Dr. Gordon, 
I spent over nine years on Active Duty, had two children in military  
hospitals and taught breastfeeding classes in another military hospital for two  
years.  TRICARE (the military health insurance agency) is doing a very good  job 
of promoting breastfeeding.  Since the military is now competing with  civilian 
hospitals (Recent deployments of MDs have left a shortage on base and  
mothers are able to go off-base to deliver.) for patients, esp. for OB  services.
Depending on how many waves this mom wants to make I would suggest she tour  
the L&D and speak to the head nurse about her wishes.  I would also  suggest 
she visit the patient representative at the hospital prior to giving  birth.  
The patient rep. works directly for the commander of the  hospital.  Again, 
this is all prep work.  The nurses are not allowed  to give supplement without 
notifying the parents.  As long as she keeps the  baby with her and refuses 
consent for supplement then this should not be a  problem.  If anyone gives her a 
hard time, call the patient representative  (having already seen this person 
pre-natally).  If this does not suffice to  get the nursing staff of her case 
or the patient rep. isn't available (i.e. on a  weekend) then I would ask to 
speak to the chief of the ward (a MD).  If  this does not suffice then tell the 
staff she will contact the IG (Inspector  General).
Depending on her husband's rank this may or may not be an intimidating plan  
for her.  I only say that because some soldiers and their spouses are led  to 
believe they should "go along to get along" and this becomes more prevalent  
the lower in the ranks one goes.
Does the hospital have a lactation consultant? A midwife?  Anyone who  could 
be her advocate to the staff?
I have done all sort of unconventional things (at least according to the  
Army) in the process of birthing and parenting the way I wanted to despite many  
people's best efforts to make it otherwise.  It takes a lot of energy and  
knowing where to go to get help to make it happen.  I would be happy to  talk to 
her by phone or by email if she would like.
BTW--most military facilities have really great support for breastfeeding  
mothers as well as great medical care in general.  I am trying to combat  (no 
pun intended) this notion that military healthcare is somehow  sub-standard.
Sincerely,
Christine Pillado, CLC
El Paso, TX

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