Dear Cathy and other Lacnetters who work in WIC clinics. My heart goes out
to all of you who are working with women who are in the difficult situations
that WIC recipients will be facing more and more as the welfare rules change
in this country. I always wondered why some people thought, in fact, that
getting on welfare was an acceptable solution to the problem of needing to
work and having a small child rather than working and fighting to have
affordable work site or close to worksite based child care.
Fortunately, or unfortunately, I have spent the last 27 years of my life in
a country where no such problems exist, simply because there is no welfare
system.Women who are lucky enough to have a job, simply go back to work at
the agreed upon time. If they have formal sector employment and have paid
maternity leave, they can have 6 weeks at 2/3 salary. Otherwise, they go
back to work immediately.
The average duration of breastfeeding in my adopted country, Honduras, is
well over one year. While most women who work do not breastfeed exclusively
for six months, at least 80% of them keep on breastfeeding after six months.
These are poor women, for the most part, women who are not well nourished,
yet they produce milk for their babies and the limitation on their
production is the possibility of their babies sucking frequently enough.
We started with breastfeeding promotion around 13 years ago and one of the
things that I noticed right away was that women who were able to manually
express or use a manual breast pump (which was extremely expensive for
Hondurans but is not so expensive here) were able to take out 10-12-up to
16 ozs./day to take home for their babies. We are not talking about super
milk producers here, but hundreds upon hundreds of quite ordinary women.
However, there was no particular expectation on their part either that it
was impossible or that they needed to have an electric pump to be able to
carry out this task. They were grateful for learning that having time,
space, and someone around to support them when they had concerns or
questions was more than enough. In one hospital where we worked, we adopted
a plan of giving women a letter to their employer explaining that they were
breastfeeding and requesting that the employer cooperate with them to give
them time in the morning and time in the afternoon to take out their milk.
In many workplaces there is no refrigeration and women have to think of ways
to keep their milk cool enough so that they can take it home with them to be
able to give their baby the next day. Some women worked out an arrangement
with the next door neighbor or the corner grocery store to keep their milk
in a commercial refrigerator.
In Guatemala, a La Leche League group working with peer counselors invented
a homemade "refrigerator" made of a can which would hold ice and the bottle
would be placed in the ice which would then be kept cool by layers and
layers of newspaper placed in a carton around the tin can.
I would assume that most women who are in WIC have refrigerators at home --
although I would imagine that there are some who don't, but the ones that
don't probably have neighbors with refrigerators. Women who have
refrigerators with freezers can start freezing their milk two weeks before
they actually go back to work and then can set up a little "cushion" against
which they will draw down as they go back to work and start using the milk.
They can hand express at work or buy a good manual pump that is not very
expensive. They can hand express at home in the evenings and over the weekends.
We found that explaining to mothers that when they were in the house, they
should give breast to their babies and not use any supplements and that
THEY, the mothers should never give the baby a bottle helps to maintain that
special bond that mothers and babies develop and pretty soon the baby begins
to wait for mom to come home.
In surveys we have carried out we find that "planning" to go back to work
doesn't really affect mother's breastfeeding status in a place where the
expectation is that one will breastfeed, but "current" work status does when
women don't have support in the workplace.
It seems to me that in the WIC clinics that are being affected by the "back
to work" changes in welfare rules, that it would be a good idea to start to
work with the local Chamber of Commerce, breastfeeding taskforce, employers
that will be giving women jobs and when mothers of under six month old
babies will be beginning to work -- the clinic ought to try and help them
work out a way with their employers to take out their milk on the job.
In thinking through Cathy's concern about her WIC moms, it seems to me that
maybe by having all of these technological gadgets available in our society
that we have sold ourselves a bill of goods that one needs to have a pump or
any other particular "special" gadget in order to be able to breastfeed or
breastmilk feed a normal, healthy baby.
We have found out in the course of our work in many other countries that
this is NOT necessary. It sounds to me that the clinic and probably many
WIC clinics need to work a little harder at creating a "breastfeeding
culture" so that women who come to the clinic feel comfortable and supported
in their choice and don't feel that they are "oddballs" if they don't start
to feed their babies foods and other milks right off the bat.
Someone put a question up on Lactnet about whether hospitals have support
groups, but I would like to ask how many WIC clinics with peer counselor
programs have support groups. Support groups provide an excellent way of
helping mother express their concerns about these issues and to hear from
other mothers the creative solutions that they came up with.
Cathy, if you are interested in discussing some strategies that we have
found work with women who are financially strapped, please email me privately.
Judy Canahuati
***************************
"The future is not some place we are going to, but one we are
creating. The paths are not to be found, but made, and the
activity of making them changes both the maker and the
destination." Attributed to John Schaar, University of California.
Judy Canahuati
email: [log in to unmask]
*******************************
|
