In a message dated 12/12/2003 8:26:28 AM EST, [log in to unmask]
writes:
<< <A HREF="3D">Ted Greiner's comments on breastfeeding</A> by HIV positive
women are worth studying because he points out the tremendous problems of
supporting artificial feeding for poor women in developing nations. >>
In case anyone is interested,my attempt at a brief summary: WHO and UNICEF
guidelines are AFASS, an acronym which means Acceptable ( socially, not being
shunned/killed for artificial feeding since it has come to mean AIDS to some),
Feasible ( can one get bottled water every day many times a day, or is there
only clean water ten miles away, etc., is there enough fuel to heat the water,
prepare the bottles, clean the bottles and teats, and still cook food, is
there some way a mom can measure properly and prepare feeds at night without
lighting, or prepare them and save them without refrigeration etc?) Affordable (who
is going to foot the bill for the formula, bottles, teats, fuel, possible
refrigeration, and increased health care costs which go with artificial feeding.)
Sustainable ( the ER show MD rightly mentioned that a baby not being
breastfed requires a year minumum supply of everything, which will lead to years of
artificial feeding induced illness, there have been cases where moms were told
not to breastfeed, and then formula supplies ran low or out) and Safe ( clean
water, adequate access to fuel for heating, etc. you get the idea.) Some
would argue that it is nearly impossible to meet these standards, and a refugee
camp would surely not meet them. It was good to see one doctor educating
another, plus appearing sensitive to HOW the ignorant MD had no concept of the impact
of telling a mom from a culture where breastfeeding is normal and valued, not
to breastfeed, and that she was endangering the children she loves. ( No fear
of inducing guilt there, huh?) The sentences that was the most helpful to
hear for the public to learn from was : a baby will most likely go on to die of
cholera or diarrhea if not breastfed and therefore a 3 % transmission rate (
thereby rightly focusing on health outcomes not just transmission numbers) is a
"bargain" in this mom's circumstances...
Judy LeVan Fram, PT, IBCLC, Brooklyn, USA
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