X.W.C. is a 37-year-old gravida 3, para 1011 at 39 weeks and 6/7 days' gestation. She has no medical problems. Her obstetric history revealed that she had a normal spontaneous vaginal birth of a 4000-g live infant male 12 years earlier in China. By her account, the infant had been exclusively bottle-fed. Her primary language is Mandarin. Her prenatal course was mostly uncomplicated. She had a positive purified protein derivative (PPD) test, but a chest radiograph was negative for tuberculosis. She also had a condyloma that was ruled safe for vaginal birth, and a pronounced rectocele and cystocele that were to be followed postpartum. During each of the first 10 prenatal visits, X.W.C. was handed a pamphlet with facts about the benefits of breastfeeding. Toward the end of her prenatal course, she was asked what method of infant feeding she preferred, and she indicated that she would try breastfeeding.
Shortly after being admitted to the labor unit she was given Pitocin to augment her labor because she presented with prelabor rupture of membranes (PROM) at term. Two hours later, she had a normal spontaneous vaginal birth of a live 3515-g female newborn; her 1-and 5-minute Apgar scores were 9 and 9, respectively. The baby was placed on the mother's abdomen and warmed and dried. After the delivery of the placenta, and after a second-degree laceration was repaired, she was asked if she would like to breastfeed or bottle-feed. She hesitated for a moment before answering that she would like to try both. Her husband then looked at X.W.C. and asked if that would be the best thing for them. Sensing her husband's wishes and possibly having discussed feeding methods with him beforehand, X.W.C. then took a minute before telling the nurse that she had changed her mind—she wanted to bottle-feed. On her first day postpartum, she and her baby were both doing well. Her baby was by her side, and she was exclusively bottle-feeding.