Just wanted to clarify a few points of confusion about my  post that Judy
brought up.  It's hard to describe in detail all that is covered in a 2+ hour
class, and taking my suggestions out of context didn't reflect the overall
"atmosphere" I try to create in the class.  When I suggest introducing the
bottle after the baby latches "while mom is on the phone", it is with the
knowledge that there may (SHOULD) be many nursings before then that have
become "easy", or "natural", etc. before the day comes when mom doesn't have
to think about it at all. I do NOT mention that this happens at "1,2, 4 or 6
weeks"--we have tried to eliminate #s from our teaching, and emphasize
watching the baby.  But every once in a while some mother will say, "My
sister started a bottle at 1 week with no problem".  I also do not bring the
subject up until someone in the class asks about this.  It seems (and this
has been observed by others who teach our prenatal classes) that the moms who
anticipate being employed outside the home after delivery all come in with
"how am I going to be able to return to work if I bf" as their primary
concern.  Even though I repeatedly get them "back on track" focusing just on
getting bf well established FIRST, then reminding them we can always discuss
returning to work a few weeks after the baby is born, I either get
evaluations back complaining that "she didn't cover returning to work, didn't
talk enough about breast pumps, etc" or they arrive at delivery having
decided to bottlefeed because they couldn't resolve their anxiety about how
to bf AND return to work.  Many of our moms come to class still "on the
fence" about whether they want to put forth the effort to bf when they can
"only" bf 4-6 weeks before returning to work.  They have heard "horror
stories" about babies who wouldn't take a bottle, about babysitters/day care
centers that wouldn't consider alternative feeding methods, etc.  I have
found that giving them those few "guidelines" on how they CAN do both, often
makes the difference in whether they even consider bf.

Also, I DO spend quite a bit of time talking about how much more convenient
it is to travel WITH baby than to try to leave baby with bottles, etc.  I
even get the dads' attention by describing how I got Lou Brock's (a famous
ballplayer in St. Louis) autograph because I breastfed!  And I share with
them how to go out to eat with a baby, emphasizing again how easy it is (mom
can eat & bf a baby, but can't eat & bottlefeed at the same time, for
example), as well as saving on sitter costs, etc.  But to ignore or rebutt
the parents who are set on leaving the baby, either for work or play, doesn't
"win them over".

I also forgot to mention that our health center has an LC available on the
hospital floor, 6 days/week (and on-call Sundays for REAL tough bf problems),
who also teaches a postpartum bf class to reinforce the prenatal class info
and to answer questions that have come up since delivery.  We also have an
outpatient lactation clinic and a "warm line" for our patients to access.  So
what I describe prenatally is only part of the overall picture of followup
new parents receive.  Obviously, if a mom has a baby who is having trouble
organizing to suckle properly, we stress that NC is a very real possibility,
and strongly support her in exclusive breast contact for as many weeks (in my
2nd son's case it was 3 months!) as it takes to get proper suckling well
established.

When this whole discussion comes up (in almost every class, I might add), I
also use this opportunity to bring up in detail the ways Dad & grandparents
can be supportive of the bf couple, and help the couples explore how they can
make bf the priority for the first few days/weeks, even in the face of a
constant stream of visitors, other siblings, etc.  But that wasn't the
question that was asked originally.  As I remember, the original post simply
asked how we answered the question of when to start a bottle, and that person
seemed to still be looking for a number.  I had hoped my post shared what I
believe to be a "baby-led" way that doesn't "put off" the parents who,
rightly or wrongly, have separation from their baby as an expected event that
they want to learn how to handle.

Carol (COLD AND GLOOMY St. Louis.  Sigh.)