Dr. Jen, you are doing a great job! it is so important for the mother and family to hear supportive bf messages from the physician. you have rec'd some wonderful suggestions too. I beliieve Best Start Social Marketing has done some excellent research w/ focus groups and found that messages about bf benefits are not very successful in continuing bf. Mothers know this but still wean due to other real/percieved barriers. Some barriers were found to be: embarrassment, bf ties you down (and return to work issues). I would try to find out the reason that mothers wean prematurely. For a brief time I did some f/u phone surveys to that effect. The reasons for weaning were often: return to work, lack of decent pump, told to wean (incorrectly) due to mastitis or meds, milk dried up (usually someone doing breast/formula from the start). Once you know some of the reasons, you can target interventions. For example if working and bf are problematic you could even do pump rentals from your office! You could have support group meetings there or working moms meetings. You could invite the local LLL or other established support network to meet there. You could have one of your staff do a brief f/u call during the early postpartum (I try for day 3-4) and again at peak identified times of weaning, if you were able to identify this. I believe Evergreen in Washington does a very successful nurse/Ibclc run clinic for bf dyads to come back at day 3-5, I've heard Molly Pessl say they leave the cord clamp on and have the moms come back in to have it removed. This is a sneaky way to get them to come for that early return visit. In my community babies are d/c'd from hospital and return to peds at age 2 wks. Then they come back at age 2 mos. Perhaps there are peak times of problems or weaning that are coming in between there. Well visits could be scheduled then. Do alot of your clients utilize WIC? If so, maybe you could hook up w/ them to see what they are doing and make sure you work as a team. Good luck, you are certainly on the right track and I predict will slowly get your rates to increase. Laurie Wheeler, IBCLC, MN, RN New Orleans Louisiana, s.e. USA _________________________________________________________________ The new MSN 8: smart spam protection and 3 months FREE*. http://join.msn.com/?page=features/junkmail&xAPID=42&PS=47575&PI=7324&DI=7474&SU= http://www.hotmail.msn.com/cgi-bin/getmsg&HL=1216hotmailtaglines_smartspamprotection_3mf *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] 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