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The Myth of Insufficient Milk

In our modern world, very few mysteries remain.  We can measure the distance from the earth to the stars, and explain the voids between.  We can travel to the bottom of the darkest oceans, and reveal their secrets.   We can see inside our own bodies, our veins, our cells, and we can even know the sex of a baby long before it is born.  Little wonder, then, that when we ask ourselves, 'How much milk is my baby getting?', and we can't provide an answer, we find this disconcerting, to say the least.

Breast milk, and in particular, the quantity that has left our own body and is now residing happily in our baby's stomach, is difficult to measure.  We might try pumping, so that we can see how many millilitres we can produce, but this does not give any real indication of how much our baby is actually getting out.  Not only are babies mouths unsurprisingly more efficient than a plastic sucker, but the actual loving act of nursing and looking down at our babies face has been shown to encourage 'let down'.   And as for let down, some of us, myself included, don't feel any sensation at all when our milk is coming out, and in my case, I have hardly ever even caught a glimpse of the seemingly magical fluid that has now sustained and nourished two human beings for the first six months of their life and beyond.

So, we can't measure our milk, and in some cases, we can't even feel it or see it.  We might be just about able to hold our nerve, but what if our baby is not behaving as we had expected?  The tiny soul who is entirely dependent on us for her survival suddenly begins to cry a great deal, or wake up hourly throughout the night.  It is at these times that the doubts can begin to creep in, and they can often be fuelled by the comments of friends, family and even professionals: 'Are you sure they are getting enough milk?' 'Do you think they could be hungry?', 'What about just one bottle of formula at bedtime?', and so on.

Such comments are part of a wider cultural picture of treating babies as problems that need to be fixed, rather than simply accepting them as they are.  It is our expectations that we need to change, not our babies.  When a new mother tells us that her baby keeps waking her up at night, we should be offering reassurance that this is perfectly normal and entirely to be expected, rather than attempting to advise her on what can be done to get her baby to stop being so needy.

As well as being overwhelmed by her small baby's intense levels of dependency twenty four hours a day, a new mother might also be feeling shocked or even traumatised by her birth experience, in which she may have 'failed to progress', or 'needed intervention'.  Her confidence in her body and its ability to function normally and without outside help may well have been undermined.  She could not birth her baby naturally - it stands to reason that she also may not be able to feed it naturally.  She may wonder, perhaps I am not making enough milk for my baby, or, worse still, perhaps my milk is lacking in some way?

Further doubt and anxiety may be added by advice to place the baby on a routine of feeding and sleeping.  This idea of spacing out breast feeds according to the clock dates back to the 1940's, and it is no co-incidence that this is also the moment in time that women began to report trouble with their milk supply.  If we try to space out nursing sessions too widely and, for whatever reason, choose not to nurse on demand, we may well be jeopardising our chances of continuing to breastfeed. We need to nurse on demand during the first few weeks in order to establish our milk, and even the Queen of Routine, Gina Ford, acknowledges this, urging mothers who follow her program to pump in between the routine feeds to keep their supply up. 

Of course, if a new mother succumbs to the voices of doubt - be they inner or outer, valid or invalid - and reaches for the bottle of formula, then this is when the real Booby Trap is set in motion.  For once we introduce milk from a source other than ourselves, we interfere with the chain of supply and demand, and our own supply actually will begin to diminish.  That which we most feared, and sought to remedy, will in fact become reality.  And in some cases, our motivation to continue breastfeeding can also diminish, and we become added to the statistics of women who wished to nurse their babies, but for whom it did not work out.

'Insufficient milk' is one of the most commonly given reasons by mothers for stopping breastfeeding sooner than they would have otherwise intended.  And yet the stats just don't add up.  Whilst around 25% of women state that a lack of milk was their main reason for stopping nursing in the first two weeks of their babies life, research has shown that in fact only a tiny percentage of women are actually physically unable to produce enough milk.  A major piece of research published in the journal Medical Anthropology states that in only about 5% of cases is there something making it impossible for a woman to breastfeed. Another article from the NHS cites the figure for insufficient milk being as low as 0.2 to 1%.

It's important not to ignore the real human stories behind these statistics. Whilst the numbers of women who are genuinely not producing enough for their babies may seem low at perhaps 5 or less percent, this still amounts to many women for whom the breastfeeding experience is a tale of anguish, frustration and loss. And, perhaps sadder still, our stats tell us that there are many more women who don't actually have any physical problem with their supply, but who are doubting their ability to feed their baby naturally due entirely to external factors such as poor advice and support or negative cultural messages. In these cases, women who desire to nurse their babies are having their hopes dashed for no good reason.

It is hard to believe in something that we cannot see, feel or measure, particularly when something as hugely important as the welfare of our baby is at stake.  But the message needs to be spread: in the majority of cases, 'insufficient milk' is a construct, a misconception, an invention, a myth.  If you are having doubts that your milk is enough for your baby, don't feel panicked into drastic action, but instead nurse as much and as often as you can, and seek good reliable advice. (see below).  Above all, believe in your body, it was built to nurse your baby.

If you need advice about this or any other aspect of breastfeeding consult your local LLL Leader or ring their helpline 0845 120 2918, or the ABM helpline 08444 122 949.  For detailed information about low supply I highly recommend this and other reading from the wonderful site kellymom, and this article from The Baby Bond.

This article was amended on 15th March 2012.



  1. What a fantastic post. Insufficient supply is definitely an breastfeeding myth that is always bantered about. I think our obsession with 'how much milk' our babies are getting is due to our bottle feeding culture. An ounce of breast milk is not the same as an ounce of formula. You are right in saying that as mothers we need to fight our own anxieties in order to establish a good breastfeeding relationship.

    Brilliant post and thanks for linking up xxx

  2. thanks so much DA
    i really enjoyed your BAWeek post too.
    and that's a great point about formula and breast not being of the same value per ounce.
    just about to spread the word about your link up!

  3. I always think it is the weirdest thing. In many ways the trauma of my first birth saved me, breastfeeding wise. So distressed and crazy was I, that it never once occurred to me that he may not be getting enough milk. I just fed him when he cried, or grabbed my boobs, whether that was every 2, 10, 45, 60 minutes. Fed him until he stopped - sometimes milky and drunk and clearly sated, others still restless and getting on with the complicated (and I often suspect quite traumatic in its own right) task of looking at the world and working out his place in it. It never crossed my mind to stop, or that my tits might not be providing for him. He peed, he gained weight etc. With my second son he took longer to get his birth weight back. A midwife at 10 days made a 'might need a top up' noise and I just looked at her totally surprised (and not a little annoyed). He was healthy and growing, just not terribly fast. Rocked my confidence though. And I was a second timer with a long history of lactivism behind me.
    What is interesting to me is the expectation of breastfeeding, and the pressure not just in terms of weight gain and supply, but also that, for example, you'll love it. I didn't love it. I just posted this week about how I'm not sure I even liked it. But I didn't think it was something I shouldn't or couldn't do.

  4. interesting L.
    i'm curious at the moment about why some women - such as yourself - have the confidence to follow their intuition whilst others get lost in bad advice.
    i'm not sure i like BF all the time either, like everything else there are the poignant touching blissful moments and the downright irritating ones! still glad i'm doing it though as it feels like it is ALWAYS a positive experience for my kids, if not always for me!

  5. I really really did and still do have insufficient milk and have always had to top up with bottles so Aaron has always been combination fed, even now at 13 months. I had all the breast pads in the wardrobe before he was born and I have never ever leaked and never ever been engorged or any of those things.
    Liska xxx

  6. that is interesting liska. i've never used a breastpad either and never really leaked at all, as i said in this article, i have hardly ever seen my milk. however it is true that a very small percentage of women really DO have insufficient milk, so perhaps you are one of them? i would love to hear more of your story and how you came to the decision that your own milk was not enough...without any judgement of course as we all try to do what is best with a combination of our instinct and the information available to us at the time. love to you and fair play for continuing to breastfeed for so long xxx

  7. I wonder where on earth that site got their statistic of 0.2 - 1% from? They don't give a reference for it.

    I've been trying to track down data myself - which is nearly impossible to pin down, simply because it is so hard to figure out how many of the women who thought they had insufficent milk actually had insufficient information. But the WHO cite a breastfeeding expert (Marianne Neifert) who think it's probably between 1 and 5% in the Western world. Neifert did a study herself on a group of women who were highly motivated to breastfeed, making sure they were all given proper advice before birth about frequent feeding and that they saw a breastfeeding counsellor at an early stage if they were having any problems, and she found 15% of the babies still didn't gain in accordance with the weight charts. Obviously that's going to be an overestimate since those were the days of weight charts based on formula-fed babies, but it still suggests levels may be higher than we think. They certainly aren't as high as 25%, but they aren't insignificant either. It's a tough one.

    By the way, it's also a myth that introducing formula will invariably lead to milk supply dropping. It can, but plenty of women do still continue feeding with supplements.

  8. They may continue breastfeeding but they usually cannot then drop the formula feeds. Which proves that their supply has dropped. Let's say the baby usually had 12 feeds a day (this is just a figure for the purpose of demonstration, not a recommendation or advice!!!) If the mother introduced two formula topups then her breasts would only be stimulated to make 10 feeds worth of milk rather than the 12 it used to. So her supply has dropped to 10 feeds. If the baby continues to need 12 feeds she is then forced to continue the 2 formula topups. The baby hits a growth spurt and wants 16 feeds. She now lacks the confidence to trust her breasts so introduces 2 more topups. So now baby is getting 4 formula topups. Baby finishes growth spurt and is now regularly getting 4 topups so her breasts are now only getting stimulated for 6 feeds and so only produce enough for 6 feeds. Drop in supply. Yes she is still breastfeeding but now reliant on formula topups. Now the option of exclusively breastfeeding has gone.

  9. @Dr Sarah - you ask The Mule for her evidence but don't provide references for your assertion that formula top ups don't reduce supply. As the poster above me so clearly explains, if you interfere with the supply and demand nature of lactation, invariably woman don't breastfeed for as long as either they would wish or the WHO recommends.

    Of course, there will always be cases that will defy the norm, but us Breastfeeding Counsellors have seen too many 'slippery slopes' to lactation failure not to approach formula supplementation with trepidation. Plus, of course, there are all the attendant risks of supplementation - the odd bottle of artificial milk is not necessarily a benign intervention for mother all baby.

    I'd like to comment on your assertion that insufficient milk production is greater than The Mule reports. I'm not sure what you base your feelings on, but in nearly 10 years of supporting mothers to breastfeed, I've met one mother who really didn't make enough milk. Most women who have a poor supply have not made enough prolactin receptors in the early days. This could be because of a separation of the dyad, sleepy, jaundiced babies, tongue-tie etc.

    The biggest causes of insufficient supply I see are those above and things like retained products of conception and PPH.

    Even the most concerning cases can usually be helped to nurse exclusively with a supplementary nursing system or lactaid so that the baby is receiving the supplement at the breast.

    I do wonder whether your suspicion that insufficient milk is higher than previously though is due, in part, to the birth interventions that so many women suffer these days. If maternal oxytocin levels are not peaking after normal birth, how can we be expected to eject our milk? The stress of motherhood in an industrial society full of fractured families and lack of social support means that often, women just can't allow the milk to flow. I've seen many women suddenly have more milk once they've talked things through, had a massage and been nurtured a bit.

    I do think we really need to be careful that we don't count women affected by modern interventions and extrapolate that those numbers are what nature intended...

  10. There was a short article in Fit Pregnancy magazine about a year ago that said the number or women that were unable to produce enough milk was on the rise. As high as 15% I think the article said.
    I'm guessing it has to partially with more women trying to breastfeed, but more than that, all of the other factors that are new in the last decade or two-GMOs, higher rate of estrogen dominance/progesterone deficiency, EMF pollution (especially from cell phones).
    Instead of just saying someone is lying that they can't produce enough milk, please help them to be able to! No lactation consultant (7 lactation consultants total and many appointments) with any of my kids was able to help me produce enough (I was able to do it partially). Someone that's under immense stress already doesn't need shaming, that will only excaberate the physical issues.

  11. Hi Anon
    I'm sorry if you experienced my article as 'shaming' in any way, that is not how it was intended at all.
    Nowhere did I say that a woman is 'lying' if she says she can't produce enough milk.
    I try to promote women's confidence in their bodies through this blog, which I sometimes feel can be undermined through culture or society or family. Sometimes women doubt their supply and top up with formula or stop nursing entirely, when there is actually no 'real' evidence that they are not making enough.
    Please do say more about your own story if you so wish. I'm sorry it didn't work out for you and it is possible that you WERE one of the very small group of women who have a significant problem with supply.
    You make a lot of claims in your comment that need more scrutiny I think. I would like to hear what research you have found that supports your suggestions.
    In the meantime thank you for your comment. x

  12. I have seen everything from 0.02% to the study which found 15% of women are unable to breastfeed. I don't really care - I was in that percentage (not perceived - measured via weighing baby before and after a feed resulting in baby getting nothing even with correct latch and continuously nursing for over 45minutes.) I am not a mythical creature. I am simply a women that has a body part that does not work correctly. Until I was diagnosed with 'Lactation Failure' (medical term) I was told by all the LC's/midwives/doctors etc that all women can breastfeed if they really want to and try hard enough. That the percentage of women who can't breastfeed is so insignificant that surely I could not be one of them.
    Telling women to just trust that they are making enough milk is a little dangerous. Let's say that the figure is 5% - that is still 1 in 20. Or how about 1%? That is still 1 in every 100 mothers who are unable to breastfeed. What support is available to them? Emotionally it can be devastating. The 'breast is best, formula is evil' mantra seems to be every where you turn. And then you just keep hearing 'o poor you - you must have been booby trapped cause if you were better educated or got better support you would have been able to breastfeed.' It is a bit like saying 'diabetics don't really need insulin - they just think they do, if they tried hard enough and trusted their bodies they would be able to produce their own insulin' Some times some parts of our bodies just don't work. When you look at the way breast milk is made (although it is very cool) there are alot of intricate hormonal levels combining at the right time coupled with having sufficient glandular tissue - so it is understandable that if just one little part is not quite right it could all been thrown off.
    Sorry - I know that is all abit of a rant, I am a bit touchy on the subject (especially since I have been thrown out of mother's rooms, told by shop keepers that 'I should be breastfeeding that baby' amongst other things for feeding my baby the best way I could) and it can be hard when you say "I didn't make enough milk" to be doubted.

  13. I always wonder why, if nutrition is so crucial for young babies, that people seem to feel it's okay to keep starving and starving and starving a baby because supposedly so few women truly have insufficient milk.

    Sorry, but your post IS shaming and you ARE accusing women of something much worse than lying because your post in its title and line of reasoning chalks up a natural occurrence to myth. As in the people who are saying they have insufficient milk supply are as dumb as you might think people in the Dark Ages were, when we used to accuse women of witchcraft if something unlucky happened. Even when you admit a small percentage of women truly don't make enough milk--what are they, unicorns, then? Not real women? You disprove your own point. If my "biological norm" is to not produce milk, what does your post say about me? That I'm not human? That my experiences are a myth? That my baby's starvation is a myth, and that her health doesn't matter? That it's okay to sacrifice innocent babies on the altar of breastfeeding?

    Even if your math is right--that this is as rare as you think it is, is it all right to call insufficient milk supply a myth? Or are you just being a typical breastfeeding activist who routinely throws away the dignity of women who cannot breastfeed because they don't meet your almighty expectations?

    According to the March of Dimes, about 4 million babies are born in the US every year. These stats are also courtesy of MoD:

    About 6800 American babies are born with oral-facial clefts--so does that mean that the .17% of babies that have cleft lip/palate are a myth?

    About 3400 American babies are born with Down Syndrome--so does that mean the .018% of Down Syndrome babies are a myth?

    About 12,000 American babies are born with some kind of hearing impairment--does that mean the .3% of babies who can't hear well are a myth?

    How about moms? According to, about 5-8% of moms develop pre-eclampsia. Are they a myth?

    About 2-3% of mothers develop gestational diabetes, according to Children's Hospital of Wisconsin. Are they a myth? Should they have just "tried harder" to avoid diabetes?

    According to, less than 1% of women suffer uterine rupture during a VBAC. Are they a myth?

    According to about 10-20% of American women have PCOS--which can have devastating effects on supply, not to mention the extreme trials these women go through to conceive and carry their babies. Are they a myth? Or are they just not believing in themselves enough for you?

    According to Dr. Weil, about 5% of Americans have fibromyalgia, mostly women of childbearing age. Are they just succumbing to the voices of doubt if they don't breastfeed because they're dealing with enough as it is? Or are they just a myth?

    How about people in general? According to the CDC and, 1 million people have HIV/AIDS out of a population of more than 312 million. That .3% of people with HIV/AIDS a myth?

  14. Even if your numbers are right, the idea that because a small number of women are affected by something means it's a myth and that every single one of them is just ignorant, selfish, booby trapped, or whatever else you might think of them says a lot more about you than it does about them. I sincerely doubt your numbers are right, and the site you got them from hardly counts as an impartial source. It doesn't source its numbers; I have yet to find a study that truly does. You say "research" claims .2-1% of women can't nurse--yet you don't cite any research at all, just one biased site that is too chicken to give a true citation for its bull! How disrespectful of all women.

    I think you need to face it: you are curiously adamant about one-size-fits-all medicine for women and children. Well, forget children, apparently if they can't nurse or breastmilk isn't good for them because of allergies or any other reason they just don't count in your magical number of .2-1%. You just want to pidgeonhole all women into breastfeeding whether they can or not, and are setting yourself up to be judge, jury, and executioner of who is a good mother and who isn't.

    I just want to know who died and made you so omniscient that you can tell if a woman truly can't make milk? Cause you could take that show on the road--plenty of moms are devastated to find out they simply don't make enough milk, and would love to hear that straight-on instead of starving their babies for weeks because people like you imply they're mythological, just not trying hard enough, and/or are too stupid to avoid booby traps. Maybe you'd also develop, y'know, some perspective, and perhaps a conscience.

    Telling people with rare (and not-so-rare) medical conditions that they are a myth is not cool, doesn't make breastfeeding look any more attractive, and hurts real women who don't get enough respect as it is.

  15. i must be pretty naive because i'm quite shocked by how much this article has enraged some of you!
    my intention was to reach out to people who might be in the throes of doubting their supply, not to condemn those who have already taken the difficult decision to stop nursing.
    my initial inspiration for the article came from the book our babies, ourselves by leading anthropologist meredith small, which i highly recommend. she cites the figure of 5% which i have now added to the article with an accompanying link.
    even if the figure is as low as 2 or 3 per cent that is still a substantial amount of women who will experience genuine difficulty and i have no desire whatsover to condemn them, judge them or imply any kind of moral high ground on my part.
    it would be interesting to work as a team on this and look further for more research, however, it is difficult to enter into any sort of meaningful debate with people who are clearly so angry that they feel they need to attack me personally.

  16. So, because something is rare, your message to those who are struggling with breastfeeding's a myth, it doesn't apply to you, now shut up and keep nursing because you couldn't possibly be having true supply issues?

    Maybe I'm naive, but I call that booby trapping far more than any formula company ad. To tell someone that breastfeeding naturally occurs in just about everyone when it doesn't is deliberately giving false information about breastfeeding. Isn't that what your lot accuses the formula companies of? Who needs Nestle, we've got so much unethical behavior among lactivists you don't need some big company to spread lies about breastfeeding.

    Worse than that, many moms who use formula are accused of child abuse by breastfeeding activists (who also typically accuse us of making things up when we talk about supply issues). How is it not child abuse to keep insisting that all mothers nurse, against their judgment, and babies starve as a result? How is it not abusive, stripping women of their dignity, to tell them that they need to trust in some impersonal stat that someone made up rather than their own bodies? I fail to see how the lactivist movement is pro-woman or pro-child. You do nothing but doubt the ability of women to make a judgment call or their ability to know their bodies best--YOU claim to know best, because according to YOU breast is best and according to YOU supply issues are a myth. You do nothing to promote the health of children. Babies are sacrificed on the altar of almighty breastfeeding because YOU think it's best, regardless of what is actually best for that child.

    Further, your assertion that you can't engage in meaningful debate with angry people is really funny coming from someone who just told a whole lotta women that their very real problems are "all in their heads." Can you understand why women might be sensitive to that? Can you see why it is not us who have stopped all meaningful discussion--YOU stopped it before we even opened the door? You, like so many lactivists, are a very controlling person to say what we should and shouldn't be angry about, not to mention what is real and what isn't in our bodies. If you're not going to be able to handle being proven completely wrong and totally disempowering of all women, then don't post lies like "the myth of insufficient milk supply."

    Yes, I'm angry. I'm angry at you and so many others who so smugly and sanctimoniously tell people like me that breastfeeding is the be all and end all of motherhood, that issues that preclude it are so rare as to be mythological, that not breastfeeding is more often a result of being too stupid to navigate around your laundry list of "booby traps," that what you say is the gospel truth instead of a booby trap in its own right, that women need people like you because you're so superior that the rest of us can't figure out on our own what's the best method of feeding our children. I'm tired of seeing women disempower other women. And yes, I'm angry about it. When you've seen the kind of condemnation I and so many other formula feeding moms have endured, I think we've a right to be.

  17. Hey again Teri.
    I'm really sorry that I've upset you so much.
    Perhaps the title of the article should be amended, as you are right, there are some people for whom insufficient milk is a reality, not a myth.
    It's said that there are lies, damn lies, and statistics, and even sound research such as the paper I have added a link to in Medical Anthropology could be called into question I'm sure. However, what does seem to be clear it that there is a mismatch, and quite a significant one, between the number of women who cite insufficient milk as a reason for stopping nursing, and the number of women who actually have breasts that are not fit for purpose.
    I am most passionate about women's issues and I do feel that often women are sold a lie that their bodies are inadequate - in many ways, not just breastfeeding. I have never thought of myself as a 'lactivist' as to me this does have some negative associations with the condemnation of formula feeders and I have never spoken in judgement, either publicly or privately, of women who make this choice. To promote breastfeeding and informed choice is NOT to condemn or judge those who feed formula. Anyone who feels this way is perhaps not entirely confident in their own path or choices, I would speculate.
    I do wish you well and I am truly sorry to have made you so angry. x

  18. Teri, the way I understood this article was that the 'myth' referred to those women who are led to believe that they have insufficient milk and encouraged to top-up with formula when they did not in fact need to.
    Nowhere can I see The Mule assert that women with real problems in producing enough milk don't exist, regardless of whether the figures she used are accurate or not. After all, the scientists haven't even managed to come up with accurate figures or agree themselves.
    I did not sense any disparagement in the article towards women with genuine physiological milk supply issues, or to those who have to or even choose to use formula.
    The point of The Mule's article as I understood it, and extrapolating from my own experience, was that in the UK at least, formula is routinely used by health specialists as an easy way out of minor breastfeeding problems, often right at the beginning while new mothers are still in shock and vulnerable to well-intentioned but sometimes regrettable advice. Obviously if a new mother is led to believe that she can't produce enough milk when actually she could, and is encouraged to start using formula needlessly, you would expect this to affect her milk supply as per normal supply and demand rules.
    This interference with otherwise perfectly adequate supply is the only 'shame' that I could find in the article.
    I too am angry that this article should be so wilfully misunderstood and am sorry that you feel it necessary to vent your fury so inappropriately.

  19. I thought it was a great article and understood it to be encouragement to mum's that were uncertain of their own bodies but still wanting to give breastfeeding a go. I've personally found that all my children have gone through what I call a growth spurt, where I've felt my supply wasn't up to the job and with my first child I gave up through lack of encouragement and inexperience. I regretted the decision and felt that more people needed to speak up and encourage new mum's to be confident in their decision to continue to breastfeed, just like this article does.

  20. "Walk in someone else's shoes." These ladies have a right to be angry. Twelve years on and it's people like you that still make me feel guilty for not continuing to breast feed my baby after six weeks. Six harrowing weeks with lots of professional intervention and encouragement. Of cause we (angry) mother's would have loved to breast feed, why else did we try? I know I made the right choice in the end and would rather have a more contented happy baby than the the constant feeding battle I endured everyday. It is no myth that some women do not produce enough milk it is a fact.

    1. Helen - I'm wondering if i could add in a paragraph or a sentence that would help to make it even clearer that in some cases - rare but they do exist - women DO have a problem with supply. What the stats seem to show quite clearly is that the number of women who cite poor supply as a reason for stopping is far far larger than the number of women who have a genuine physical problem. This is what I meant by the 'myth' in my title. Would this help? I don't want the article to make people feel guilty or bad about not breastfeeding. I just (as i said in the comments above) wished to be helpful by making women think twice before they doubt their natural ability to feed their baby, which often happens in error due to negative cultural messages or simply bad advice. Let me know if you think the article could be improved through clarification. Thank you x


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