Kim Hansen wrote: " I'm at a crossroad.....   I had worked hard to establish a
respected Lactation Program at my hospital and am working to do the same
at our new location..... Every time I go to work with a mother who is having
problems there's a bottle in the crib ... Has anyone had any experience in
this area?  Has anyone had any success with changing attitudes?  I'm about
to give up."

Kim, how awful for you, you had a good program going and now you must
backtrack to that early VERY frustrating time in making change.   I and I am
sure many other hospital based LCs here can share your frustration.  YES,
attitudes can change, and do change although it can be SO SLOW.  I often
think of myself as a little burr in the side of the formula lovers. I just
irritate them enough to keep them aware of me all the time but not enough to
make them smack me away.   Every hear that saying about how if you doubt
that one person can make a difference try sleeping with a mosquito?  Well,
that little bug is us.

One  practical suggestions:
Hospitals have to have "competency" training these days, JCAH demands them.
Try to get lactation subjects included as mandatory competency inservices.
Keep the focus small, we have done separate competencies on breast pumps,
alternate feeding methods, and assessment of latch on recently.  Each was a
group lecture followed by return demonstrations on a one to one basis. Since
JCAH demands the return demonstrations for competencies this gives you some
one to one time with everyone.   You can get to know who you are working with.

It sounds like you are approaching burn out stage.  This is very intensive
work we do.  Take good care of yourself.  Remember you made a difference in
the first setting, you can do it again but only if you survive the stress.

Best of luck, Carla D'Anna