Thanks to those of you who have replied to my request for references and with ideas on tackling the backsliding that is going on locally with regard to nurses feeling that they need to observe babies in the hospital for four hours post-birth. Becky Engle, I absolutely agree with you that references don't always get at the source of the problem, but I feel like that I very well may be challenging many routines -- not just the mother-baby separation issue -- as the first nurse-midwife to practice in our community, and it may be easier to gain support on a management level if I am armed with literature to support my position. When I worked there in the past, I did inservices on breastfeeding, wrote a discharge handout for breastfeeding moms (all they were previously doing was giving out formula literature), and was generally enough of a "squeaky wheel" that at least some of the staff paid attention. We will see. Ione Sims (who remembers what a thrill it was to get her IBCLC four years ago, and just received her certificate of completion from nurse-midwifery school today and is even more thrilled)