I was thinking of changing the subject line because this issue is much
greater than "pump companies" and "WHO Code"...  Unfortunately, the more
breast milk is touted - not just by pump companies but by our own
researchers (Breast milk and obesity, breast milk and Necrotizing
enterocolitis, breast milk and stem cells, breast milk and ...you get the
picture) and our own "public health campaigns" the more likely it is to have
people like the phone call I got yesterday:

"My girlfriend finds pumping and bottle feeding breast milk easier ... all
she has to do is pump and we then can see what the baby gets, I can feed the
baby and she can sleep, and we can go about our life and work...  Is that
wrong?"

(This call from a friend of my son, college educated and VERY involved in
his new baby's care.)

Of course our counseling skills need to come out:  Could the mom have been
an abused woman and doesn't want the baby at the breast?  Could the mom want
to make sure she gets the father of the baby "hooked" on the baby, as they
aren't married?  ???

BUT the bigger message is - what message are WE giving in our public health
and prenatal education?  Are we touting the value of breast MILK at the
expense of valuing breast-FEEDING (the hyphen added because my computer
insists on NOT capitalizing where I wanted it).  

Just today I added a slide showing mothers breastfeeding (and fathers
present) and encouraged a discussion among the participants (members of the
state Maternal, Child and Adolescent Program - researchers, MDs, nurses,
epidemiologists) to elicit from them the importance of the feeding method.
They came up with:

* BABY controls the amounts

* BABY controls the frequency

* Oral development of the tongue, hard and soft palates, dental arch.

* The spray of the milk actually exposes the nasopharynx and eustachian
tubes and even the respiratory tract to the fine mist of proteins that are
immunoglobulins and protect the baby from infection  (I used Jelly Bean
activity from Linda Smith's book, Coach's Notebook: Games and Strategies for
Lactation Education
<www.amazon.com/Coachs-Notebook-Strategies-Lactation-Education/dp/076371819X
>)  

* The milk changes from watery to thicker, fattier milk which exposes the
baby to changes in the feed and helps trigger "end of feeding" which does
not occur with either formula or bottled breast milk

* Eye-to-eye, skin to skin and the smell of breastfeeding is essential to
eye hand coordination as well as the development of mother-child
interaction, trust and bonding 

Interestingly, despite my other VERY BRILLIANT <grin> slides about the risk
INCREASE of formula-feeding (based on some of the 2008 ILCA Conference
presentations - thanks to the syllabus I purchased, as I was unable to
attend - the AHRQ Evidence Report and the CDC reports), it was THIS slide
that elicited the most discussion at the end - and a list of interventions
to help promote breastfeeding...

Jeanette Panchula, BSW, RN, PHN, IBCLC
California, USA

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