Responding to the two comments below, my Maternal-Child Director said we would never go Baby-Friendly because it's too expensive. She was referring not only to more than the perceived cost of buying formula, but also to the hospital's cost of having everyone trained on BFing in the 18-hour course. That's 18 hours of staff salaries with no patient time to show for it.

She said they would go "Family Friendly" instead. I have seen articles about this in nursing journals. They say it includes the whole family where Baby-Friendly focuses only on Baby and Mom. (i.e. it's exclusionary) My take of their reasoning and the articles I read: there is no formal organization the hospital must pay to do surveys, and the hospital can set its own rules on how Family Friendly is to be accomplished. I don't think there is any special focus on BFing, or requirement to do more than they are at the moment. That's 2 LCs on staff for 3500-4000 deliveries and a 35 bed Level III NICU. Does anyone know anything for sure about Family Friendly compared to Baby Friendly?

Like Kelly's hospital, mine is focused solely on the Bottom Line: the most Bang for the fewest Bucks by discharge day. And be sure that happens as soon as the patient is medically able. Insurance in the USA does not pay for one more day to be sure baby is BFing well. And so many of our patients say they will BF when they get home. (Yeah, I know.)

I really like Alice's imaginary response. If opportunity permits, I may use something like, "Can you help me understand this? Are you are saying..."

Phyllis

"He said the reason that the hospital I am currently training in is not a baby friendly hospital is because they refuse to comply with The International Code of Marketing of Breast milk Substitutes. "They give us $300,000-400,000 in formula and tube feeding. What should we do? Pay for it? That is 6 nurses we would have to fire. Plus, when talking about monetary savings of breastfeeding- that is to society, not our institution." 
 
"My imaginary follow-up comment to this is, "Would you be willing to put that in writing and go on the record as placing savings to the hospital above the health of the patients who come here? How many of this 
hospital's patients understand that their well-being is secondary to monetary concerns? Would they continue to come here if they understood that? I'm asking these questions because I see an ethical dilemma that I doubt you've examined." 
 

--
Phyllis Adamson, IBCLC, RLC
Glendale, AZ.
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