Hi Kim, I just wanted to make a comment about your dilemma. I agree totally with Dorothy. Since many breastfeeding moms do use formula to I think it is within our scope of practice to discuss and teach this topic. I hold support group meetings (we call them New Mother's Teas) at my office and advertise them for ALL new mothers, although it is usually 100% breastfeeding moms who come. We hope to reach some of these bottle feeding moms and get them to hold their babies, bond better, maybe breastfeed next time. We decided to hold one "Tea" on formula. It was titled someting like "everything you need to know about infant formula". I tell you it was packed ------- with breastfeeding moms!! They all wanted to know about formula because they were afraid they may have to use it sometimes (afraid of insufficient milk supply) OR because they were planning to use it, wean, etc., in the future. I used a lot of the information from Kathleen Huggins book The Nursing Mother's Guide to Weaning. I also prepared by gathering all the information the local pediatricians give to new parents about bottle feeding. THEN what I decided to recommend to the moms was: !. It is a serious/medical decision which formula to use. This will be your baby's TOTAL source of nutrition for months during the most critical period of his little life and you want to choose carefully. Consult the baby's doctor!! What are signs and symptoms of the baby having any problems with the formula, and what should be reported to the doctor. Stess there are many different kinds of formulas because many babies cannot tolerate some of them. Haven't they heard of mothers having to swith formulas and having trouble finding one their baby can tolerate? (There are usually people nodding in agreement in the class when you say this) You should not make the decision based on what your next-door-neighbor recommends. 2. Preparing the formula properly is VITAL for the good health and development of your baby. I showed cans of the 3 basic types, ready to feed, concentrate, and powder, and have people read the directions. Lately in a hospital in N.C. where a close LC friend of mine works, they have had 2 calls in the past month from frantic parents who fed their baby the concentrated formula with out diluting it. Both times the dad did it in the middle of the night to "let mom sleep". I tell this to parents to show how easy it is to make mistakes. Stress information about the hazards of overdiluting or overconcentrating formula. Many people put "a little extra" in because they believe they are doing baby a favor to "beef up his formula", and don't realize they are over stressing the little one's liver and kidneys. Talk about the different brands which may have different directions. What does a scoop full mean? A level scoop? A rounded scoop? Packed down? (NO!) Stress taking the time and effort to read the instructions and follow them exactly. Stress that mom should not delegate making formula to just anyone, as it is so important to her baby and must be done exactly right. (More work for mom!) 3. Stress proper cleaning of the equipment!! The doctors here do not recommend steralization anymore, BUT Kathleen Huggins brings out the point that formula fed children get more infections, and feels part of these are due to inadequate cleaning and steralizing of equipment. After all formula is an excellent growth media for bacteia. Therefore, even if the doctor does not recommend it parents may CHOOSE to steralize for at least the first 3 months and deserve the proper instructions on how to do this. I have also found parents that didn't scrub the nipples and bottles with a brush, at all, EVER. Noone ever stressed this to them or showed them how. Bring a dish pan with soap and water and demonstrate how to do this for them. You are being realistic and showing them how much time and effort they need to be putting into this for their baby's sake and perhaps, making them feel a little bit guilty if their baby does get sick without actually saying this. 4. THEN stress how to give the bottle, tilting it so the formula fills the nipple, holding the baby for ALL feedings, not giving into the temptation to prop bottles, hazards of choking, and the importance of holding the baby EVEN when the baby is old enough to hold the bottle himself!! Talk about the importance of the feeding for the social and emotional development and perhaps how to mimic breastfeeding, by switching sides, some skin to skin, mom doing most of all of the feeds, etc. This was in JHL a few years ago. I think LCs are the BEST people to teach bottle feeding, because we will not make it sound easy and care free. You can show them honestly how much time, effort, and care they need to put into it if they decide to use formula. That helps make breastfeeding more appealing. Good luck, Jane Bradshaw RN, BSN, IBCLC Lynchburg, VA Doesn't it look stupid for the lactation consultant to be teaching how to bottle feed your baby! If I could only tell them the truth about formula. Of course I'm sure that wouldn't go over to well with my employer. I said that I wasn't comfortable about discussing bottle feeding because I'm the L.C. but, my boss just went on to something else of course. I'm very frustrated. I can't wait to hear your words of wisdom. I asked if there is a short film that can be put on to cover this topic but, none of us knew one off hand. Any help would be appreciated. My boss said you need to educate parents on all aspects and more than 50% choose formula. Yuck! How do you tell them the great benifits of nursing and then take a breath and talk about the benefits and how to formula feed. I feel like I'm a traiter. Anyone who knows me knows I'm a very strong proponent of breastfeeding. I'd rather be silent about bottle feeding than have to teach it. Thanks for letting me vent!!!!!! KIM PINCUS R.N., I.B.C.L.C., A.C.C.E