Hi!

I am a nutritional anthropologist and work in public health in Kentucky.
I don't have any references at hand, but (I suspect Kathy Dettwyler
might post similar info to you, too) there will be a lot of CULTURAL
issues that will play into this.
-- New immigrants to the U.S. perceive ABM as the 'modern' and 'U.S'
thing to do.
-- WIC provides ABM free, so cost is not necessarily a difficulty for
low-income moms (especially since they can often get the extra through
Food Stamps or food banks).
-- In some areas, use of ABM is a status symbol, especially if only poor
people breastfeed (I had a friend tell me a story of counseling a young
mother with her father present about breastfeeding.  The father
said,[sic] "we aren't poor -- we can afford to buy you formula.  You
don't have to breastfeed."
-- Of course, people self-select onto WIC in order to get free ABM --
they do recognize the cost, but WIC makes it less an issue.

Bravo that your folks are interested in a paper.  How about having them
talk to the moms themselves?  Then, it's primary research and local.
Furthermore, it could be used for World Breastfeeding Week activities
(since WBW 1998 theme is "Breastfeeding: The Best Investment."

I've been doing a lot of work on this, and there are a lot of other
issues in infant feeding decisions besides 'cost.'  In addition,
breastfeeding can be seen as having 'cost':  "I can't go back to work
and breastfeed" (loss of income); "I have to buy an expensive
breastpump/bf clothes" (outlay costs).

It seems to me that people with a little too much money to qualify for
WIC (typically working poor) are more concerned with costs because they
have less of a safety net.  As health educators, we don't do enough
talking about costs, either (direct cost of feeding, but also indirect
costs of infant/maternal health care and associated costs for
transportation, medicines, etc.).  Of course, folks also spend money on
a lot of 'wants' -- how much stupid plastic stuff will folks buy for
their kids because they are 'necessities' for child rearing?

Ah, money makes the world go around!

--Doraine Bailey, MA
Breastfeeding Support Services
Lexington-Fayette County (KY) Health Dept.
ILCA WBW Coordinator

______________________________________________________
Get Your Private, Free Email at http://www.hotmail.com