Jeannette, I agree with you that supplementation is a tool and that in some
instances may be an option that allows breastfeeding success.

What I don't agree with (and I am not saying this is what you are doing,
but it is what is being done with this article) is drawing blanket
conclusions from such a limited study. And I disagree even more with the
way the media are reporting this, both in the US and abroad.

Formula supplementation, however you use it, is a tool among others. I am
pretty confident that formula supplementation was not the key factor in
breastfeeding success in this study. And that it won't be the key factor in
any breastfeeding experience.

Understanding the situation and providing the best support and help the
mother and baby need is the key factor. The way this result is being
portrayed, formula seems to be almost magical...

Veronica

Veronica Garea MS, PhD, IBCLC
GALM Bariloche
https://sites.google.com/site/lactanciabariloche/




  4. "A little formula ..." Science section of the LA times
> Date:    Tue, 14 May 2013 17:12:28 -0700
> From:    Jeanette Panchula <[log in to unmask]>
> Subject: "A little formula ..." Science section of the LA times
>
> I hope I'm speaking to my friends - and I may be getting in really hot
> water here...but thought I'd also suggest that when working with moms, this
> option might actually work to help breastfeeding.
>
> Just like the use of nipple shields and the use of bottles to support
> breastfeeding were once considered absolute no-no, and then we learned that
> there were times and places and situations that these tools were totally
> appropriate...perhaps we may want to see how this study might provide us
> with an additional tool.  Below are some quick thoughts:
>
> 1. I wonder about the why they used 5% weight loss by 36 hours?  Now that
> we have studies indicating that babies may lose a considerable amount due
> to "over-hydration" when mom received IVs late in labor - that amount of
> weight loss would occur in a large portion of the babies in some hospitals.
>  Perhaps clarification of using the 24 hour weight?  I imagine the "up to
> 36 hours" was due to the fact that all (in my experience) healthy
> moms/babies are discharged in the US by that time.
>
> 2. I appreciate the limited amount of formula (10 ml or 2 tsp),  mentioned
> - in SOME of the reports, but not all -  the timing (after breastfeeding)
> the feeding method (syringe) giving the parents the clear indication that
> this is a very time-limited intervention.
>
> 3. It appears that in addition to the use of small amounts of formula,
> there was close follow-up of these families - that, also, needs to be
> included in any care plan being developed utilizing this study as a
> reference.
>
> When a mother insists in supplementing, this option (limited amounts,
> given after breastfeeding and for limited time) may be a useful alternative
> - with clear instructions (Plan, Rationale, Duration) and appropriate
> (within 24 hours after discharge) follow-up.
>
> Again, this is a "tool" that may help to avoid the situation mentioned in
> one of the comments after one of the articles by an already-experienced
> breastfeeding mother, referring to the "breastfeeding nazi" who was
> obviously unable to hear the mother's frustration and exhaustion - and
> respect the mother's decision to supplement while she recovered.
>
> As IBCLCs we may not like the idea of giving formula - knowing full-well
> the importance of keeping the baby's digestive system free of non-human
> proteins.  However, as the Code of Professional Conduct stresses that IBCLC
> is to provide the mother with the ability choose an option "to meet her
> breastfeeding goals" that might be less damaging to breastfeeding while
> meeting a mother where she is...  we may want to keep an open eye/ear/mind
> to this tool!
>
> If we research other articles by the primary author - Dr. Valerie
> Flaherman - i.e. "New moms who express milk by hand breastfeed longer" and
> others -  we may be willing to read this study with a more open mind?
>
> (By the way, if you do a search on this article, which seems to be
> published in over 30 different sites that I could find, you see picture
> after picture of older children drinking huge amounts from bottles -
> including clear liquids - but not one could I find with the actual feeding
> device: a syringe...formula companies must love this!)
>
> Jeanette Panchula, BSW, RN, PHN, IBCLC
> Vacaville, CA
> (Hesitatingly sending this off...hoping not to set off too many
> fireworks...)
>
>

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