Greetings, colleagues, from Cathy Bargar in Ithaca, NY!
I am a newcomer to Lactnet, and this is my first posting, so if I'm not
quite in the swing of how this is done, please correct me.

I am an RN IBCLC, formerly working in the maternity unit of a community
hospital for 11 years, most recently serving for the past 41/2 years as the
Breastfeeding Coordinator of the Tompkins County WIC Program. That position
was terminated due to lack of funding (and there's plenty we could say about
that!), and am now starting out in private practice.

Kathleen Bruce's note about not being willing to do home visits to
formula-feeding mothers, not wanting to "pansy around and pat them and tell
them that formula feeding is a good choice when it's not", is what moves me
to enter this forum today. My years in the WIC program have led me to take a
very different position.  I had the blessing in that program of working with
all kinds of women, and I found that any woman, whatever the feeding method
she's using, has benefited from the attention and care of an LC.

We know a lot about babies, and about feeding babies and caring for babies,
and (hopefully) about sharing what we know with others in a nurturing,
supportive way.  We are accessible to women in a way that most physicians
and health care providers are not. We (breastfeeding promoters) are so
emphatic in our BF promotion that "breastfeeding" is not just feeding - it
encompasses the whole range of loving, caring, nurturing skills that we
surely want all mothers to learn and all babies to benefit from. When a
woman has decided for whatever reason that breastfeeding is not for her, do
we want any less for her and her baby than we would want for ourselves and
those who share our views? I've found that it's very often exactly those
women who are not breastfeeding that most need a little extra help and
support to become effective, loving mothers, and if I can give them that by
spending a little extra time with them, supporting their parenting skills
and modeling more positive ways of caring for their babies than they may see
around them, I figure that they and their children will be better off for
it. Nobody ever benefits from being given the cold shoulder for choices they
have made, and nobody is ever a better parent because of disapproval for
their feeding method.

I've found that when I've gone out of my way to visit and spend extra time
with a formula-feeding mom, she is more likely to be receptive to the
positive things I have to say about breastfeeding and decide to "give it a
try" with her next baby, or pass along what I've said to a friend or a
sister who then is willing to breastfeed her baby. Often the reason she
isn't breastfeeding is because she lacks confidence, doesn't know anybody
else who has done it, thinks she's too young or too uneducated or not
adequately "equipped" or whatever; lots of women don't live in the world we
do, where BF is "normal" and the stuff of our everyday lives.

I'm willing to bet that I don't have the whole context for Kathleen Bruce's
comment, but when I do a home visit to help a mom, I don't assume she is
asking for my approval of her choices. She's asking for my help with
something, and that's a different matter. I'm willing to consider myself
knowledgeable enough about babies and their care and feeding to offer that
help without being judgmental.

If the question at issue is time/reimbursement, etc., I still come out in
the same place; I'm not going to do a home visit on anybody unless I'm being
reimbursed for it. If a formula mother can pay my fee (in private practice),
or if circumstances allow it (in WIC, physician's practices, hospital
after-care programs, whoever pays my salary), why wouldn't I assist someone
in need of my services? Would I, as a nurse/LC take a fee from a formula
company to be their "feeding consultant" or some such thing? No way!

Hope to hear from others on this.

Cathy Bargar, RN,IBCLC
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