Mary asks if there is some way to educate her colleagues regarding the harm that just one bottle of formula can do. Since the staff ignored my paper on this issue and seems to practice anecdotally rather than on an evidence-based basis perhaps approaching at this in another manner may help. Joint Commission has the new Perinatal Core Measure Set. If a hospital chooses to work on this particular core measure as a quality improvement effort then they will need to address exclusive breastfeeding (and it won't matter that the staff practices in denial!). Ask if this Core Measure has been chosen. If it has not, work with those who select core measures and see if you can persuade them to choose this measure.
Marsha Walker, RN, IBCLC
Weston, MA
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