We have had several issues come around consent to supplement. And in the final analysis it comes down to this: 1. Consent must be *informed*. Any nurse or doctor who really wants to can make any new mother consent to anything. 2. Staff training and attitudes. Any nurse or doctor who wants to get around the policy can. Just one example: In one hospital where consent was necessary and where a friend of mine is an LC, she was speaking with a mother behind a current, she overheard a nurse enter the room and say something like this "Your baby is dehydrated and this may result in severe neurologic damage. Would you like us to supplement? Yes? Sign here please". Like what new mother is going to say no? Not always so egregiously, but any place where the hospital has a policy of consent to supplement, staff are doing what my friend described above. It always comes back to attitudes and that means the person in charge has to put down the law--if you are not interested in helping mothers with breastfeeding, if you don't think breastfeeding is important, please find somewhere else to work. Of course, we still need training, because a good attitude is not enough, but it's the most important basis from which to begin. So, I'm not against the policy or principle in theory, because just making such a policy sends a message, but don't hope for too much. Jack Newman, MD, FRCPC *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html