Thanks to all of you who responded to my request for references on problems that can be caused by giving abm when it is not needed. The hospital librarian is still looking up some of the articles for me. I typed up the one page "Just One Bottle" article which I think summarizes a number of potential problems very well. My partners and I copied the article for a Mother/Baby and Admissions Nursery educational bulletin board; before we put it up, our boss saw it and said it is "controversial" and she wants us to have a forum to discuss how comfortable/uncomfortable the staff nurses are with the info before we circulate that information. (We were not planning to give it to parents; just to staff). :-( {How do you spell Aaarrrrgggg!?} One of the M/B nurses (an experienced nicu nurse) is very much concerned that our taking a strong line to avoid abm unless ordered for medical reasons will result in many dehydrated babies. She says some nurses will just give bottles without recording it (we know of one case where this happened) if we keep trying to keep tabs on the abm that is given. (Making a "big deal" of it.) She says she'll get the pediatricians to order "may bottle or finger-feed at night" or something similar whenever she feels it is advisable. We are keeping a list of the moms who call back with babies who have been supplemented in the hospital and are having problems at the breast once they get home. Don't know if those statistics will help show people more of the big picture. We also give every BF family a log sheet to record feeds, wet diapers and stools from discharge until the 1st wt check at the peds office, and are explaining the importance of being sure the baby is getting milk.This issue is causing a great deal of stress on the job for all of us. Does anyone have any ideas about helping to solve this? Our lactation program is 1 yr old, and has been very well received by families, and for the most part by the staff nurses until now. I'm sure many of you have been in a similar place. How do we know which battles to fight, and in what order?? Some fear we will undo the good our program has accomplished if we make too much of this issue. I'd appreciate any words of wisdom. Thank you all again! Anne Stiller, RNC, IBCLC