Hi, Lactnettters

I've been reading all the WIC-related posts and thought I'd throw in a tale. A
few years ago (1991), I was asked to be a La Leche League representative on an
advisory board for a USDA (United States Department of Agriculture for you
non-USA-ers!)-funded grant for a Breastfeeding Incentive Demonstration Project
in south Atlanta, GA. Thinking it would just mean sitting in on an occasional
meeting, I said sure. Wrong. It ended up being a lot of work, a lot of meetings,
and a terrific experience for me. This was my first real exposure to the
workings of WIC and BF so it proved to be an education from that standpoint,
too.

This particular project was run by 2 energetic women, the WIC coordinator and
the BF cooridinator for this district in a low-income, depressing part of
Atlanta. The grant involved creating a program of incentives to get these moms
interested in bf and in keeping them going once they started. Basically, the
program revolved around a point system. Moms would earn points for doing
anything related to bf and good health. They got points for prenatal dr. visits,
signing up for WIC, attending bf classes, every month they bf, well baby checks,
etc. The points could be exchanged for useful items donated by any businesses
that we (the advisory board) could come up with. They ranged from inexpensive
layette items all the way to car seats and even some fun things like hotel
vacations. The "cost" of the incentive in number of points needed was based on
the cash value. Participants could save their points to exchange for larger
items.

This required a system of keeping track of all the points, and involved a point
booklet that every participant was given, and everybody at the clinic was
involved in signing the sheets to verify the points.

The advisory board included both inhouse staff (Drs, OB nurses, etc) and
community people (United Way, a local Medical college professor, LLL(me)) and
the state BF coordinator in the public health department, as well as bf moms.

In addition to the incentive program, they also ran bf support groups which were
well attended, much like the following that LLL groups get--dedicated moms who
returned month after month.

At the time, the OB staff at this clinic was giving out a "free" bf video
"gratiously" donated by one of our Artificial Baby Milk companies. They were
thrilled to have something like this to hand out to these moms, and because of
questions we raised, asked if the advisory board would review the tape. I ended
up with that honor, and as I watched the tape I saw the things most of us see
(or maybe don't see) in these tapes--glaring omissions, emphasis on treating
problems that are largely preventable in the first place, and blatant
advertising.

The tape came in a package with a little pocket full of--you guessed it--the
other "stuff" and coupons for same. We came up with the idea of making a booklet
that would just fit that pocket that would address some of the concerns brought
up (or left out) of that video that would replace the sample. I got to write the
booklet, and as it turned out, it was more of a free-standing overview of bf in
question and answer format.

The project went on for months, and ultimately was selected to be presented at a
big meeting in Denver, Colorado (I think--it has been a while!). Out of the
original 8-10 grants, this one was the most extensive and impressive and was one
of only two that were asked to present at this meeting.

A how-to notebook came out of that project that the clinic was selling to help
keep the program self-supporting after the grant money ran out. They were also
selling the little booklet I wrote (no, I don't get any royalties!!!). I haven't
talked with the director since sometime before I moved from Georgia to Tenness a
year and a half ago so I don't know how the project is doing. If any of you are
interested in finding out more about this project, email me and I'll give you
the name and address of the WIC Director who spear headed the project.

This project worked for a lot of reasons: it was conceived with the realization
that a broad-based community support system is necessary to make these kind of
changes. It also rewarded moms for doing more than just bf, such that even moms
who came to prenatal bf classes but ultimately decided to formula feed could
still earn minimal points, as could moms who bf for just a short time. The
prizes were good items that moms perceived as being worth working for.

It will be nice when bf is its own reward for all moms and babies, but
sometimes, circumstances demand a little help. This was one program that worked!

Melissa Vickers, IBCLC
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