Thursday, December 23, 2010

When and how to give formula to the developing world

Every new disaster in the developing world seems to bring e-mails to my inbox with appeals for donations, and every time one lists "infant formula" that I cringe, and ponder whether or not I should try to start a dialogue around the dangers of those donations and importance of providing them correctly.

Via the Motherwear Breastfeeding Blog, here's an example of when and how to offer infant formula appropriately: in a setting of acute medical need, under medical supervision, prepared safely and accurately by professionals, and - so importantly - in a way that is supportive of breastfeeding:

Helping Hospitals Treat Malnutrition in D.R. Congo from Action Against Hunger USA on Vimeo.

Watching the baby's eyes light up as it nursed away using the improvised supplemental nursing system reminded me so much of babies I've worked with in the hospital. We sometimes need to provide a supplement for babies who have lost more than 10% of birth weight. Often this is because the mom's milk is delayed coming in for some reason - very long labor and/or long pushing stage, or a lot of postpartum blood loss. Of course, taking the baby off the breast and giving the supplement by bottle has the potential to confuse the baby, demoralize the mom, and creates extra work for her having to pump to continue stimulating her breasts in order to get the milk in ASAP. We always prefer to use an SNS, assuming the baby is latching and nursing well - just put the baby to breast, get the suck going and then slide the tube in the corner of the mouth.

When you start the SNS you just see the babies' eyes fly open as they nurse away hungrily thinking "Hey! This is new!" A day or two of SNSing, and with all this continued stimulation mom's milk comes in, we pull the tube, and they're good to go. It feeds the baby while keeping everyone - baby and parents - breast-focused, and protects the milk supply. It's so neat to see it used half a world away for not-dissimilar purposes.

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