Edie asks, how do you change the institutional approach of letting babies sleep during the noc.

Have a one-day (or half/day) inservice for the nurses of your institution where you or someone with even more credentials talks about the current understandings of the lactation process and promotion of successful breastfeeding;

Require as part of your protocols, that the BF baby be offered the breast at least every three hours, regardless of the time of day.

Forbid the use of pacifiers until baby has left hospital; disallow ABM supplements during the noc.

Encourage co-sleeping, even in the hospital (especially if baby's room-in).

Teach breastfeeding, where possible, in positions most conducive to mom and baby being comfortable enough to sleep.  

Chanita, San Francisco