Monday, November 20, 2006

Why does WIC provide free infant formula?

Comments are open for responses to George Kent's unforgiving criticism of WIC's free provision of infant formula, amounting to perhaps half of the infant formula consumed in the United States. Kent's essay appeared earlier this year in the International Breastfeeding Journal.
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.
Whether you find yourself agreeing or disagreeing, the full essay contains answers to some of the natural questions. Are breastfeeding rates higher among participants or seemingly comparable nonparticipants? Is the WIC formula provision consistent with international protocols? Is it true that many women cannot breastfeed? Doesn't WIC actually promote breastfeeding? Is formula that much worse than breastfeeding anyway?

25 comments:

kati said...

Let's also add: what percentage of WIC mothers work? what are the infants of WIC mothers eating when their mothers are at work?

Breastfeeding is the best way to go. But let's face it, there are still many barriers to breastfeeding. Is the WIC population presented with more of those barriers?

Jack said...

As you convey, Parke, it's a complex issue. What is obvious is that (some/many) Women need to be encouraged to breastfeed and that this program does the opposite. :(

Mensch71 said...

If one assumes (as is the case in Michigan) that many of the mothers who receive WIC for themselves and their infant child are also participating in one or more social programs the odds are very strong that the WIC mother is required to return to work long before breastfeeding advocates recommend supplementing with other foods.

WIC mothers are often forced to choose between receiving assistance (WIC, welfare) and staying home with their child(ren).

The issue is complex but highlights the significant problems of the country's social safety net.

Freudian Slip said...

At first when I started to read this post, I was offended. I thought about all of the people having a hard time finding $$ for formula, but this post has really opened up my eyes. I am so glad my wife was able to breast feed our son, and it is terrible how these programs actually discourage breastfeeding. Interesting.
Matt

Parke Wilde said...

Much thanks for your comments, Matt, mesnch, jack, and kati. Meanwhile, a week's reflection and a lively discussion in class remind me to tread carefully. Without WIC, the challenge facing a low-income mother who is unable to breastfeed, due to health or employment limitations, would be heart-breaking. Still, Kent's essay, the Pediatrics article it cites, and also a conversation this fall with Julie Smith (a fascinating economist who specializes in breastfeeding economics), have prompted me to be more outspoken in at least questioning the current design of WIC.

Smythe said...

Thats all fine and good and I know I am a new face in this crowd - but I think it is imperative to have walked in the shoes before stating opinions. WIC is a Godsend for many low income mothers - and a most of these mothers are without choice. And don't state comments like they should have thought of that before they brought a child into this world. They didn't and it is important to take care of what we have.

Anonymous said...

I think it's pathetic that you would equate formula to beer and alcohol! Get a grip. Of course breastfeeding is best, but formula is NOT poison.

Anonymous said...

What is with people today? Even if a woman can't breastfeed, she can still choose to not do so. Are grandmothers everywhere weeping over the fact their kids are retarded because they gave them cow's milk, the supposed worst of all? No, because their children are fine.
I believe it is a choice, no matter how much people would like to insist breastfeeding is the only way. And I think until you've been through breastfeeding, you shouldn't have a say. You wouldn't understand the pain, the inconvenience, even the heartbreak of having troubles with your infant. I chose not to breastfeed after two months, and it doesn't make me cruel, weak, or negligent. It means I get the same choice everyone does, and I don't blame WIC for making me do anything. They try their hardest to get you to breastfeed, I know.
But it's still a choice. We haven't outlawed coffee or cigarettes. Leave our formula alone.

Alisha, CA said...

What are you talking about????? I am on WIC and I breastfeed, and they have never once encouraged me to formula feed. WIC gives you formula if you chose to use it. However if you chose to breastfeed, they give the mother free nutritional food and have breastfeeding counselors that call every week or two in case you have any breastfeeding concerns, difficulties, or questions. They tell you the truth about breastfeeding myths, encourage you when you are down, give you advice to keep breastfeeding, and let you know you are doing a good job and remind you how good breaastfeeding is for your baby. I never once was asked if I would formula feed nor if I wanted formula-- they asked ME what I was going to do. When I told them I was going to breastfeed, they even offered me a pump in case I needed it. At my WIC office they are throwing a raffle as well strictly for breastfeeding moms.
So, I, speaking from experience, totally disagree with this article.
The only thing I could say bad about WIC, is that they do not educate more pregnant and new mothers about breastfeeding. A lot of poorer people formula feed because they don't know the benefits of breastfeeding. WIC tells you all these benefits after you have made the decision to breastfeed but I do believe WIC should make it their priority to educate women on the importance and the benefits of breastfeeding before their baby is born.

rosalyn evans said...

I totally disagree. I was unable to breastfeed my child after spending endless weeks trying and working with lactation consultants and following all recommendations, even trying medications to stimulate milk production. At the time I had very limited income and was helped by WIC helping with formula costs. Even still, WIC is relentless with telling mothers and posting EVERYWHERE to promote breast feeding. I don't think anyone ever encouraged formula in the least, either at the hospital, my doctor's office, or at the WIC office. In fact, for those who can't breastfeed the reminders of how terrible formula is viewed are never ending.

Anonymous said...

I feel like WIC never promoted formula, and they do supply breast pumps for people who choose to work and breast feed. However, when I applied to receive a breast pump so I could keep my milk supply going for work, they didn't have a pump for me until after I started work, and I applied for one three months before I started. Its sad that if you want formula that is no problem and you can have it the next day at the supermarket, but to continue to work and breast feed and use a breast pump, its a miracle if you can ever get one.

Anonymous said...

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.

Ashley said...

As a mother myself on WIC currently, Im greatful that they provide formula as well. I tried my hardest to breastfeed and was heartbroken when my son never took to it, so i was forced to give him formula and even though my husband and i both work, without the assistance wic offers with the formula, we would have been screwed when it came to buying formula every month. thats just my opinion though

Anonymous said...

I think that there are situations that call for formula but the truth is that most mothers/babies can breastfeed fine.
It may be difficult for some babies in the beginning, reasons being the way we interfere with the birthing process (epidurals/pitocin/immediately washing babies, etc.), babies being given bottles in the hospital so mothers can 'rest' or babies being swaddled and put down instead of being held skin to skin.

Since babies are born to breastfeed and only 5% of women are unable to produce enough milk, the fact that so much formula is fed to our babies is awful, considering what we know about breastmilk vs formula.

WIC agencies vary from city to city/state to state. Some are better than others at promoting breastfeeding but that was the original intention of the program. WIC now means free formula that low income women come to expect when they have their baby.

Our country allows formula companies to market to women when other countries follow the WHO code and do not. Doctor offices/hospitals are filled with formula ads/freebies that promote their products before mothers even give birth, undermining their confidence that they even can breastfeed. Our society shuns public breastfeeding and a lot of mothers haven't even ever seen a baby breastfeed, again making them think they can't do it.

It may be hard in the beginning but most mothers, who are persistent - which may mean hand expressing their milk if a pump isn't available, are able to do it and their babies are healthier because of it!

Turtle said...

As a breastfeeding mother who is on WIC and was receiving help from social programs, I thought I'd weigh in.

With the way social programs in my state (California) work, a mother is required to be out of the home attending training or work related activities at least 32 hours a week after the baby hits 6 months. Frequently, parents need to attempt to return to work even earlier than that because the help provided by these programs doesn't come anywhere near providing enough to support an individual, let alone an individual with children.

With what I received from California when I was medically unable to work I would have been able to pay about half the rent of an apartment in a bad neighborhood of a large city with no utilities or personal items, as well as no transportation help to find work.

They were, however, totally ready to pay a babysitter about $800 a month to watch my child if I wanted to go wander around (on foot) looking for work or attend a training program.

WIC offers manual breast pumps immediately if it has any in stock (I remember being told I got the last one when I asked), and electric pumps after a mother has managed to work long enough to prove they need one, assuming they have any milk supply left at that point.

I am very lucky. I have skills I was able to use to become self employed successfully and work out of my own home, allowing me to move off of social programs and support my child without sending her to a sitter. Of course, I'm also college educated and most of my reason for being on that stuff in the first place involved a medical crisis and bad timing. I just felt that bad timing was no reason to give up on having a child I desperately wanted and would be capable of supporting in good time.

I don't think many people who end up poor are anywhere near that lucky. My child is going to be turning 1 in a few weeks, and I am still breastfeeding her because I work at home.

There is no way I would have had the resources, time, or energy to pump for my daughter if I had been forced to struggle with the kind of low wage service industry job that most people coming off of social programs are able to get.

I have held those jobs before, and I've seen mothers terrified of loosing a job they desperately need afraid to demand the time the law allows for pumping. There is also usually no sanitary and private place where pumping can happen. Break rooms are always busy at large retail stores, and the only private place left is usually the bathroom.

Anonymous said...

Wow ok so lets say your milk is coming in? Or Your not producing enough milk? Should we just let the baby starve to death? No ! Thats why wic is giving us formula!!!

Christina said...

This is rediculous, first of all I am pregnant and get WIC. Not one time have they pushed, advocated or even suggested taht formula is a good thing. If anything it is time consuming to have to leave my job to go to all these required breast feeding classes and lectures. They wont even give you formula for at least the first month of your babys life to try to force you to breast feed. I work full time and will have to return to work at about 1 month because I work for the fed govmnt and we dont get maternity leave of any sort and cannot apply for temp disability like most other places. This makes me angry because like alot of other things breast feeding/formula feeding is a personal choice that is up to each individual to make for themselves. If you prefer breast feeding, great do it. I dont know why it would offend someone that others have a right to make a choice as well.

Anonymous said...

Im a wic mother and when you get signed up with wic they encourage you to breast feed. You are only allowed 9 cans of formula milk most babies use at least 13 a month. before you even get the formula voucher they evaluate your situation and make sure you at least attempted to breastfeed. WIC wants tobe sure you are healthy througout pregnancy and after.

Anonymous said...

does anyone know which infant formulas WIC provides??? My grandson breaks out from Enfamil, gerbers good choice...He does real well with similac but WIC doesnt provide this...He can also drink carnation milk, WIC doesnt provide that either...HELP!

Anonymous said...

does anyone know the infant formulas WIC provides...besides Enfamil and Good Start

Anonymous said...

not everyone can breastfeed.. and yes for some its a choice.. but WIC encouraged me to try, I did, for 2 weeks. NOT FOR ME! Its better than nothing, formula has gone a long way!

Anonymous said...

WIC does not discourage breastfeeding, it encourages it as the first thing you should be doing. But not everyone can breastfeed. I tried with all three of my children, and after 2 weeks of trying it wasn't working. So we went to formula. Formula is the best option when you can't breastfeed. And the idea that people do not like women breastfeeding in public, but don't mind seeing a bottle in a babies mouth or a toddler making a mess while eating is ridiculous. If women weren't so ridiculed by people for breastfeeding in public, more would try. Women shouldn't have to hide in bathrooms, or their cars or back offices or stay home to breastfeed. People should be more open minded, no one complains if you eat at a restaurant, so don't complain when a baby needs to eat even if that food comes from a womens breast. All I ask is that you try and keep coverage at the table.

Ashley(young mommy of a beautiful FF baby girl) said...

There are many occasions that a mother cannot breastfeed. My daughter who is a month old now, had difficulty regulating her body temperature and couldnt eat for a long time after birth and once she started breastfeeding it took so long for my milk to come in (partially due to the emergency c-section) that the nursery had to give her formula for her own safety and well-being. Before she was born, because of things like this, I had convinced myself that if I didnt breastfeed exclusively that I was a bad mother. Its terrible that people are so judgemental when they don't know until they have gone through it. I also have multiple autoimmune problems that require medication that make breastfeeding unsafe for my baby. So do I give up my medication and try to breastfeed and end up in the hospital where I will be placed on mediction and not be able to breastfeed or do I skip all that and just formula feed her? Don't make judgements until you know what it's like to go through it.

Anonymous said...

I am a mother who is on WIC and am not ashamed to be so, where so many in this country want to guilt trip society into believing they are doing something bad, even feeding a helpless baby. I am also very grateful for WIC. I breastfed for 3weeks and had to switch to formula (which is a headache all on its own finding a compatible formula). I have a prolactin deficiency, and first the pediatrician at the hospital made me supplement, then after what seems like a ton of fenugreek, mothers milk tea, and pumping/feeding a nipple confused baby, pumping an hr and only getting 2oz of milk, my baby went to fulltime formula. I am an educated woman who will be graduating in less than a month as a Registered Nurse. You're stereotyping "poor people who use WIC" is highly innappropriate and you should be more open minded before you judge. Any assisted help that I have been given, my household has paid taxes for and will continue in the future. If it is so upsetting to you that people are getting help or assistance and you aren't maybe you should try to live a life of poverty, or low income and see how life treats you then. On the other hand, there are people who abuse the system and take advantage of any help they get like selling formula, food, etc... however, there are scandals across the wage scales in the U.S. big and small. If a woman is able to breastfeed, there are so many benifits as to why it really is the best choice for the baby, it is aggrivating some women don't even want to try.

Anonymous said...

Getting a statistic based on only an ability to do something ( brestfeeding) is completly bias. It seems you are not educated enough to even judge the poor and uneducated, being you part of this same group. Before making an argument you should understand that an ability is not something measurable in terms of only one idea. Your percentage would dramatically increase if you take in consideration all other factors that make brestfeeding impossible for not some but many women such as the fact that many of those women who in your bias opinion could brestfeed have other condition for example a chronic disease that requires them to take daily medication for life and it is unsafe for brestfeeding aswell as many others have told already employment is simply impeding for most mothers, also did you consider mothers milk vs child acceptance. There is an increasing number of babies that won't tolerate their mothers milk. There are also many other factors restricting an ability so natural that you believe in modern society as more and more health, psychological and social problems affect appear everyday. It's simply not possible to estimate an ability that is afected by everything. For instance I did not tolerate my mothers milk as a child, a friend of mine who was under too much stress stop producing brestmilk, my sister in law could not afford to stop working in the retail business, and I found out myself that I cannot brestfeed because the only medication available that controls my seizure disorder leaves, which if I didn't take in order to brestfeed would have mee seizing all the time with possible head trauma that could lead to impairment or death not only for myself but also for my future baby as it happened to my Ant, how is it possible for you to estimate that only 5% of women cannot brestfeed, when I just were able to name so many instances occurring in only one family? Therefore how can you blame WIC for seeing the big picture and being able to provide nutrition for everyone who needs it, in whatever form is needed for that particular family? If it were 5% only the number of people who cannot brestfeed for valid reasons believe me, the goverment would not waste their time and money funding this organization? Don't waste your time being a critic of an issue that you don't really understand.