Just wanted to make one comment on bottle-feeding.  Most of the time I see 
moms, it is because something is really wrong.  She is already at the end of 
her rope, or would not be going out on a financial limb to hire me.  I think 
there has been an all out panic about nipple confusion among the general 
public.  Tell me, is nipple confusion really an issue if she ends up giving 
the whole thing up and formula feeding?  Many of these moms need to use a 
bottle if things are not going well- for whatever reason, suck issues, 
weight issues, supply, etc.  And to reassure them and tell them that as long 
as they are pumping that milk into the bottle, and paced feeding, etc- 
usually things will be fine when we get to the root of the problem. 
Obviously, we can never promise, and I tell this to mothers, but more often 
than not- I think 99% of the time, they are so relieved to hear it, have a 
couple of days of rest just pumping and bottling- needing to hear that every 
bottle IS NOT getting her further away from full breastfeeding, but one step 
closer-You end up with a calm mother who is confident and ready to face the 
challenges of getting that baby back to the breast.  The other way, many 
times you end up with a frantic panicked mother who is at high risk for 
throwing it ALL overboard- because to HER, in HER world, this is much worse.
So I really try to tread lightly on the bottle issue, for the sake of the 
long term of breastfeeding.  I always feel bad when I see that feeling of 
relief wash over a mother when I "allow" her to use the bottle.

Jessica Billowitz, IBCLC
Israel 

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