Ruth, I have given up trying to sound "balanced" on the issue of abm vs.
breastmilk and that is what I tell folks who ask me. I tell them that as
person who is a specialist in human lactation it is difficult for me to use
the "f word" and impossible for me to to be  unbiased.  There are times
when abm is useful and I list them (very short list). Presentation is
everything, and I work  to carry off a lighthanded approach.  I explain
that it is easy to think of abm as benign, since there are rarely any
sudden, shocking results of feeding abm.  This opens the door for me to
mention long-term health outcomes (for infant and mother).  And  I add
that, before I studied this subject,  I thought people like me were on the
fanatic fringe--(it gets a laugh.)

Of course, somewhere in here I try to discover where they are coming
from: is mom exhausted and feeling so-called "relief" bottles will help? is
Dad feeling he wants a turn to feed? are relatives or friends telling
wonders-of-abm tales? is there a fear of insufficient milk? Based on
what I discover, I tailor the information I dispense. Most of the time (and
this surprised me at first) parents are very thoughtful and interested in
hearing the facts. (I used to believe I would be "making them feel guilty"
:-/ )

Linda Smith (aka: the Coach) was the first to give me the confidence to
be honest about my biased opinion in a professional setting. (Thank you
Linda!) Once I started being honest I found that such discussions
naturally became forums for "informed choice."  By giving the parents the
info that I have (and how many other HCPs have all the facts about abm
and human milk as we do?) I feel satisfied that I have empowered the
parents to make their own decision.

Of course, one has to be accepting and able to support the decision the
parents make. By being honest about my views I am able to come away
feeling that I did not swallow my "real" feelings--and know I left the
decision where it belongs: with the informed parents.

Margery Wilson, IBCLC
Old enough to be a Granny Zealot
Massachusetts Institute of Technology
ILCA Region I (New England states) Representative