We have a high-80's% breastfeeding initiation rate but sometimes moms do tell us they're going to combine breast and bottle. Nurses need to clarify this statement - after all, what these moms are usually telling us is that they're going to be doing culturally-acceptable breastfeeding - they're just more observant than most!
 
We suggest that we'll start out with the breastfeeding in the hospital and get that off to a good start; then, they can come back for a lesson a couple of weeks on out if they need help getting the bottlefeeding started. We also educate around ways to "combine breast and bottle" that have the least effect possible on breastfeeding. (Don't be flaming me, I DO know that's a terrible statement!) 
 
I've found that these moms often have interesting reasons for their statement, eg They want to breastfeed but need to return to school or work in three weeks; they tried breastfeeding last time and the baby lost a lot of weight and they don't want it to happen again; they had PPD last time and the sleep factor was a big problem. So pursuing the questions and the answers is a good idea. Also - sometimes a mom DOES want to combine breast and bottle, right from the beginning. If I truly believe in informed consent - which I do - then I want to honor that mom's wishes.
 
Dawn Kersula
in Brattleboro Vermont
looking forward to the cold front coming through tonight!
 
 

 

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