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Lactation Information and Discussion

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Lactation Information and Discussion <[log in to unmask]>
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Thu, 31 Dec 2009 08:12:18 -0500
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When I worked at a large HMO, I served not only as the director of the breastfeeding support program but often saw bottle-feeding infants with feeding problems as the ""infant feeding specialist." Some of my breastfeeding mothers also needed to supplement with infant formula for a variety of reasons. I made sure I knew then and continue to keep up with changes in the components of the various infant formulas and how to use them safely. I was asked to create a set of guidelines for the safe use of infant formula as well as feeding plans for how to feed babies bottles of formula. I receive many emails and phone calls regarding what formulas are composed of, how to use them, and how to help mothers and health care providers understand that they are not equivalent to breastmilk. All infant formulas are not the same, in spite of what claims are made. Some formulas have double the amount of DHA as others, which sometimes causes diarrhea in a subset of infants who do not tolerate plant based DHA. Hydrolyzed formulas should be used if a breastfeed baby needs to be supplemented with formula and has a family history of diabetes or allergies. The FDA regulates 28 ingredients in formula but has little to say on all of the additives claimed to make babies smarter and healthier. While mother's own milk or banked human milk is always our first choice for supplementation, we run into situations where we need something to feed the baby until we can get that precious mother's milk. I also make sure that mothers understand that infant formula will not make their baby smarter or boost his immune system. These are false and misleading claims.
 
I have whole lectures on the hazards of infant formula, how to use it, how to reconstitute it, etc. While we may not be infant feeding specialists, we still need to know about the competition to mother's milk in case it is medically indicated. We can't not feed the baby. There is a publication from the American Dietetic Association called "Infant feedings: guidelines for preparation of formula and breastmilk in health care facilities." It is a little old (2004) but has some good pearls in it.

Marsha Walker, RN, IBCLC
Weston, MA




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