Dear Kimberly,

It certainly is tough to present objectively other choices when it seems so
clear what is the best choice. However, as we all realize or have come to
learn through life's experiences, what is the best choice in one situation
is not necessarily the best in another situation or possible.

Dorothy Rae Collier presented many good points. I don't want to repeat. I
would like to just add to what she wrote the experience of a wonderful La
Leche League Leader, Rivka Servetnick.

About five years ago, Rivka, our Coordinator of Leader Applicants, was faced
with not being able to resume nursing her three month old daughter after a
month of intensive care in a local children's hospital. She had Job's
Syndrome and so did her daughter. Apparently, Rivka had passed through her
milk an illness that nearly killed her daughter when she was two months old.
I am not able to detail the specifics, however, her not being able to nurse
was concluded after consultation with a number of doctors, including a local
member of the International Health Advisory Board of LLLI.

Rivka was devastated. Rivka herself was dying at the time. We did not know
it. Her daughter's doctors knew that she was not in good shape, but she
refused to tend to her own needs. She poured all her energies into her
daughter's care. Day and night she stayed in the hospital next to her
daughter bed. She never gave up hope even - when the doctors came to tell
her that daughter would live only a couple more hours.

Her daughter's recovery was long and hard. SHe was in the intensive care
unit for two months and an additional month more in the hospital. There was
a period when her daughter was throwing up all oral feeds up. Rivka began to
pull out every idea that is used to help nursing breastfeeding babies and
overcame every problem in that period of time. Short hourly feeds of very
small amounts of formula, - sound familiar - got her daughter over this
problem.

[It was not possible to use donated breastmilk because of the transmission
of viruses through donated milk.]

Eye to eye contact, close cuddling during a feed like what occurs during
breastfeeding, lots of skin to skin contact, mother giving the feeds as many
times as possible, helped Rivka deal with her upset at not being able to
breastfeed. I remember her describing to me how she held her daughter just
like a breastfeeding one and gave her the bottle in almost the same position
that a child would get the breast.

Her daughter has scared lungs from all the oxygen that she needed. But she
is alive and very happy. SHe is 5 years old now. With knowledge of this
Syndrome gained from Rivka's long medical problems, her daughter is getting
the best medical care.

Outside of a heart transplant, Rivka had no chance of living at that point
in her life. Rivka died before her daughter's first birthday. This daughter
has the continued love and care of five other older siblings, parents, and
grandparents. One other child of Rivka's, prior to this daughter's birth,
did not survive, what we know today, was the same situation.

Not every Mom who attends your hospital classes will be able to breastfeed.
 From time to time, there will one with problems as severe as Rivka. They may
not want to tell you. Those moms and the ones who simply chose to bottle
feed, will benefit immensely from good breastfeeding information. Just like
Rivka did. And your positive, objective, presentation of breastfeeding
techniques along side a positive presentation of bottle feeding, - leaving
the decision in the mother's hands -, may help many a mother and father
chose to breastfeed.

Devorah, Leader, APL, HREI
LLL - Israel