I have had a few mothers ask me about safe bottlefeeding, because they
can't/won't nurse because of breast reduction surgery or some type of
asthma medication .

The biggest debate I have had is about sterilizing bottles.  A lot of
doctors here are now telling mothers not to bother sterilizing bottles,
just to wash them in hot, soapy water, "it's all the same".

I recently had an argument with another LLLLeader who disagreed with me
that I tell mothers to sterilize every single bottle up to a month old, and
after that to  sterilize once a day.  (Premies, of  course, bottles should
always be sterilized.)

My main guidelines are:

1) Up to one month old, sterilize every bottle and artificial nipples
before each usage.  Also, sterilize any breastpump parts at least once a
day. During same day, rinse and wash with hot water all parts that touch
mother/mother's milk.
If baby is a premie, sterilize before each use all parts that   touch
mother/mother's milk.

2)  Never prop bottle. Always hold baby.  Try to use a bottle that allows
baby to eat sitting up ie: the "Natural Nurser"  (silly name.. the only
natural nurser is a mother...)

3) Cuddle and maintain eye contact with baby, talk to baby.

4) Allow baby four swallows and then give him a breather so that he won't
become asphyxiated.  (Then of course I hear the complaint "That will take
as long as BREASTfeeding!") I always state "Recent research shows that
babies oxygen levels drop dramatically while bottlefeeding.  This can
impair brain development and cause choking."
(Sometimes I stress this more than others.  I am not going to make a mother
who went through breast reduction feel guilty that she can't Bf; but it's
not a bad line for a mother who still hasn't made up her mind. )

Any other ideas?  I think that we should really try to give parents ALL the
information, so they can make a really informed decision.

Maybe I should also bring up all the things that can happen to the baby if
the bottles AREN'T properly cleaned?

Nofia