Yes, I agree it can be tricky to leave a six week old baby for work and also
avoid the possibility that the baby may be upset and not wanting to take a
bottle.  In fact, I could go so far as to say it is a nice thing to hope
for, but in reality not all that likely to happen.

I object to the idea that the baby will be less upset if bottles are started
earlier, rather than later.  In fact I object to the idea that it is the
bottle that the baby is upset about, in the first place.  The baby is
missing his mother!  He wants her breast.  Of course he may be upset.  To
imply that starting bottles sooner would make a difference seems to me to be
denying the baby's real feelings.  And it puts unfair pressure on mothers.

A mother who agrees to return to work at six weeks must place her baby in
the care of someone who will hopefully be prepared to do a lot of holding,
carrying, rocking, slinging, laying down with, whatever it will take to try
to help that tiny newborn to get along all day without his mother. After
all, six weeks ago the baby was still in the womb.  I would hope that they
would likewise be prepared to help the baby adjuest to a different feeding
method than they enjoy with their mom.  In other words, we are talking about
a situation which is far from convienent.  It will take a LOT of work and
focused attention.  And yes, it may take a little time for the baby to learn
to take a bottle.

To my way of thinking, the possible benefit of getting the baby to take the
bottle before mother is gone must be weighed against the potential costs to
the breastfeeding relationship.

Benefits?  Possible making things easier for the caregiver.  Some might say
it makes it easier for the baby, although I doubt it.

Costs?  Possible bottle preference.(Note I am not even inferring nipple
confusion...)  A need to spend some of the precious and disgustingly short
maternity leave time trying to get the baby to want to bottle when he could
in fact be nursing.  The need to decide what to put in the practice bottles-
(and let's not kid ourselves- when parents buy the idea that this practice
is REALLY necessary they are very likely to use formula to follow this
mandate... do we really want to be encouraging other foods at two weeks of
age?  Four weeks?) And finally there is the potential interference with
growth spurts.

I see mothers worrying that if they don't get the baby to take a bottle, he
will never eat while she is away.  I encourage them to think through this
belief- that the baby will not eat if he isn't taught to take a bottle
before she returns to work at six weeks.  Let's say the baby refuses the
bottle.  There are still options.  Firstly, hungry babies can also be fed by
cup, eyedropper, or spoon.  And unless the mother is not reachable by phone,
she can always be called and choose to return to the baby.  This is why I
usually suggest "weaning back to work" -starting a half day on a Thursday,
seeing how that goes, with the idea of being back full time by the end of
the following week.  Meanwhile, a gentle and loving caregiver can be
gradually coaxing the baby to accept the bottle.

I encourage mothers to see that they can retain some control over their
situations- and having some flexibility about what may happen and what she
can do about it seems to me the best we can offer to help mothers and their
babies who are in the unfortunate squeeze between birth and the too-soon
return to work.

Until we collectively agree to "Just say "NO" to the inhumane six week
maternity leave...

Sue Jacoby, IBCLC
Fresno, CA

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