Sadly it is the norm in US hospitals.  Even with being Baby Friendly it's sometimes a struggle.  Now that the joint commission is looking at Exclusive breastfeeding as a perinatal core measure, I would hope more hospitals would do away with unnecessary  supplementation (and most of it, is..).  Of course how you calculate your exclusive rates?  Well that's a whole 'nother story.  TJC has fairly strict guidelines stating what is to be excluded when you figure these number and what is not.  Most hospital supplementation of healthy full term (including late pretermers) is not to be excluded from the denominator.  When I hear someone saying they are 70+ exclusive...my next question is always, how do you get your numbers?  Sure it's nice to say you have a 70% exclusive rate...however if you are excluding "medically supp" infants who are not on the TJC list of exclusions...well then what are we really comparing?

I keep hoping people will follow TJC standard or perhaps at least the same standards so we are all comparing apples to apples.  Sadly the exclusive numbers are not good.  But don't we have to own that in order to improve?  Isn't that always the first step to recovery...admitting there's a problem?     

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