LacNetters --

Pamela wrote: "The Pakistani twins picture definitely originates with UNICEF."

The photo doesn't *originate* with UNICEF, nor does UNICEF have the
exclusive rights to this photograph.  Patricia Stuart-Macadam and I used it
in our book, Breastfeeding: Biocultural Perspectives, with permission from
Dr. Mushtaq A. Khan, Pakistan Institute of Medical Sciences, Islamabad,
Pakistan.  UNICEF may have some sort of arrangement to approve (or not)
other people's requests to use this photograph, rather than having to
contact Dr. Khan, but one can also write directly to Dr. Khan for permission.

This photograph has appeared in *many* places.  I first saw it on a research
article by Dr. Dorothy Mull (anthropologist), many years ago.

Pamela continues:

>However, even if
>she found that she could not produce sufficient milk - unlikely as that
>would be - a much better alternative to bottle-feeding would have been to
>find a wet-nurse.  Ironically, this role has sometimes been taken by the
>grandmother.

Wet nursing by the *paternal* grandmother (the mother-in-law) is NOT common
cross-culturally.  It would usually be the *maternal* grandmother who would
offer to nurse her daughter's baby if the need arose.  There are very
culture-specific rules about who can nurse who-else's baby, depending on the
relationships among the individuals involved, as breastfeeding a baby
creates kinship between the baby and the provider of breast milk, as well as
all the provider's relatives.  See "More than Nutrition" by me, in Medical
Anthropology Quarterly, 1989.

Again, Pamela writes:
"The breast which is being nursed from is about 4" lower than the other one,
>which is small-ish, so it wouldn't "droop" that far.

Pamela, I think you are misinterpreting the photograph.  What can be seen
clearly in a good color print is that the mother's sari is patterned, and
what you are thinking is the bottom of her right breast is really just a
place where the pattern of the sari changes.  There is no way to compare the
size of her left and right breasts from the photograph, nor is this
particularly relevant, I wouldn't think, as many women have asymmetrical
breasts, especially when lactating.

Pamela writes:
>She has her hand
>supporting the back of the breastfed baby's head, but she is not touching
>the dying baby at all, in fact her hand is turned away from her - this
>strikes me as very posed and unnatural in the circumstances - the baby is
>mortally ill, and she would feel protective - and I have always wondered if
>the bottle-fed baby is already dead.

Pamela, you are probably mistaken in how a mother in these circumstances
would feel toward a baby who was this sick and certain to die.  Women who
have multiple experiences of children dying (many mothers in the Third
World) and who have little control over their lives and little access to
resources *know* that children have to be strong willed and spirited to
survive under the conditions they live in.  Mothers will often make an
evaluation of the chances of a particular child, and if they don't think
that child is likely to make it, they will scale back on their investment in
the child -- both their emotional investment and their investment in
resources (food, medical care, time).  This is a well-described phenomenon.
Probably the best sources if you want to read more about it are:

Child Survival, edited by Nancy Scheper-Hughes, particularly her own
chapter, titled "Mother Love and Child Death" which I often use in classes I
teach

Child Survival : Anthropological Perspectives on the Treatment and
Maltreatment of Children (Culture, Illness and Healing Series) by Nancy
Scheper-Hughes (Editor), December 1987, D. Reidel Pub Co; ISBN: 155608028X

AND

Death Without Weeping, by Nancy Scheper-Hughes

Scheper-Hughes research was done in a very poor area of northeastern Brazil,
and is absolutely heartbreaking to read.  Her book Death Without Weeping won
a bunch of prizes when it came out.

Death Without Weeping : The Violence of Everyday Life in Brazil
by Nancy Scheper-Hughes, Reprint edition
(September 1993) Univ California Press; ISBN: 0520075374

Her conclusions have been controversial, but I can verify that they ring
true to me, as someone who has also done research among women who lose many
children to death under circumstances beyond their control.

She also has a brand-new book out,
Small Wars : The Cultural Politics of Childhood
by Nancy Scheper-Hughes (Editor), Carolyn Fishel Sargent (Editor)
Paperback - 464 pages (November 1998) University of California Press; ISBN:
0520209184

It is interesting that I, having seen similar conditions and behaviors among
some Malian women and having read Scheper-Hughes work, never paid any
particular attention to the fact that the mother is not touching her dying
daughter.

Kathy Dettwyler