At my hospital, getting the baby to breast is a high priority.  All immediate
care of baby - assessment, eye tx, vit K, weighing, bath, etc., are done at
mom's bedside.  The only unfortunate thing is that all babies go to warmer
initially to be assessed by nurse anesthetist, although if no resusc is
needed, then go immediately to mom.  Other procedures are delayed until first
nursing has occurred.  Also, we rarely supplement breastfed babies with
anything.  If it is needed (rare occasions of hypoglycemia, small babies not
nursing, etc.), some of our pediatricians order it given by syringe.  Some of
the nurses - thanks to my inservices - will give it with startes SNS at breast
- though not all, of course.  We have a few that will still give formula to a
fussy baby in the middle of the night, etc.  But in general we do pretty well.
It is my impression that immediate breastfeeding is the standard of care in
most hospitals around here, although there is variation in how consistently it
is carried out.  One problem we have is that C-section moms are recovered in
the general recovery room and babies go to nursery, so they miss the initial
time.  I have tried to talk about taking baby in to mom in recovery room, but
no luck so far.
Because we're a small hospital, usually not overly busy, we tend to spend a
fair amount of  time helping moms with breastfeeding.  Still, even I don't
spend as much as I would like when I have other nursing tasks that need doing.
Again, the quality of assistance and information given varies among the
nurses, but overall we do better than most places I've worked.  Our
breastfeeding initiation rate is probably 80-85%, pretty typical for Northern
California.   Recently I have started doing follow-up phone calls within the
first week.  I find that most of the moms are doing well.  I think it's no
coincidence.  Things are far from perfect, but most of the moms feel well-
supported in getting breastfeeding established.  Miriam