Dr Abrar Ul Haq Wani
Milk is produced from the mammary gland (exocrine gland) by humans and other mammals to feed their infant offspring, but sometimes babies also produce milk from their mammary glands. In folklore, milk secreted by newborn infants and immature mammals (Galactorrhea) of either sex is referred to as Witch’s Milk or Hexenmilch. It has been mentioned and discussed in scientific journals across the world, and dating back to 1686. Some communities associated it with women who had sold their souls to Satan in return for the reward of mystical powers. They were believed to persecute babies by suckling their mammary glands and leaving “Witches’ marks”. This lingering superstition led to the custom of removing baby’s breast milk quickly and repeatedly to safeguard the neonate from wit ches.
Another belief was that the formation of milk from the babies’ breasts was induced by evil spirits, goblins or imps to provide themselves with a source of nourishment, and that this bad milk must be sucked out. This superstitious cultural practice became extinct in the developed countries after the advent of modern science, but still persists in the less developed countries, India being one of them.
Many communities in India follow the customary practice of milking a neonate’s breasts everyday from the age of 7 days up to the age of 7 weeks. In rural areas of north India, a recent study found that manual extrication of breast milk was done in 15 out of 32 neonates. The practice of breast manipulation is cruel to the infant as parents have reported babies crying when vigorous attempts were made in a bid to squeeze out the last few drops of milk from the breasts. The suffering of pain by the infant over many days or weeks is enormous and should be perceived as a form of cultural cruelty.
In medical science, infant milk secretion is considered as a normal physiological episode and it is not mandatory to go for diagnostic or therapeutic amelioration unless the area becomes red or tender. Partly on the basis of some significant studies it is now generally believed that two maternal hormones, estrogen and prolactin, during the later stages of pregnancy prepares the maternal mammary glands for lactation, and escape into the foetal circulation in sufficient quantity, causing the same phenomenon to appear in neonates. Additionally, incidence of breast enlargement has been reported in around 70% of normal neonates and is considered as a physiological response. The breast enlargement may considerably vary in size but the palpable breast tissue usually measures less than 2 cm.
Hyperprolactinemia may also stimulate the breasts to produce Witch’s Milk and its secretion most likely occurs in infants born at full term, and not in prematurely born infants. The milk’s consistency is estimated to be quite similar to maternal milk. Its production also may be caused by certain medications such as metoclopramide. Physiological phenomena of breast enlargement and milk secretion are usually self limiting but may sometimes persist till 2 months of age. However, repeated manual emptying of glands may result in continued milk secretion for up to 24 weeks.
In lower mammals, mammary gland secretion in a five-weeks-old horse has been reported with variable concentrations of casein, albumin, extractives and sugar. We have also encountered cases of Witch’s Milk in calf from districts Shopian and Baramulla and in the near future we are looking forward to discover more cases of Witch’s Milk intended for clinical and research studies. Analyses clearly suggest that the mammary secretion of the newborn is truly milk. The extent to which microorganisms or chemical substances are secreted into Witch’s Milk is relatively unexplored; serum proteins being the only substances analysed. The next step for future studies on Witch’s Milk would be to thoroughly analyse the chemistry and microbiology to determine if it expresses any substances of diagnostic usefulness. The use of Witch’s Milk as an alternative body fluid to detect chemicals and microorganisms is a virgin field that deserves further investigation in both human and animal medicine.
In some parts of Kashmir valley, expression of milk from neonate’s breast is still practiced by quacks to cure neonatal jaundice, with no scientific justification. We must not forget that every biological mark whether a post-delivery stretch mark or the so-called “Witch’s mark” will have its own implications. The resultant change in body appearance can negatively affect the image and self-confidence. The sufferers of marks or scars feel devalued by society. Those with scars experience a remodelling of their emotional state and are more prone to the development of depression and anxiety. Doctors often lack training in recognition and management of psychosocial issues. So, it is a prime duty of us to contemplate and talk about this social malevolent myth breathing in our communities. The primary roles in this regard have to be played by parents. They must consult doctors instead of hiding any complications with their babies. It is the suppression of facts that causes the mushrooming of myths within societies. The medical fraternity, civil society, and NGOs must organise programmes to make public aware about the reality of Witch’s Milk. They must also carry out regular inspections in villages where this malpractice may be customary.
The writer is a PhD scholar at Dept of Medicine, FVSC&AH, SKUAST K [email protected]