I think that one thing we forget is that breastfeeding behavior (as with
other forms of sexual expression) differs from culture to culture.  Having
read with great interest  anthropological studies of  sexual, birth, and
breastfeeding behavior in other times and cultures, I've been struck with
just how varied this behavior can be. I recently watched an old documentary
film about New Guinea which has shots of a woman suckling a piglet.  Drs.
Jelliffe and Jelliffe show a picture of a woman suckling a fawn in HUM MILK
IN THE MOD WORLD. Dr. Dettwyler's 1st book talks about African men being more
interested in the sexual attractiveness of buttocks than of breasts (which
are seen as objects of nurturance, not sexual fetishism.) You speak of the
concern in Sweden of interfering with early breastfeeding by touching the
breasts or of giving 'rule' based teaching. You are lucky to live in a
culture where things are relaxed and breastfeeding frequently enough
practiced for this support-style.

 Here, in the US, where many women may never have seen anyone put a baby to
breast, and who have no visual models for doing so, having 'hands-on' help
may be critical to success. Your point is certainly well-taken that the
public-health requires we treat breastfeeding as normal and don't complicate
it unduly, but as my practice is primarily special situations, I often come
up against the fact that we're swimming upstream against some of our
homegrown cultural issues.I guess my point is that I spent many years
thinking:  If I could just go somewhere where breastfeeding had never been
interrupted and they are doing it 'right', then maybe I'd gain the skill to
salvage some of the sad situations I see in my clinic.  What I'm starting to
think is that maybe there is no absolute 'right' way to do things, just
varieties of different.  We do have to work within the culture where we live,
even as we do our part to help our culture evolve. And I think that
underlying all the cultural stuff is a basic true love-attachment phenomenon
that is fostered by breastfeeding, and that is what we try to access when we
work with mothers.

For instance, I have had a client this week who had fertility problems and
then two miscarriages (on the same day a year apart!)  Her husband told her
he was too upset to go through any more fertility stuff so if she didn't get
preg. within 3 months and carry to term, it was over as far as he was
concerned.  She had a terrible pregnancy,during which they moved. Shortly
after arriving in Austin, she  was hospitalized for asthma (during which time
his company sent him to Japan) She came to me at 2 wk pp after a week of
pumping and bottle feeding, low milk supply, scrawny "colicky" baby, husband
angry because breastfeeding is too stressful for HIM.  She's 38, never
babysat, only child, doesn't even know how to hold the baby.  She asked me
why  the baby was "jerking" when she lays him on his back (normal kicking.)
 This woman had not been allowed to grieve the loss of her miscarried babies,
was afraid to express her anger to her husband, etc. etc. and yet is a very
successful executive -- very assertive in other spheres of her life.

As sad as this story is, I wouldn't describe it as particulary unique in my
experience.  For my practice, its actually a fairly common scenario.  So
helping this woman learn to handle her breasts in a new way, and helping her
learn how to hold her baby naked against her body, and helping her  learn to
read her baby's body language are part of helping her breastfeed.  She needed
to cry and to talk and to be told she could call and come back as often as
she needs to (no, I don't charge for these follow-ups, although  I would if I
were a doctor or a therapist or even a hair-dresser.)  I will feel very very
happy if this woman can overcome and have a successful experience, because I
feel it will be healing for her, and empowering. (Yes, I've ref. her to LLL
and to a counselor and to a massage therapist.)  In some cultures it takes a
whole village to raise a child.  In our culture it often takes a whole
village to rescue a mother FROM THE CULTURE!
Sorry this is so long.
Barbara Wilson-Clay, BSE,IBCLC Austin, Tx