This is a retransmission that may have been garbled. As moms and babe are being discharged after 12, 24 and 48 hours post delivery (I know that this old news for my US colleagues) we Public Health Nurses are seeing more and more moms and babes having breastfeeding difficulties, ie cracked, bleeding and falling nipples, breast engorgement as well as the infant not attaching correctly at the breast, nipple confusion, jaundice, discontented, tired, frustrated mom, babe and family. Our Health Unit is in the process of formulating goals and objectives, and guidelines for us Public Health Nurses to follow. The supervisors verbalize a keen interest in increasing the breastfeeding rate as well as a desire to help these early post natal discharges. Unfortunately their behaviours do not appear to follow their verbal intent. As the only LC in our region I feel that there is a lot of breastfeeding lip service and that we are going backwards instead of progressing. The rural hospitals are supposed to be supporting breastfeeding but practically every bassinet has a bottle of abm in it and all have a soother. All but 1 hospital have a breastfeeding protocol, (a few years ago they did not have any). Only a few health professionals follow the recommendations. I realize that the Alberta's Health Care system is in a period of great change. As a result the hospital staffs appear to be getting smaller whereas their case loads are increasing. They may be working in ICU one minute and in the case room the other. I am not sure if this is reason to excuse them. Our Health Unit region include 5 sub offices and our population is diverse; predominantly rural, middle class with an important native transient population, an older population who did not breastfeed and a younger generation of single mothers. Would any of you who have a critical, analytic, rational mind be willing to share insight and pointers as to set forth goals and objectives, and guidelines that would reflect an proactive measure in supporting, promoting and increasing the successful breastfeeding rate in this community? Our Health Unit did a nutrition assessment on children up to one year old 2 years ago. I look forward to reading your responses. Big thanks in advance. Rosemarie Allain RN BScN IBCLC close to the north pole. St. Paul, AB, Canada