As I make visits with the Public Health Nurses (and am a PHN myself) I have
observed how important this is!

When I see a mom, usually there have been quite a few days between birth
and my visit.  If no one has referred her until her milk supply was badly
compromised, we work on it while at the same time making sure the baby is
fed.  Access to human milk from the milk bank takes time.  Often we can get
mom's milk supply up to the needs of her baby by the time we could get
system going and convince the doctor to sign the forms.  We have arranged
for banked human milk for NICU adopted babies and for PCOS moms.

However, the point is, we are dealing with mothers who are already
supplementing with formula.  I've learned to not only ask what they are
feeding the baby, how much, how often...but also to SHOW me how they are
mixing it.  Errors that I have observed, either because of illiteracy,
mistaken beliefs (our babies don't need the heavy meals that American
babies need, an Indian mom told me through an interpreter), language
barriers, etc. have been very serious.

I am wondering too if there are those of you from countries that have the
formula with the amino acid additives, could share  your experiences if you
have had breastfeeding mothers who also gave these formulas  Could give us
some information on what you observed?   I have heard there is concern
about weight loss when initially "complementing" OR "supplementing" (in
addition to or instead of) breastfeeding with these formulas.  Has this
been the case?

California WIC has changed to Ross Advance formula, so ALL babies on WIC
who are not fully breastfed will be changed to this formula as of August 1.
 Although this will not affect some of the mothers I see (and this is going
to be a great "selling point" on breastfeeding), I do want to be
informed...and not just from the very slick formula booklets being given to
us.

Jeanette Panchula, BSW, RN, PHN, IBCLC
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