Michelle said, <<I'm perplexed at why WIC does not include the funding of a full time IBCLC to perform lactation evaluation and assessments, for every WIC agency.   >>

Let me say first of all that I am speaking on my own here, not on behalf of the WIC program in Miami Florida for which I work as an IBCLC.

That said....as I have mentioned here in the past, I am an IBCLC and have worked full-time in that capacity for the WIC program since 1996. And I am not a nutritionist; my Bachelor's is in Education. I agree completely that WIC should specifically fund for IBCLCs in every agency. I am blessed to work for a local WIC agency that dedicates a portion of its budget for this purpose. The program here has a rather large caseload, so we (the IBCLCs - I am not the only one) - are kept quite busy providing IBCLC services to the WIC population in Miami.

So, this CAN be done. It IS being done, and probably not just in Miami. But it should be happening across the board, in all WIC programs IMO.

Michelle also said, <<What I've witnessed in a lot of the agencies in my area is they occasionally do have an IBCLC on staff, however they often are multi-tasking as a certifier or RD as well.>>

I have noticed this as well. Luckily, we don't have that problem here. 

I can only guess as to the answer to your question - why doesn't WIC fund more IBCLC positions. I think that at the top (at the federal government level) much progress has been made since I started out 16 years ago, with respect to the feds' awareness of the issues involved in breastfeeding promotion, including the importance of IBCLCs. I am very hopeful that that trend will continue. 

I think the government has simply been on a (necessarily) long learning curve. They started out (many years ago now) realizing that WIC should be actively promoting breastfeeding to its participants, moved on to the realization that moms need support and accurate, timely assistance in order to breastfeed, and now I think they are coming around, slowly, to the notion that for many women, the support and assistance provided by PCs is not enough - that in fact some need an IBCLC. I think they'll get there. I honestly do.

Provided the funding materializes :-)

Michelle said:  <<With the objective of increasing breastfeeding initiation, duration, and exclusivity, it seems to me that having a full time IBCLC to perform clinical evaluations and assessments, develop feeding plans etc. for this population would be vital.>>

Agreed, 100%. We will not be able to significantly improve either duration or exclusivity in this country without much more widespread access to IBCLCs, for WIC participants, after hospital discharge. There are simply too many breastfeeding problems out there that are beyond the scope of practice of a PC. I know - I see them: breast reductions, tongue ties, all stages of prematurity. The list is long and varied. Half the infants in this country are on WIC - as goes WIC, so goes breastfeeding in the U.S.A! It is just that simple.

Just my opinion, of course....
Regina Maria Roig-Romero, BS IBCLC

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