The discussion regarding the Institute of Medicine's new report on WIC is  
certainly welcome, but breastfeeding support within the program still has  
shortcomings. I wrote an article in the May 2002 issue of JHL describing  specific 
recommendations for remodeling some of WIC's breastfeeding  components. 
Formula rebates fund over 27% of the food packages given to WIC  participants. This 
dependence on formula money to feed WIC participants presents  both ethical 
and financial conflicts in how WIC specifies the allotment of money  and 
resources. My article recommended many changes. Here are a few:
1. Amend legislation so that the first food package offered under  
participants' benefits is breast milk and the support services necessary to  ensure that 
a mother can fully breastfeed her infant
2. Amend food package II (infants 4-12 months of age) to eliminate the  
excessive and unnecessary amounts of fruit juice allocated to this age  group
3. Require that all WIC state breastfeeding coordinators possess the IBCLC  
credential
4. Amend regulations so that the position of breastfeeding coordinator of  
each local program is dedicated ONLY to overseeing breastfeeding activities and  
not combined with other duties. 
5. All WIC programs should have paid staff to carry out the mandated  
breastfeeding support programs including peer counselors and access to  IBCLCs
 
There are many more. Until USDA, WIC, and Congress recognize that access to  
human milk and breastfeeding are important parts of nutrition programs, 
formula  subsidies, rivers of fruit juice that rot teeth and cause overweight in 
children  will continue to be distributed. Intense lobbying by the American Dairy 
Council,  cereal manufacturers, fruit juice manufacturers, etc have resulted 
in cereal  being distributed when the infant is 4 months of age, even though 
it has been  linked with increased rates of diabetes.
 
It's not just the food packages that need to be overhauled, the whole  
structure of WIC works against providing WIC employees with the tools necessary  to 
help breastfeeding mothers with what they really need.
 
Marsha Walker, RN, IBCLC
Weston, MA

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