Pam - Thank you for hearing me!  In response to a couple things you said:

>>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? >>

My idea here is not to focus any class on feeding ABM only - it is to teach
safe feeding practices for primarily EBM with ABM being discussed because it
needs to be.  Many, many of the moms I work with have a heck of a time
maintaining a milk supply that meets their baby's needs.  It is a real
problem.  They take herbs, try to pumps as often as they can, but many just
can't.  So they must use ABM (or donated breast milk if they can find
it...).  In this situation I feel it is important for them to know how to
safely prepare it.  

I have a way of pointing out the risks and hassles of preparing ABM in a
manner that doesn't freak parents out, but educates them so that they not
only do their best to provide only breastmilk, but, if they need to use ABM
they do it safely.  My parents know I do not put a seal of approval on ABM
by any means.  It is a product used to feed babies ONLY when there is NO
breastmilk to be had...

In a small group - such as only 5 or 6 couples - I am confident that I can
maintain their focus on the topic at hand.  I've done it before many times
with other subjects - why not this one?  Now, in a group of say 10
couples...forget it.  :)  

>>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:>>

Yes - I know of these and have copies - But - parent IGNORE them.  :)  They
are too tired and too busy to read this stuff.  I have provided many parents
with the information and many of them simply don't read it.  

However - when they hear it and see it first hand it is amazing the
difference.  When I cannot see a dyad immediately and I know they will be
using ABM, I refer them to the website - take a look please, follow the
instructions for safe prep of ABM.  I get to the house and see they are not
doing it at all.  They are too tired to go do this research.  To them, ABM
is fine, everyone uses it, and you just use tap water (or for more educated
parents bottled or boiled) and mix it up as you need it.  When I go over it
with them in person - they are shocked at what I tell them.  The vast
majority who need to supplement end up with the partner running to the store
to get concentrated or ready to feed and they quit using the powdered - but
this is ONLY after a one on one frank discussion about the risks of powdered
ABM.  Rarely do I find parents who know about the risks of powdered ABM and
use only ready to feed of concentrated...

In a different post on a different subject but still talking about ABM,
someone mentioned using a powdered ABM container and having pre-boiled water
ready for mixing in the middle of the night.  I think it was Morgan...  A
nice point was noted about the babies being hospitalized for Rotovirus 4
times.  What I'd also like to point out is that it doesn't matter that the
water was boiled - I mean that helps, but the point is that that ABM needs
to be prepped with the water HOT to kill any bacteria - Parents DON'T do
that here.  This is why a class that teaches how and why can be so much
better than handing tired, sleep deprived parents a handout they are not
likely to read in the next month or so...

Lastly, you mentioned the BFHI.  Do we all fall under that?  I don't work
for a hospital nor will I ever.  While I am a breastfeeding advocate I am
more importantly, first and foremost and baby and parent advocate.  I MUST
meet them where they are at and in the process gently educate to help them
learn and grow and recognize the importance of breastmilk, breastfeeding and
safe feeding.

Tough times we live in trying to meet the parents needs and the babies needs
while staying within the boundaries of the Code and our own ethics...

Thanks for hearing... 

Warmly,
Jaye

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