In a message dated 5/15/01 3:16:54 PM Pacific Daylight Time,
> stunned to see what seems "a lot"
> of talking about supplementing with formula on Lactnet.  Truly. It is an
> absolute last resort as far as I'm concerned and will remain so with every
> woman I help.  The impact on the infant gut is too dramatic to take it
>

I agree that the decision to add supplementation is not one to take lightly,
and also see it as a last resort.  In my practice, the advice to use formula
often doesn't come from me, but from the baby's health care provider (MD,
Nurse Practitioner, etc.), when the baby is not gaining or is "gaining too
slow" with exclusive breastfeeding.
If/when the mother calls me later -- I then work with her to improve latch,
use breast compression, build her supply, etc., and encourage her to use her
milk when supplementing as a first choice.  And as her supply increases I
encourage her to decrease the amount of formula used.
Of course the ideal would be if the baby's Dr. sent the mom and baby my way
before adding the formula -- and some of them do --  but in our community we
have a way to go before this gets advised every time.
Lori Salisbury RN IBCLC
Hospital based LC in Spokane WA

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