I liken staff lactation management to keeping my kids motivated and stimulated during the summer when they are out of school. They're good kids, they just get a little lax. At Grady Hospital in Atlanta we tried many tactics such as taking one the most recent worst things that had happened to a breastfeeding couplet, make it a research question, pit the several MCH areas against each other to see who could find the correct answers, ( several options of care) write the answers up and get them to the lactation staff. We would then reward the area with a homemade pound cake or chocolate chip cookies(not toll house though). It did wonders to keep them stimulated. They would pull in attending OB and Ped physicians and residents to get reference materials and help to answer questions. I have more I'll send later. Don't get too frustrated. The mom's and babies need you!!! kim bugg