>I am a Lactation Consultant in a SCN/NICU in the states. The reality 
>in my world is babies get bottles. My partners and I work very very 
>hard to make sure these babies get breastmilk in those bottles, NOT 
>formula. Families on the Mother/Baby unit will tell you most moms 
>are returning to work. Reality, bottles. Will I stop using Medela 
>products that help these moms provide milk? No!!!!


No one is asking you to stop using products that in your judgement 
are useful to the mothers in your care , Christine.  The WHO Code 
does not proscribe the *use* of bottles (or formula, in fact) by 
mothers or HCPs.

It does proscribe unethical marketing - so there should be no 
informational material in your unit showing anything other than an 
educational depiction of products in use, for example (you can have a 
leaflet showing a mother how to prepare formula, and how to hold a 
bottle - it should not be branded, though, but it does;t need to be!).

It also means you cannot have a commercial relationship with 
manufacturers who are not Code compliant - this does not mean your 
unit cannot buy products from them, but to be Code compliant there 
should be no way the unit can sell them to mothers .

Retail outlets are not covered by the Code (outside their marketing 
role, which is covered), so of course they can sell these products 
and make a profit. You can also inform mothers where to buy the 
products, if they need to know.

>In my humble opinion, the Code should be revised to reflect the 
>needs and culture of the times in all countries. Without changes, 
>there is division within, and the one who suffers from all of the 
>opposition is the baby, who deserves to receive mom's milk.  We 
>should be promoting breastmilk, however the family choses, instead 
>of focusing on the vehicle by which it is being delivered.
>Christine Gabler, RNC, IBCLC


I find this viewpoint utterly shocking - am I naive to feel that way? 
Breastfeeding support is *not* 'promoting breastmilk', and  I rather 
resent the 'we should' stricture, 'cos it sure as  anything isn't 
something I feel I 'should' do!

Mothers need to know that it *matters* how breastmilk is 'delivered'. 
We know a huge amount about infant mental health, communication and 
relationships, and the way this is enhanced by *direct* breastfeeding 
(and undermined by the use of bottles) - how can we not share this 
with mothers and fathers?   If they are not able, or choose not to, 
breastfeed 'direct', then lets at least ensure they are not marketed 
to unethically :(

Yes, it means challenging the 'culture of the times' - I can live with that!

Heather Welford Neil
NCT bfc, tutor, UK

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