Beth,

        I came in a little late on this discussion, but caught your last response
about the in house LC working only 18 hours a week.  I've worked in
hospital only and have found that the fastest changes take place when the
patients suggest change.  In this day of HMOs, hospitals work hard on
having a good public image.  Just look at all the television ads for
hospitals!  You may want to consider working with the in-patient LC to get
an in-patient evaluation program started.  You may also want to think about
keeping statistics (i.e. rate of sore nipples, rate of supplementation,
length of breastfeeding, etc) comparing those that were seen by the LC with
those that were not.  Through all this, you may be able to make a proposal
for an increase in LC hours.
        Donna Zitzelberger, RN BSN IBCLC