Sunday, February 07, 2010

New WIC breastfeeding package

This past October, WIC made a major revision to its foods program: it will now cover fruits, vegetables, whole grains, and baby food. The most exciting change is its new breastfeeding package that rewards exclusive breastfeeding. You can read more about the new WIC program at the Motherwear Breastfeeding Blog or you can visit WIC's website. Here are some details on the breastfeeding package:
To get breastfeeding off to the best possible start, the new WIC food package strongly encourages exclusive breastfeeding. Since giving formula in the early weeks may prevent mothers from making enough breast milk, WIC helps protect a mother’s milk supply by not offering formula to breastfed babies in the first month of life.

In turn, fully breastfeeding mothers receive a greater variety and amount of foods than anyone else participating in the program. Fully breastfed infants receive more than twice the amount of baby foods than formula-fed babies from six months of age until their first birthday. Throughout an infant’s first year of life, the new WIC benefits are greater for women who choose to offer their babies more breastmilk than formula.
This news prompted some questions that I'd like to discuss:

1) WIC is one of the largest purchasers of infant formula, distributing around half of the infant formula used in the United States. Is giving out formula for free (to the receipient at least, not to the taxpayer) inherently incompatible with its support of exclusive breastfeeding? In other words, can you really be promoting breastfeeding when you're still providing formula to any qualified WIC mother who wants it? I found that others have been asking the same question. In the International Breastfeeding Journal, George Kent discusses WIC's promotion of infant formula in the United States (full text is available--it's definitely worth the read!). A few excerpts from his article:
WIC has a breastfeeding promotion program, but its positive impact is diluted by WIC's infant formula program. It is difficult to see how offering free formula could fail to be an incentive to use formula. The inducement is not simply that something of value is being offered at no cost. Even if it is unspoken, there is the implicit message of endorsement: if a government agency is handing out this product, it must be good....

WIC encourages breastfeeding as the best source of infant nutrition, and it earmarks funds for breastfeeding promotion and support activities. However, the budget for breastfeeding promotion [0.6% of the total WIC budget excluding rebates] is far less than the amount spent on obtaining formula.
2) Should WIC restrict formula distribution to mothers who have a medical contraindication to breastfeeding (adoption, certain medications or diseases, documented low supply from an IBCLC, etc)? One could argue that this would inhibit "freedom of choice"--a phrase that Americans love to throw around whenever they feel threatened in some way. Would women feed their infants something else besides formula (diluted juice, straight cow's milk, etc) if WIC did not provide it for free? Is it better to provide an inferior substitute for free, than to refuse to subsidize it "just in case" some women might (hypothetically) feed their infants something even worse?

On the other hand, would ending formula subsidies really inhibit freedom of choice? Women on WIC would still receive assistance with their own nutritional needs, and with food for their baby once it starts on solids. They could still choose to use formula--just at their own expense.

Is it right--from both public health and ethical perspectives--to not give free formula to women who choose not to breastfeed? There is a huge body of evidence about the health risks of infant formula. Is it right to supply it, for free, when breastfeeding would have greater health benefits and fewer health & medical costs? George Kent argued:
In 1993 the US government's General Accounting Office (now called the General Accountability Office) recommended that the government "develop written policies defining the conditions that would contraindicate breastfeeding and determining how and when to communicate this information to all pregnant and breastfeeding participants of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)" [p3]. The resulting study spells out the benefits of breastfeeding, and it provides a detailed analysis of the conditions under which breastfeeding might not be advisable, such as cases in which the mother has specific diseases or has taken certain kinds of drugs. The study concludes by reiterating the benefits of breastfeeding, and recognizing that there are rare situations when the mother should be counseled to not breastfeed. It ends by saying that "Breastfeeding should not be withheld from any infant unless absolutely necessary" [p32].

What happened with these recommendations? Surely one must recognize the contradiction between acknowledging that mothers should only rarely be counseled to not breastfeed, and at the same time providing free infant formula to very large numbers of mothers.

Perhaps people should have the opportunity to choose to use infant formula, just as they are allowed to choose greasy hamburgers and cigarettes. The point here is that allowing a questionable product to be on the market is one thing. Having the government promote it is quite another. Having the government promote infant formula particularly among poor people raises enormous ethical questions. Does the balance of benefits and risks from the use of infant formula justify the government's providing infant formula to almost half the infants in the US?
Even if they ask, WIC will not provide alcoholic beverages to its clients. The fact that they might ask for beer, for example, is not a sufficient reason to provide it. Similarly, the fact that some WIC clients prefer to use infant formula is not a sufficient justification for WIC to provide it. The large-scale distribution of free infant formula by WIC to all clients who ask for it is a situation that needs to be fixed.

If infant formula could be demonstrated to produce better infant health, there might be a reason to distribute it without cost to those who could not otherwise afford it. However, there is no evidence to support the generalization that the use of infant formula results in better infant health than breastfeeding. On the contrary, the evidence clearly and consistently shows that the use of infant formula increases the risks of morbidity and mortality throughout the life cycle. The use of infant formula has been shown to be harmful to the health of mothers as well. The inescapable conclusion is that the government should not be distributing free infant formula.

It might be argued that if they were not supplied with infant formula, some WIC clients might instead use juice, cow's milk, evaporated milk, or over-diluted formula. There is that risk, but it is likely to be overcome with proper breastfeeding support, from WIC, employers, and others. Moreover, those who feel that they must use infant formula would remain free to purchase infant formula. It does not seem sensible to promote an inferior product simply because one can imagine something that is even worse.
The US Food Policy blog has a discussion about these very issues. Several commenters pointed out that there are other complex behind-the-scenes issues: lack of education about breastfeeding, breastfeeding difficulties, lack of maternity leave, lack of support for breastfeeding/pumping in the workplace. One commenter wrote:
The true killer of breastfeeding is the fact women in the US have to work to make ends meet- not the WIC office. Mothers are not milk cows and unless you have a sympathetic boss, pumping every two hours to maintain your milk supply disrupts work. Even then, some women find it impossible to pump because their bodies know the difference between pumping and nursing so then their milk supply drops or even dries up completely. Am I saying that women should not work?- No I am not. However I am pointing out how complex this problem is.
Let's discuss!

28 comments:

  1. Yeah, until we live in a society where all women can take their exclusively breastfeeding infants to work with them or where we all enjoy lengthy maternity leave, taking away a source of adequate nutrition (formula) is not going to help.

    Formula is incredibly expensive. If breastfeeding doesn't get established, or women work in a non-supportive environment, or can't pump for some reason, formula really is the only practical option.

    WIC is not the problem. There are much larger social problems at play here. WIC helps insure that all babies get at least adequate nutrition for the first year of life.

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  2. I wholeheartedly agree and believe that maternity leave in the US is atrocious. I think some SERIOUS social changes need to be made in that area!!!

    I love this quote:

    "On the other hand, would ending formula subsidies really inhibit freedom of choice? Women on WIC would still receive assistance with their own nutritional needs, and with food for their baby once it starts on solids. They could still choose to use formula--just at their own expense."

    And I agree with this - with nutritional help and practical breastfeeding support, I believe most women can successfully breastfeed. I'm sure, too, that WIC would be able to take into account times when mothers are incapable of pumping and need to work, therefore NEEDING formula. I don't think anyone wants to deny formula to a mother or infant when it is a true necessity, just when it is not.

    Perhaps, too, breastmilk banks and donations could improve to help supplement these infants' diets with human milk.

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  3. I have no doubt that not providing formula would lead to some women giving their babies cow's milk straight out of the jug, or some other substitute. Some people are dead set against breastfeeding and are not going to do it. If someone is from a family, local culture, or geographic area where breastfeeding rates are extremely low and they're put in a position of having to choose between breastfeeding, using part of their rent money to pay for formula, or giving the child something else cheaper to drink, they're going to do the latter.

    And I think there could be a feminist outcry of sorts: the govt trying to coerce/corner women into using their bodies in a way they don't want to.

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  4. As a formula feeding mother and someone utilizing WIC, I really appreciated this post. It's a great shame that my son is on formula, I think about it every day and almost every day I've got some new reason why I wish he was breastfed. That said, I couldn't possibly be more grateful for what WIC provides. It doesn't cover all of our expenses, for one thing, people on WIC still have to buy formula and baby food, despite how much they give you. But we would be unABLE to feed our son if it wasn't for that program. I mean, 2 cans (which gets us through 2-4 days depending on his appetite) is $30. We only get nine a month from WIC so I'm sure you can imagine how quickly that would add up if we were paying for it all.

    One thing that disturbs me, though, is that the WIC employees, while supportive of breastfeeding, are generally very lacking in knowledge about it. Well, allow me to temper that with "in my experience". I've only met five of them, after all, lol. Anyway, as nice and encouraging as they are, they know very little about it and I found out that they no longer offer breast-feeding benefits to mothers who are still nursing past 6mo. When I questioned this policy (as I found it appalling) it was explained to me by the woman assisting me that I was the FIRST women she'd met in three years that *actually* nursed that long. I guess she believed me because my 2yo kept asking to nurse while we were sitting there. Apparently so many women were receiving the benefits but not actually nursing that WIC can't afford to do so anymore. It's a great shame that instead of properly training their staff to support and encourage long-term nursing (I mean, really, 6mo is NOT extended breastfeeding! It's the BARE MINIMUM!) they've removed any incentive to do so.

    I honestly don't think WIC as an organization has the place of deciding for women whether or not their kids need formula, that's something they shouldn't get involved in (though I fully support legislation that would make formula available by prescription only or something similar). If we want to see formula feeding rates drop, we need a major societal change. I think WIC offering out huge amounts of free formula is a symptom of a serious problem, here, not the cause. That said, properly supporting breastfeeding could (and should!)certainly be a bigger focus.

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  5. I once knew a woman who was on WIC.. and not working, yet was to lazy to go to her appointment at the WIC office to get her coupons, so instead she fed her baby powdered milk. The baby almost died of malnutrition.
    Regardless of the debates around this issue, I think this is definitely a step in the right direction. When I was pregnant 20 years ago, no one encouraged me to breastfeed. The subject was never brought up, and I used the WIC program.

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  6. When breastfeeding is difficult or my friends find it taking up too much of their time, I always hear, "Well, we can always get formula from WIC for free."

    There are too many women taking advantage of this - and not out of need, but out of convenience.

    It's flu season in Idaho - and those babies are suffering.

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  7. I think it's fantastic that WIC is supporting breast feeding mothers more than formula fed, however, the fact that they provide formula for those who do not or cannot breast feed is much needed. I was on WIC with my daughter and received formula. I tried everything I could to breast feed her and she would not take it. I was young and we did not have a lot of money, and after leaving the hospital, I wasn't sure how to get a lactation consultant without having to put out our own money to do it. As a result, I couldn't get her to eat and we had to use formula. WIC was a great help because there is no way we could have afforded it without them. We are still on the program and the changes they are making are definitely positive. I wish I would have been able to breast feed, however, I do not regret my choice. She is healthy (actually healthier than most babies) and a good eater. She has not been to the doctor for a sick visit her entire life. She has never had to take medication for anything and has not gotten flu shots and managed to stay healthy. I don't doubt that breast feeding is a good idea, but for my child, formula feeding was what worked for us and WIC provided that!

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  8. I have to agree with some of your commenters. Until certain social infrastructure is changed, removal of access to free infant formula isn't appropriate, in my opinion. You have to give more support before you can take away free formula. First of all, universal access to some type of high quality health care is fundamental.
    I read recently somewhere the idea that breastfeeding promotion without support is fundamentally flawed and, in my opinion, almost cruel. If the WIC is looking to save money overall, they shouldn't. If they remove infant formula from the list of foods they offer, they should reallocate those funds towards actual breastfeeding professionals who go to moms' houses and help them in the early weeks, for as long as they need help, to establish breastfeeding--and then also be available for as long as they breastfeed if they need other support or advice along the way.
    And absolutely universal access to decent maternity leave is needed. The poorer a woman is, the longer should be her leave from work, since her social situation puts her children at higher risk for just about every negative outcome. Maternity leave is a fundamental empowering tool: it helps moms to tend to their babies during the most vulnerable stages of the babies' lives, and makes breastfeeding logistically attainable. Breastfeeding is natural, but pumping is not--therefore it takes an enormous amount of effort and commitment and support to successfully pump full time for an infant of a young age. If women are allowed a significant span of time at home with infants, and guaranteed the same position or a better one when they return to work, by the time they do return, a baby can often eat solids, stretching out the time between pumpings, and possibly (if the baby is a year or older), not even needing to pump while at work at all. Older babies of working moms often switch their milk feeds to evening and nighttime, and mom's body adjusts accordingly.

    Great topic!! Excellent discussion, and I definitely agree that something has to be done to reduce the amount of free formula that goes to infants, especially by WIC. I just think that it is probably NOT the best idea to make the first step removal of access to formula. A few intermediate steps need to be put in place first. And WIC needs to view this as a reallocation of funds, rather than a cost saving measure, otherwise I really think that moms will become desperate, and more poor, and some babies will die from lack of milk. Because they are hanging off the end of mom's nipple, or because they are not facilitating milk transfer on the breast, or because of being fed diluted formula or non infant cow's milk, etc.

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  9. Rixa,

    Great question & I'm glad you're bringing this up!

    A few things I think are worth noting about the relationship between WIC & formula companies:

    1) Rebates are mentioned briefly in your post. The way this works is, WIC buys a HUGE amount of formula from the formula companies. This is expensive, and WIC is a government program with limited resources. So the formula companies give them "rebates", which can lower the cost of formula for WIC by as much as half. Why do the formula companies do this? Because as Rebekah notes, WIC doesn't give you enough for a month. Once the WIC formula runs out, parents go to the store to buy more, and most likely they buy what WIC has been giving them. It's a massive marketing tool.

    2) If the formula companies did not regard WIC as a marketing tool, or if WIC was forced to pay retail or close-to-retail prices for formula, WIC could not afford to give out nearly as much as they do.

    3) The new packages for breastfeeding moms are promoted as being equal in value to the formula feeding packages. (So while formula feeding moms get expensive formula, breastfeeding moms get extra food.) But my understanding is that they are not really equal, because they are using the prices WIC pays for formula to calculate the value of the package - not the retail values. The formula package is still more valuable and when every dollar counts, people recognize this.

    4) Like Rebekah noted, and as your statistics demonstrate, WIC supports breastfeeding in theory but often doesn't have the capacity to be very supportive in practice. Where I am now, some county WIC offices have free personal pumps to give out and in-home breastfeeding support counselors (in fact, the WIC moms who get this free support are better off than the ones with private insurance, who have to pay out-of-pocket for private LCs and then try to get reimbursed.) Other county WIC offices have nothing - no pumps, no breastfeeding counselors, nada.

    My take: I hear WIC is about to push some more money to breastfeeding support, which is great; I'd like to see them take money from the formula budget until every county has a full breastfeeding support program. Despite that, I do think they need to continue formula distribution, as hard as that is for me to say. To me, WIC formula distribution is "harm reduction" - if you didn't give out the formula, what's the alternative? Would everyone breastfeed, or would some people be giving cow's milk or watering down the formula they could afford? I worry about the latter possibility. (Although thinking about it, I don't know that there is an evidence base out there that this is what WILL happen.)

    I also agree that maternity leave is the #1 problem with breastfeeding promotion in this country (along with a lot of the other "mommy wars" debates). It is just not practical to tell many of the women on WIC to pump, even if we give every one of them a free pump. I don't know how we would ever get maternity leave passed when we can't even manage health care, but to me it is the single most crucial element that American women are lacking.

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  10. p.s. I would also like to refute some comments regarding womens' attitudes towards breastfeeding. I read a few comments regarding women being 'lazy' or 'not caring' particularly if they are poor. I think poverty is a high risk factor for MANY things, but laziness or lack of love for their infants is not one of those things. Accusations of the women involved is very disempowering and does not address the root causes, which in many cases are rooted in poverty itself. Education, social support, and decent resources to enable moms to climb OUT of poverty are all very positive things. So is a change in middle and upper class attitude. If you believe poor people are fundamentally bad and lazy, you automatically make it more difficult for those who are poor to overcome poverty, because society's view of them is just another wall to overcome. The truth is that people are all capable of good and bad emotions and actions, regardless of their income level or need for social assistance. Support for women is what empowers them, not accusations of laziness or lack of love for their infants.

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  11. WIC is definitely one of the best promoters of breastfeeding amongst low-income families. There is no question where their allegiance lies. That said, I really do believe (like others) that until larger social issues are changed, formula should be available via WIC. I really do think removing it would lead to over-dilution, feeding juice, water, etc... partially because women might not know of the dangers and/or risks involved in doing so. These women want to feed their children - they just often don't have the social support for breastfeeding (which, at least in my experience, is HARD and requires a lot of help) and they simply can't afford formula.

    What if WIC still subsidized formula, but didn't subsidize as much of it? What if the mother was still paying out of pocket for 25% of her baby's formula? That would still give women a financial incentive to breastfeed, but would still supply the infant with adequate nutrition if the mother wasn't breastfeeding without putting a gigantic financial hardship on her shoulders.

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  12. http://seasonchanging.blogspot.com/2010/02/great-debate-spirals-down-into-whining.html

    In here I make several points about people's assumptions regarding why women choose to FF and I would repeat some of them here:

    Some women literally can't pump. We can all bemoan the lack of support for that all we want to but the bottom line for many women is that even WITH amazing support, being a SAHM, excellent quality pumps, etc etc, it's not going to work. I know, I'm one of those women and I was spending a total of 8.5 hrs a day JUST pumping and feeding my son what I could get with a hospital grade pump and *it wasn't enough*. I have excellent supply, have nursed two other children for 3yrs a piece (and counting) and am willing to go the extra mile. But I'm not just a mother to one child. I have three children, five and under, and I canNOT spend 8hrs a day pumping and feeding my son a whopping total of 8oz a day and neglecting the rest of my family in the process. A family of six, a husband who works and is a fulltime student, a child in school, laundry, meals, all of teh OTHER things that go into caring for toddlers, infants...it just wasn't working. I'm not lazy, my nipples were cracked, bleeding, blistered and STILl I was trying. The reality is that breastpumps were designed around a cow's teats (they were designed by a dairy farmer and an engineer). For some of us pumping absolutely will NOT work. It's just reality. I hate that my son needs formula but I'm very, very grateful for it. I wish I had any kind of knowledge about how to design something because I WOULD be designing a new pump based on the anatomy and physiology of a woman's breasts because I'm a statistic that is FAR far too common to be dismissed. Those of us that support breastfeeding need to get away from the mentality that ignorance and laziness are the main culprits of breastfeeding (especially the latter) because the issues FAR exceed those. I go into more detail in my post, but I just wanted to follow up the previous commenter's words.

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  13. As a feminist, my motto is "trust women." Of course, education and breast feeding support are crucial, and energy should be focused there. But regardless of whether it is present, it is ultimately, in my mind, a woman's decision whether she is going to breastfeed or not. There are too many factors affecting that decision to ask a woman to "prove" that she cannot breastfeed. You may be able to prove low supply. Can you also prove work circumstances that are non-conducive to BFing? Can you prove that past sexual assault has made breastfeeding too traumatic? Can you prove that you really need to be taking your psychotropic medications, rather than BFing? Who gets to make those decisions? I really don't think its fair or right to put the burden of proof on women, especially for these issues that can be so subjective.

    Teach women, and trust women. That is enough.

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  15. My main objection to WIC and the whole breastfeeding point is that they don't extend the breastfeeding 'perks' for women past 1 year (exclusive breastfeeding for 6 months but, at least in Oregon, I still got extra food for breastfeeding until 1 year), and, if you got pregnant again, you had to choose to be registered EITHER as a breastfeeding woman OR as a pregnant woman (either way you choose you'll lose something the other might give you ), they didn't have a category for women who where both, taking into account the additional need a women who was both supporting a breastfeeding infant/baby/toddler AND a growing baby. My feeling on how WIC approached breastfeeding, based purely on my personal experiance, was along the lines of 'breastfeeding is great until you have something better to do or until it burdens the mother'.

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  16. In the United States, breastfeeding is a luxury. If I weren't out of a job, there is no way I would have been able to work a minimum wage job and be able to take breaks every 3-4 hours to pump.

    Women have to make difficult choices everyday. As passionate as I am about breastfeeding, until there is real social change in America, WIC will still be doling out more formula than breast pumps.

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  17. I receive WIC benefits right now, but have not rec'd formula. I think another step WIC could take to reducing formula use would be to subsidize the cost of pumps. Maybe they could even provide some advocacy for mothers whose employers don't want to provide breaks for pumping.

    At my local office there are many posters and flyers about the benefits of breastfeeding and La Leche League meetings, but these have to happen on the mother's own time. Perhaps requiring a breastfeeding course at the end of pregnancy to receive benefits would help.

    As for the changes since Oct., I would guess that the marketing aspects that have been going on with formula are being traded for marketing of baby food. There isn't jus one brand, but the amount seemed like a definite push to feed baby solids. For one baby, I was receiving 90 jars of fruits/veg and meats, and 3 boxes of cereal per month. I ended up donating 2/3 of that (and all of the meat, blech) because it was too much since we are more or less going with baby-lead weaning.

    Last month I was able to tell the office they could take away the meat and cereal, and reduce the fruits/veg by half. The office worker was really surpised by that.

    Overall I think they are encouraging breastfeeding, but need to do more to actually support it. And the money for fresh fruits and vegetable is awesome and is really helping my family eat more.

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  18. I would like to see more changes in WIC, especially in certain areas. I know that when I was on WIC - ten long years ago, heh - with my son, there wasn't a "breastfeeding" option: you received formula, and then you received 4359875892 jars of baby food at 4 months.

    While I nursed at first, I admit that the free formula (mostly...as others have said, it turned out not to cover all needs) was an easy excuse when the going got tough at 4 months, and I quit (also thanks to poor LC advice). I didn't find out until almost 6 years later that WIC offices were even supposed to have a breastfeeding option, or help, or anything; no one ever said anything to me. I know from others that - at least in the area where my son was born - it remains the same.

    I also think that, fundamentally, changes have to be made at how we look at women, and children, and families. Despite going to law school full-time, I was able to nurse my daughter until she self-weaned at 2.5; I will also be nursing our third child, due in April. However, we also have the resources to be able to do this. We have the resources for me to take an extended leave, even without pay, thanks to my husband's pay. We have the ability to purchase a hospital-grade pump to maintain supply, and pay for a care provider for our children who agrees with - or at least solidly respects - our choices and does not attempt to undermine them. It's hard to forget how lucky I am to be able to maintain these nursing relationships and hard it was way back when for me, and how hard it is for others now.

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  19. As a Canadian, it totally baffles me that your gov't does this. As mentioned, WIC won't supply beer (but the welfare check might be used for it). I just don't understand why the gov't is promoting a food that is known to be inferior for babies, and also puts the mother's health at risk. And then they complain about the cost of health care?!
    I highly agree that maternity leave needs to change in the US. A woman hears "It takes 6 weeks to establish breastfeeding" but she has to go back to work in 6 weeks, so she thinks "why bother, I can get formula for free". And, I think WIC is also determental to the bf rates of babies that are NOT in the program--if the gov't gives it away, then it must be okay.
    I can see that a mom who is interested in bf, and educates herself, would benefit from the changes, but unless ALL clients get the education (which includes the negative aspects of formula such as that they will still have to buy some and the cost of increased health care needs), way too many women just simply don't care. Apathy breeds apathy.
    If I ran WIC, I wouldn't allow formula except in medically indicated situations. If I ran the US, I would take the profit-making ability away from formula makers; make it a restricted item, etc. Sigh.

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  20. TracyKM, (or any other Canadian), would you be willing to walk my non-Canadian readers through what social/welfare/maternity leave/housing/family assistance/etc policies Canada has? Does it have any agency akin to WIC, for example, that helps low-income mothers and children obtain food? How long is maternity leave, and at what percent of pay? What other kinds of assistance do low-income families, and mothers in particular, receive? etc...

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  21. I am Canadian. Mat leave (EI) maxes out at $381 a week. Between the various parental leave programs, you can be off for roughly 1 year.
    I have lost jobs twice for taking mat leave. People can holler all they want that employers can't do that...they can, and they do.

    I agree that the Canadian system is ahead of the US, however, the amount does not allow me to stay home with a child, and I have not heard of 1 employer make the necessary arrangements for a women to pump at work (clean room, locked door, power outlet, etc).

    I think it's ridiculous that people feel that WIC offering mothers formula does not support their breast feeding campaign. I cannot sustain a milk supply while I work, pumping is not sufficient.
    There is no need to punish woman already behind. Provide the education but don't make the choice for someone, medical reasons are not the only reasons why people choose or cannot breastfeed. We are supposed to be an open supportive bunch here, this conversation feels very judgmental.

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  22. I'm also Canadian and worked before I had my first daughter - at a hospital. They topped up my Employment Insurance benefits to 90% of my pay for the first 6 mos, at which point it dropped to the aforementioned $381 per week for the next 6. Most employers do not'top up' the EI though.

    You can take mat leave for a maximum of 1 year - spouses can take a maximum of 9 mos (I think).

    I'm not aware of any programs like WIC, but I honestly don't know.

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  23. In Canada we have a variety of food type programs, these vary regionally, anything from a food bank to food stamps.

    To clarify, $381 a week is after tax. Much better than nothing, but not a whole lot. Also keep in mind that the cost of living in Canada is much higher than in the US, especially housing costs.

    As I mentioned, Canada is much further ahead in mat support (in some ways) than the US, however, it's not far enough forward, we need much better support by the government and companies, where we already have programs in place, I feel that it will never increase as it's not a priority.

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  24. I wish you would have said something about the lunacy of the infant food supplements!

    My daughter turned 1 on Oct 29. So for one month, she got the infant food supplement. That consisted of NINETY jars of infant food, 15 4-oz bottles of infant juice, and 36 oz of infant cereal.

    Now I've been very frustrated by the cereal all along. I bought ONE box of infant cereal for my previous 4 children. I bought it for my first because I was "supposed" to. She didn't like it. So I didn't buy any more for my others. Now I've got cereal coming out my ears, that my husband feels compelled to use. And quite frankly, I don't think it is all that great of a nutritional product...ignoring the issue that you can only purchase Gerber brand, which is made by Nestle... Ggggrrr.

    The juice, likewise...why in the heck do I need this stuff? *Fruit* is needed for a child, but juice really is optional, so why should WIC be providing juice for anyone unless they specify calcium fortified juice for children who don't consume milk?

    Then those 90 jars of food. Sigh. They were STAGE 2 foods...for an 11 month old baby. Where is the sense in that?

    And of course I never really used much jarred babyfood for my previous kids--probably well under 90 jars for all 4 previous kids combined...let alone using 90 jars in one month for one child! I would have much rathered have coupons to buy real food--chicken breast for $2-3/lb rather than jarred chicken sticks for $9/lb. Fresh produce which my daughter devours, rather than the jarred mush that she refused to eat.

    Sigh.

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  25. Rebekah C, there must be variation in policy from state to state or office to office...because while the staff at my office was shocked that I was still breastfeeding (when my file got sent to the front to print the coupons the woman there yelled back to the nutritionist in shock "did you verify her???"), they did continue to give me "breastfeeding support food" until my daughter was 12 months old.

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  26. Oh it's not a variation, it's just a brand-new policy. Very new, like within the last year or so. When I was there with my first, that was not true.

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  27. Rebekah Costello, I'm in the same boat regarding the humongous amount of baby food from WIC. For the loads of cereal, I found recipies for cookies and pancakes to use it up. The pancakes are really yummy.

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  28. This has been a great discussion. Sorry it has taken me this long to discover it.

    One of the comments suggests that the formula provided through WIC is provided at high cost to taxpayers. My article suggests that is not so. The US government's serving as the marketing agent for formula allows the manufacturers to charge very high prices for formula for non-WIC users. This allows the manufacturers to provide formula to WIC at prices much lower than regular retail prices.

    Infant formula is cheap to produce, since its primary ingredient is milk solids, obtained at low cost from a highly subsidized dairy industry. WIC's contracts with the manufacturers actually include hefty rebates from the manufacturers to WIC!

    I believe the WIC program helps to get many more women to use formula than would be the case without the program. Then, when their WIC benefits end, they have to pay the inflated prices for formula in the supermarkets.

    As I see it, the manufacturers are using a kind of addiction model, giving out free samples for a time, and benefiting from retail sales later.

    Aloha, George Kent

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