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Yard Sale = Huge Profits

Area Flooding

Area Flooding

Summer usually brings many many garage sales and yard sales in my neighborhood. Over the last 3 years, I have accumulated a large quantity of items that I just never got around to selling on eBay. I had been a fairly active seller…. sometimes making a really good profit!  The things I had accumulated lately either weren’t suitable for the eBay market or the fees charged would not make it worth my time and effort…. so they sat in boxes collecting dust. We had many antiques, collectibles, items from our old barn, chairs partially refinished, in need of repair etc..etc.. It was going to be the kind of yard sale I would love to peruse!
The day before the sale, as we tried to prepare and set-up, was the day when “Daniel” came up the east coast causing huge torrential downpours in my area… We had already advertised, I had to be ready for the dealers that come at 5 am! Waves of heavy rain hampered our efforts, collapsed tents and blown away drapes caused my husband to make a few trips out for more tarps and plastic drapes.
I knew we would not be ready  for the incredibly annoying dealers… so I parked my van sideways at the end of our driveway effectively blocking entry. I did not sleep before the sale and subsequently got a migraine to add to our muddy fun. All in all it turned out to be a profitable sale. The weather eventually cleared and we had waves of buyers instead of rain.

I have tried to tally our profits.. …..   keep in mind I don’t know how much I originally paid for some of these collectibles over the years…

Amount in my pocket at end of sale : $342.00

Total money paid by buyers over 2 days : $302.00

Start-up pocket cash for change : $40.00

Ad in the paper : $24.00

Markers, stickers, flourescent paper for signs : $11.50

Trips to Home Depot and Lowes for more tarps/plastic : $43.00

$342.00 in pocket minus costs and start-up cash = $223.50 POTENTIAL PROFIT

Handing over the ENTIRE $342.00 to my mom to help with her taxes—>

The look on her face and her tears–>

PRICELESS

😉

 

Babies EVERYWHERE! Wordless Wednesday

Babies Everywhere!!

Babies Everywhere!!

I got this greeting card a while back and I adore it.

1950’s to 1960’s style maternity outing…

cloth diapers and outfits

Partial of the inscription inside reads:

“Whatever you’ve got,  bet your glad it’s not this!”

(Credit—> Shoebox division Hallmark)

A Wonderful Day in the BirthingHood

What a great fun day in the world of birthing.
The first words I heard at work today were words that I just love to hear when used in this sequence….

“Section’s Canceled”

Hooray!

Her Cesarean had been scheduled because her baby had been in a transverse lie position…. for weeks.  However–> this smart little genius baby had positioned his little self into a beautiful head down position before arriving at the hospital this morning! Mom was also contracting regularly and was 3 cm dilated. This was her second baby, first exam of the day, so she hung out for a while until it was clear she was continuing to make cervical changes and labor was underway.

A few others decided it was their time to make an appearance today. One baby boy was a couple weeks early and another a few days over 41 weeks.

Ever hear that things sometimes happen in 3’s ??

 As luck would have it, 3 young men decided to be born within 15 minutes of each other! All 3 were spontaneous vaginal deliveries. All 3 boys were breastfeeding within that first hour and 1/2 … not bad!

All the moms were so happy with their birth experiences. All the babies were healthy. The staff worked really well together. Our midwife was awesome! The doctors were fun, funny, thoughtful and kind and made really good patient centered decisions.

It was just an all around wonderful day in the birthinghood!

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Wordless Wednesday ~The Mom Song

This is funny ~

Have you seen it??

You may be able to appreciate more at my age…….

 

Frustrations in Obstetrical Care …Culturally Sensitive? Oppressive Male Partners?

027 The drama  that went on here this weekend would be fodder for 10 or more Jerry Springer shows!

~Unreal~

I kept thinking…

“Please help me”

I am not and never have been prejudiced or bigoted in thought process, personality or behavior towards others. I am actually on a campaign to help educate our staff on being culturally sensitive and delivering culturally competent care in relation to obstetrical, breastfeeding and newborn care…. I’m currently organizing a quick reference handbook so certain beliefs & cultural values are better understood by our staff.

This type of sensitivity is very important to me.

It may not matter how I say this. Despite me trying to convince you that I am not intending to offend any type of people…..someone will most likely get annoyed or upset. I don’t usually enter into this type of discussion. I am quite adept at diffusing anger. I am not singling out a problem with any specific culture, ethnicity, or country of origin. I am not attributing any certain behavior to any certain culture.

 

This weekend, we had mother’s giving birth who have recently arrived in the United States from the following  areas: Argentina, Poland, Liberia, Egypt, Iraq, India, Dominican Republic and Nigeria. Sometimes their husband,  boyfriend or significant other was from yet another different country.  These are not unusual immigrants for our patient population. It is however,  unusual to have such diversity in a single 2-3 day period!

My concern is this— As a health care provider– how do you even begin to try to understand another’s strong belief’s or values when you are treated with tremendous disrespect and confronted with attitudes which are unusually demanding of the caregivers to “provide” for any and all needs. Now this is of course what we do…. provide for the needs of those in our care. That includes our responsibility for understanding different certain religious beliefs, cultures and their various norms and values. But this should be done within an environment or culture of MUTUAL RESPECT.

As  much as it is our responsibility to provide for those individuals in our care….. to be culturally sensitive. I feel there should at least be some responsibility on the part of the patient — and or their family- to learn what may be expected of them …. to communicate their history, needs and or wishes to the doctors and nurses~~ or at least to try to understand when it is explained to them at the time of birth and not lash out with anger or disrespect to their caregivers.  Is it too much to ask for a little bit of responsibility to understand at least a little something about what is involved in childbirth, postpartum, newborn care and the legal recording of birth in the facility, state and country in which they have come to and chosen to give birth!  {Many times I have been told they came here so their baby would be an American citizen.} Am I allowed to ask that those from other countries try to be somewhat sensitive to and try to understand our culture? I am not trying to victim blame here.  Really. Many of the patients exhibited rude entitled behaviors and were very disrespectful to staff.  We are all “others” to each other –> but one big blending of society. Lets ALL understand and respect each other.

Some of the behaviors we dealt with include:

  • A mother is married, the father of her baby is NOT her husband. The FOB becomes physically violent that his name can not be on the birth certificate–yet– until there is an affidavit submitted that the husband is not the father…. This turned into an all out fist fight between the the 2 men. “SECURITY!!”
  • A husband refused to allow his wife to be examined in labor during his absence, yet left for hours at a time demanding the hospital provide for his transportation to and from his business 15 – 20 miles away.
  • This same father would not allow his wife to speak for herself…. then called our unit many times after the birth when he was not there to say he was sure his wife was suffering from post-partum depression and we needed to treat her!
  • An unmarried young girl had a PFO against the father of her baby — She did NOT want to see his family yet that FOB’s family demanded to be allowed to visit, displaying hostility, speaking loudly and threatening staff  in a non-English language outside the entrance to our unit!
  • Another mother delivered and the father of her baby was currently in jail on drug charges. She met the criteria (for other reasons) where she and her baby were screened for drugs…. Both were positive for cocaine and heroin… sadly.. 😦  This infant needed to be placed in protective custody of Children’s Services and treated for withdrawal. This is always difficult and heart wrenching. This mother spoke very little english, was ANGRY the tests were done and we were not able to help her understand a situation of this magnitude easily with the language line….
  • Frenzied inpatient banging on the window and yelling for the only nurses’s attention to simply ask a question or get more supplies for their infant even though she was involved in an exam with a doctor on a new very sick infant and had signaled she’d be there “in a moment’…
  • The family and multiple extended family members demanding minute by minute updates on a sick newborn, interrupting our care by knocking on the doors and windows to the nursery… after we have explained all  minute by minute updates to the parents of that baby who were at the bedside.  I have a feeling that culture may have placed a value on the elders decisions over the actual parents, but this mother did not want the father’s family to be in the nursery with her. They don’t understand HIPAA or even know what it is! My job is to support the mother and keep her informed and with her baby.
  • A family not wanting to answer most of the questions for the birth certificate because… it was simply an invasion of their privacy. Alright then.. it will remain blank and the Bureau of Vital Statistics can deal with it, right?
  • A father of a baby requesting then ultimately demanding to speak to the doctor ONLY for each and every one of his questions.. (I am just a nurse).. did I mention it was the weekend?? We don’t have doctors present 24/7 !

 

 

There are times when these situations unfortunately occur. Many times the individuals involved are Americans who are 2nd or 3rd generation of mixed ethnic background or are of no discernable ethnic or cultural background, have lived in this country all of their lives and still exhibit the same type difficult personality traits.  Since they are more “Americanized” shall I say-or however is politically correct to discuss it— it isn’t so difficult to diffuse hostility’s, discuss options, assist with birth, newborn care, breastfeeding, do birth certificates…etc. It is my opinion that sometimes they understand things better simply from living here. We will ALWAYS encounter individuals with difficult personalities regardless of background who may be demanding in nature. They may not initially understand what’s happening but usually respond well to a gentle receptive approach.

That was NOT the case this weekend!

I only wish for strength and future guidance to help and support those who don’t quite understand.

Don’t yell at me or treat me with disrespect.

I ask those individuals new to our country to help themselves a little and learn some of our language and the framework for which we deliver our obstetrical care.

Please.

Prescription and Herbal Galactogogues

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Gotta make more milk!

I have compiled a literature search of the most common presription drugs and natural or herbal galactogoues used for low milk supply.

Check out my comprehensive guest post over at Breastfeeding Mom’s Unite here! I would love for you to visit her awesome site and leave a comment for her (and me)!

Thanks!

Not your Usual Birth Plan

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A birth plan is usually a written plan from the mother to her caregivers describing her wishes, what type of options she’d like to take advantage of, things she would like to happen thru out her labor and birth, what things are important to her as she experiences birth.  There are various resources out there to help a new mom explore options and formulate a plan.. especially for a hospital birth.  It is important that the mom review this with ALL her care providers AND especially the L&D nurses…. the advocates who help you actually realize the goals with in your plan. I have a fellow L&D nurse blogger who has done extensive research on the topic and wrote a 2 part series on Writing Your Birth Plan- Tips from an L&D Nurse over at nursingbirth. I would highly recommend you check it out especially if you plan on a hospital birth.

Many times these birth plans accompany a mom’s prenatal chart weeks in advance of her birth. Over the years there has been a gradual acceptance of the plans in my facility where historically, there had been much resistance for the mother’s input what so ever.  Much like the attitudes towards homebirth…. The doctors or nurses would casually peruse the plan then toss it aside and have a good laugh…. saying…. ” oh- she’ll end up a section for sure!”  Unfortunately, they were often right about that– many of those early birthplans never seemed to go as mom wanted, giving the staff fodder for snide comments and remarks. Sad but true. 😦

Recently, we recieved a birth plan that was not at all like any other.  Maybe some of you have seen plans like this… maybe some of you actually wished for births like this…. Hey~ who am I to judge? …. I am only here to help,  it isn’t my birth.

Her Birth Plan requested:

  • Pain medication as soon as possible….. I prefer to have an epidural as soon as possible
  • Please do not try to make me have breathing patterns through contractions… I’m afraid I’ll be too nervous
  • If a Cesearean is needed, please put me to sleep
  • I want only my mother with me in the labor and delivery of my baby
  • When the baby is born, I do NOT want to touch him until you clean him off
  • You can do his eye ointment and Vitamin shot, bath and all procedures before I hold him
  • I want to hold him wrapped in a blanket, not skin to skin
  • I want the baby to be in the nursery as much as possible at night so I can rest
  • I want to feed my baby formula from a bottle. I don’t want to breast-feed
  • I want to stay in the hospital for the whole allotted time so I can rest

My first thoughts were… Sweetheart, you could have ALL THIS without even asking!” ……..

Sadly, despite all efforts to improve,  …  things still happen exactly like this for many births.  We just don’t usually see it written out as a formal request or plan!  At least this is how this mother wanted things to happen.

This little mommy came in and delivered vaginally. Her plan was very easily carried out. 😉  I am very happy to report that she and her son were healthy and she displayed very postive interaction with him. Very loving and caring. She was very very happy with her birth and with being a mother!

That is all that really matters in the end.  Options– and what you as an individual would like to have for your birth. How much education she had before chosing these options… I’ll never know.

 Now I am asking the rest of cyberspace world.. have you ever seen birth plans like this???

A Formula Rep turned my Maternity Leave Injury into a new career as an IBCLC? Really?

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My contribution to this fabulous Carnival of Maternity Leave  , is a story of how during my maternity leave, an injury occurred leading to a career change specializing in Lactation… ! It starts with the birth of my third and last baby…… A  girl….. (after 2 boys) was also born by C-Section.. a first for me.

Well– first, let  me back up a few years… I’ve had a potpourri of maternity leaves. I have been a Maternity/L&D/Nursery since the mid 70’s.  I always worked full time and had never entertained thoughts of staying home with my children once they were born because the USA didn’t assist in providing any type of viable option for families who rely on two incomes or single moms with one income.  Prior to FMLA,  maternity leave was pretty much up to the employer as far as I understand it. The USA doesn’t offer any paid leave (unless offered by individual employer). For my first baby in 1979- I took 7 .5 weeks and went to a weekend 12 hr shift job which at least allowed me 5 days each week with him. 

 When my next baby was born in 1985, I worked at the same facility I am now. We were allowed to save up ALL Vacation, Holiday, and Sick time to be used collectively with your hospital allowed 12 weeks off.  I was able to have 5 1/2 months total, partially paid time to be with my new baby. Since he had to have surgery at 3 months, I needed that time and could have used more.. My leave was actually supposed to end on Christmas day (YUK).. however, they graciously allowed me to come back on the 26th… also his first day in Day Care. 😦

So back to my third baby in 1988~I had had a C/S — (that’s another story).  I had to be hospitalized for 10 days after the surgery with a whopping infection. A fresh incision and chills with a temp of 103.8 do not go well together! [Nurse Curse] Anyway, I made it thru–> healed and returned to life as a mother of three. The same type of collective accumulated paid hours were allowed withthe hospital’s offered 12 weeks. I didn’t have as many hours saved up as last time but was hoping for the best length of time.  One day in church, I held my little 2 month old baby girl on my shoulder with one hand, while using the other to hold the hand of my active 3 yr old boy as we made our way down the aisle. Suddenly, my boy squealed with delight and whipped over in a different direction. I held my daughter and did a sudden twist and reach for my son as he squirmed away. I immediately felt something “give” in my back.

It took a few days for me to feel the true extent of the injury. I thought it was just a little pulled muscle. After a 5 hour drive to my sister’s for a family visit, I ended up writhing on the floor with the unstoppable intractable “fire hot poker” pain of full blown sciatica…. all down my right side. I had to go to the hospital ER away from home, unfamiliar doctors, for help and drugs! Boy, I needed relief. As explained to me by the doctors… this was not the same as sciatica from many other causes. This was a swollen inflamed sciatic nerve… we didn’t know why yet.  The only thing helping at that point was medication and ice.. a lot of ice. I still insisted they give me meds I could take while breastfeeding, so they weren’t too strong.

I got home, went thru an MRI and diagnostic process, different doc’s, different opinions. I had a disc “blow-out” with”free extruded disc fragments” at L5-S1. Some felt surgery was needed immediately, others said to wait.  After careful consideration, we decided to wait and do some conservative type treatments with oral and epidural steroids. I still had to heal well enough to work, though. I spent many nights crying and wondering HOW I could work ??? How could I go and be on duty…running all over to keep up with the pace, helping people thrulabor and delivery…respond to emergencies…how?? I could barely care for my family! I called many friends while I was on periods of bed-rest and had various treatments during the time I had left of maternity leave. (I eventually did have to extend the leave a couple weeks for more recovery. I ended up witha 5 month leave altogether). I was searching for ideas.. visions of something less physically taxing which could combine my knowledge of labor/delivery/postpartum and neonatal care….. and allow me to continue working. I was, after all, the major bread-winner in our family!

Finally, a friend came up with an idea. He was actually a formula and drug rep for Ross labs.. TRUE!! But he was a friend, had heard I was hurt and stopped by the house to see how I was. He was a rep to many hospitals in the NorthEast and had exposure to what else was going on– what other hospitals were doing.  This was 1988, only a few years after the emergence of the Lactation Consultant profession. I had never heard of it. Sometimes word traveled slowly (by pony express) and things changed slowly in my little neck of the woods. He encouraged me to check it out and gave me phone numbers of LC’s at some of his other hospitals. I was really excited! I called a few and found out more about the lactation profession and the relatively new Board exam given every year in July to gain the credential of IBCLC.  I was actually naiveenough to think I could take the exam with my current knowledge base!  HA! (Unfortunately, this is what many nurses with a little experience think…we think we already know it all! Ha!) 

I called one of the LC’s at a hospital not too far from me. We talked a while and I had my eyes opened as to the extensive and vast knowledge base needed to become a lactation professional. I launched a quest for the best way to gain this knowledge. I joined LLL and went to meetings. I made home visits with the local LLL leader. I wrote many letters, made many phone calls searching for some type of education program. (remember– no Internet back then!)

Finally I found the perfect program for me. There was a correspondence course offered to be done all through the mail and phone calls designed to be an 18 month course.  It was a Lactation Consultant Course offered by BSC Breastfeeding Support Consultants! (the link shown is for their current course) Back then, you could be called a Certified Lactation Consultant after completing the clinical practicum and final exam. Because of continued back problems, I started this course in early 1989, had to take a few months leave from the course and completed it in early 1991. I then went on to continue studying and sat for the IBLCE exam in 1993 earning  my IBCLC status!

I have always continued to work as a staff nurse. I found a corset style back brace and found the best balance possible between family, back pain, work and more pain. I was able to get the pain subdued with steroids to carry on with life. In 1992, during a particularly gruesome relapse, I eventually consented to a myleogram… something I had previously NOT wanted. They also did a CT scan while the dye was in place. These tests showed my right Sciatic nerve had been pushed way up out of place by the disc material. I consented to surgery by a fabulous neurosurgeon the very next day. It turns out, the disc was actually adhered to my sciatic nerve!! He had to meticulously excise it off the nerve!!  My post-op pain was minimal compared to the pain I had before surgery. I was able to go back to full duty in 8 weeks!

Over 20 years later, I am still working as a staff nurse and am now a CLC… Certified Lactation Counselor.  Becoming a breastfeeding professional has enhanced and fortified my life! I am immensely happy I have gone down this road. To think it all came about as a suggestion from a Formula Rep!?!?!

Hope all had a great WBW 2009!!

Hope all had a great WBW 2009!!

WBW~ Breastfeeding in a Personal Disaster…. C.Michael’s Story

SendPicture14 August 2nd…..Today is my son’s 24th birthday. Yeah…I’m old 😉 This is not really the theme of WBW but I will take this opportunity to tell his breastfeeding story on his birthday.

In 1985, I gave birth to my second son. C. Michael. He was 37 weeks and behaved like many     near term babies… Breastfeeding got off to a slightly delayed start but then was awesome and without problems! Yay!

I wish C. Michael’s physical health was the same way.

C.M. was born with craniosynostosis.  Specifically, saggital craniosynostosis. Infants skull bones are purposely NOT fused together at the time of birth so the head can mold as baby makes his way down the birth canal and into the world. The different skull bones will overlap easily along the suture line so as to fit thru the pelvis. These bones then gradually reshape and the sutures eventually fuse.

My son’s saggital suture line was prematurely fused…causing a misshappen head. When there is a premature fusion, the growth can only occur parallel to the fusion. The saggital suture goes from the anterior fontanel along the top of the head to the posterior fontanel. Parallel growth would cause his head to be really oblong, or football shaped.

We took him to 5 doctors to decide if we would have corrective surgery… Yes that’s right…. it had to be OUR decision. Although this is a birth defect and causes a visual deformity, it does NOT affect healthy brain function UNLESS there is fusion of more than one suture and growth is impeded. So it is cosmetic surgery.

We decided to go ahead with the surgery at age 3 months and had everything arranged at CHOP (Children’s Hospital of Philadelphia). The craniofacial team was amazingly supportive. I was so very scared. My husband and I could not sleep. I hadn’t been able to sleep well since he was diagnosed. How many new mom’s tell you the baby is sleeping but they can’t sleep??? I’m not going to get into the whole surgical procedure… but the  main point of this story is how breastfeeding not only provided C.M. with the best nutrition and immune system protection, it also saved me thru my son’s ordeal.  My husband was able to pre-donate blood so we both felt like we were doing everything physically possible as his parents to help him tolerate and recover from this major surgery.

I was so pleased to be able to sleep right next to him in the hospital. We had to go in the night before and the he was not allowed anything after 4 am… he could nurse up to that point. I woke him to nurse around 3 am. It was very bittersweet. I was crying and he was happily nursing, not know what was coming next. It was difficult just to see the IV placed, let alone the actual surgery.  I was so grateful and happy they had done alot of pre-op procedures the night before when I could nurse him after each study. Now , when they wheeled him off to the OR, I was almost happy he had been slightly sedated because as hard as it was, I could never have handled him screaming at that point.

While he had the surgery, I headed first to the pumping room to try and get as much milk stored as possible. I had not been able to pump well before this so I had limited expectations. It was the first time I had used a hospital grade pump so I had much better volume than I expected. I stored a couple bottles and was feeling actively involved in his recovery already!

They called us to meet him outside of recovery a couple hours later. It was very difficult to see his head swollen and heavily bandaged. He had had a blood transfusion once already in the OR and they expected he would need more. Apparently the bone edges ooze when cut.  We took turns with him until he wasn’t groggy any more, then, once awake…. I rarely left him.  I was told he had to have a little bit of an electrolyte solution in a bottle first before I could nurse him, just to make sure he didn’t vomit.  He was ready to nurse in about another hour. They took him out of the crib, with his massive head bandage, black and blue eyes and 2 IV lines….place him in my arms and we gently rocked and nursed.SendPicture12

I felt completely lost, even as a nurse or especially as a nurse…. because seeing your child like that is very difficult. I kept thinking all the worst possible complications would happen to him. I wanted to keep him safe, protect him. I struggled with tremendous guilt, thinking I must have done something to cause this to happen… It must have been my fault.  Many parents go thru that, I’m sure. Breastfeeding him thru the hospitalization, two more blood transfusions and recovery period helped me feel like I was actively healing him. My husband felt similar thoughts because they used his blood for the first 2 transfusions. It was an empowering feeling.

I’ll close by saying that finally being finished with the decision process, the surgery completed (sucessfully I’m happy to say) and on the recovery road also cured my sleeplessness.

The night nurses at CHOP laughed at me! There I was, sleeping right next to my precious brave 3 month old post-op son…and they had to wake me up to tell me he was crying to feed in the night.  😉

What a handsome guy now!

What a handsome guy now!

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August is here! World Breastfeeding Week Aug 1-7

World Breastfeeding Week

WBW Theme Logo 2009

WBW Theme Logo 2009

WBW Theme for 2009
Breastfeeding: A Vital Emergency Response
Are you ready?

OBJECTIVES OF WORLD BREASTFEEDING WEEK 2009

  • To draw attention to the vital role that breastfeeding plays in emergencies worldwide.
  • To stress the need for active protection and support of breastfeeding before and during emergencies.
  • To inform mothers, breastfeeding advocates, communities, health professionals, governments, aid agencies, donors, and the media on how they can actively support breastfeeding before and during an emergency.
  • To mobilie action and nurture networking and collaboration between those with breastfeeding skills and those involved in emergency response.

RATIONALE

  • Children are the most vulnerable in emergencies – child mortality can soar from 2 to 70 times higher than average due to diarrhoea, respiratory illness and malnutrition.
  • Breastfeeding is a life saving intervention and protection is greatest for the youngest infants. Even in non-emergency settings, non-breastfed babies under 2 months of age are six times more likely to die.
  • Emergencies can happen anywhere in the world. Emergencies destroy what is ‘normal,’ leaving caregivers struggling to cope and infants vulnerable to disease and death.
  • During emergencies, mothers need active support to continue or re-establish breastfeeding.
  • Emergency preparedness is vital. Supporting breastfeeding in non-emergency settings will strengthen mothers’ capacity to cope in an emergency.

Source: http://worldbreastfeedingweek.org/

What we are doing…….

At my facility we are working on action plans to include breastfeeding support in our exisiting disaster response plans. We are never immune to disaster…. we just had a tornado here on July 29th with a lot of damage, small flooding and many homes with loss of power and clean water.

We are promoting WBW with staff and physician education as well as small gifts to new moms congratulating them on their decision to breastfeed!

WHAT ARE YOU DOING???? I really would love to hear your stories and your efforts so that we can share ideas.