Dear Lynn,  I hear you.  I share your agony.  It is a difficult decision.
I too live in a country with extremes of wealth and health care and in our
case, a small country, our poor live down the road.  I can hear the music
as I type this.  I cannot comment on your particular situation,
circumstances being  so different, as we have learnt to our detriment, when
foreigners come into our health system and try to tell us what to do.
Still, I cannot help but feel so uneasy when I hear or read about "free
supplies of formula, bottles and teats, and sterilizing fluids".  Firstly,
I do not believe that free supplies of anything, especially formula, has
ever been anything but a tragedy for the recipients.  Secondly, our
experience with free formula in Trinidad is that our mothers sell the
formula to buy food to feed their other children or their partners.
Thirdly, who is going to ensure a constant supply of sterilizing fluid and
who is going to ensure that the mothers, overworked even at the best of
times, do sterilize the bottles etc?  Will the babies then not get AIDS but
die of diarrhoea?  Fourthly, I believe that this is another ploy of the
formula companies to put down human milk.  We might end up winning the
battle against AIDS but losing the war against bottle feeding or at least
having it put back by many years.  I have a sinking feeling in my stomach
as I write this.  Make no mistake.  What happens in your country will
affect us in the Caribbean.  Already, last week there was an article in one
of our newspapers about the "advantages" of bottle feeding. First time in
the last ten years!  Finally, what about some innovate thinking?  What
about pasteurized mother's milk?  What about sitting down and asking these
moms, humbly and quietly, what they would like to do?  Are these feasible
in your situation?  Has anyone looked at them seriously?  There must be
other solutions to this horrible problem, other than the quick, convenient
one?  Wishing you all the best and hoping you'll make the correct decision,
as you see it.   David, paediatrician from Trinidad, West Indies.