Breastfeeding fundamentalism

[ocelot]

The hospital I volunteer at is working to become Baby Friendly, which means they provide a high standard of care as far as breastfeeding support goes.

This includes 10 steps:

1 - Maintain a written breastfeeding policy that is routinely communicated to all health care staff.
2 - Train all health care staff in skills necessary to implement this policy.
3 - Inform all pregnant women about the benefits and management of breastfeeding.
4 - Help mothers initiate breastfeeding within one hour of birth.
5 - Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.
6 - Give infants no food or drink other than breastmilk, unless medically indicated.
7 - Practice “rooming in”-- allow mothers and infants to remain together 24 hours a day.
8 - Encourage unrestricted breastfeeding.
9 - Give no pacifiers or artificial nipples to breastfeeding infants.
10 - Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic

Yesterday, I noticed a posting detailing recent steps taken and steps to be completed. Included in steps to be completed were "remove formula instruction from parent education video and manual" (the hospital gives a ~100 page infant-care manual to parents who have a baby there). This seems to me to be taking things over into abstinence-only education territory, and beyond the baby-friendly steps.

I'm a breastfeeding advocate. I'm proud that our breastfeeding rate is so high (something like 97% attempting, 90% exclusively breastfeeding at the time of release), and that we're close to obtaining Baby Friendly status. But this move strikes me as neglectful and potentially dangerous.

People using formula need to know how to do so properly. Babies here in the US die from improper formula usage. Some percentage of the patients are going to end up using formula at some point, whether out of choice, medical necessity, or because they must return to a job that does not provide adequate opportunity for pumping. These patients may not be identifiable before discharge from the hospital (especially a hospital that so strongly encourages breastfeeding), and, considering they may not take their child for well-baby visits, the hospital may be the only opportunity to educate them.

They don't have to promote formula, or support it's usage in the hospital, but not at least providing the information seems wrong.

ETA: I found my copy of the manual. The breastfeeding section is 30 pages of what (at a quick glance) seems to be very good, helpful info. The formula section is 2 pages, and presented after the breastfeeding section. It's certainly not advocating formula usage in the current form.

Comments

[purdypiedad.livejournal.com]

I don't disagree. But all the instructions anyone needs are on the container of formula itself. There is no excuse to not use formula properly.

The hospital my daughter was born in tried everything in their power to get her hooked on the bottle. They were lucky I could barely walk. Somebody would have died.

Eventually a pediatrician went to bat for me.

[therealocelot.livejournal.com]

The current (formula-including) manual does not include the info that would be found on the bottle (what dilution to use, etc.). It makes sense that they don't include this, as it is 1. on the bottle, and 2. subject to change or vary from brand to brand. It does include things like positions for feeding the baby, not to bottle prop, sterilizing bottles, expected amounts needed per feeding/day, and things like that. Important information, and not the type found on a formula bottle.

The breastfeeding section is 30 pages (and is, in my opinion, pretty good), while the formula feeding section is 2. The formula feeding section is after the breastfeeding section, and the last thing in the book. It is certainly not an advocacy or support of formula, as the breastfeeding section is for breastfeeding - just the basics for the people who need it.

[purdypiedad.livejournal.com]

Ah. Gotcha. In that event, yup. I agree with you completely.

[paquerette.livejournal.com]

Some of that info is not even formula feeding info, it's just bottle feeding info! A lot of bf'ing moms are going to need that, too. :-/

[murphymom.livejournal.com]

I agree. And, WRT the previous commenter's remarks regarding "...the instructions...are on the container...", what about people whose first language is not English, or those who might switch from liquid ready-to-feed to liquid concentrate or powder, all of which have very different (and potentially fatal) dilution requirements?

The only one of my four children I was successfully able to breastfeed was my youngest - and that only because I chose to supplement with formula, to get relief from what was essentially non-stop nursing. If you think I'm exaggerating, let me tell you about the UTI I got because I couldn't get him off the breast long enough to get to the bathroom.

"Breast is best", but the alternatives need to be taught as well.

[purdypiedad.livejournal.com]

--what about people whose first language is not English--

Then, unless the manual is written in their language, too, they wouldn't be able to read it either.

--those who might switch from liquid ready-to-feed to liquid concentrate or powder, all of which have very different (and potentially fatal) dilution requirements?--

Yes, and each container has it's own instructions, be it powder or liquid.

I breast fed my own baby, but I also did respite care for fosters. Formula is expensive and impractical, but it's not difficult to use.

On the other hand, given the greater detail that therealocelot was kind enough to include for my benefit, I am most definitely in support of her opinion.

[therealocelot.livejournal.com]

I know they provide a Spanish-language version. I don't know if the content differs at all, or if they have other languages available.

[purdypiedad.livejournal.com]

That's awesome!

[jtersesk.livejournal.com]

I agree. I entered the hospital with absolutely no intention of using formula and with no clue how to do so. They used the ready-to-feed "nursette" bottles in the hospital, and we made off with a case when we left, so the first time we had to buy formula, we were like, "er...." We were afraid to try the powder, had no idea what the "rules" were. (Yes, we could read the cans - we are intelligent, educated people after all, but still, it's way different from any other food you have to prepare.) In the hospital, they told us important safety information, like never to use a partially-used bottle after an hour, not to leave out formula at room temp longer than 2 hours, etc. A lot of that may be on the can, but it's a lot more impactful coming from a nurse in the maternity ward, you know? So, yeah, not everyone will leave the hospital bf-ing, and not all of them will continue to bf after 1, 2, 6 weeks (or at least not exclusively) no matter how baby friendly the hospital is. And they do need that info.

Plus, as paquerette said, some of that info that you need is just plain bottlefeeding info, even if what's in the bottle is EBM.

So, er...yeah. I agree with you. :)