Working on staff ed this week, looking at Joint Commision (US) reporting for 
exclusive breastmilk feedings starting in April, but realizing that many mothers 
dont want to exclusively breastfeed. What will that mean to stats? What if "no 
milk" is just a way of saying "I don't want to," like children say "I can't" when 
they don't want to do something? How does this work in Baby Friendly 
hospitals? I can see how the whole snowball started rolling and got bigger over 
the years into the whole "Both breast and bottle" "norm" we have right now, 
but can't see how to melt that snowball from all sides. Staff can be trained, 
mothers "educated" but it comes down to alot of them dont want it. Similar to 
healthy diet choices. Nurses make post surgery patients get out of bed to 
avoid iatrogenic problems, whether patients want to or not. Can you imagine 
nurses refusing to give formula when a mother insists, to avoid iatrogenic 
problems? Is it that the whole institution has to be able to say "We don't 
practice that way in this hospital" with the same determination as the post 
surgery nurse? Is this what makes BFHI so powerful? I was meditating on Joint 
Commision getting behind bf for a long time, now wondering how to use that at 
the bedside. 
thank you, Judy

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