First of all my apologies Margaret for mixing up your name.

Dr. Newman is competely correct that breastfeeding classes should not teach
the feeding of artificial baby milk.  However, many classes are stated as
infant teaching classes geared for all mothers.  In these cases I think it
is best to mention both types of feeding making it clear that they are not
equivalent and in fact formula feeding is inconvenient and less health for
mother and baby.  The problem with teaching breastfeeding only classes in a
WIC situation is that the mothers who are breastfeeding will be steered to
it and those who have decided (WITHOUT ALL THE INFORMATION THAT THEY NEED)
to bottle feed will be given a bottle feeding class by someone else.  If
everyone is exposed to the breastfeeding advocate it does make a difference.
In the low income clinic I worked at all pregnant women met with the
mutritionist who is an avid breastfeeding advocate, no holds barred. The
breastfeeding initiation rate went up from 36% to 51% in one year.I think
the WHO code is wonderful and would like to see it be make international
law, but in the interim I think we have to be a little flexible in certain
surroindings to have breastfeeding promotion goals met.

On a similar note, I started teaching the resident education class in my
residency program on "INFANT FEEDING". When I received the lecture it was 30
minutes of formula feeding and 15 minutes of breastfeeding.  When I give it
is 40 minutes of the benefits, mechanics etc of breastfeeding with 5 minutes
at the end about formula.  Had I insisted on giving a breastfeeding only
lecture then there might have been 45 minutes of breastfeeding with equal
weight and importance in a separate lecture on formula.


Deena Zimmerman MD MPH IBCLC