Jennifer, I work for a WIC agency in a large Texas city. We have a few hospitals in our main downtown medical center that promote breastfeeding and send NICU babies home with at least some breastfeeding experience and that encourage pumping all during the baby's stay. BUT, the local hospitals on the SE side of town that most of my WIC moms go to, do not. Almost none of my moms bring the premature baby home having nursed even once in the hospital. The need for mother's milk is stressed after delivery, but then -- nothing -- no encouragement to pump and lots of formula feeding "just because baby needs it." By the time they come home, these mothers are so stressed out that they won't even try to breastfeed. And my WIC will help them as many times as necessary to help achieve breastfeeding. Every week I tell them I will help them after baby comes home but it usually does no good. Some of my moms do breastfeed but these are the determined ones. And what I consider worse, is that these moms are usually not even taught how to bottle-feed a premature baby properly. They come home with a baby who often doesn't bottle feed well, is very sleepy, and shuts down too quickly for mom to be sure what it needs. And who either never has been put to the breast or was shown once before discharge. They are usually told to feed this five to 6 pound baby 3 ounces every 3 hours (which also hinders breastfeeding).

Kathy Eng, BSW, IBCLC

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