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 *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome