Dear Lactnetters!

I have been asked to give a lecture at a conference for the Midwifes 
Assosiation of Finland. The subject is how to support mothers to breastfeed 
with supplementation
ie. partial breastfeeding. I have been planning my lecture for a while and I 
would appreciate feedback and suggestions from this community .

My target is to give information about partial breastfeeding and why mothers 
end up with supplementing, and also on how to breastfeed while supplementing 
and ways on how to do it. Most of the audience is likely to be hospital 
based midwives at delivery rooms and post partum wards where supplementation 
is still far too common. I would like to be able to affect the decision 
making of midwives at the hospital so that they would not supplement so 
freely.

I would like to see also that if the supplementation at the hospital is 
needed, the mothers would go home with specific instructions on how to 
gradually stop supplementing when the milk comes in and how a mother may 
determine at home if the baby is getting enough milk and that adequate 
follow-up is received. In Finland all mothers and babies do get follow-up at 
local health care centers, but HCPs there are not too well educated about 
breastfeeding.

I would cover up these things first and then tell about how to supplement 
while breastfeeding if it is needed and how to support mother. The recent 
discussion about bottles has been very helpful for me! Thank you all who 
have been writing about it! In Finland the majority of families who 
breastfeed partially choose to supplement with bottles so I would speak 
about things that need to be considered when choosing a method and paced 
bottlefeeding if bottles are used.

In Finland the majority of women plan to breastfeed "according to the 
official nutritional recommendation" but end up supplementing in the first 6 
weeks. According to a survey done in 2000-2001, as many as 79% of the 
newborns got supplements at the hospital. In 2005 a national survey about 
breastfeeding was done and 60% of 1 month old babies were exclusively 
breastfed, at 3
months only 34% and at 6 months 40% mothers had quit
breastfeeding altogether. The main reasons in my opinion are the 
supplementation given at the hospital and the HCPs lack of knowledge on how 
to solve even basic breastfeeding difficulties during the firts weeks. The 
mothers
don't get enough information about living with the breastfed baby 
antenatally, so they don't know what to expect. Then they get not so 
adequate information from HCPs and start giving bottles. Well, that would 
hopefully
change at least a little since Imetyksen tuki (Breastfeding Support 
Association) got two different grants for the next years from Finlands 
Health and Social Ministry to develop antenatal education for the families 
and to develop peer support programs and education in Finland.

The resources I have include Riordan: Breastfeeding and human lactation, 
Wilson-Clay & Hoover: Breastfeeding Atlas,  Mochrbacher & 
Stock:Breastfeeding Answer Book and Newman: Latch. I also have internet 
access to Pediatrics and British Medical Journal etc. What I would need is 
your input
and suggestions and especially more references!

I would be very grateful for any input! I am a little bit nervous since this 
is my first lecture for HCPs and the audience is quite big... I have been 
speaking for HCPs before, but that has always been about our association and 
peer support, not breastfeeding itself.

Sincerely,
Pia Ruohotie, RN, breastfeeding counsellor and Breastfeeding educator,
Imetyksen tuki ry
from Helsinki, Finland, Europe

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