Dear Bethany, there is no standard here in US.  Each hospital can do as it
pleases basically.

JCAHO monitors the whole hospital but BF/BF ed isn't high up on the priority
list.

The Baby Friendly hospital movement (getting approval for indiv hospitals
that meet high standards in the BF area) is out there and some very
impressive programs have been implemented in various hospitals, but again it
is individual choice of each hospital to participate.

I believe in many areas WIC is becoming more influential, again it is
spotty, no consistent participation.

My (unpublished) research from 1994 implied that a nurse's personal
experience was weakly related to use of research-based BF knowledge in
clinical practice.  Nurses' use of research based BF knowledge was related
to BF knowledge score and positive hospital policies.  "Strong research
based policies provide a basis or frame of reference for nurses with
inadequate knowledge regarding breastfeeding.  The novice depends on rules
and looks to role models for guidance and assistance in learning her role.
Types of novices may include new orientees, nurses who have not had children
or nurses who bottle fed their babies.  Research based policies need to be
current, state-of-the-art, and detailed for novices."  Four other variables
were also found to predict use of research based policies:  on-the-job
training, required continuing education, workshops and conferences and [most
interesting] self report of ability to help mothers with breastfeeding.

So the things that can help make hospitals better are strong research based
hospital BF policies and mandatory education.  The policies are do-able,
after all a hospital has to have them anyway !  The mandatory education is a
luxury in today's health care financial climate.  I haven't got a clue as to
how we can get around the almighty $.

Sincerely, Pat in SNJ

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html