Dear Ms. Bain,

        The WHO code comes out strongly against group sessions teaching formula
feeding.

        Though it may take more of your time, perhaps you can do the
breastfeeding class, and then announce that anyone who has made an
informed decision to feed artificial milk to their babies can get
individual instruction at another time.  You might add that the only way
to make an informed decision is to initiate breastfeeding, because how
can you make a real informed decision about something you have never
experienced? You can also say that starting with formula may make it
difficult to switch to breast, but starting with breastfeeding, they can
easily switch to formula, and then the mother can get instruction if she
requires it.

        Your supervisors might understand that it makes no sense to teach as
normal an unphysiologic method of feeding, which, in addition to the
stupendous costs in money for the formula, also cost plenty in health
care costs and suffering (but no one cares about suffering anymore, only
the bottom line).

        Might work, but don't count on it.

Jack Newman, MD, FRCPC