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Monday, January 13, 2014

Do Adopted Children Want to Breastfeed? Karleen Gribble's Report

After I commented on some recent discussions of breastfeeding for adopted children, Karleen Gribble, of the University of Western Sydney , responded and sent me a copy of her paper “Post institutionalized adopted children who seek breastfeeding from their new mothers” (Journal of Pre- and Perinatal Psychology and Health, 19(3), 217-235). I’m going to comment on Gribble’s paper today.
Let me say first that I’m thrilled to see more observational work on care events in infancy and childhood. I consider this to be a much-neglected topic, and exactly what happens during breastfeeding--  including the many variations--  is rarely given systematic attention. I attempted to do some data collection of my own some years ago, but unfortunately La Leche League (it was at one of their functions that I was observing) was not willing to give permission for this. I also vividly recall being roundly scolded by the journal editor Marc Bornstein for submitting a comment that proposed more such work. I confess that I have not been entirely evidence-based or free from speculation about breastfeeding interaction (www.psychologytoday.com/blog/child-myths/200906/breastfeeding-speculating-wildly), but this is an area where knowing what to observe depends partly on thinking through one’s own experiences and other people’s stories. Nonetheless, it’s the observation rather than the speculation that we need to attain.

In considering Gribble’s paper, it’s important to look first at the a priori assumptions it contains. The author refers frequently to breastfeeding as a causal factor in attachment and attunement, but at the same time concludes the paper by noting that attachment may need to precede breastfeeding. (It is not clear whether this implies that newborn infants who breastfeed must already be attached to their mothers.) In addition to Gribble’s statements in the paper, we need to look at the reference section and see what authors she considered to provide appropriate background for her work; these include Deborah Gray, Mary Hopkins-Best, Terry Levy and Michael Orlans, and Nancy Thomas--- all people committed  to an alternative theory of attachment rather than to Bowlby’s conventional psychosocial approach. In line with this background, Gribble references the so-called “attachment cycle” as a series of experiences that cause emotional attachment (see http://thestudyofnonsense.blogspot.com/2012/08/parsing-attachment-cycle-fox-terrier-of.html for a discussion of this issue). Like other authors who publish in JPPPH, Gribble also references ideas about children’s memories of birth and early life. All of the assumptions displayed here suggest that Gribble is very ready to accept the belief that unconscious, biologically-driven motives and behavior patterns play powerful roles in children’s development even after the first few months of life have passed. She quotes a mother as saying that her child’s need to suck was ”primal”, exemplifying the belief I have just described, and suggesting strongly that some human maternal and child behaviors are best seen as instinctive.

The assumptions I have just described are in contradiction to established conventional views of early development (and of course such conventional views can turn out to be quite wrong, but it has yet to be shown that they are wrong). Conventionally, feeding modes are not considered to be important to development of parent-child relationships, although a parent’s sensitivity and responsiveness to infant feeding cues are important, just as they are in every other area of parent-child communication. Neither is skin-to-skin experience thought to play a strong role in establishing emotional relationships. Infants are not considered to have an attachment to anyone at the time of birth, nor are they thought to have memories of birth or of early life. Biologically-determined infant social reactions are thought to be paramount in the early months, but after that learning from social interactions begins to take over. While initially biological, modes of communication become a matter of learning and therefore are strongly culturally influenced rather than instinctive.  

Understanding the assumptions of Gribble’s paper, and the ways they differ from the foundations of conventional approaches to early development, let’s go on to look at the information reported about adopted children wanting to breastfeed. Gribble reports information about 32 adopted children, of both sexes and a range of ages (ages at placement= 8 months to 12 years) and separation histories, whose adoptive mothers stated that the children asked for breastfeeding or signaled that they wanted to breastfeed. It is not clear how many of the mothers were actually interviewed by Gribble, as some of the cases were said to have been reported by social workers or drawn from published material. In addition, it is unclear what sex ratio was involved; of the five interviews reported by Gribble, four of the children were girls.

Gribble’s paper provides an interesting beginning for discussion of children’s motivation for adoptive nursing, but a much better context is needed before we can interpret this report. For example, the Wikipedia article on adoption in Australia states an average of 330 intercountry adoptions per year (the children in Gribble’s study were adopted from other countries). However, Gribble does not say over how many years her information was collected, so it is impossible to know whether the 32 children discussed were a very large or a very small proportion of similar adopted children.

In addition, Gribble does not state or even speculate upon the number of nonadopted children who, having been bottle-fed from the beginning, or having been weaned from the breast, later communicate to their mothers that they want to breastfeed. This is an important issue because of Gribble’s argument that adoptive breastfeeding facilitates attachment in children who have experienced separations. Nonadopted children have presumably had ideal opportunities to develop attachment and have not experienced serious separations, so if they signal their wish for later nursing in the same proportions as adopted children, it is hard to see what the emotional motivation for this behavior would be. A full understanding of the phenomena reported by Gribble  awaits information that would permit this comparison.

Another important unanswered question is the role of the adoptive mother’s beliefs, expectations, and caregiving behavior in creating the child’s interest in breastfeeding. Gribble has pointed out elsewhere that mothers are not likely to provide information about the atypical behavior of adoptive breastfeeding unless they trust their confidant; this suggests that the mothers have a belief system that is not entirely shared by most other people. Gribble states a belief that skin-to-skin contact is important for attachment, and describes a mother who “used skin-to-skin contact via co-bathing and a cuddle time in the evening as a way of promoting attachment”. Mothers who share this belief provide opportunities for breast contact that would not occur in the Western world in most other situations or be presented by mothers who did not share the belief. Adoptive mothers who believe in the “skin-to-skin” and “attachment cycle” system may also accept the idea that breastfeeding is important for the mother-child relationship and therefore be exceptionally ready to read child behavior as a wish to nurse. (Gribble refers to sucking on clothing as such a signal, although mouthing and sucking objects is common childhood behavior, as often seen in school-age boys who like to chew on the necks of their t-shirts.) Interestingly, Gribble also describes children who sought to breastfeed as part of “birth games” played with their adoptive mothers, suggesting that she is focused on a group of adoptive parents who are committed to an alternative theory of early development--  not surprising in light of the journal in which the study was published.

The information Gribble presents is of great interest, and certainly should be kept in mind in cases where breast-touching by adopted children is regarded as “sexualized” behavior indicative of previous sexual abuse. (If Gribble’s reports are accurate, such behavior may not be an indication of sexual experience at all.) However, interpretation of the reported cases must await contextualization by information about other adopted children and about nonadopted children as well.  Gribble’s extensive discussion of why adopted children seek breastfeeding is premature, because we have no idea whether they actually do so more than nonadopted children do, or whether their adoptive parents’ belief systems lead them to read child messages differently than they might otherwise do.

As a final comment, I want to turn to two sentences that Gribble places at the end of the article abstract and that she does not actually discuss in the body of the paper. The first sentence states that the “frequency of adopted children seeking breastfeeding is unknown, however adoption professionals should advise adoption applicants of the possibility”. Such advice, if it is being given, is certainly likely to increase the number of cases where mothers interpret ambiguous behavior as bids for breastfeeding.

In a second sentence at the end of the abstract, Gribble makes the following claim: “It may also be appropriate for adoptive mothers to pursue breastfeeding in the event that the child does not.” Nothing in the paper provides grounds for this claim, and it is most concerning to think that a group of parents who have already (as Gribble notes) experienced various disappointments and losses should be offered an additional challenge when there is no evidence that it is necessary.  



28 comments:

  1. 8 months to 12 years? ! TWELVE YEARS ! ?

    In what world is nursing a double-digit, PRE-TEEN healthy???

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    1. Until the Americans brought their white bread, cow meat and artificial milk in baby bottles to the world, the cultural norm was to allow access to the breast for anywhere from 2 years to 15 years. In Japan the norm was 7 years (which is the biological norm) and in the Solomon Islands it was 15 years, as it was in Ethiopia, but among the Inuits the norm was 12 years, as in ancient Egypt, the norm was 12 years. Of course the uninformed dont know that only 1 or 2 feeds per day are enough for most women to maintain lactation after the first 12 months of lactation. Then as the years go by, only a few feeds per week, then a few feeds per month, then a feed every few months, are necessary to maintain minimum lactation. By that time women produce colostrum, not really milk as in what we see for a child under the age of 12 months, but as I'm sure everyone knows by now, the colostrum produced with infrequent feedings is just as powerful as the colostrum in the first days and as it was in the diluted "mature" milk form those first 12-24 months when it flowed in abundance. Anyone who lactates at least 12 months can produce with little stimulation for many many years. Ancient peoples have survived total lack of hygiene and unhealthy conditions thanks to the power of human milk. How fortunate that marketing had not yet taken over people's minds. Astharte in Paris.

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    2. I'm not sure what this has to do with the discussion about this post... in any case, I'm not sure how you define the cultural norm-- do you mean that people are not shocked and surprised by these events?

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  2. I think it's a world with two beliefs: 1) you can create attachment by re-enacting early experiences, and 2) attachment prevents or corrects mental disorders.

    And yes, the article does say 12 years. That was not a typo on my part. I actually came across an incident (from a different source) in which an adoptive mother was breastfeeding an adopted daughter in her middle teens, once again with the belief that the girl would benefit emotionally.

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  3. Jean, you've got my email and I would have been happy to answer questions for you if you wanted more info. As you will have noticed that paper was published many years ago and I've collected many more case histories (approaching 100 in total- without going looking for them). I'll address a few of the issues you raise in your response.
    1) Breastfeeding causally related to attachment. I don't believe that I said this and it is not my view that this is the case.
    2) I am of the view that for some of these children who seek breastfeeding it is the instinctive feeding behaviours that are coming to the fore that result in this behaviour. Hearing from very many mothers whose children were in institutional care and were not exposed to breastfeeding there or in their new family it's hard to explain how they would even know that breastfeeding is something that children do with their mothers. The fact that the children usually know how to breastfeed is in itself quite incredible. It is well known that once weaned for any length of time that many children cannot go back to breastfeeding because they don't know how to do it. It is ALL speculation- we really don't know. I'd be interested in what you think might be behind this??
    3) On the 12yo child I did tell you in my previous postings that this child sought breastfeeding but this was not accommodated by the mother. I can't imagine that the child's beliefs were in any way what you describe...
    4) I have indeed done some research on non-adopted children coming back to breastfeeding. It's common for children who have been breastfed to seek to go back after a period of time- usually not more than a few months. Sometimes they can, often they can't because they've forgotten how to do it. None have done so after years. For children who have been bottle fed since birth the only cases I have heard of (and this just anecdotally) is where a younger sibling was born and the older child wanted to breastfeed. They've not been able to breastfeed in the cases I've heard of where the mother has allowed them to try. These situations are very, very different to the cases of adopted children.
    5) Mothers wanting this or being eager to read a desire to breastfeed into their child's behaviour- I've not seen this. Most women have been exceedingly shocked by it and children's behaviour has been very obvious so sucking on clothes is not sucking on their own clothes but sucking on their mother's clothes over the top the nipples. Quite unmistakeable.
    6) Birth games- in the case described it was a child-initiated birth game. Also doesn't seem to be uncommon behaviour but not something that I've looked at in detail.
    7) On women initiating breastfeeding with their adopted children. I would never suggest that this is for everyone but for some mothers and children it can be very worthwhile. I've got data that I have to write up this....
    So really, I'm very interested in what you think might be going on for these children. I've put my speculation out there for comment and it is just speculation. I'm very open to alternative ideas. BTW I sent you a link to a blog that contained a story of a child who sought breastfeeding and a number of other accounts were contained within the comments. Did it not come through??

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  4. Yes, I do have your e-mail, but I said I would comment on this blog, so I did.

    1. No, you didn't say this. You did say that the mothers believed it.
    2.I think it would be impossible to answer this question, or even to speculate productively, unless there was direct observation of what the children did. Otherwise, there's only the mother's report, which can be influenced by what she believes and expects-- e.g., the child might suck lots of places, but she only notices and remembers when it's over her nipple.
    3.I was talking about the mother's beliefs, not the child's.
    4. By "doing research",do you mean data collection? I would certainly agree that just casual observation shows babies who are exclusively bottle-fed strengthening feeding skills that interfere with breastfeeding, just as exclusively breastfed babies lose their early capacity to bottle-feed.
    5. Maybe those women didn't expect to breastfeed-- I have no idea-- but the more recent ones certainly will have some expectations about it if the caseworkers tell them it might happen, as you suggest. But did you actually get any systematic information about what they believed or wanted?
    6. You do know, don't you, that "rebirthing" has been for years a popular concept among adoptive mothers?
    7. The thing is, in the last sentence of your abstract you do seem to be saying that it's something mothers should pursue. Nothing else in the article says so, but lots of people may read only the abstract and go from there.

    If you really want to know what I think is going on-- and of course this is the purest speculation on my part-- it's that the mothers had expectations that made them interpret child behavior as a bid for breastfeeding. Some of them clearly were committed to the skin-to-skin belief, otherwise they would not have been holding the child in such a way that taking the nipple was easy. I would be very reluctant to say that most child behaviors are "instinctive" or that reflexive/instinctive behaviors characteristic of the early months would emerge much later. I think it's premature to talk about why something is happening when it's not completely clear that it does happen as stated.

    I think what you're working on is extremely important, though, and I hope you will write up what you have.Also,how about submitting it to something other than JPPPH? That's not a respected journal in child development circles or even one that's easy to find.

    No, somehow I did not get the blog link. Would you mind re-sending?

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  5. I think that it is possible that some mothers could misinterpret children's behaviour as suggesting that they want to breastfeed but I can assure that many children make it abundantly clear what they are wanting- the most comment age of children seeking breastfeeding appears to be 5-6 years (I don't know whether that's really the most common or just the ones I hear about most commonly- I suspect the latter). Children this age undo buttons to get to the breast. There is absolutely no mistaking it. Go looking for experiences of children seeking breastfeeding- there are plenty of them (some cited in my paper others on the net). The blog I was referring to is http://slowmama.com/adoption-2/why-i-let-my-adopted-preschoolers-nurse/ The vast majority of women I have heard from have not been told about the possibility beforehand (I think that Australia is quite unusual in that respect and even then applicants are not told this in all jurisdictions).
    Believe it or not, I had some difficult getting that paper accepted....reviewers simply did not believe that this was something that children were doing. I'm OK with it being there- at least it's published. And BTW I didn't say that mothers said that there was a causal relationship between breastfeeding and attachment and nor did I suggest that most child behaviours were instinctive. I do know that some adoptive parents do "rebirthing" but that's not what I'm talking about, again birth play driven by the child occurs- have you not heard of that? I thought that your response to Mirah's question about a 12 yo breastfeeding was unhelpful because you did not let her know that in this case the child did not breastfeed because the mother did not allow it and therefore it was unlikely that this had anything to do with the mother's beliefs. I don't think that you understood what I was saying when I talked about children who have previously weaned not being able to go back to breastfeeding. For my work on children weaning and coming back to breastfeeding look for my publications on long term breastfeeding- there are a few of them ;-)
    Given that so many mothers felt that allowing their child to breastfeed was beneficial it does raise the question of whether mother-initiated breastfeeding with adopted children could be similarly helpful. As I mentioned I have data on mother-initiated adoptive breastfeeding (all children >3mo at placement) but just have to find the time to get it written up!
    I won't be writing more on children seeking breastfeeding simply because I don't have any further knowledge to add. The purpose of that paper was just to indicate that this happens and to propose some possible reasons. At the very least I would hope that it might assist women not to be so alarmed when their child seeks breastfeeding (knowing that they're not alone) and potentially helpful in cases where mothers might be accused of sexual abuse for allowing breastfeeding. I know that you're skeptical that this is a real phenomenon but if you can assume for a minute that it is, why do you think this is happening??

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    1. Karleen, I do want to point out to you that Gordina's PPT suggests strongly that you think breastfeeding causes attachment. Maybe you want to clarify this with her.

      I have to apologize for my answer to Mirah; I missed the point that that child had not been allowed to nurse.However, it is true that I've come across a child older than that nursing, and this was associated with the mother's beliefs about attachment.

      I feel I need to ask you to slow down a little. You say, "Given that so many mothers felt that allowing their child to breastfeed was beneficial...", but was it actually beneficial? Until that's known,I would be very reluctant to suggest to adoptive mothers that they should be attempting to initiate breastfeeding as well as everything else they have to do. In any case, you do have some information that indicates what happens when a mother adopting an older baby initiates breastfeeding? You seem to say that you do-- it would be awfully interesting for the rest of us to know what you have.

      It's awfully hard to think about why something might happen when I'm not clear that it does happen in exactly the way you report that the mothers describe it. My extremely speculative response is that the children do a lot of sucking in general, as well as playing with their mothers' buttons and so on, and the mothers pay attention primarily to the breast-oriented behavior. In the cases where the mother was doing skin-to-skin, the fact that nipples stick out, and might well be erect under this kind of stimulation, would certainly make them likely to be the target of sucking. If the mother has come across the ideas that are all over the Internet-- like Gordina's-- she may think this is something she needs and wants to encourage,
      even though no caseworker has told her so. Also, whatever she thinks, the mother probably enjoys the contact and likes to continue it (and I would not for a moment say she should not).

      Actually,an interesting question would be how the adoptive mothers, who have not weaned this particular baby, compare in their attitudes to a group of bio mothers who did nurse and then wean the baby in question. Do the latter mothers fail to interpret breastfeeding bids their children may make, or do they avoid the whole issue just because they don't want to have to go through weaning again?

      This all reminds me of a series of photos I have somewhere. A mother with a baby in a back carrier is walking around an art museum, and she happens to pause in front of a nude female torso statue. The baby looks at this with great interest, then in the last picture turns,leans over, and takes the statue's nipple in his mouth-- while the mother of course laughs hysterically!

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  6. While I would not say that breastfeeding enables attachment I would say that breastfeeding is one of any number of reciprocal interactions between mother and child that can facilitate the development of trust and attachment and it is certainly the case that breastfeeding is an attachment behaviour for many children. I don't think that talking in absolutes is very helpful.
    As for whether allowing breastfeeding is beneficial- in that I can only listen to the mothers and hear what they think of the situation. No one is ever going to do systemic research on this and it would be extremely difficult to attempt in any case. Again, with my research of mother-initiated adoptive breastfeeding I am relying on mothers' view of the experience.
    I agree that maybe with a 1yr old baby that the situation you describe is very possible- breasts do stand out! However, as described in the paper and as I've since described many of these children are much older and there's no mistaking it. In on case the mother had been attempting to dissuade the child (who was a foster child) but the child (who was 6 years) got on herself. In other cases where the parents speak the same language as the child the child directly asks. Even with the Internet most women are very shocked when their child indicates a desire to breastfeed...and as mentioned this is not a new thing and the first published case I came across was from a child adopted at about 4year (I think) via operation babylift.
    As I said, I've not heard of any cases where a child weaned early (in the first year of life) has sought to restart breastfeeding except after the birth of a younger sibling.
    Have a read of some of the stories on the net and see what you think. If you would like my publications on long term breastfeeding I'd be happy to send them to you.
    And yes I've seen those photos too. One of my favourite parts of my research on long term breastfeeding (all children 2 years or older and currently breastfeeding) was the responses of children to some questions about breastfeeding and descriptions of discussions that they'd had about breastfeeding. Young children can see things quite differently to adults when it comes to breasts and breastfeeding.
    And BTW sorry for the typos- I find the little reply box tricky to use.

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    1. Yes, I would very much like to see your papers. I don't have access to those publications.

      I'm sorry that you don't plan to pursue this topic more systematically, though I know it's hard to do and very time-consuming. But I would feel more comfortable about all these reports if you placed more emphasis on the fact that these are the stories told by the mothers, that they are therefore subject to all the filters and interpretations that we humans bring to our own memories, and that there is no way to verify what actually happened. However, just collecting anecdotes can be a good beginning for understanding, as long as everyone keeps in mind that they are anecdotes.

      Speaking of anecdotes, here's one about long-term habits related to breastfeeding: one of my children was a nipple-biter, and when he was about 4 months old I had to teach him not to do
      that by breaking the suction with my finger each time. He learned quickly, and because I would let him bite my finger, he would pull my hand to his mouth to bite it when his gums were itchy (or whatever it was). When he was 6 years old, he was standing waiting and holding my hand while I did something, and suddenly he put my finger in his mouth and bit! I shrieked, and he looked absolutely amazed at what he had done-- it had obviously been unintentional. But it seemed so clear that this was a remnant of what he had done earlier when uncomfortable, and he had learned to do it as part of breastfeeding.

      So, does this mean that your older children who made bids to nurse were acting out earlier action patterns? I have no idea, and of course it would be nearly impossible to know what they had done, seen,or overheard, that might be behind their present acts.

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    2. I was going to suggest that an older kid might see another mom breastfed and think they want to try. That's not in usual at all.

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    3. That could certainly be, but if the report depends on the mother, and she didn't notice such a thing, I guess we can't find out.

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  7. Russian peasant women breast suckled all Russian aristocracy ... but .. it was not an obstacle to the Bolshevik Revolution and interclass brutal civil war. Such was the love and affection on based breastfeeding. Americans amazing visionaries

    http://occupations.asu.ru/pictures/Nyny_Pasternak.jpg

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    1. This is a good example of problems of interpretation (not translation!)-- the same situation existed in the American South during slavery, when slave women were wet nurses for children of affluent white families, but these relationships did not prevent racial conflict.

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  8. Yes. The situation is similar but the result is different. Russian nobility were killed or forced to live in exile without the ability to return home. It was a national tragedy. People pay too much attention to the tactile reflexes, but they forget about the emotional, spiritual communication and common interests.

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  9. Paper sent. Yes, a case series is far from ideal in terms of understanding a phenomenon but it's better than nothing and prior to this paper there were just small mentions scattered in different places with no analysis of why this might be happening. You might find the quote from the 1980 thesis on children adopted in the early 70s from Vietnam interesting. This is a quote from the mother quoted in the thesis. "It was a week or two after he had come to us that Tim showed me that he wanted to suckle. He knew how to undo my clothes in order to find a breast to suck or play with. It was a small inconvenience to me and seemed to mean a lot to him."
    The story about your son biting you is really interesting. As described in the paper, I am sure that early memories coming to the fore can play an important role. For some children smell seems to be really important in their breast seeking behaviour and they smell the skin and the breast before suckling. Given that smell is the most powerful driver of breast seeking behaviour in newborns I think that there may be a link between the two. I find it fascinating but I guess the most important thing is what it means to children. There is one child whose experiences are in my collection (I referred to her earlier) she initiated breastfeeding when she was a foster child- against her foster mother's best efforts. Not long afterwards a decision was made that the placement would be permanent and she would be adopted by this family. On being told that she was going to be adopted by her mother and that she was going to be her "last mummy" the child responded with "I know, I have your milk" It was clear for this child that breastfeeding had a claiming component to it and this appears to be most common (or perhaps most obvious) with the kids on the older end of the spectrum.
    Mihail on the issue you raise I'd like to make the following comment. It's not uncommon for individuals to make statements that suggest that breastfeeding is somehow magic and can fix all manner of ills- both behaviourally and health-wise (consider the amount of research that looks at health outcomes in never vs ever breastfed). Such assertions are not helpful. However, lack of absolute impact does not mean that there is no impact. I think we should be more reasoned than all or nothing.

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    1. Thanks very much, Karleen-- papers received and saved to my desktop-- also put on my to-do list! I'm sorry not to go straight to them, as this is fascinating stuff, but I am working to a deadline on a book chapter right now.

      Your comments on breastfeeding as one of many relevant factors, and worthy of study as such, are really important. But honestly I think you should tell this to Alla Gordina, who is referencing your work to support a rather absolutist perspective.

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    2. Unknown ,
      You should not think that I am against breastfeeding. Conversely. I was always confident that every woman giving birth can bring up feeding someone else's child. It was common practice in the Russian peasant families. If an extreme situation but it is necessary to save the child ...... Very often hungry kid absorbable breasts and milk appeared. Weak child will not be able to do it and he die .. Strong child always sought the appearance of milk. I thought that the problem is not the presence or absence of milk but in the desire to save life child, or that he even be silence for a while. Nature gives kids a chance to survive. I do not see anything wrong with that. I do not understand what the big kids suck chest .. This perversion. Normal child does not need breastfeeding after 1 year of life. But the newborn kid needs just breastfed but not of synthetic substitutes.

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    3. Unknown ,
      Breastfeeding can not provoke trouble if a woman is healthy and properly nourished. I even admire women who breastfeed other people's baby .. This lack of antipathy but the presence of a huge desire to love someone else's child. But do not jump the line beyond which no maternal love but sexual pleasure. It's no secret that women experience pleasure at the time of feeding breast favorite child. That a child experiences? ...... I do not know. Perhaps he wants to eat and then sleep ...

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    4. Dear Mihail-- I am posting your second comment only because I want to point out that the idea of sexual pleasure associated with nursing a baby is a myth, usually circulated by men. Breastfeeding is often pleasurable, relaxing, and calming, and if the breast has been very full of milk it can be quite a relief. But anyone who compares it to sexual pleasure has either never breastfed or never had sex.

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    5. Jean Mercer,

      I could not deny it .. You know better. So it's a myth.

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  10. Jean I don't think that Alla is an absolutist either- I must read that presentation differently to how you do.
    On Mihail's point I think that some mothers experience bodily sensations during breastfeeding that are not dissimilar to feelings experienced during sexual interactions however, I've not come across any mother who confuses the two. That said, the idea that there is something inherently wrong with breastfeeding continuing beyond infancy is common. It was in fact a reviewer's comment to my paper on adopted children seeking breastfeeding that stimulated my research on long term breastfeeding. The reviewer did not believe that this was a child-driven phenomenon and pathologised long term breastfeeding in general. I use this statement in presentations I give on long term breastfeeding, “It strikes me that breastfeeding older children signifies a lapse in appropriate boundaries for mothers and places the child in the position of meeting the needs of the mother rather than the mother meeting the need of the child”...and so I did research looking at how and why women continued breastfeeding beyond infancy and looked at the experience from the child's point of view...

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  11. I am curious as to how that reviewer defined "infancy"-- was it 0-3 years, or what? And would the person have equated continuing to nurse a child long-term after beginning at birth, and nursing a child adopted some time after birth?

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  12. I really don't know Jean. For many, a child older than a year is too old to breastfeed and to be honest I would suspect that breastfeeding an adopted child would just add to the repulsion of a non-infant breastfeeding. As my colleague Rhonda Shaw described it, the "yuk factor" came into play.

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    1. So frustrating not to know what people are thinking-- they can use "infant" to mean anything from a neonate to a 5-year-old (in law, anyway).
      And the "yuck" factor is curious. You can see why people might think breastfeeding unnecessary, but why repulsive? I know many do feel that why-- I just don't get it, myself. People do seem to dichotomize quite strongly into OK and not-OK when they think about child-rearing, though.

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  13. A few things that should be disclosed. Dr. Karleen Gribble is not a "doctor" of anything that's even slightly related to breastfeeding. She has a PhD in plant physiology. She's a botanist. Her "appointment" at the University of Western Sydney is strictly a volunteer posting. She is not a paid member of the faculty. Her research is largely self-funded. So, if she seems to be lacking understanding in certain areas of child development or science, it may be because she's simply untrained. She's a botanist who developed an interest in breastfeeding and has restyled herself. But at the core, she is a lactivist, an activist who seeks to promote breastfeeding.

    She's also unethical in her research. In this article http://www.internationalbreastfeedingjournal.com/content/1/1/5, she shares several "case studies" about adopted children who were encouraged/coerced to begin breastfeeding by their adoptive parents. One of them is her story of breastfeeding her adopted daughter. You'll notice that nowhere in the article is this disclosed. Writing about yourself as if you were just another research subject is more than a touch unethical. I don't know if she even disclosed this to the journal. If she did, and they still published, then they would share in the shame. If she didn't disclose, her ethics are even worse than I imagined.

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    1. Thanks for your comments. I knew about the botany background and the probable lack of training in child development, but I didn't know about the nature of her appointment, or about the possible nondisclosure.

      I do give Gribble credit for the fact that in the papers I've read, she does not advise people that they necessarily should try to breastfeed adopted children, nor does she appear to claim a connection between breastfeeding and attachment. My real concern is about people like Alla Gordina who use Gribble's work as support for unfounded claims about attachment.

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