> I'd love to hear any suggestions for tackling this issue in a manner
> that is fresh and less likely to be met with defensiveness and derision.  It
> seems that as breastfeeding rates inch up, but exclusive breastfeeding slides
> down, the "mixed" feeding is becoming more and more prevalent.

I agree that this is likely at large, what is happening.  However, in
the greater scheme of things, I think we are seeing more and more women
who bf after going back to work when they wouldn't have 10-20 years ago,
or at school if not at work.  They pump at work/school, and the baby is
bottlefed during their absence on their pumped milk, or sometimes a mix
of pumped milk and formula if she's having a hard time producing enough
with 8 hours of just pumping per day and a baby that doesn't actually
nurse a *lot* when she's around.

I think that in this case, mixing breast and bottle (or other feeding
device, as I know some families do use things like sippy cups instead of
bottles) is by far the best thing she can do for her baby if she is
unable to quit work (not enough income), or unable to quit school (needs
the schooling to continue on to work).

First of all it continues to provide all the health plusses of bf to a
child who is likely going to spend his/her days in daycare (= more
exposure to germs).

Secondly, it permits for a down-time that is special when she comes in
from work/school at the end of the day:  a "re-union" time between her
and baby.

Thirdly, I can't see how it would be more expensive for most moms to do
this, than to formula-feed exclusively, because although they end up
buying a pump (probably a good 2-300$ expense if they buy a really good
one), if they are able to provide most or all of baby's nourrishment
with MM rather than using formula (and what little formula some might
use is that:  small amounts), then by far that large pump purchase ends
up "paying for itself" long before the baby is very old.

I am not sure exactly how one would tackle the idea, but I'd start with
the idea that mixing breast and bottle is something that *can* be
detrimental to baby/mom even after 6 weeks of age, and therefore it is
best, when possible, to avoid as many bottles or other supplementary
feeding as possible.  Some babies even self-regulate, and will only take
1 small 4-oz bottle during the 8 hours Mom is away, but will reverse
their cycle and nurse through the night every couple of hours or more.

I think we want to send out the message that breast and bottle is FAR
better than only formula-feeding in a bottle for both baby and MOm...but
that when Mom has a choice, being with her baby and nursing exclusively
is even better.  Partly for dental formation (mom's nipple being better
for the baby's mouth than a hard rubber nipple), partly for ease for Mom
(no bottles to prepare etc.) and in some families it *is* worth it for
Mom to stay home, once one counts up child care, extra gas, clothes for
Mom's work, the pump, the bottles, etc.  It depends on the family, and
what kind of salary Mom is pulling in (or would pull in if at work).

I also know families where Dad stays home with the kids.  While I think
that most often, for a newborn, having Mom home is the best treat they
can have, having Dad is certainly better than having to go to daycare,
and it still necessitates having their food given to them in another
manner than at Mom's breast...so if Dad feeds expressed MM in a bottle,
cup, spoon, syringe (etc.) and then Mom nurses when she comes home, I
think that if the family *needs* for Mom to work, then it is better to
give baby at least the MM in a bottle for the time they are apart, than
to put out negative vibes about breast & bottle mixing.

It would probably be good to stress that if at all possible, a day care
provider who is close to work (or at work, in some rare instances) where
Mom could go and nurse baby on breaks/lunch time is a very very good
thing to have.  If Dad can bring baby to work to see mom if he is the
provider that is also good.  Not everyone has these options, but when
they are available, the moms should make use of them!

Fio.

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