Yes, Caren, they're all over. The only way to fix the problem is for a hospital to have protocols and procedures related to breastfeeding and for management to enforce them. If a nurse gives glucose water or formula without a MD order, or encourages a mom to sleep though the night rather than explaining the ramifications of skipping feedings i.e. engorgement, nipple confusion ( I believe it exists! ), etc., she gets written up. If she persists with these practices, she gets a poor evaluation and no raise. And if she's really stubborn about it, she's out of a job. A nurse can't give out medication without a MD order, or do a dressing change "her way". ( My apologies to the gentlemen who are nurses out there! ) Has my hospital fixed this problem? Well, not yet! Just yesterday I did a maternity home visit with a very sweet 18 year old and her 4 day old, 5 lb. 7 oz. baby girl. The chart said the baby was on Nutramigen, having gone though all the other ABMs during her 2 day stay. ( Regurgitating them all.) A diagnosis of "reflux" was made, although no pneumogram was done, or reglan or apnea monitor ordered. Anyway, while examining mom, I ask about how her breasts are feeling. She says they're full and leaking "lots of milk". Then she asks wistfully if she can still breastfeed. Of course, I'm delighted to say yes. She then tells me that she had always intended to breastfeed, but "the nurse scared me to death!" Apparently, when the baby was brought to her at 6 AM, she was awakened confused from a sound sleep and "told" to feed her baby. When she said she would need some help because she had never done it before ( Obviously, L & D dropped the ball, too. An unmedicated delivery, even! ), "the nurse" told her she didn't have time and she better just give her a bottle, because she was so small. My sweet young mom thought she shouldn't breastfeed, or she would hurt her baby. An almost admission to the NICU to R/O reflux certainly didn't ease her worries. Well, after getting this baby started breastfeeding ( they were doing terrific when I called today ), I got a description of said "nurse", and wrote a memo to the head nurse of maternity, with a copy to the Director of Nursing for Maternal-Child Health. They were happy to get it, for they are supportive of breastfeeding and knowledgeable about the proper management of it. And yes, we do have those policies and procedures in writing. Please know you're not alone, Caren. We'll win this battle in the end, one mom and baby at a time. Kim former NICU nurse, current home care nurse and lactation consultant in NJ, who thinks most nurses care and try to do the right thing.