Here is a different BF related issue that I have not yet seen raised here or elsewhere. Our small 34 bed hospital is about to breakground on a 2.5 million dollar renovation/improvement project. We currently use a labor/birthing room and move moms to a private room after delivery. The new OB area will be 3 LDRP and a nursery. However the idea of the LDRP is for the moms to have the baby's all the time. Except when they need their "rest" (We only do about 100 deliveries a year). When I asked the planners why we even needed a nursey if the babies were going to stay in the mothers rooms, I was informed that the State Code (of Iowa) requires that all hospitals have a nursery (If they do OB). This really seems to be to be a bit of antiquated thinking from the 40's and 50's. But because of the administrative building codes there appears little that can happen. So now we will spend thousands of dollars for a room that will not be used that much. I now some of you might say we need a place to keep a sick newborn but our practice is only to keep the sick ones long enough to prepare them for transport to the regional neonatal center and we could do that in one of the other rooms in the OB area if we needed to. IMHO it will be hard to enact many of the reforms of the BFHI (Baby Friendly Hospital Initive) if these nursery building codes are present in all the states. Does anybody know about the Joint Commision requirements? In theory if the Joint Commision would accept the BFHI as their standard then that would help in the implamentation in the US. Katherine D., are the building codes an area that you have looked at that reflect the cultural influences of BF practices? I know about the design assistance that some of the BMS (Breast Milk Substitue) Companies have done for hospitals before. I welcome others comments and experiences. ******************************************************************** * Jon Ahrendsen, M.D. FAAFP, LLLI Medical Associate * * 215 13th Ave SW * * Clarion, Iowa 50525 USA * * 515-532-2836, FAX 532-2523, Email [log in to unmask] * ********************************************************************