Mary, you did a great job of describing the WIC program!! Thank you! I am the Breastfeeding Coordinator for our local WIC Project (and also one of the LLLLeaders in town). Our clinic is WAAAAY breastfeeding friendly. In fact, outside of our LLL groups, we are the breastfeeding friendliest place in town. I do have some insights to offer to add to the other posts. 

WIC began at a time when moms were told to breastfeed every 3 or 4 hours and of course their milk supplies dwindled quickly and the baby was on the bottle, often with a Pet milk and Karo syrup mixture. The babies might also have been fed diluted formula or milk substitutes, in some cases. Some places everyone chose to bottle feed because to breastfeed was "low class" (there is still this prejudice here). Providing properly manufactured formula was a step up for many. Of course, Breastmilk does much more than just grow the baby, and WIC began encouraging moms to nurse. This is possibly why I nursed, because my sister went to a WIC clinic when she got pregnant at 17 (argh!) and she was encouraged to nurse. She did and I saw my very first nursing mom. (This is sad, People, because I am 10 years older than my sister!) Our mother was horrified that we would do "that"! (She later came around and was proud of us.) Anyway, I began working for WIC in 2000. Our
 Breastfeeding rates were decent for the WIC population when I started (50%'s) and have steadily climbed. (WIC populations typically showed 8-12% bf rate in the past.) Our whole staff is on board. Our Director sends as many staff (nutritionists and clerks and well as pc's and me) to breastfeeding trainings like crazy. Our rates hover between 70 and 80 per cent, sometimes reaching higher (they are measured monthly). We offer classes, individual counseling, phone follow up, hospital visits, hand and electric pumps, SNS's, Nipple shields, breast shells, nursing covers. We demonstrate slings and moby wraps. We encourage skin to skin care and hand expression. We explain compatible family planning. We work with moms from where they are and try to encourage as much breastfeeding as they feel able.  

We are swimming upstream because the hospitals are not bf-friendly. (I just erased what was turning into a rant. You're welcome!) The moms are living with people who want their "services" to continue. They expect the mom to cook, clean, support the family, and provide other services, ON TOP OF caring for an infant. We think the family should rally around the moms and take care of them while they build their supplies that first month. Not happening. I just issued a purely yours to a mom who is s/p c-section and returning to work on Monday, 2 weeks postpartum. She is apparently the breadwinner. She is determined to continue nursing,so I made some suggestions I think will help. Also, sometimes the moms are dismayed by the amount of work an infant requires and blame that on breastfeeding. I was surprised, too.

LOTS of the moms use formula, often because the formula "medicine" was "prescribed" before they left the hospital. The nurses and doctors have confidence in formula, so the clients do, too. The birth month the moms have a choice between formula and the exclusive breastfeeding package. The point was apparently to stand behind the fact that the supply is built that first month and exclusive bf builds the best supply. The participants in focus groups said the extra groceries were incentives to choose the exclusive bf pkg.  What I find often is that mom wants to nurse but has no confidence or has some difficulty, and she is afraid not to have the formula. She gets the postpartum package for one month and can come back next month to switch to breastfeeding. Some do. We do have those who insist they are formula feeding just to get the package and then they sell it, but I think it is not common. Some say that WIC is encouraging formula use by providing it. That
 may be in some cases. I keep in mind that for some of our moms, formula feeding is the best they can or will do. We have to work on society to make it possible to choose breastfeeding for more of our mommies. Sorry about the ramble. Rowena, Texas


      

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