Hola Lactnetters!
I have been reading your messages but not sure fo how to introduce myself, but
here goes.
I've been in LLL for 23 years (from the day I learned I was pregnant), a Leader
for 19 , breastfed my 3 children who are all in college on full scholarships
(SEE, Dr. Lucas), became an IBCLC (self-taught with Counseling the Nursing
mother as my primary text and Danner-Cerrutti reprints, LLLI material, and
Lawrence as additional backups) in 1985.  I was in LLLI as Spanish Translations
coordinator for 4 years, have lived in Illinois, Indiana, New Jersey and
Missouri as a Leader.  After 16 years I decided not to return to Social Work,
but to get an RN and pursue LC-ing.   The latter did not pan out as a source of
employment from 1985 until 1994 when I moved to Puerto Rico and found 3
Pediatricians who were trying to get some breastfeeding promotion going here.
We are very busy, very challenged, and very lonely - pretty far to go to the
ILCA, HEA or any other course!
Currently we have recieved a grant which includes three parts
        Identify the current breastfeeding rates (last study done in '82 gave 4 %
exclusive bf  at one month)
        Teach health care educators in 9 clinics how to promote and support
breastfeeding.
        Begin an LC center for low-income women.

Barriers here include:
        The highest c-section rate of all the US (60%)
        Even educated people do not tend to read (we are <talking books> as Helen
Armstrong pointed out)
        Lack of support from OB's
        Public hospitals allow 1 breastfeeding contact prior to discharge (fear
of baby-snatching prevents rooming-in)
        Only one private hospital has modified rooming-in, but even there, staff
is erratic in their support.
        Little/no bf education in health care professionals' programs

We do have some wonderful pluses
        New public policy on breastfeeding
        Very supportive administration in one private hospital
        Some great pediatricians who are VERY supportive
        An MD/IBCLC in private practice who also has an MPH and wants to teach.
        Interested nurses/health care educators have attended various programs
offered covering the BFHI from all over the island
        A small number of dedicated LLL Leaders

SO - if anyone has material I could use in relation to health care educators'
programs, process of establishing a baseline and running an LC Center  and would
be willing to share with me, and give me permission to translate, I will send
you a copy of whatever I do translate.

Nice Lactnetting with you all!
Jeanette
(PS - now I have to study alone again - must re-test next year!)