Jeanette asks, " They want to get to the "baby friendly"
status, so the administration is asking her how they can replace the free
formula they are now getting (the value is around $60,000 if purchased).
Granted, with more of the moms breastfeeding, the cost would perhaps not be
that high, but they do not see as an option to tell the moms to bring in
their own formula (after all, surgical patients are fed), nor can they
increase the cost as they are assigned a flat rate per patient by most
insurance companies....So - I ask those who are already successful - what is
being done to replace these funds?"

Step 6 of the Ten Steps says "Give newborn infants no food or drink other
than breastmilk, unless *medically* indicated".   In order for the hospital
to achieve baby-friendly status (global criteria) 80% of babies should be
exclusively breastfed unless there are "acceptable medical reasons" for the
use of formula.  These are very few, and very precise.  This means that only
tiny quantities of formula will be required in a hospital that is truly
baby-friendly (for sick/prem babies whose mothers are not yet producing
quite enough EBM in spite of being "assisted" to provide it, this is also
strictly assessed). So the need for formula, and the need for the hospital,
or anyone else, to pay for it simply doesn't come up.  The whole
baby-friendly concept is designed to promote *breastfeeding* - not
formula-feeding.  Giving away free formula sabotages breastfeeding so a
hospital that accepts these gifts would fail the assessment.  Baby-friendly
hospitals are required to *pay* (at least 80% of the retail cost) for any
formula that is required, in the same way that they pay for any other foods
and medicines, and I think (I'm not sure) that these costs are expected to
be passed on to the parents (parents pay here, anyway!).  Furthermore there
is to be an absence of all promotion of infant foods or drinks other than
breastmilk, so that gifts of formula worth $60 000 to the hospital could
neither be used nor given away.  The assessments are *very* strict.

Pamela Morrison IBCLC, Zimbabwe