Jaye

Just seen your latest message, and then scrolled backwards through 
several LACTNET digests to find the beginning of the thread.  I love 
it that you always advocate so loudly for your moms and babies!  And 
I think I hear where you're coming from.

It is true, teaching bottle-feeding in groups may not specifically 
contravene the Code, but the BFHI doesn't permit it, and nor do the 
HIV and infant feeding guidelines, where formula is actually 
recommended IF it can be safely done (the emphasis is mine 
...).   I'm also forced to acknowledge the reality that not all 
mothers breastfeed, and that not even all mothers who want to 
breastfeed receive sufficient help to do so.

I've taught individual breastfeeding mothers whose babies needed 
formula supplementation to safely bottle-feed.  And I've taught 
individual breastfeeding mothers how to express and feed sufficient 
breastmilk by bottle in preparation for returning to work.  And I'm a 
champion of breastmilk-feeding (EBM by bottle) for those mothers who 
for whatever reason simply cannot actually put their babies to their 
breast but do want them to have the "best" milk.  I've taught groups 
of antenatal mothers for 16 years, but in answer to questions about 
bottle-feeding EBM in preparation for a return to the workplace, I've 
confined the discussion to the need to generate a really good 
breastmilk supply in the (short) time that they will be home with 
their babies, and suggested they might like to seek individual 
assistance with the specifics - later.   In group situations (and in 
reviewing/writing documents) I try to characterize formula-feeding as 
a sort of unnecessary evil, which could be prevented if all mothers 
received the help they needed to breastfeed.

The thought of actually teaching bottle-feeding of ABM to groups of 
mothers would seem to go against the tide of breastfeeding advocacy 
for several of the reasons Karleen mentioned - it would "idealize" 
and "normalize" formula-feeding, and it would put your seal of 
approval on it.  Is that what you want?

Finally, for mothers who really want the last word on how to safely 
prepare and feed formula, you could refer them to the highest 
authority.  Surprisingly, WHO have recently released the following documents:

WHO 2007, How to prepare formula for bottle-feeding at home.
<http://www.who.int/foodsafety/publications/micro/PIF_Bottle_en.pdf>http://www.who.int/foodsafety/publications/micro/PIF_Bottle_en.pdf

WHO 2007, How to prepare formula for cup-feeding at home.
<http://www.who.int/foodsafety/publications/micro/PIF_Cup_en.pdf>http://www.who.int/foodsafety/publications/micro/PIF_Cup_en.pdf

WHO 2007, How to prepare powdered infant formula in care settings
<http://www.who.int/foodsafety/publications/micro/PIF_Care_en.pdf>http://www.who.int/foodsafety/publications/micro/PIF_Care_en.pdf


Pamela Morrison
Rustington, England

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