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WIC's promotion of infant formula in the United States

George Kent

International Breastfeeding Journal 2006, 1:8  doi:10.1186/1746-4358-1-8

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Phasing out infant formula in the WIC Program

Valerie McClain   (2006-05-11 21:54)  not applicable email

I agree with George Kent's proposal that "large scale distribution of free infant formula by WIC should be phased out." I was employed by WIC in Florida from 1994-1998 as a Breastfeeding Peer Counselor Coordinator. (there was no job description for an IBCLC in the Program and I believe that is still the situation) While I agree with George Kent's proposal, I do believe that the situation is more complex than it appears to people who have not worked within the Program.

I believe WIC staff have worked hard to promote breastfeeding despite the fact that infant formula is given out. There are many roadblocks in promoting breastfeeding. In the State of Florida, each district gets to determine how monies are spent on breastfeeding. Thus administrators of each district can make or break a program.

One major roadblock is that some WIC clients; those who received medicaid, temporary cash assistance, food stamps; are required by law to be employed at two months postpartum. Most of these women had jobs in service industries in which getting a scheduled break is next to impossible. So pumping milk for a baby becomes enormously difficult. Many of these women were young (16-21 years old)and unable to discuss their needs as breastfeeding mothers to their young male managers.

Not understood by many people is that income eligibility for WIC is 185% of the most current Poverty Income Guidelines. As of April 2006 a family of 4 can make up to about $37,000 annually and qualify for WIC. The program gives a set amount of infant formula (powdered or liquid concentrate). That set amount will not meet all a baby's nutritional needs as she/he gets older, or if a particular baby needs more than other babies, or if there are 5 weeks in the month rather than 4 weeks. Mothers who decide on formula feeding are told this when they enter the Program. They either must buy the extra formula or use food stamps to purchase enough to meet the needs of their infants. Medically and ethically, this is questionable. In some situations mothers may feel the answer to being short on formula is to water it down creating a situation of "water intoxication" in the infant. Although I never saw this happen and WIC staff did all within their power to educate women on this risk. But we did have mothers come to the office desperate for a can of formula because they had none. They were given formula to tide them over until their next WIC checks and given appointments so that a nutritionist could evaluate why it happened. But it still shows how risky this situation can be.

Currently in our local grocery stores are small labels next to the current WIC contract formula--Nestle's Good Start. A tag with the Nestle Good Start Trade Mark and in big letters WIC and under WIC "approved infant formula." Who decided to do this? Who approved it? Nestle? WIC? The grocery stores?

The phasing out of infant formula in the WIC Program will be a complicated process. The problem is that our society/government has made a major social and economic investment in artificial feeding.

Competing interests

No competing interests

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WIC's promotion of formula

Niki Konchar   (2006-05-04 10:35)  Nacogdoches Lactation Services

I agree with George Kent that it is time to make changes within the WIC program. While I also recognize that there are many dedicated, hard working people working within WIC, who do their absolute best to promote breastfeeding, I would suggest that these isolated groups are not able to serve the mission of the WIC program, which is to improve the nutrition of the women, infants, and children in the U.S.

Changes which would better serve the WIC population's needs would include allocating at least as much in resources toward lactation services as is provided for formula. While there have been steps taken to increase the amount of Peer Counselor funding, PCs cannot take the place of IBCLC's and should not be expected to have the knowledge base needed to handle clients after only a 20 hour training. All PCs programs should have an IBCLC to refer to, and this does not seem to be the case, but the exception.

The WIC definition of breastfeeding currently includes women who breastfeed only once in 24 hours; this is a token term, and any professional knows that a woman who offers her breast once a day is not going to maintain a supply for long, and her infant is the one that will pay the price.

If the federal government were to truly support breastfeeding, there would be an IBCLC in every WIC office. Women must receive the suppport they need to successfully breastfeed in their own communities, in a timely manner, and not days later, ater a referral is made, if a referral is even made before the mother gives up.

WIC is a federally funded program and it is time to make changes which will truly serve the needs of the clients. It should be the goal of the program to improve the health of all infants. This can best be done by helping their mothers to breastfeed, not by giving them free formula.

Competing interests

No competing interests.

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WIC and Breastfeeding

Lucia Jenkins   (2006-04-25 22:45)  North Shore Lactation Associates email

Comment:

There are many WIC workers who put huge efforts into promoting breastfeeding, establishing peer counseling programs and offering nursing mothers ongoing support. The efforts, however, are sporadic due to sparity of numbers, and occur only in pockets across the US where WIC professionals are educated about breastfeeding.

Until the Nation's leaders believe and state openly that the use of Formula is a known HEALTH RISK, instead of stating that Breastfeeding is just a "Better" choice, there will be no effective changes brought about.

Lactation professionals work tirelessly trying to educate other health professionals about formula risks, but they are fighting against the huge, financially wealthy, and extremely effective advertising machine of Big Pharma. Our Nation's leaders have to put a stop to the Formula Companies' unethical marketing of such a HEALTH RISK everywhere, not just in WIC offices.

Of note: Massachusetts Breastfeeding Coalition (www.massbfc.org.) is currently working to get a Public Health Council regulation passed prohibiting the marketing of formula in Hospital Gift Bags across the state of Massachusetts, which, if passed, will set precedent for the nation. While multiple national and professional health organizations openly back this regulation, it is currently meeting with questionably influenced government opposition. Feel free to visit the website for concise information on the issue.

Lucia Jenkins RN, IBCLC

Competing interests

None declared

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