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From:
Melissa Vickers <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 7 Mar 1997 09:36:45 -0500
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Hi, all

Thought I'd add a few more comments on the value of incentives.

There's a part of me that cringes at the thought of "bribing" anybody into
breastfeeding. I'd like to think that we are all capable of making this
important decision based on the overwhelming information tooting its
benefits. And I think if we ever get to the point that breastfeeding is
anywhere near the cultural norm that offering incentives for breastfeeding
would be like offering incentives to breathe.

(note: I'm basically talking USA here, since that's where I am and that's
where the WIC program is.)

The reality, though, is that women make infant feeding decisions based on
many different reasons, and reason and research are not necessarily at the
top of that list--especially for populations in which bf just isn't seen.
And that's the case for many WIC populations, though hopefully it is changing.

If I can give a woman a tangible incentive that encourages her to bf when
she might not otherwise, then I'd do it in a heartbeat. If I can give a
woman an incentive that encourages her to keep bf when she might otherwise
quit, I'd do that, too.

However, I'm not gullible enough to believe that just giving a mom a
play-pretty of some kind is going to do it. It takes more than just a gift.

That, I think, is why the incentive program at the Southside clinic in
Atlanta I wrote about the other day was so effective:

1. Two dynamic, energetic, dedicated-to-the-cause women spearheaded the effort.

2. Incentives were items that the mothers valued and wanted to work for. I
don't think pencils would work--other than to just create the image of a
bf-friendly place to be.

3. Inticing these women to bf was not enough. The incentive program was
combined with active support group meetings (that moms earned points towards
incentives for coming, but obviously kept coming for more than those points)
and community education efforts.

4. The incentive program helps women concentrate on a long-term goal that
may very well take them beyond those first few weeks of bf/parenting that
are, at best, an adjustment. If you are dealing with the realities of new
parenthood, combined with bf in perhaps a less-than-supportive environment
and recovering from labor and delivery, it is difficult to imagine that life
with a new baby can be fun--in 6 weeks or so. The incentive points can be
traded in for something useful, but only if you earn them. Hopefully by the
time mom earns enough incentive points to get what she wants, she is also at
the point in her new role of motherhood to realize she came through a
difficult time and survived.

I don't think incentives are needed or would be effective in every
population, not even every WIC population. But I've seen them work in one
inner-city, predominantly poor, minority population in Atlanta.

Melissa Vickers, IBCLC, in SUNNY west Tennessee!
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