I like Gonneke's comments about measurability not being everything.  In
fact, the "point" of lactational amenorrhea is to provide appropriate child
spacing based on the neediness (or not) of the older child.  22-month-old
twins, presumably (in this culture) with an older mother?  *Definitely* not
time to be adding another child to the mix.  It would diminish quality of
care for all 3 children and very likely run down the mother's health (at
least as her body and the WHO view the situation).  Amenorrhea sounds to me
like an eminently sensible physiological response - one for which there's no
need at all to be looking at hormone levels.

She could, of course, wean, so that her body thinks the twins are much older
and much more capable than they really are.  But then she's stuck with the
unavoidable realities of all those closely-spaced children.

When systems are working as they're meant to, it's usually a mistake to look
further.  I love the story about the early days of C-T scans, when they were
looking for volunteers in order to see what normal looked like.  In a few
cases, totally normal involved a *dramatic* absence of brain tissue.  So
what?

Diane Wiessinger, MS, IBCLC, LLLL  Ithaca, NY






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