Mary says,

<< Since we live in a bottle feeding culture, nurses
 "know" bottle feeding, have received training in bottle fdg. and are
 therefore capable of teaching bottle fdg.>>

I disagree.  I think they waltz in, hand the mother a bottle of RTF, tell them
to give the baby 1 or 2 ounces, burp, and waltz out.  In the archives
somewhere is a more extensive list of what to teach when teaching bottle
feeding.  How many nurses can tell you the difference between the aseptic
technique and terminal sterilization techniques?  How many know that if the
mother accidently switches the scoops used in Similac and Enfamil powders that
they will get the wrong concentration of formulas -- one under concentrated
the other over concentrated?  How many discuss the possibility of using tap
water causing methylhemoglobinemia?  Or over boiling of water causing lead
concentration?  Or too much copper in the water if they live in a newer house?
Or if they are going to buy water, which one they should buy?  How many nurses
remind the mothers that they MUST read the directions on the cans of formula
EVERY time because the companies often change the directions without noting
NEW directions on the can?  How many can tell you whether or not you should
pack the formula powder into the scoop; loosely tap it against the side of the
can, scrape off the top with a knife or just exactly what?  How many remind
the mothers to check their water content for fluoride so the baby isn't
getting too much?  How many tell the mothers that the formula needs to be
stored exactly according to the directions -- and that any formula not used
within 1/2 hour needs to be discarded because of the overgrowth of bacteria
--against which the baby has no defense because their own IgA hasn't kicked in
yet -- and won't for several months?  How many know that there really are some
differences between formulas, but though Similac may claim they are putting
"bacteria" into their formula to make it more like mother's milk, that the
outcomes of the babies may not be any different than babies without the
bacteria in the formula, because in human milk, each element complements the
other to cause better absorption?  For example, zinc is added to formulas, but
why is it that only breastfeeding can save a baby that has acrodermatitis
enteropathica?  Because only human milk also has the prostoglandin E that
allows it to be absorbed properly.  Or that when SMA added neucleotides to
their formula, that although the babies had "better" immune systems, they
became just as ill as babies fed formula without neucleotides?  Or that the
casein:whey ratio of Similac and Gerber formulas are the same as cow's milk --
82:18 -- causing babies to sleep "better" without the safety factor of waking
more easily, and yes, the deeper sleep can be a factor in SIDS.  That Enfamil
has a casein:whey ratio more similar to mother's milk -- (40:60) but that in
later lactation the casein:whey ratio is 50:50 -- and in early lactation it is
10:90 -- probably designed so that babies eat early and eat often.  (Just like
we vote here in Chicago).

How many nurses know and impart this information to parents so they are making
a fully informed decision about choosing which formula to feed their baby.
How many remind the mothers that since the baby is not protected from
pathogens brought home from day care by their older children or by their
husbands that it is probably a good idea to invest in some masks so that the
babies have at least a modicum of protection from flus and colds -- at least
until they are three to six months old and their own immunoglobulins begin to
kick in?

How many nurses remind the mothers that breastfeeding is the norm, so that it
is important to mimic breastfeeding as much as possible when bottle feeding
their infants so that the babies get the same benefits as a breastfed infant?
That the babies need to be switched from arm to arm so that they get equal eye
stimulation.  that they need to be held for just as long as a breastfed infant
-- that the feedings should be no shorter than at least 20 minutes, and the
babies should be held and cuddled longer than that at each feeding.  How many
nurses remind mothers that babies need to be "groomed" during a feed -- and
since bottle feeding takes two hands, they will need to be held for at least
another 15 minutes or so after a feed so that the appropriate stroking that
comes automatically to breastfeeding mothers can be done by a mother that
bottle feeds?

How many nurses REALLY know about bottle feeding?

 Jan Barger, is Linda Kutner's bottle fdg. instruction sheet available
 anywhere?


I'm sure she will share it with you -- she's on-line, just not on Lactnet:
her e-mail address is [log in to unmask]  I don't know if it is on her computer
to be able to send it to you via e-mail, but I'm sure if you send her an SASE
(if it isn't on her computer) she'll be glad to send you a copy.


Warmly,

Jan Barger, RN, MA, IBCLC