At our hospital, we serve women who belong to a small Christian sect which among other things doesn't practice contraception.  Mothers of 10 or more babies can turn up.  This group breastfeeds from birth but uses supplements readily at the first sign of baby needing feeds oftener than every 3 hours.  At the moment, we have a mother with her 9th baby on the ward.  She has for the last 6 or 7 kids always requested that baby be in nursery at night, is adamant about getting a full night's sleep while in hospital-- 4 days is a routine stay here-- and equally adamant that the baby not be given anything but water if it cries.  This time we refused, and said that she was welcome to sleep, but her baby has a right to food when he's hungry (birth weight 11 pounds, no maternal diabetes) and she could decide.  She chose formula at night without batting an eye.
Given the lives this group of women leads, I don't find it hard to understand how they choose what they do.  It disturbs me to see mothers who are so exhausted that they can't even muster a smile for their babies before they leave the maternity ward, and who let their 12 year olds do all the baby care except breastfeeding.  There are exceptions, but we can pick out these ladies at a distance because they are so TIRED.  It is hard to talk up BF enthusiastically, because the constraints on exclusive BF include needing to care for your four other children under school age.  But if exclusive BF were a stronger community value than family size, the mothers would probably only be here every other or every third year, and not annually.  And who would suffer from that?
Rachel

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