It is surprising that although the IPPF is 27 years old it has never previously had a meeting on this topic. On rational grounds, it is one of the first subjects at which it might have looked because many of the data we have discussed were available long ago. I remember reading about a Western doctor in Asia who saw the familiar scene of a mother with a young baby being suckled from one breast and an older child from the other breast but, in this case, the older one was also smoking a cigarette between sucks! Perhaps we need some kind of startling image like that to make us look closely at the role of lactation in fertility regulation.