Our small 30 bed hospital that does 100 births a year is finally getting serious about implementing ALL the 10 steps for the BFHI.  We have been trying over the past 4 years to do all the right things but of course the free formula was the last obstacle.  We now have a sympathetic administrator that believes becoming "Baby Friendly" will help in marketing our OB services to our rural service area. 

[[We should be popular with the BF and LLL crowd, we offer rooming in for mom and dad, we don't do any epidurals, any number of mom's support people can be present for the birth (my record was five people besides the mother, me and the nurse.  There was; husband, mother of preg. mom, 14 yo sister of husband, mother and father of husband), and my moms can put the baby to breast immediately after birth if the APGARS are good and the cord long enough. ]]

At any rate I am asking for help on what to do with the 40 % of moms that we have that still don't initiate BF.  What do the other Baby Friendly Hospitals do with the bottle feeding mothers?  I know about the need to purchase formula, we got the administrator to agree to that, but do we buy ready to feed so that the nursing staff doesn't grumble about using  non ready to feed ABM?  Or do we include a large can of powdered ABM to the mother and then help teach her how to mix it while she is at the hospital.  (Most of our post-partum moms still stay about 48 hours.)  

One of our concerns is that the change in present procedure of using "free ready to feed ABM" will cause the nursing staff to view the new policy as more work and hassle and lead them to not be as supportive of the BFHI.

Any input from those with experience in this matter would be appreciated.
Thanks.

Jon Ahrendsen MD FAAFP
Clarion, Iowa