Chris, you said
>I have a young woman who only gained 8 pounds during pregnancy who says she
wants to bf, but tells me she gets nauseated every time the baby latches on
and is repulsed when comes time to actually feeding.  I suspect that there
may be a history of sexual abuse, but she hasn't revealed it.<

I wouldn't suspect that before I'd tried telling her about the gastric
hormone response to suckling which can make non-anorexic mothers feel
nauseous unless they eat as they go to feed and so alter stomach
contents..Nausea and even vomitting can be a response to suckling. This
nausea is a biological phenomenon, not a psychosomatic one. Read the
Widstrom et al work: search Medline by Widstrom AM and Uvnas-Moberg K and
you'll find the basic articles.And like other hormonal responses I expect
this can be conditioned to occur when one even thinks about the event that
triggers it in reality...

And who knows, if she wants to breastfeed and you tell her her body is
saying it wants her to eat before and during breastfeeding, we may help the
anorexia problem. Also, investigate these mothers for history of food
intolerance: pregnancy can lead to decreased appetite for "good" foods to
which they are intolerant, feel averse to, and so cut back on food intake
without realising the basis for their reduced intake.

Of course you may also be right, but what I'm proposing (hormonal responses
and food intolerance) are guilt-free and fixable explanations that make
breastfeeding success more likely than unacknowledged conflict over past
sexual experiences...

Maureen

Maureen Minchin, IBCLC
5 St, George's Rd., Armadale Vic 3143 Australia
tel/fax after March 1: 61.3.95094929 or 95000648