I've held off commenting on this one, but Cathy Barger's posting about the after-care home in (I think) Korea has spurred me.  It certainly depends on the underlying ideology of the home.
    After-care homes have existed for many years in a number of Australian states, and some have been better than others.  In the days when the 4-hourly schedule was inviolate and the "no night feeds" enforced, the well-intentioned aims of helping Mums improve their breastfeeding met with less than success - except, of course, for those Mums with bigger breast storage capacities who could get by with fewer feeds, or where the home reduced the interval between feeds (though still maintaining a schedule).  Rigid schedules and test weighings at every feed meant that babies were topped up with bottles.  As Mums were made to express after every feed, "to 'empty' the breast", a lot of the top-ups were from this pooled EBM.  In time, some staff became less than favourable towards breastfeeding because they'd seen it repeatedly fail.  How do I know?  These comments are based on personal experience in 1965 with my first baby, my current research, and what Mums have told me over the years.  (I'm keeping this message as brief as possible.)
    Later, some of the homes went in for "controlled crying", when it became fashionable, as a way of eliminating night feeds - to me, this is child abuse.
    So, to reiterate what I said at the start, the underlying ethos and written policies are what will make an after-care home either good for breastfeeding mothers, or deleterious to their lactation.   A home which is set up to follow the Ten Steps to Successful Breastfeeding as the written policy would be the gold standard - and why should anything be less than the gold standard?
    Funding?  This sort of thing would probably end up being on a user-pays basis, meaning only those who could afford it could benefit - *unless* insurers could be pursuaded to reimburse (!!) or a benevolent fund or foundation be established to set it up and maintain it.  Neither of these options is easy, but I've learnt in life that very little is totally impossible.
                                                    Virginia Thorley, OAM, IBCLC
                                                    Brisbane, Queensland, Australia
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