6 Things We Do For Exclusively Formula Feeding Mothers at a Baby-Friendly Hospital

Working at a Baby-Friendly designated hospital, we "do" breastfeeding support well. However, it is not unusual to care for a mother who wishes to formula feed exclusively. She is well informed and this is her choice. Here are the 6 things we do to make sure the dyad receives the best possible care.

#1 Ensure skin-to-skin contact occurs in the Labor and Delivery Unit

We follow Step 4 of the Ten Steps to Successful Breastfeeding for all infants, regardless of feeding method.  Step 4 states: Facilitate immediate and uninterrupted skin-to-skin contact and support mothers to initiate breastfeeding as soon as possible after birth. The following points are from Baby-Friendly guidelines:

• Skin-to-skin contact is when the infant is placed prone on the mother’s (parent’s) abdomen or chest with no clothing separating them.

• It is recommended that skin-to-skin contact begins immediately, regardless of method
  of delivery. It should be uninterrupted for at least 60 minutes or longer if the mother wishes and/or if the infant needs more time to complete a breastfeed.
• Step 4 applies to all infants, regardless of feeding method.

#2 Review appropriate volumes per feed per day

We recommend feeding on feeding cues and help the parents with how much to feed their infant each day.

• Day of Life (DOL) 1 - up to 10 cc per feed
• DOL 2 - up to 20 cc per feed
• DOL 3 - up to 30 cc per feed
• DOL 4 - up to 40 cc per feed
• DOL 5 -7 - up to 60 cc per feed

#3 Review paced-bottle feeding

Most parents have a smartphone so we ask them to pull up You Tube and we help them find a paced-bottle feeding video. I like the six-minute video by Jessica Barton but there are many to choose from.

#4 Recommend using pacifiers when sleeping

Breastfeeding offers protection against SIDS (Sudden Infant Death Syndrome). Pacifiers provide protection against SIDS. If a mother chooses to breastfeed we recommend holding off on pacifiers until breastfeeding is established. If a mother chooses to formula feed we talk about immediate use of pacifiers at sleep time.

#5 Review how to safely prepare infant formula

Prior to discharge, staff review how to safely prepare infant formula. This includes the Centers for Disease Control (CDC) and American Academy of Pediatrics (AAP) recommendation to boil the water when preparing powder formula to eliminate any possible bacterial contamination in the powder formula.

#6 Pay for infant formula industry products

To eliminate any ethical issues, the hospital pays a fair market value for any infant formula and infant formula products provided.