Valerie wrote,
>Yes, we all must deal with reality and that is that most of us have no >or
>limited access to human milk banks.  Thus infant formula is often >our only
>resort when we have a mother with a low milk supply. Does >that mean that
>we should accept this as the only reality for the future?

Valerie, essentially I agree with you.  Since the dismally low breast
feeding rates of the 60s rates have improved but it will be a long slow
battle to  increase them more.  Being pro-active with breastfeeding
information is a start. Encouraging and making it worthwhile for hospitals
to obtain baby friendly accreditation should be a goal for all governments
and health care workers. Certainly BF rates are higher when BF is actively
promoted right from the ante-natal stage, it is promoted as the norm and
staff are trained in the 10 steps.

>Currently there are parents who choose not to breastfeed.  What kind of
>education are parents getting?  Do parents need to hear about the >benefits
>of breastfeeding?  Parentts need to know that infant formula >will increase
>theirinfant's risk of a wide variety of infections and >increase their
>infant's risk of hospitalization due to those >infections.
All parents should receive accurate information on the benefits of
breastfeeding and should be encouraged and supported to BF by appropriately
trained staff. Certainly, in the SCN I work in these benefits are discussed
with parents. However the research also shows that if their partner is not
supportive of breastfeeding, then breastfeeding is less likely to be
initiated or sustained. With mothers of preterm babies, who were not
planning on breastfeeding, I ask them to consider expressing  for a short
period at least to help their baby over the most fragile period.  Some of
these parents agree and some then subsequently decide to continue
breastfeeding longer.  However we may give them the information, support and
encourage them but ultimately they may choose not the breast feed.

I believe one long term way to counter this problem is educate the community
about the benifits of BF. It is also high time governments put their money
where it makes most sense and promoted breastfeeding from early on, ideally
as part of the school curriculum.

>Do we truly know the rarity of infant formula mistakes.
Maybe not, and the formula industry should work at eliminating them
altogether, no matter how rare they currently are.  We cannot eliminate
formula altogether. However there are also "mistakes" from breastfeeding
that also have been reported, sadly too often with poor management babies
dying of dehydration and starvation and reports of kernicterus from
breastfeeding jaundice.  In such cases we need to "fix" the information
given to mothers and manage breastfeeding issues properly before they become
a problem.
>How research is funded is an important consideration in whether to
>accept or reject the validity of research results.
This is only one element in assessing the research.  The reputation of the
journal and researcher, whether the hypothesis is sound, whether they have
considered compounding variables,the sample size, how study group was
recruited, the methodology, the type of study (eg double blinded)etc. are
all important.  We should not accept or reject results on the basis of
declared funding.

>The improvement of infant formula is in whose best interest? The >Healthy
>People 200 project funding went to improving infant formula >not
>tobreastfeeding education to improve breastfeeding rates!!  The
> >improvement of infant formula is based on the assumption that we can >as
>humans, imitate nature and improve upon it.

I also  believe that improving breastfeeding education and improving
breastfeeding rates is in everyones best interest.  However for those babies
that are formula fed, or weaned early, it is in their interest (if not
breast fed) to have the next best alternative available, even if this means
imitating nature. This is prefereable to feeding them the unimproved
formulas of the past. (This is particularly relevant for premature babies
who already have a compromised start to life anyway.) This does not mean
that I in any way condone breaches of the Code of Marketing for Breastmilk
substitutes, which I firmly believe should be adhered to.  I don't
disapprove of improving formula and giving accurate research based
information to health care personel but I do disapprove of illegal and
unethical marketing practices.

Marian Rigney RN and IBCLC candidate


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