies may seem to fall into a routine of
3-4 hour spacings between nursings, I think Malian mothers and babies fall
into a routine of frequent nursing.

 I =
>don't think the closeness to the mother's body, and movement, =
>necessarily wakes a baby up.  I have had babies sleep for hours in a =
>sling after what I would call a "good'' feed.

Right -- they sleep a long time on a big stomach full of milk.  The babies
in Mali rarely if ever get a big stomach full of milk at one time.  They get
the same amount of milk, but spread out over many meals.  Mothers in Mali
don't worry about how much their babies nurse or how much they sleep.  They
don't "put the baby down for a nap".  Babies go to sleep when they are
tired, or when mother ties them on her back and does something rhythmic like
pound millet or wash clothes, or walk to the fields.  No one worries about
noise or movement waking them up.  In many ways, the babies there adapt much
more to the adult world than vice versa.


>It seems to me that there is an enormous range of lifestyle patterns in =
>breastfeeding that are good enough for nurturing the child.  It also =
>seems that babies who take large feeds and sleep for long periods are =
>not necessarily disadvantaged (ie sensory deprivation).

Well . . . . I'm just saying that long periods of no sensory interaction
with another human being is not typical for primates species in general, and
not typical for most of the human species on the planet.  James McKenna's
work seems to indicate that when babies are left alone to sleep they spend
much more time in very deep sleep, which is one of the risk factors for SIDS.

Katherine A. Dettwyler, Ph.D.
Associate Professor of Anthropology and Nutrition
Texas A&M University
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