Diane wrote:
"But if a baby *hasn't* been exposed, I'd
 rather see him gain less than optimally for a short time than break the
 barrier.  If the barrier's been broken, I tend to encourage mom to "pour it
 in - all he wants"."

I agree that I would rather see a little less than optimal gain than see a baby get that first dose. But, I don't necessarily think that once the barrier is broken, going gangbusters is the best thing, either. First, I am not convinced the harm isn't does-related. More importantly, I think about the psychological impact on the parents. The more you use, the harder it is to understand why you shouldn't just keep using it. And the more you use, the harder it is to accept that it really is a harmful substance. I try to keep it in the realm of a "medical food" or a drug.
     I wonder if there is any research which addresses the attitudes parents have about using formula even when nursing is going well, once they have used it "for medical reasons" early on. Perhaps a mother who is going out to dinner or whatever would be more likely to use formula than express once she has used it before. This, in my mind, would constitute a risk to that early use. I guess what I am saying is that anything that gives the impression it really isn't such a risk is to be avoided. I want it to be viewed the same way a drug is viewed--more is not better and in a given situation the benefits outweigh the risks, but given the risks you limit use and stop ASAP.
Jennifer Tow, IBCLC, CT, USA

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