Dear Barbara,
It's wonderful to hear that your hospital is considering training it's staff. I think that all of us that work with breastfeeding mothers realize that education is the key to meaningful change. I'm an IBCLC at a hospital and recently we have begun a staff training program in an attempt to become baby friendly. I have to say that the more that I have researched this, the more that I'm convinced that the training must be an in-house training program to realize any meaningful change. IMHO, online programs just do not work. There is no way to learn how to help a women breastfeed by watching an online program, they are a waste of time and money, even if you have a motivated staff which you generally don't. You wouldn't want to go to a doctor that went to medical school online, right? We are a small, community hospital, near a very large hospital with a lot of money. They started this process before us, but they are used an online program for their nurses.
 Some of our nurses work at both hospitals. After they completed their online training at the other hospital, I asked these nurses a few basic questions and they were not able to answer any of them. Whats more, I could tell that it didn't work because it didn't change any of their practices. These nurses are the ones on the unit that were still heavily pushing formula at every opportunity even after there online training. It is really hard to get people in for training, but it can be done! I really pushed for it, we have to do it or things will never change. I've asked these nurses about their online training and every one of them has admitted that they didn't read any of the information in these programs, they just clicked through the pages as fast as possible and guessed on the answers until they passed the test. Baby Friendly stresses that training must be to the point of competency. This one of the reasons we have decided not to accept any outside
 training, but all of our nurses must have our in-house training. I'm sorry if I've offended by saying so, but I don't think that online programs create nurses that are competent in helping mothers breastfeed. I can't tell you the amount of complaining that went on when we announced that all the nurses were coming in for mandatory 20 hours of training. I can tell you that I was not very popular! But it has been such a wonderful experience. Our nurses are becoming excited about helping mother's breastfeed, they are beginning to understand the importance of human milk for babies and maybe we should pause and offer education before just handing over the bottle of formula. And the counseling skills are so important! And the group discussions are invaluable. There is just no way to replicate that with an online program. These nurses were so angry at me at first, but I will tell you that at least 80% of them have come up to me at some point and told me how
 much they are enjoying the classes and how much it is helping them with their patients. They are looking forward to more training and excited about the changes they see for their patients. I highly recommend getting your staff in for an in-house training program.

Sincerely,

Tricia Shamblin, RN, IBCLC

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