Breastfeeding and WIC {Is that an oxymoron?}

>> Saturday, August 29, 2009

Today I engaged in an online conversation about WIC and it's role on breastfeeding success.  The person has a notion that WIC should charge a dollar a can for formula.  I don't really agree with that idea.  Now, just so you know I don't think that the idea for free formula is great because it makes it an easy choice, but I can also see another side of it.

When my second child was born I breastfed for 6 months.  At 5 months the doctors became concerned with his weight gain, or lack thereof. The doctor said she would give it a month, I went back every week or two (it's been 13yrs so hard to remember exact details) by then end of the month he was diagnosed as failure to thrive (I do remember he was only wearing 0-3 month clothing at this time) and I was instructed to put him on formula.  (Now I know there are many flaws to this, but I didn't know as much about breastfeeding as I do now so just go with me on this...) So I proceeded to follow the doctor's instructions, because after all she is a doctor and she would only have my child's health in mind.  Around this same time my husband at the time lost his job.  I was not working, and we ended up on welfare & WIC.  There was no extra income at all, nothing.  We lived entirely on what the government gave us and it wasn't much.  So dealing with the fact that I had once again failed at breastfeeding a child then imagining going into a WIC office and them telling me I needed to find 30+ dollars (infants easily go through 1 can of concentrate liquid formula a day) so I could buy my child's formula for that month - that I was told by a doctor I had to give my child, when I had no money would have been alarming & anxiety causing to say the least.

How would charging me a dollar a can for that formula have benefited me at all?  It wouldn't have! I don't think WIC charging a dollar a can for formula is going to change anything, that isn't how change is going to happen. I often think if one could only get formula with a prescription then there would be less people quitting breastfeeding so quickly and that would be changing things.  But really that's not even where the heart of change would start. I think either of those options that would be like trying to put a band-aid on a finger that is half cut off.

In my opinion change has to start in the medical community and from there we will see a trickle down effect.  Our doctors need to be trained in medical school about breastfeeding; how to give proper support and how to effectively give help when a real breastfeeding problem arises.  They need to be trained on the risks of formula and how formula needs to be a last resort not a just as good as breastfeeding replacement. At that point having formula be by prescription could be a do-able option, because the doctor would really be trying to make the breastfeeding relationship succeed. And for those mothers that really do not want to breastfeed what would be so wrong about the doctor making sure she is educated about breastfeeding and the risks of formula and then letting her make a choice. At that point the Doctor could write the script for her, knowing she has made an educated decision.

As someone who has been on WIC I know there are things that could be done to increase the success rates of breastfeeding. Formula is handed out too easily there, I agree with that 100%. The example I gave above was not my only experience with WIC.  I know first hand that they say "breastfeeding is best", "you should breastfeed for X amount of time" but at the first whimper of a "problem" they make no qualms about printing up your formula coupons.

So what do I think WIC could do to actually help breastfeeding mothers succeed? Well, first of all they could educate moms.  I don't mean offering a 20 minute video on the benefits of breastfeeding.  But instead having a real class, talking about all the normal problems that most new mothers face and what you can do when you think you have a problem..

They could ask questions.  When mom comes in and says I need 1/2 formula for the month, instead of just printing those coupons up they could ask "Why do you feel you need to supplement?". Mom might say "well I want to be able to have a few drinks on the weekends", or "I think the baby will sleep better if I give him formula at night".  They could educate the mother that she doesn't have to supplement to have a drink or two. They could educate her that giving the baby formula at night will effect her overall supply and may risk the entire breastfeeding relationship.  Maybe then that mom may decide she really doesn't need that formula after all.

What about that mom that only had 6wks maternity leave and the breastfeeding relationship is just getting established and she has to go back to work?  She comes in to get formula to supplement.  Why not educate her that she can exclusively breastfeed and work. And then offer to loan her a pump and the supplies she would need for that. (Apparently some do offer this service they just don't advertise it).

They could have a Board Certified Lactation Consultant on staff or offer a free referral to one when mom really is struggling with breastfeeding.

Those are things I feel would actually be beneficial in increasing breastfeeding success rates. I don't think charging parents who are already low income or poverty level for formula is going to change anything  positively.  How to make these changes happen? I wish I knew.  I would love to see more people succeed in breastfeeding their children and I would love to see the medical community & WIC be a part of that success.


Slee August 29, 2009 at 8:19 PM  

You are, of course, right. Without the education and support necessary on all levels, breastfeeding success rates will still be low. I also know that I wouldn't have been able to feed snapdragon *and mongoosine* if wic charged for formula, and I was formula feeding. Witjh mongoosine I got a LOT of bad advice, 10 yrs ago, and in the face of said bad advice in the face of poor latch and ewxcruciating engorgement, she became a formula baby too. I was still in colege and only less broke than now in that I'd moved home to my parents and they were wonderfully supportive.
Doctors need to be able to offer genuine support. LCs need to be more acceassible. Society needs a better nursing bra to support lactation for the sake of all the babies and mother's whose nursing relationship is threatened by ignorance and the overly easy "option" of formula.

InnerWizdom August 29, 2009 at 8:57 PM  

I agree that it has to start with doctors. I live in a small town with only 3 pediatricians. I was forced to see one but it was not my choice which one I saw. He knew nothing about breastfeeding at all. Nothing. Without watching me breastfeed, without even examining my baby (his co-op student did it) he declared that my baby would never be able to breastfeed and that was just the way it went some times. About 2 months earlier my baby had his tongue clipped and was breastfeeding while I used a Lact-Aid (to supplement with breastmilk) while his suck and transfer improved. This doctor was adamant and forced us into the hospital where I was to pump around the clock, my breastmilk measured and formula sitting in the room because he was sure I didn't have any milk. At first he told me I would have to stop breastfeeding altogether and would need to stop tandem nursing as well. At least I got him to back down on those things. He didn't even care that I had been working with a Lactation Consultant since birth and he didn't bother to ask her her opinion. He kept telling me that wimmin who'd had breast surgery couldn't breastfeed (huh? I never had any surgery!) I could go on and on and on but I will end by saying that thankfully baby caught an illness from that forced hospital stay, had to be readmitted and see a new pediatrician who a very different take on what was happening. She took over our care and I didn't have to deal with a doctor who is completely uneducated about breastfeeding. His student was going to forcibly retract my child's foreskin until I yelled at her not to! Yikes!

Good post - you make great points!

Christina August 30, 2009 at 2:21 PM  

I've worked at WIC, and I agree wholeheartedly. We need more incentive to bf other than charging money for formula (which could just leave more hungry babies in the many families who can't afford even a few dollars). The process is slow as mud, but I have seen improvements in WIC breastfeeding support over the years. You have great points and suggestions, and I'm happy to see the enthusiasm for bf support from the other side in your experience as a WIC customer. Have you written to your state WIC department? I wonder if there were more voices like yours, the progress might be faster!

Thanks for the thoughtful post.

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