Bonnie, It sounds like you have a big job ahead of you, but just remember the surest way to get to your destination is to keep walking one very small step at a time. We started in a similar place about 6 years ago and you wouldn't believe how we've change. I think your idea of a survey is a great idea you could even work it into a QA project. You might also want to tie in with the national campaign Health Goals 2000 (something like this anyway) The surgeons general report also outlines guidelines as well. Try to find out your rate of breastfeeding at discharge, 6 weeks and 4 mo. You also might want to get some strong articles for your Peds. A very good and recent article: Breastfeeding Update 1: Immunology, Nutrition, and Advocasy Wendelin Slusser, MS MD and Nancy G. Powers, MD. Pediatrics in Review Vo. 18 No.4 April 1997. Then you can start on The Ten Steps to Successful Breastfeeding outlined in this article. Theres a part II too but I couldn't find it. Another on Hospital Policies: Crucial to Breastfeeding Success, Nacy G. Powers, Audrey J. Naylor, and Ruth A wester. Seminars in Perinatology, Vol. 18, No.6 (December) 1994: pp 517-524. All our changes started after our director sent 2 nurses interested in breastfeeding to a week long workshop at Evergreen Hospital in Kirkland, Wa. Good Luck and start with something easy like rooming in: you'll need less nurses, ie. increased productivity! Linda Rosetti RN, BSN, IBCLC