I just wanted to respond briefly to your wonderfully written post by Anita Bartels regarding formula feeding.  It touches on such important points that need addressing in formula feeding families.  It is so important to stress these things when talking to families who choose formula or even feeding ebm in a bottle.  It is especially important to talk to the alternative caregiver, whether that is the father or grandmother or the mother's partner.

But I also wanted to mention that it is VERY important to cover how to mix formula. The hospital staff may be assuming the mother is breastfeeding and never cover this, not wanting to open a can of worms.  You may be the only person to discuss this with the family. I can’t tell you how many times, in my job as Breastfeeding Coordinator for a WIC agency I had moms feeding concentrate formula undiluted or over diluting powder to make it last longer or because they thought it would provide some crazy benefit (like being easier on the baby’s tummy, or because the baby was gaining weight too quickly or not quickly enough, or some other crazy idea).   People with limited reading skills often don’t bother to look at the can because they assume a lot of things, such as: they don’t read so they won’t understand it, even though the directions are diagrams and pictures, or they know how to do it already, though they may have learned how to mix powder and not concentrate or they assume it's the ready-to-feed stuff.  

I also discuss the difference in storage times between formula and breastmilk.  I can't tell you how many times I would see a mom with a bottle of abm on her stroller for hours and hours!  Would anyone do that with a glass of cow's milk??  What are they thinking???

I worked in a local hospital for a few years as well.  One day we had a readmit because the father, who was a dentist and clearly well educated, didn’t understand that he had to mix concentrated formula with water.  Fortunately the mother realized after 24 hours so no harm was done, but it could have been a mess.

So, I never take for granted that someone will read the can.  And I don’t want anyone to assume it’s really easy to formula feed.  It actually is quite a complicated process, which is an important thing to discuss.  So many families think formula feeding, or pumping into a bottle is easier, when actually it's much more complicated. There are a lot of steps involved with feeding artificial milk.  Sometimes I think if we weren't so concerned about discussing those things, it would just make the case for breastfeeding.  I can't tell you how many times that has happened to me.  After explaining how to manage the formula process the mom was really happy to have a short latch on lesson and went home happily breastfeeding.

As for what formula is the best…. It’s been said here so well.  It’s all the same.  It’s not meant to meet the needs of growing babies.  Only human milk does that ;-)

Barbara Leshin-Zucker, IBCLC
Senior Lactation Consultant
Morrisania WIC Program
Bronx, NY
 Who never knew how to make or feed a bottle (after having 4 of my own kids) until I started at WIC in 1991.  

Date:    Mon, 26 Jul 2010 17:47:51 -0400
From:    Anita Bartels <[log in to unmask]>
Subject: teaching formula feeding

Yes, I teach formula feeding. Not how to mix it, mom's can read instructions as easy as I can. 

When I go into a formula feeding mom's room we first discuss her reason for not breastfeeding. If there is misinformation or a real desire to nurse we explore those options. If she still wants to formula feed her baby I explain to her how importatnt it is to make bottle feeding as much like breastfeeding as possible. Skin to skin, eye contact, switching sides, gently introducing a bottle nipple into babies mouth, stomach capacity, frequency of feeding, etc. We then discuss what to look for as far as risks to formula feeding. Upset tummies, constipation, ear infections, fussier baby, less mothering feedlings,etc. I always leave the mother with my name and phone number and the comment that her milk is going to come in anyway, let me know if she wants to breastfeed and I will help her.

It continues to amaze me how many women associate working and breastfeeding as an all-or-nothing situation. I have begun to recommend the book "Balancing Breast and Bottle" (no financial interest) to moms who will be returning to work. It is a very well written, mother friendly book that explains how choosing the right bottle nipple will continue the breastfeeding relationship for as long as desired. I think it is within our job responsibility to make sure mom's have all the tools and education they need to make the best choices for their babies, parenting, and life style.


Anita Bartels RN, IBCLC
Jerome ID



P.S. Anybody going to the Lamaze conference and need a roommate? [log in to unmask]

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