Loni writes of a common barrier to breastfeeding that mothers encounter in the hospital. Health care professionals who are not current in breastfeeding management are a risk to continued breastfeeding. One of the most successful ways I have seen to help those you work with become part of the team is to use your hospital system. When you want to make changes it is best not to go it alone. Writing an open letter to the health care providers is a set up for disaster! Think about going to your Quality Improvement Department and request that breastfeeding care and services become an issue to be studied and improved. They like to improve patient care since JCAHO requires them to show improvement each time the hospital is assessed. Go to them with patient satisfaction surveys where patients have complained about the inconsistent information given to them. If you have not done a mother survey regarding breastfeeding information, consider doing this before you approach anyone. You need the data first! Contact your risk management people and ask what liability the hospital has for the inconsistent and incorrect information given to their patients. Contact your hospital ethics committee and ask if it is ethical for health care providers in your institution to base their care on something other than evidence-based practice. How ethical is it for temper tantrums and whining to influence patient care. Where are the breastfeeding policies? Change is difficult and it is a process that takes time and careful planning. One lone lactation consultant writing a letter is doomed from the start! Everyone must feel that they own the change and the outcomes. The letter will go straight to the circular file! You might even wish to conduct focus groups with mothers who have previously delivered at your hospital so that you have the evidence of what poor breastfeeding care and services causes. Marsha Walker, RN, IBCLC Weston, MA *********************************************** 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