Regarding Baby Friendly hospital staff refraining from giving formula
during the night shift--I am the sole Lactation Consultant at the 32nd
or 33rd US Baby Friendly hospital.  The night shift is an on-going
challange for us too, with the largest number of either less experienced
or oldest and most- stuck- in- their- ways staff.  Since I'm not there
at night, it's easy for me to tell them how to do their job, right?  So
even tho I suspect not 100% complience, I try to give them lots of good
ideas, things that I know will be helpful, try to encourage them when I
hear of them doing things that worked.
Night Comfort Measures Supportive of Breastfeeding:
1.  start with prenatal ed classes dealing with challanges of the early
hours after birth, esp. nighttime.
2.  teach and demo skin to skin, starting right after birth.
3.  early latch right after birth helps alot (observe more colostrum
swallows then, generally)
4.  if fussy baby that next night, teach handexpression (if not already
doing) and spoonfeeding--talk about baby's small capacity--most babies
settle and rest, albiet briefly with just a few cc's from a spoon.
5.  if still fussy, offer clean, inverted finger for sucking (Mom's or
Dad's prefered)
6.  at night, snuggle Mom and Baby with warm blanket over both, if
applicable.
7.  explain how sleeping with baby benifits both Mom and Baby--put
effort into making it work.
8.  Strongly encourage side-lying sleep/nursing position, make sure Mom
is comfortable.
9.  offer warm fluids, backrub to Mom, while Dad or loving other cuddles
 baby.
10. give positive assurence that morning will come, and when it does,
limit the visitors!
Hope this helps, no doubt others can add things they have found helpful.
It's certainly not an exact science, but over time seems to get more
successful--involve the night nurses by frequently asking them how it's
going and what they have found that works for them.  Good luck.
Becky Garcia, RNC, IBCLC in Walla Walla, Washington

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