What wonderful Baby Friendly news!
Please use the tins of formula and teach parents how to make it up for
themselves!
Some parents have no idea how complicated this can be, Make sure you
emphasise how sterile the bottles and nipples need to be, how to make
sure the amount of formula is exactly correct, not to boil the water
too long or reboil water, we know the risks of lead poisoning, not to
mention other nasties that can be concentrated by boiling. Then the
storage, ensuring that they do not carry warmed bottles with them, as
bacteria grows well in warm bottles. Wash them out immediately after a
feed, so that they don't smell and they are easier to clean
properly.... Oh, and don't forget they should taste the stuff!  Then
make sure they know that if baby has problems, they may need to use
one of the expensive brands of formula, as nothing is as compatible
with their little insides as breastmilk and some babies need special
formulas to be able to digest the stuff.
With a bit of effort, the mums may leave hospital breastfeeding
happily every time!
Then the staff will actually have less to do.
To get the initial breastfeeding rates up, there probably needs to be
an expectation that mums will breastfeed, not a "will you breastfeed
or bottle feed" option. Look carefully at the literature given to the
mothers, even the "what to bring to hospital" lists. Do these make
bottle feeding be seen as an equal choice? When a mother books in, is
she told about the birthing options and that, "of course you are able
to feed your baby straight away, and we encourage this". Are there
beautiful posters of breastfeeding mothers everywhere? If you find a
supplier, maybe the local LLL Group will donate one, or if a mother
wants to give a gift, it can be one of these, to promote
breastfeeding. In Wollongong, we had posters showing proper attachment
next to every bed, NMAA information in the take home information
packages, visits by NMAA Counsellors, a full set of NMAA Booklets in
the nursery and videos available to watch. When it is assumed that all
mothers will breastfeed, at least for X time (to give them a good
start in life) you will probably find those b/f initiation rates go up
all by themselves. Now, if you can manage to get all those mums
breastfeeding comfortably pretty quickly you will have HUGE success!
Hope it works out well.
Best wishes,
Querida David

Querida David
Alyangula, NT. Australia
NMAA Counsellor, Editor 'Upfront'
NT Publications review team
Email: [log in to unmask]
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-----Original Message-----
From: Jon Ahrendsen <[log in to unmask]>
Date: Wednesday, 1 April 1998 15:22
Subject: Transition to BFHI


Our small 30 bed hospital that does 100 births a year is finally
getting serious about implementing ALL the 10 steps for the BFHI.  We
have been trying over the past 4 years to do all the right things but
of course the free formula was the last obstacle.  We now have a
sympathetic administrator that believes becoming "Baby Friendly" will
help in marketing our OB services to our rural service area.

[[We should be popular with the BF and LLL crowd, we offer rooming in
for mom and dad, we don't do any epidurals, any number of mom's
support people can be present for the birth (my record was five people
besides the mother, me and the nurse.  There was; husband, mother of
preg. mom, 14 yo sister of husband, mother and father of husband), and
my moms can put the baby to breast immediately after birth if the
APGARS are good and the cord long enough. ]]

At any rate I am asking for help on what to do with the 40 % of moms
that we have that still don't initiate BF.  What do the other Baby
Friendly Hospitals do with the bottle feeding mothers?  I know about
the need to purchase formula, we got the administrator to agree to
that, but do we buy ready to feed so that the nursing staff doesn't
grumble about using  non ready to feed ABM?  Or do we include a large
can of powdered ABM to the mother and then help teach her how to mix
it while she is at the hospital.  (Most of our post-partum moms still
stay about 48 hours.)

One of our concerns is that the change in present procedure of using
"free ready to feed ABM" will cause the nursing staff to view the new
policy as more work and hassle and lead them to not be as supportive
of the BFHI.

Any input from those with experience in this matter would be
appreciated.
Thanks.

Jon Ahrendsen MD FAAFP
Clarion, Iowa