Today I met with a pediatrician as part of a round of meetings our coalition
is doing with doctor's offices in our county.  In response to the question
of what she saw as the obstacles to breastfeeding in our community, the
first she named was the free cost of formula to the low-income population.
Working for WIC, I know exactly what she means.

 

Not long ago a study was published showing that WIC mothers are less likely
to breastfeed than their income-matched non-WIC counterparts. Now perhaps
the women who join WIC do so in order to get free formula and in that way
the results are skewed, but still as an LC to WIC mothers I see firsthand
when they throw in the towel because it is easy and cheap to do so. I've
been in private practice for many years, and my clients who choose to
formula-feed know that there is a cost involved when they make that choice.
But for my low-income moms ,there is no cost attached.  No penalty, no
financial consequences. It's too easy to throw in that towel.  What started
out as a program to guarantee good nutrition and protect from over dilution
of formula has become instead an enabling of formula use over breastmilk. 

 

As I talk with my colleagues about ultimate solutions, two thoughts fall
out. The first is to try a system such as I understand is in place in Papa
New Guinea, where formula is available by prescription only.  In my perfect
world! But then someone pointed out how easily HCPs could cave on that and
just write prescriptions per mother demands. It would be easy to manipulate
the system here because we are already biased in favor of formula.

 

The second idea I like best: co-pays.  What if there was a co-pay for every
can of formula?  A shared cost.  

 

This change must start at the top, at the USDA.  And so they first need to
understand how the program was built on a faulty foundation and honestly
needs to be rebuilt from the ground up so that it promotes breastfeeding
with consequences attached to the choice not to breastfeed.  How can we
start this?

 

Lisa Marasco, on her lactivist soapbox today


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