OK - I got smacked around a bit privately for my question about how do I
teach safe/proper bottlefeeding in a group situation without violating the
Code.  So I decided to just stay out of the fray.  But after reading about
diabetes/same argument/testing etc and political this and that, group
teaching it doesn't work and shouldn't be done, only one on one... I am
going to jump back in here and offer some words from the trenches to
hopefully make a point here. 

I am a Private Practice LC - I have no financial backing other than my own -
I work with parents daily who need this information.  How do I get it to
them in a manner that makes sense - where they get what they need
(information and education), I get what I need (compensation) and no one
gets screwed financially or otherwise?

1) I am NOT suggesting that anyone teach a roomful of people how to
bottlefeed regardless of whether or not they are returning to work.  I'm
talking about a specific class ONLY for those who need it.

2) I get it that we need to change the political atmosphere - I feel it is
NOT being heard that it takes TIME and there are people who need information
NOW in order to protect their babies and their milk supplies.  We need to
deal with the here and now WHILE working on the future.

3) Talking about one on one is all well and good (and I agree it is a better
option) - but:  How many clinics/hospitals/organizations/Dr's offices are
willing to pay someone to do one on one education for bottlefeeding a
breastfed baby or to teach proper ABM preparation?  None that I know of.  In
my area I just got word that a local hosp is likely dumping its Lactation
program...and it is one of the better and bigger hospitals!  Are they going
to keep someone on staff to teach one on one safe bottlefeeding?  I think
not.

4) How many parents are going to pay someone to come to their homes to teach
them one on one how to safely bottlefeed their baby or how to safely prepare
ABM?  I sure wouldn't.  Why should I pay someone to teach this when I can
(usually incorrectly) read a label on how to prepare formula, go buy a cheap
pump, pump only 1 -2 times while gone then wonder where my milk went and why
my kid keeps getting sick on that formula I'm using but my Dr says it's
fine?

5) How many of us actually have time to drive from house to house teaching
people on one one how to safely bottlefeed their baby or prepare ABM?  I
sure as heck don't.  I can do 2 LC consults a day - 3 at most - I do home
visits and sometimes I am there for 3 hours...including drive time if I do 2
- 3  consults I can easily have a 9-10 hour day.  With the cost of gas
($3.40 in my area for the cheap stuff!) I am not willing (nor rich enough)
to drive all over town to do one on one classes for 30-60 minutes and charge
someone anything under $40-$50 for the service and my time.  I'd use up a
full tank of gas ($40) doing that and parents won't/can't pay that kind of
money to be taught this kind of thing in 30-60 minutes.  Yes - I have asked
my parents in the last few days...but they will pay for a class they can go
to for $20-$30...

So - being the realist that I am and looking at times as they are what is
the answer?  Leave parents without the education?  Tell them I cannot teach
them when they ask because it takes too much of my time to do it for free
and I'll need to charge them a reasonable fee to come to their home ($40-50)
because I can't do it over the phone?  Hell no!  

Why not teach a specific class designed to teach the information they need?
Why not make it a small group even - 5-6 parents - no more.  Class is
specifically for those who MUST be separated from their babies and MUST
bottlefeed.  Topics of discussion include protecting the milk supply, proper
pumps &/or hand expression; how to properly express & store breastmilk;
appropriate bottles & how to properly clean bottles;  ABM - how to properly
prepare, store and feed;  How to feed SAFELY with bottles; how to teach the
caregiver the proper way to use bottles.  And lastly (but first in the
class) talk about different ideas and strategies to keep mommy and baby
together.

This is information CERTAIN parents - not ALL parents - need.  We can talk
all we want about politics and post-partum needs and keeping the baby with
mom.  The fact of the matter is (imnsho) - It is Idealistic to believe that
we can change USA politics to actually give a damn about mothers and babies
anytime in the near future; it is idealistic to believe that all teaching of
the above nature should be done one on one and that parents/organizations
will actually pay for such teaching; it is idealistic to say that we
shouldn't do this and can't do it without violating the code - they HAS to
be a way to do this.  There HAS to be a way to give the information in a
manner that is appropriate. 

We need to look at BOTH situations.  We need to not only address the problem
parents have now - Lack of education for safe feeding and the lousy maternal
and baby care we have (at least in the USA).   To focus on one and ignore
the other is foolish.  To talk about how we shouldn't teach in group
settings without any recognition to the difficulties many will have to find
one on one is to wear blinders.  And to talk about how group health teaching
doesn't work is an easy out - what about working to find a way to MAKE it
work.  I believe it can be done.

In my Professional opinion - we need to look at ALL options.  We need to
discuss how we can appropriately teach those parents who need the
information in a group setting making sure that they get the information
they really need AND we need to work in the political arena and get our govt
to actually recognize that moms and babies need to stay together and that
children actually ARE important.  (don't even get me started on that one...)


If we simply continue to discuss how group teaching doesn't work, that one
on one is better, that we should focus on politics, that there should be no
discussion on how to teach safe bottlefeeding in a manner that does not
violate the CODE - then we have just limited our options and the possibility
of educating parents and protecting them and their babies.  Doesn't sound
too good to me.

If there is anyone who would LIKE to discuss how we can teach appropriately
maybe we need to set up something off LN - but it seems to me, that it would
be in all of our best interests to keep our options open - have a frank
discussion on how to make this work.  It seems to me it would be in the best
interests of the parents and babies.  

My 2 cents and then some...please don't smack me around off-LN - I don't
want to hear it.  I am open to ALL options - I am looking for a way to take
care of the here and now while looking at how to help the future.  If you
don't like my ideas or thoughts that is fine with me - but I am tired of
being criticized for wanting to help people NOW.  My desire is to make a
difference in the world - I may not have the big guns others do to hit the
political arena to make that change - but I can certainly help the parents
of today and help them protect their breastfeeding, their babies and their
milk supplies while educating them on the needs of today that won't happen
until tomorrow... 

Happy Holidays!

Jaye







Jaye Simpson, IBCLC, CIIM
Breastfeeding Network
Sacramento, CA
www.breastfeedingnetwork.net

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