I am a lactation consultant in a small (650 births/year) city hospital.
 I recently submitted a proposal to expand breastfeeding support services
to the primary care sites owned by the hospital--family practice and
pediatric.  The health care providers in these offices are employees
of the hospital.  I based my proposal on the reduction in costs related
to healthier babies and mothers as a result of breastfeeding.  I promoted
it as an advantage in the managed care and capitation environment.
If babies and mothers are healthier, they will require fewer office visits,
less medication, and allow the providers to retain more of the money
they are paid per enrolled patient under the capitation system.  IT WAS
ACCEPTED.  I am now in the process of developing this program in 4 offices
as a pilot, in anticipation to expanding it to all the other hospital
owned offices.

Many, many thanks to my lactnet friends who helped me get the Kaiser
study info.

to include with my proposal.  I think this is a very exciting time
to be an LC.  It is a time of great change.  It is a scary time.  But
with chaos comes opportunities for those who recognize them and go after
them.

Barb Berges, RN, IBCLC
Rochester, New York