The question was posed about what would happen if WIC didn't provide formula at all...I know from a rural clinic standpoint that it would create a very contentious situation.  Take a postpartum hormonal mother, and then tell her she cannot get any formula for her baby...I would hate to be the one to say no.   While I hate to imply that this could cause someone to go violent, I can imagine some very distraught moms & dads reacting in ways we just would not want in clinic.

On the other hand, I am a firm believer in limiting formula for the first month.  As a WIC peer counselor, I see first hand moms who are experiencing trouble breastfeeding, but boy does that formula get tempting.  Often they see the full formula package as a security blanket, when truthfully it robs them of their security in breastfeeding.  I see the way we implement things now as a "punish the breastfeeding, praise the formula feeder" system .  

I personally think a better strategy would be to limit *all* moms to no more than 1 can of formula in the first month.  In addition, all WIC staff should be able/willing to work with new moms on strategies to help them breastfeed in that first month, which would include unlimited weight checks, in clinic consults, and follow up by a peer counselor.  

I did some calculations based on our WIC participation in my region. Not exact numbers but a good rough estimate Assuming that WIC pays $13/can of formula, a 13% BF rate and about 2500 prenatal participants in a year, if we stopped giving 4 cans of formula to newborns and instead gave all only one can, the program would save $85K/year. If one took this savings and converted it to part time peer counselors, working 20 hours a week at $12/hr,  approximately 6 additional peer counselors could be hired in our region which covers 15 counties.  

Assuming that the peer counselors were effective in their job, that would boost the $$ even more, as the BF rate would increase, and the total number of cans of formula issued for the year would decrease.  

From a $$ standpoint there is a bunch of logic in this type of approach.  The main critique would be if this puts low income newborns at risk of being malnourished due to lack of formula...   

I would love to hear the pros and cons of my fantasy WIC world.  

Lisa Paul, ICCE

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