One of my supervisors has said that I have to warn each patient before I help her baby hands-on that there will be a charge, the magnitude of which will depend on how much help the baby needs to learn to breastfeed. I haven't done it, as it obviously will discourage many women from breastfeeding. Of course, in the long run the charge is negligible compared to the cost of formula-feeding, but I don't feel like going through and explaining that to everybody, either! Do dietitians or physicians or anyone else who works with patients in the hospital have to warn the patients first that their services need to be reimbursed and get their permission before helping them? Martha? Arly [log in to unmask] (Arly Helm, MS, CLE, IBCLC)