role of midwife
...k of support that midwives offer to women that bottle-feed their babies (Kaufmann 1999). The World Health Organisation and UNICEF (cited by Martyn 1998) published the International Code of Marketing of Breastmilk Substitutes in 1981, which states that while infant formula should not be promoted, parents that have made an informed decision to use artificial milk should be provided with adequate information to do this safely (cited by Martyn 1998). This was also re-iterated in Changing childbirth (Department of Health 1993) and Maternity care in action (Maternity Services Advisory Committee 1982). However, many health professionals have been identified as pressurising women into breast-feeding (Battersby 2000), and have even reported that allowing informed choice in infant feeding is inappropriate (Robertson 2000a). It has been identified that prospective parents are not usually provided with adequate information on artificial feeding, and as a result, unsafe practices often occur (Kaufmann 1999), and truly informed choices are not made (Minchin 2000). For this reason, the topic of ‘reconstitution of an artificial feed’ was chosen for the teaching session. It should be considered as an excerpt of a larger teaching session covering all aspects of infant feeding to allow informed decision-making and safe practice, in accordance with the wishes of the client group. The session was organised in advance, using a teaching plan (appendix one). This has been identified as a helpful teaching aid (Wilson 1990) and clearly identifies the desired outcomes for the session. In this case, the objective is that all attending clients feel able, by the end of the session, to prepare a bottle of formula milk safely and confidently. The client group involved was actually a group of 17 student midwives, and two assessors, but for the purpose of this essay, they will be regarded as a mixed group of antenatal women at about 26 weeks into their pregnancy and their partners. Although 26 weeks may seem early to be discussing infant feeding, Robertson (1999a) states that as pregnancy progresses, parents tend to become more focussed on labour and delivery, however, too early in the pregnancy, and the practicalities of parenting may seem too distant to the client (Wilson 1990). Also, starting classes earlier in pregnancy allows the development of an improved support network among the parents, particularly with a closed group (Robertson 1999b, Wilson 1990). Partners would be encouraged to attend. A recent study demonstrates the perceived inadequacies of current parent-craft classes by the attending men, but also, their desire to be more involved (Smith 1999). This implies we should tailor course content to suit both parents (Smith 1999, Wilson 1990, Priest and Schott 1991, May 2000). The setting of the session would ideally be an airy, clean, well-lit room (Priest and Schott 1991), with easy access to toilets and refreshments. The room would be made to feel as comfortable and welcoming as possible, and to help achieve this and to improve group interaction, the chairs would be arranged in a circle (Robertson 1999b, Priest and Schott 1991). After a quick introduction to ensure everyone knew who the session facilitator was, the teaching session was started by ensuring everyone was comfortable with adequate refreshments. A comfortable, relaxed atmosphere will aid group work, and encourage clients to return (Wilson 1990). The clients attending the session were all adults present through choi...