No longer will I consider ND the end of the world!  Actually, I know how
impressed the rest of Lactnet must be with ND based on the activity coming
from the UND nursing majors.
It seems to me you need a two prong approach: education of the providers
but also the mothers who give birth at this facility.  The practices you
describe are archaic, even to this North Dakotan!  (Alright, I am being a
tad hypersinsitve tonight, but there was a satirical skit on NPR last night
where Hillary bemoaned that the First Lady of ND probably had more
important things to do than she did!)  You know the climate at your
facility best: what will they respond to?  Would the information about BFHs
encourage them to rethink there practices?  What is the rationale used?
Does scientific evidence impress these people?  Kathleen Aurback
presentation a year and a half ago in Fargo had a wonderful bibliography
addressing each of the ten steps that she might be willing to share with
you.  I have also done a staff inservice on the ten steps that I would be
happy to share with you, much less than Kathleen's.
What seems to help is having the mothers ask for the things that optimize
breastfeeding and bonding.  Is the a LLL group in your community?  How
about WIC?  How are the requests from these women met?  Are there
breastfeeding classes offered in the community?  What information is
provided there?  Mothers asking, asking, asking, demanding is a very
powerful cause for change.  At a leadership conference I just attended at
the U of Michigan it was said over and over that health care has gone from
the focus in the '70's as being a quality service provider to the focus in
the 80"s of customer satisfaction to the focus in the 80's to customer
loyalty...does the facility have this?  Why?
Hope this helps.  And keep the faith!  It can be done...
"We sit as many risks as we run."  Henry David Thoreau
Linda Beckler, RN, BSN, IBCLC