Sue Huml writes:

>In Dr. Ziemers previous study (JOGNN Voll 22 No 3 May/June 93) she found that
>Skin changes in the nipple were visible in 100% (20) of the sample, and 65% has
>severe skin damage and 90% reported pain.  (she did NOT offer positioning or
>latch-on advice).  Many have said her study is not an accurate portayal of the
>average breastfeeding mother, however, there are still the majority of women
>(worldwide) who get no LC help or advice at all upon the initiation of
>breastfeeding, so perhaps her women in the study are more representative of the
>normal breastfeeding woman that we would like to think.

I want to point out that the majority of women worldwide don't *need* LC
healp or advice upon the initiation of breastfeeding because everyone in
their culture breastfeeds, for many years, openly, in front of them, and so
girls grow up seeing how to do it properly from their earliest moments.
They don't need LCs because everyone knows how to position the baby
properly, how to deal with the little problems that come up (latch-on,
tongue-tie, etc.), and have numerous very experienced older female
relatives, friends, neighbors, and medicine women to turn to for help if it
is ever needed.  They also don't have sleepy babies because they have no
drugs during labor, and they don't have nipple confused babies because there
are no artificial bottles, etc.  Of course, when it comes to things like
preemies, the babies die (no oxygen, no IVs, no antiobiotics available) so
those issues don't present themselves either.  I saw one case of cracked and
bleeding nipples in my 2.5 years of research on breastfeeding in Mali, West
Africa, and NO reports of any difficulties breastfeeding whatsoever.  There
was one woman who supplemented because she had "low milk supply" due to
having lost a lot of blood in a car accident 15 years previously (some
Bambara women believe that the blood is not replaced if lost due to injury,
and that the blood serves as the source of the breast milk).  There was
another woman whose 6 month old was very malnourished and dehydrated and the
mother said she had no milk -- she *did* have terrible asthma, on the edge
of the Sahara, during the Harmattan (windy) season.  There was also a child
with a bilateral cleft lip and palate, alive at well at 3-4 years of age,
having been breastfed as a matter of course.

Note that these comments have nothing to do with the issue of helping women
find pain relief and cures for sore/cracked nipples.  I thought Sue Huml's
post was very informative.

Kathy Dettwyler