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Subject:
From:
"Jane A. Bradshaw" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 8 Oct 1997 13:01:33 -0400
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Hi Kim,
I just wanted to make a comment about your dilemma. I agree totally with
Dorothy. Since many breastfeeding moms do use formula to I think it is within
our scope of practice to discuss and teach this topic.  I hold support group
meetings (we call them New Mother's Teas) at my office and advertise them for
ALL new mothers, although it is usually 100% breastfeeding moms who come.
  We hope to reach some of these bottle feeding moms and get them to hold
their babies, bond better, maybe breastfeed next time.   We decided to hold
one "Tea" on formula.  It was titled someting like "everything you need to
know about infant formula".

I tell you it was packed ------- with breastfeeding moms!!

 They all wanted to know about formula because they were afraid they may have
to use it sometimes (afraid of insufficient milk supply) OR because they were
planning to use it, wean, etc., in the future.  I used a lot of the
information from Kathleen Huggins book The Nursing Mother's Guide to Weaning.
 I also prepared by gathering all the information the local pediatricians
give to new parents about bottle feeding.  THEN what I decided to recommend
to the moms was:

!.  It is a serious/medical decision which formula to use.  This will be your
baby's TOTAL source of nutrition for months during the most critical period
of his little life and you want to choose carefully.  Consult the baby's
doctor!!  What are signs and symptoms of  the baby having any problems with
the formula, and what should be reported to the doctor. Stess there are many
different kinds of  formulas because many babies cannot tolerate some of
them.  Haven't they heard of mothers having to swith formulas and having
trouble finding one their baby can tolerate?  (There are usually people
nodding in agreement in the class when you say this)  You should not make the
decision based on what your next-door-neighbor recommends.
2.  Preparing the formula properly is VITAL for the good health and
development of your baby.  I showed cans of the 3 basic types, ready to feed,
concentrate, and powder, and have people read the directions.  Lately in a
hospital in N.C. where a close LC friend of mine works, they have had 2 calls
in the past month from frantic parents who fed their baby the concentrated
formula with out diluting it. Both times the dad did it in the middle of the
night to "let mom sleep".  I tell this to parents to show how easy it is to
make mistakes. Stress information about the hazards of overdiluting or
overconcentrating formula.  Many people put "a little extra" in because they
believe they are doing baby a favor to "beef up his formula", and don't
realize they are over stressing the little one's liver and kidneys.  Talk
about the different brands which may have different directions.   What does a
scoop full mean?  A level scoop?  A rounded scoop?  Packed down? (NO!)
 Stress taking the time and effort to read the instructions and follow them
exactly.  Stress that mom should not delegate making formula to just anyone,
as it is so important to her baby and must be done exactly right.  (More work
for mom!)
3.  Stress proper cleaning of the equipment!!  The doctors here do not
recommend steralization anymore, BUT Kathleen Huggins brings out the point
that formula fed children get more infections, and feels part of these are
due to inadequate cleaning and steralizing of equipment.  After all formula
is an excellent growth media for bacteia.  Therefore, even if the doctor does
not recommend it parents may CHOOSE to steralize  for at least the first 3
months and deserve the proper instructions on how to do this.  I have also
found parents that didn't  scrub the nipples and bottles with a brush, at
all, EVER.  Noone ever stressed this to them or showed them how.  Bring a
dish pan with soap and water and demonstrate how to do this for them.  You
are being realistic and showing them how much time and effort they need to be
putting into this for their baby's sake and perhaps, making them feel a
little bit guilty if their baby does get sick without actually saying this.
4.  THEN stress how to give the bottle, tilting it so the formula fills the
nipple, holding the baby for ALL feedings, not giving into the temptation to
prop bottles, hazards of choking, and the importance of holding the baby EVEN
when the baby is old enough to hold the bottle himself!!  Talk about the
importance of the feeding for the social and emotional development and
perhaps how to mimic breastfeeding, by switching sides, some skin to skin,
mom doing most of all of the feeds, etc.  This was in JHL a few years ago.

I think LCs are the BEST people to teach bottle feeding, because we will not
make it sound easy and care free.  You can show them honestly how much time,
effort, and care they need to put into it if they decide to use formula.
 That helps make breastfeeding more appealing.

Good luck,
Jane Bradshaw RN, BSN, IBCLC
Lynchburg, VA

  Doesn't it  look stupid for the lactation consultant to be teaching how to
bottle
 feed your baby! If I could only tell them the truth about formula. Of
 course I'm sure that wouldn't go over to well with my employer. I said
 that I wasn't comfortable about discussing bottle feeding because I'm
 the L.C. but, my boss just went on to something else of course. I'm very
 frustrated. I can't wait to hear your words of wisdom. I asked if there
 is a short film that can be put on to cover this topic but, none of us
 knew one off hand. Any help would be appreciated. My boss said you need
 to educate parents on all aspects and more than 50% choose  formula.
 Yuck!
 How do you tell them the great benifits of nursing and then take a
 breath and talk about the benefits and how to formula feed. I feel like
 I'm a traiter.  Anyone who knows me knows I'm a very strong proponent of
 breastfeeding. I'd rather be silent about bottle feeding than have to
 teach it. Thanks for letting me vent!!!!!!
 KIM PINCUS R.N., I.B.C.L.C., A.C.C.E

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