Andrew writes:
"I have found that WIC seems very aggressive in
"diagnosing" infants/children with some sort of problem (anemia is one of
their favorites) so that the woman/infant/child qualifies for WIC
assistance."

One of the requirements for WIC is the existence of specific "risk
factors" - i.e. it's not simply an age-and-income based program. So Hgb/hct
screening is a federal requirement for WIC eligibility, and a low H/H is one
of many risk factors. Others include such things as weight/height for age,
inborn errors of metabolism, conditions that interfere with
digestion/absorption of nutrients, poor or no prenatal care, maternal or
second-hand smoking, lack of cooking/food storage/refrigeration facilities,
and all kinds of things related to growth, nutrition, medical and
socioeconomic factors. Is that a bad thing? How so?

WIC also tracks child immunizations, makes referrals to other appropriate
agencies, and serves as a gateway to the health care system for pregnant
women, infants, and children. You can even register to vote at WIC!

There are several reasons for the "risk factor" requirements - the most
obvious being that they are in fact factors increasing the risk of impaired
growth and development and significant associated health problems. Another
is that WIC is not just a food-handout program - a major component of WIC,
and the one that makes it significantly different from, for example, Food
Stamps, is the requirement that WIC include EDUCATION as part of its
program. WIC participants don't just get the vouchers for specific foods,
they are required to show up at specific intervals, be evaluated re:dietary
intake, H&H, growth, age-appropriate feeding practices, etc. At WIC clinics,
clients are required to receive specific education re: these & related
matters - doesn't matter if you're a PhD in nutrition or never got beyond
4th grade! Like it or not, at WIC you'll hear what the results of that H&H
mean in terms of your child's health and diet. If you are a pregnant woman,
whether it's your first or your 15th pregnancy, you will be educated and
encouraged and promoted-to about BFing till it's coming out your ears -
there's no escape!

Now here's the tie to BFing: because of this education component, WIC has
become the major source of BFing promotion in the country. The most recents
statistics (done in 1996, by a you-know-what company, sadly) indicate that
it is among WIC clients that the biggest increases in BFing initiation rates
have occurred in recent years. Can't speak for the rest of the country, but
in the county where I was the WIC BF Coord. ,the BF initiation rate for WIC
clients was been consistently = or >76% for the past four years, while that
for the county as a whole has been around 70%. WIC clients had FREE access
to an IBCLC (me), an entire staff of nutritionists (mostly MS or higher
degrees) extremely well-educated re:BF, free use of medical-grade electric
br. pumps, manual pumps, etc. WIC is the only source of this kind of BF
education locally, and through WIC, workers in other community agencies that
work with pregnant women and infants & children have been educated re: BF as
well. (And since I provided that training myself, I know it's good stuff!)
Dozens of peer counselors (not all of them WIC clients, BTW) have completed
>20 hrs. of training each. I can assure you with total confidence that no
other agency, office, program, or service in the area provides anything like
this scope of knowledge and education and promotion about BFing.

AND...(see, I'm getting back to the point), yes, getting an H&H done
periodically is necessary to have access to all this bonanza of BF benefits.
(Not even to mention the "enhanced food pkg." for exclusively BF mothers..)
So, yes, WIC is "aggressive" in "diagnosing...problem(s)"; the reason
"anemia" is a "favorite" is that it is unfortunately very prevalent among
low-income families. It's pretty easy to fix, by pretty simple means, and
iron-enrichment is one of the main criteria for the foods available through
WIC. I do not mean to sound disrespectful or unprofessional, but they don't
just make this stuff up out of the blue, or to drive doctors crazy. So I ask
again, why is that a bad thing?

Cathy Bargar, RN, IBCLC. Ithaca NY (and if you'd like any more info about
the WIC program or the documentation of its effectiveness, please let me
know privately - theere's lots-o-stuff!)