I'm sure you've already heard of the Nutramigen recall due to incorrect
instructions in Spanish.

For those of you who work with a population that cannot read English well
(for whatever reason), I would like to stress the need to ask them what
ELSE they are feeding the baby - even if you don't want to hear that
they're giving formula - and how they are preparing and feeding it.

I saw a mom of twins last week who showed us (after we asked) the can of
Enfamil concentrate - that she had been feeding them between breastfeeding
attempts (one baby was much smaller and she had been unable to latch either
on).  The formula was a concentrated - but she was feeding full-strength
"like they did at the hospital".  

Granted, I wanted her to exclusively breastfeed - but she felt overwhelmed
and stated she could not pump.  Given that she was not going to, (at the
next visit one baby was exclusively breastfed, the smaller one still on
formula)  I reviewed the instructions on how to safely mix all the formulas
she had in the house.  (She also had some powder - all had been bought by
her husband.)  The formula cans have diagrams showing how to do it, but
they didn't read Spanish or English - and the diagrams were so tiny they
had never seen them!

I've asked that question - what else is the baby taking by mouth - and
gotten all sorts of interesting answers - teas, cereal, juices, etc.  It's
an important one to ask - without sounding judgemental so that you will get
the truth!  Often it is Grandma doing the feeding, the mother usually knows
and wants some support in asking her to stop.  Luckily I'm usually
Grandma's age and she'll take my suggestions a little more seriously that
the baby's mother!

Jeanette Panchula, BSW, RN, PHN, IBCLC
Vacaville, CA

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