Jeffrey,

Congratulations on your hospital having taken the first steps to becoming
Baby Friendly. The requirement about the hospital purchasing formula is a
tough one. You can order a booklet from US Committee for UNICEF which lists
each of the Ten Steps and ideas from hospitals who have either resolved each
one or are working on it. The ideas are really good. The title is:
Barriers and Solutions to the Global Ten Steps to Successful Breastfeeding: A
Summary of In-Depth Interviews with Hospitals Participating in the WHO-UNICEF
Baby-Friendly Hospital Initiative Interim Program in the United States.
Order from: US Committee for UNICEF, Office of Public Policy and Government
Relations, 110 Maryland Ave, NE, Box 36, Washington, DC 20002

Your hospital may be reluctant to purchase formula not only because they will
lose all the free equipment, supplies, food, trips, etc but also because
hospitals typically receive large amounts of cash along with the free
formula. This is given to the chief of pediatrics or obstetrics and used for
"educational" purposes. No nurse or patient will ever see any of this money.
There is no direct patient benefit from this money.

You also need to check if your hospital has a contract with a formula
company. If so, it becomes harder to purchase formula because you have to
wait for the contract to run out, make sure that it is not renegotiated, and
get your hospital to admit that it has one to begin with. Formula purchase is
not expensive. The hospitals that do this estimate that it costs perhaps $.30
per feeding times eight feedings in a 24 hour stay comes out to $2.40 for
each formula fed baby- highly unlikely to break the piggy bank. No other unit
in a hospital gets free food for its patients. The Dairy Council does not
drive milk trucks to the loading dock and give free milk to the orthopedic
unit to heal bones faster! Many hospitals are addicted to this free stuff and
will tell you that they cannot afford to buy formula in the current tight
money crunch. This is hog wash! They have plenty of money to feed their
patients - it is where they choose to spend it that we look at. Expensive
marketing, high cost fancy annual reports, refusal to decrease costly
interventions (like epidurals and electronic fetal monitoring), firing nurses
instead of reducing the 6 or 7 figure salary of the chief executives, all
mount up in the scheme of things.

Ask some of the hospitals who no longer purchase formula how they
accomplished this. Military hospitals and public hospitals do not purchase
formula. Call Molly Pessl at Evergreen Hospital in Kirkland, Washington or
Bonny Skrovbroten at Methodist Hospital in Minneapolis and ask them for their
input.

NABA has publications on the background of BFHI in the US. E-mail me and I
will be happy to help.