"Give infants no food or drink other than breast milk, unless medically indicated," per Step 6 of the Ten Steps to Successful Breastfeeding. Although this is our goal, there have always been those, both staff and families, who say it won’t make any difference if the infant gets just this one bottle or one day or one week of formula. Does it really make any difference? Let’s look at the work of Marsha Walker, IBCLC, from 2016.
In her review of the research, Walker found that "just one bottle" can:
• Change the gut flora and pH for 2 to 4 weeks
• Decrease protection against overweight and obesity
• Increase the potential for infection and inflammatory states
• Increase allergic sensitization
• Decrease immunity to illness
• Increase risk for lifelong diseases such as Type 1 Diabetes Mellitus
Given that parents have the right to make a fully-informed decision, and knowing that even one non-medically indicated or unnecessary feeding of breast milk substitutes can have a profound difference in the health of the infant, how do you provide judgement-free teaching?
Withholding the negative effects of formula supplementations does not allow parents to make an informed decision in the best interest of their family. Using the wrong wording, body language, or tone of voice can often imply negative judgement and could create difficult decision-making scenarios.
So how do you provide truthful, research-based information to encourage informed decision-making and to follow the guidelines of the Baby-friendly Hospital Initiative? Remember that the decision is ultimately in the hands of the parents, and they will need factual information to make a truly informed decision for their infant.
Kathy Parkes, MSN-Ed, RN, IBCLC, FILCA CHC
Professional Development Educator
1. Baby-friendly USA. (2019). Interim guidelines and evaluation criteria for facilities seeking and sustaining Baby-Friendly Designation. Albany, NY: Baby-Friendly USA.
2. Walker, M. (2016). Just one bottle won’t hurt - or will it? Free to download at https://massbreastfeeding.org/just-one-bottle/
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