Jennifer, I think you are uniquely qualified to talk to these moms who have
weaned to formula and who are seeing the adverse results.  You are a
physician and the moms are looking to you for answers.  I think you can
speak freely about the relationship between health status and breastfeeding.
If I have a mom express regrets that indicates *she herself* is seeing a
link between having weaned to formula and health problems in their baby, I
tell her she is now armed with information which can help her make a
fully-informed choice with the next baby.

However, as the baby's HCP, I think you can be much more direct.  The mother
is coming to you asking for advice, trusting your medical judgement.  If she
were a smoker and her child was asthmatic, would you hesitate for a moment
to tell her that her second-hand smoke is a possible risk factor for her
child's asthma?  I doubt it!  If you met her in the emergency room after her
child had been injured because she didn't use a safety restraint in the car,
would you hesitate to tell her about the importance of using restraints
*every time the child is in the car*?  Of course not!

I think the direct approach can work for you, and in a very powerful way for
these moms.  You don't have to tell the mothers they are bad or stupid.  You
can simply say something like, "Now that we know your child has had "problem
x," it is important for you to breastfeed any future children for at least
two years."  (or whatever time frame you feel comfortable using).  Now the
mother can make decisions based on this "new" (to her) evidence of the
hazards of formula feeding.  Of course, you have known of this risk all
along and you have perhaps even informed her of the risk before she weaned
her baby.  But the moms are being bombarded by other messages telling them
formula is safe and comforting to the baby.  So now the mom has first-hand
evidence of the hazards.  Help empower her to make a positive choice for the
next baby.

I have worked with a couple of moms who weaned after a few weeks with the
first baby and immediately saw health effects in their baby - ear
infections, asthma, etc.  I know it is possible to help them feel empowered
to succeed the next time without condemning the choices they made the first
time around.  I think it is important to share the information with them
about the risks of formula feeding, perhaps focusing especially on how this
relates to their own family's known medical history.

Sara Dodder Furr
LLL Leader
Lincoln, Nebraska USA

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