Anne Clements
<While it might go against the grain for those of us that would prefer that
they breastfeed with the accompanying benefits for both mother & baby, it is
part of my position discription to ensure these clients are able to
competently make up their baby's feed if they are not buying pre-mixed.>

It is also a condition of the WHO code (of which Australia is a
signatory)that adequate information is given to those mothers who choose to
formula feed. Mothers need to make and informed decision and information
outlining the benefits of breastfeeding should be given them. Group formula
demonstrations are out (can't quote the clause because I haven't got it in
front of me--but it is outlined with interpretations in the NHMRC
Breastfeeding guidelines for Healthcare Workers) and demonstrations are
preferably given on an individual basis.  It states the risks ie. too
concentrated formula, too dilute formula, increased risk of gastro. etc.
need to be clearly explained to the parents.

I also work in an Australian hospital and in the postnatal wards where the
mothers are caring for their babies, if they choose formula, they have to
bring in their formula and make it up themselves.  It then is not the "easy"
option.  They bring in the same tin of formula they will be feeding their
baby at home and therefore gain skill in mixing formula under the nurses
supervision prior to doing it herself at home.

The Special Care Nursery where I work is different because we are
responsible for caring for their sick babies and if formula is required it
is provided by the hospital (ready to feed bottles--purchased, not donated,
stock).  However all mothers are excouraged to express and breastfeed when
their baby is able to. Sometimes this takes a little more effort. Only last
week a mother who had a general anaesetic an hour and a half before and
couldn't get out of bed and a baby in oxygen with transient tachypnoea
(whose resps were only in the 60s) still managed to successfully (and
exclusively) breastfeed.  He was HUNGRY and demanding a feed.  The mother
was wheeled (bed and all) into the nursery, the baby fed beautifully with
funnelled oxygen near his face and the doctors cheerfully stepped around the
bed during their morning rounds.  I believe the tide is turning and medical
and nursing staff are getting better educated on the benefits of
breastfeeding.  Again last week I had one of the registrars bring me in an
interesting breastfeeding article he had read.  This was the same doctor,
when reviewing a baby's chart, wanted to know WHY the mother had decided not
to breastfeed and who also proudly brought in the photo of his 11 month old
still breastfeeding daughter to show me.
Marian Rigney RN and IBCLC2B (hopefully)


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