Someone wrote me privately:

< WIC is a mixed bag and until it quits giving out so much formula, we will struggle to convince WIC women to totally breastfeed. >

I agree that we LC's in both WIC and hospitals are a mixed bag. But I have a different perspective on formula. In a "free" (interpret that however you want) society, we cannot make choices for the mother. We can only set our own boundaries and give her accurate information.

Rule # 1, of course, is "Feed the baby". I do think that WIC participants need further emphasis that WIC's primary mission is nutrition education, and that the secondary mission of providing supplemental foods means that products received are only in limited amounts. Too many of the general public (and possibly professionals)mistakenly believes that WIC provides all the formula an individual baby needs, every month. Period. Not only do they need to know that the mother's food package is reduced when formula is supplied, but that once a baby weighs about 10#, the WIC supply will not last all month.

Our WIC project rule is that all formula requests from breastfeeding mothers must be referred to the LC to talk with her before any formula is authorized. I have found that this requires skilled communication in order not to alienate the mom at times. Sometimes, all she needs is further information and breastfeeding encouragement. But if my questions help me to reflect back what I understand her feelings and situation are, by validating them, I can often see that her wider support system beyond WIC, is a powerful determinant about her decisions. It also gives me a chance to commend her on the effort she has thus far given to give her baby the best start in life.

I have to remember that I have a strong personal history of 'codependent saviourhood', and that it is not about me, nor what my imagination suggests that I might do if I were in her exact situation. (I have been in situations decades ago where I myself made that decision 4 times out of 6, and it wasn't an easy or pleasant decision for me.) It is ultimately the mother's body, her baby, her family and her responsibility 24 hours a day, not mine. This may be overwhelming to her, especially if the mother is young and doesn't yet know how to assert herself. 

Her mother, grandmother, aunt or babysitter (or the client herself) may have experience in bottle feeding babies too much and too fast, and expect them to sleep 4 hours between every feeding, and/or feel "judged as inferior" by her ideas about breastfeeding. Her boyfriend, husband (or doctor)might be convinced that her milk is inadequate/poisoning/dehydrating/jaundicing the baby. 

So there are many times when I am able to convince a mom that preserving partial breastfeeding is much better than total weaning. One strong talking point is the financial aspect, helping them to understand just how to maintain a partial supply so that they can avoid having to buy formula at the end of the month. And I can then provide the immunological, work saving, emotional and maternal health effects as extra talking points. And putting in some infant risk reduction facts can sometimes be slipped into the conversation at this point.

I often ask moms to try my suggestions for several days and think about their options, discuss them with their families if they need to, and call back in a few days if they still feel the need for formula. Some go on to continue exclusive breastfeeding. Others call back, adamant this time. Either way, I have fulfilled my responsibility by giving good information, and the ultimate choice is for the mother to make.
 
Jean
**************
K Jean Cotterman RNC, IBCLC
Dayton, OH USA   

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html