Hello again from the first time father of a 7 week old and neonatologist.  I am
now accused of being the idealist ("lactivist", and worse terms) both at home
and at work.  It would appear that Andrew (the baby) has inherited his mother's
"adrenaline junkie" personality and is interested in activity, his environment
and pacification.  He will literally "go ballistic" shortly after a healthy
feed if he is not "entertained".  I have told my wife that this is "good".
Andrew does accept well pinkies as pacifiers; I will admit that he hates the
store-bought ones.... I know that most of you reading this are cheering.  Mom,
however, is wearing out....  IDEALISM VERSUS PRAGMATISM.  I have told my wife
that Andrew will soon learn to entertain himself and that she will soon be able
to at least leave him on his own (in the same house of course!).  Yes, I am not
a "heal" and do take care of Andrew as soon as I get home....And you should see
the funny stares I get when carting Andrew around the stores with my finger in
his mouth!

It is interesting, however, that pinkies do so well.  With the discussion of
different stroking/sucking motions and big mouth/little mouth, it would appear
and feel as if Andrew strokes with a little mouth....  I can see where nipple
preference has come into play : Drew prefers a warm meaty thing as opposed to
cold rubber or plastic.  I would submit though that in the otherwise healthy
breastfed infant at some arbitrary age (4-6 weeks) that successful introduction
of an artificial pacifier is safe, so long as the baby is smart enough to
demand a feeding when he(she) wants food.  In the big picture, though, should
babies (toddlers?) learn other successful means to calm themselves.  And if
they learn  to calm ONLY at the breast, as some of the lay literature suggests,
where does that leave Dad, if left alone (for even a brief period of time) with
baby?

Now from the professional side: I get a little steamed every time I read
something about who the pediatricians are always in bed with the ABM
companies....And, yes, I would say that a health professional is more likely to
use/prescribe a familiar product and that various companies breed such
familiarity through innumerable subtle and not-so-subtle means (this is called
marketing, a fundamental of capitalism and democracy).   It would also appear
the the breast pump industry is also fairly competitive and that these
companies market to LCs, hospitals and the like.  Have these companies ever
brought donuts or pens or paper pads while giving information on their wares?
If so, then LCs and others may be cast under the same spells as the docs....

Don't get me wrong.  As a neonatologist I DESPARATELY see a need to improve my
med center's lactation services; I WANT TO GET IBCLCs ON STAFF ASAP.  Just
please make sure that the pot and the kettle are not the same color.....

David Louder, MD, Director, Well Baby Services, Wilford Hall Medical Center
louder@ whmc-lafb.af.mil

P.S. The only formula advertisement in the last edition of AAP's _Pediatrics_
was for "Toddler" formula; I am used to seeing plenty of Baby formula
ads....Maybe the "Code" is kicking in....