Data from field research conducted in Humla a mountainous district of northwest Nepal and 1 of the poorest regions in that country were used as a basis to facilitate understanding of how women accommodate the burden of heavy work and child care responsibilities in an effort to provide a fuller perspective on the widespread transition to bottle feeding in modern urban societies in recent decades. In Humla men leave their homes for months at a time to participate in seasonal labor migration or trade increasing the burdens on women. These women also bear 7.5 children on average by the end of their reproductive lives and hold the major responsibility for child care. Supplementary cereal foods commonly are introduced within the 1st few months breastfeeding is prolonged for at least 2 years or longer and at present there is a mix of frequent and indulgent nursing when the mother is present and supplementary foods when she needs to work. The existence of such longstanding traditional patterns of early supplementation to facilitate a mothers work may lend a certain perspective on the use of bottle feeding on the part of urban working women in less developed countries. The difference is that bottle feeding seems more likely to replace rather than to supplement breast milk posing greater risks.