How about the Surgeon General's Call to Action for evidence in support of providing an IBCLC for the NICU? The CDC report card, your hospitals MPINC survey, the AHRQ study that showed that lack of breastfeeding costs the US over 13 billion dollars per year in healthcare costs. Or maybe your hospital could start paying for it's formula and then they will see the financial wisdom of an IBCLC. I was told once by a government official that the way that you motivate hospitals to support breastfeeding is generally through shame and greed. That's what you have to appeal to. Unfortunately, they get the formula for free and you cost money. What about getting former patients to write letters or make a short video of patients who went through your NICU and either got support or didn't get support for breastfeeding and how it affected them? Sometimes you can reach them on a personal level if they understand how a lack of support affects real peoples lives. We can say it all day long but until patients complain it doesn't motivate administration. And sometimes it's hard to go into a hospital and tell them that you want to spend money so that people will be healthier and not need to be readmitted to the hospital and then they will make even less money. It's not really motivating to the administrators. I would steer clear of that whole discussion and talk about this can improve customer service and patient satisfaction scores, etc. Tricia Shamblin, RN, IBCLC

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