Bonnie,

I was working for over 4 years to try to improve a hospital's breastfeeding
support.  Almost all will SAY they support breastfeeding, then have such
unsupportive policies you want to cry.  In order to reduce stress to
yourself, I have some suggestions:
1. Find supportive staff (from administrator, to nursing supervisors, to
nurses to clers and  the cleaning staff)  that you can talk to so you don't
always feel you are fighting a losing battle.  
2. Provide everyone with the 10 steps for BFHI so they understand you are
not inventing this for yourself, but that this is "official"  and
"studied", etc.
3. See if the administrators are supportive - one of my best supporters was
the hospital administrator - he and the medical director saw a potential
"increase in the market share" - hey, I'll go with whatever will benefit
moms and babies.
4. Pick the step with the least resistance and concentrate on that - we
were not giving pacifiers, so I could tell them we were already one step
ahead!
5. DON'T go in order of the 10 steps - we were able to get the policy
done(#1), the education to some of the staff (not the 80% goal, but some),
and started the support groups (#10) long before we could get babies to
stay in the delivery room (that still doesn't happen on a regular basis).

And most of all, remember that we may not be able to complete the job of
changing the hospital, but if we can just start it - we have helped a great
number of moms in the process! 

Jeanette Panchula, BSW, RN, IBCLC, LLLL
Vacaville, CA
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