Something that has gone a long way toward promoting good practices in
the Ped offices in my area is free Nursing Contact Hours for the RNs in
those offices.

For two years I offered and eight hour course called "Baby Friendly
Breastfeeding."  Dozens of nurses from the community attended. After I
had exhausted the pool of RNs for that course I began offering
"Lactation Management Two: Advanced Concepts." Have had about 20 takers
so far on this one. Will run it for two years with periodic offerings.

Our system also offers a LC study group for those wanting to take the
exam. It is open to outsiders. Guess what? First year....we had five
RN's from one of the OB offices attend! We get Ped office and home care
RNs as well at these programs. This is not free but is at a nominal
charge to cover the instructor's salary and the CE processing.

This is not that hard to do. You offer this kind of stuff to in house
staff anyway...and hospitals love to have this kind of PR for their MD
offices. Our Physician Liason is forever calling to see what little
educational "perks" she can take to the offices with her.

We are not 100% there. On the other hand, I have SNSs in some Ped.
offices here...where the nurses advise against early use of bottles. I
also get referrals from them and...here's the big one...prenatal nipple
assessments are becoming more routine! The advice given out by home care
RNs in this area is astoundingly accurate!!!

Susan Keith-Hergert RN, MS, CPN, IBCLC
Mercy Health Partners
Cincinnati, Ohio

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