Karen said "But if a mother plans to combine breast and
bottle (with EBM or AIM), I can help the mother intro bottle-feeding
behaviors that are more compatible with maintaining lactation and long-term
BF."

Karen, I have no real problem with the above. When I was referring to bottle
feeding in my post on initiation and duration, I was referring to formula
feeding. In the hospital formula feeding is rampant and just about every mom
uses some formula prior to d/c. A few do practice exclusive bf. For the most
part this formula use is totally unnecessary from a health/medical point of
view. Many moms have unrealistic expectations and beliefs about combining
breastfeeding and formula feeding from day one.

Virtually every mom in my community does regular bottle feeding. Often it is
w/ ebm and sometimes they combine breastmilk and formula use. The main
reason is back to work issues but also many moms are mortified to bf in
public and regularly use bottles when out or even when they have visitors.

I do strive to promote exclusive human milk feeding in normal situations.
Multiples are a special situation but I would still encourage and try to
facilitate exclusive or as close to that as possible. Ultimately the mother
has the final say. There is much much education and cultural changes to be
done in the hospital envt and the community at large.

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA




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