Bummer that your administrators didn't support your bid to go for the
Baby-Friendly Certificate of Intent!

How about looking at competitiveness, bottom-line, patient satisfaction
type issues?
a)  Do you have a gift shop or pharmacy or durable medical equipment
part of your institution that could sell quality breastfeeding equipment
(eg. manual pumps, pillows, slings, etc?)  That would be another income
line related to bf and increase pt. satisfaction that they could get the
equipment easily.

b)  What other patient satisfaction surveys does your institution do?
The more good evaluations and comments you (and bf) get, the more likely
administrators will listen.

c)  I think that JCAHO is getting in on the act a bit -- looking at bf
staff proficiencies, etc.

d)  There are lots of things your institution (and your staff) can do to
'implement' Baby Friendly without having to get the certificate.  That's
the most important thing -- improving conditions for moms and babies.
If you can work on all of the other steps (and get staff trained so they
are on your side), then there will be less use of ABM and more allies to
get rid of it.  Also, BF Status is a good way to reward staff for a job
well done -- how could you play this up?

e)  What about your medical housestaff?  Do they know about this effort
(I hope so), do they support it?  I know that some physicians have been
concerned when hospitals go into exclusive contracts with formula mfgs
because they lose the option of choice (especially in some of the
specialty formulas).  They might go to bat on purchase of formulas.

f)  Did you see Marsha Walker's recent Lactnet post on getting free
formula out of institutions?  It has several good ideas (I have a copy
which I can email if you don't have this).

g) Certificate of Intent is "intent".  Rome was not built in a day --
neither was a baby-friendly hospital.  None of these big fees go into
effect until the hospital is assessed and awarded the BF Status.

h)  Are there other hospitals in the area that your hospital competes
with to get perinatal clients?  Is it struggling looking for more
patients?  BF status is a marketing tool!  You may want to contact
BF=USA to see if they have any info on how BF status (Certificate of
Intent and the Status itself) have altered patient satisfaction,
caseload, income, etc.  I'd like to know if any of these hospitals have
been able to negotiate higher capitations with insurance payors because
of their BF Status.

Don't get discouraged!  Collect Data, letters of appreciation, staff
"successes" etc. and file them.  Gain allies (especially medical).  It's
okay to lay low -- BFHI is now really going to take off.  Eventually,
let's hope that your administrators will feel foolish when they are left
in the competitive dust behind other facilities who support
breastfeeding!

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