Maybe I'm not understanding the whole story on this mom who was told at WIC
(after being given vouchers for formula for an almost-exclusively BF
baby???) to have her doctor "fill out a WIC application so she could get
foods". I worked in WIC for several years, and the only way I can see this
scenario is that perhaps the mom wasn't already on WIC (maybe she had other
kids on, but for some reason wasn't on herself during her pregnancy- it
happens, for lots of reasons). If her initial WIC appointment was for the
baby (which doesn't really make sense because a breastfeeding baby doesn't
get anything from WIC until cereal at 4-6 months, but if this was her
initial WIC contact she wouldn't have known that, and it sounds like maybe
at the time she was at WIC she felt that she needed some formula), it's
likely that her local WIC agency, in a well-meaning but misguided attempt to
"help her out", might have given her some formula vouchers for the baby but
wouldn't give her any for herself until she had been "certified" (i.e.
completed the application for herself and provided the necessary
documentation). Then, at her next visit, she could receive her food
vouchers, either her "enhanced package" (for mothers who are exclusively
breastfeeding - defined at WIC as baby not getting any formula vouchers from
WIC) or the "postpartum" (i.e. formula feeding or not exclusively BF women)
package. In "my" former WIC agency (Ithaca, NY), I can easily see how this
would happen, for a couple of reasons: 1) no one likes to have a baby going
hungry (never mind that all of us Lactnetters know that this isn't the case
with a BF baby; think of it from the perspective of the clerical aides who
probably saw this mom), so most people at WIC would think that giving the
mom formula vouchers was a helpful thing to do. At the WIC where I worked,
we were all incredibly soft touches, so even though giving formula vouchers
may not be either strictly kosher OR a favor to a breastfeeding mom/baby, I
can easily see it happening, and/or 2) it may have been the local WIC
agency's way of "getting their numbers up" - funding for any given WIC
program is based on the # of people enrolled in the program, so it is any
local program's own best interest to sign up and issue vouchers to as many
folks as they can. It's easier to get a baby on and issue formula checks on
the spot than to certify a new mom for the first time, and by doing so
they've "upped" their numbers.

Or maybe the "have her doctor fill out a WIC application" just meant that
the doctor (or the nurse) needed to sign her pp med form, or give WIC her pp
hemoglobin. Or maybe the mom just didn't have everything she needed with
her. New York State has recently made it a little tougher for local agencies
to fudge the rules a little in certifications - used to be we could take a
lot on the mom's say-so, issue checks, and have her bring in her
documentation "next time".

Well, this is a kind of "windy" response...must be those years at WIC
haven't let go of me yet! I'm kind of sensitive about "WIC-bashing" (NOT
that that query was!!); they certainly do a lot of crazy things with their
regulations, etc., but my experience with them leads me to believe that
WIC's motives and intentions to support breastfeeding are mostly pure. (But
if that were really true, I'd still have my job as Breastfeeding
Coordinator...hmm, maybe I'm just naive...) Am I a little ambivalent or
what???

Cathy Bargar, RN, IBCLC