Dear Tricia,
I second your conclusion. These measures are there to show where we need 
to improve and where are we sitting today. Not to encourage false 
measures by using extreme tactics to keep them high.
In my opinion, if you want improved measures, the hospitals need to 
spend the money and energy to improve these areas. This is usually done 
through education.
I have taught several in person, 20 hour courses for hospitals, to meet 
this Baby Friendly requirement. I have been told over and over that in 
person trainings are rare. On-line is how most hospitals are choosing to 
do their education. Why? Because it is cheaper.
This is not to bash any on-line courses that offer lactation education. 
For some, it is the only way to get any lactation education! Also, some 
require more actual interaction than others.
However, as an educator for over 25 years, the way you create changes in 
beliefs and behaviors is in person. By having discussions about how we 
have been doing things and how things could be done differently.
If breastfeeding rates are important to hospitals, they have to invest 
in quality trainings that will encourage core belief changes about 
breastfeeding from the staff who work with mothers everyday. That and 
some accurate medical information about how breastfeeding works will go 
a long way in increasing breastfeeding rates and success.
My two cents.

-- Barbara Robertson, MA, IBCLC, RLC
The Breastfeeding Center of Ann Arbor bfcaa.com

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