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