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Date: | Fri, 9 Mar 2012 09:51:00 +0000 |
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>I'm following the WIC thread with much interest.
>Many people have mentioned that if mothers are
>prevented from getting hold of formula they will
>just feed their babies something totally
>unsuitable. My question: do we have any formal
>research or journal articles documenting this?
>
>I ask because, as Heather has just mentioned,
>here in the UK we have vouchers issued through
>the Healthy Start scheme whereby low income
>women can obtain fruit, veg and milk, including
>infant formula, worth ~£6 per week for their
>babies, and they can choose to use the whole
>amount on formula. They can also save up the
>vouchers during pregnancy so that they do have
>enough to exclusively formula-feed for free. As
>you may know, our breastfeeding rates are
>extremely low (the lowest in the world after
>France and Ireland ...) And it doesn't take a
>science degree to connect the dots.
Our rates of bf are indeed low (though initiation
is higher at 81 per cent (Infant Feeding survey,
2010) than the US) but I think Healthy Start
plays only a small role. I think it is possible
that the move away from 'milk tokens' to 'Healthy
Start' played a small role in raising our
initiation stats from the high 70s (2005) to
today's 81 per cent, but as no one seems to be
doing the research or evaluation into this it's
speculation!
It would be easy (practicably but less so
politically) to test a scheme whereby Healthy
Start changed in one area to exclude formula
milk, and to compare feeding outcomes with a
similar area where things remained the same.
You'd need to do this over a wide area to make
the study sufficiently powered and to allow for
all the variables.
I think it would be important to do this, before
policy was changed to prevent the ***law of
unintended consequences***.
Here's an example of just that very law in action:
A few years ago, maternity units in the UK
stopped giving formula to newborns unless for
medical emergency.
Any mother who intended to formula feed was told
she had to bring in her own ff equipment. The
idea was that hospitals were no longer seen as
endorsing formula or subsidising its cost.
The result has been that in most units where this
policy was adopted, there is *more* formula
feeding. Women who plan to breastfeed bring in
formula stuff 'just in case' and use it without
even having a conversation with the midwife first
- the stuff is in their bag and they use it.
Before they had to ask and there was a dialogue
and some education going on, and mothers were
often able to continue breastfeeding without
formula.
Any change to Healthy Start in the UK would have
to be tested first. It's just possible that
knowing vouchered formula was not available any
longer would change behaviour in a way that
meant more ff, not less.
Heather Welford Neil
NCT bfc, tutor, UK
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