Medical accidents: no such thing?

of health visitors, and feedback will be sent yearly to primary care teams.The current citywide rates of breast feeding at birth and at 3 months are 50% and 25% respectively; rates for small areas are available and can be used to evaluate local initiatives.Secondly, maternity units should strongly encourage staff to promote breast feeding.7This should include regular training and updating; monitoring such practices as separating mothers from babies after birth and offering water or cows' milk to babies; and assigning responsibility for breast feeding to a senior member of staff.This person could also fill the role of lactation consultant, to provide help in problem cases.8A close eye should be kept on the provision of samples and the promotion of milk formula on the wards.Thirdly, the hospital unit or trust should seek the status of a "baby friendly hospital."9This Unicef initiative recognises the part that hospitals have to play in encouraging breast feeding and rewards hospitals that are doing well.To receive the award, a hospital must have a 10 point policy that covers all the practices mentioned above.This initiative allows public pressure to be brought to bear on hospitals that are not up to the mark.Finally, maternity units should encourage better co- operation with voluntary groups such as the National Child- birth Trust and La Leche League.These groups can do much to provide the individual support that breast feeding mothers may fail to receive from hard pressed NHS staff.In the community the La Leche League's new peer counselling scheme is an exciting way to improve support in disadvantaged communities by offering training to breast feeding mothers, who then act as a local focus of skill.Now that the health benefits of breast feeding are so well documented purchasers should insist that hospital practices encourage rather than discourage mothers from practising it.