Today, I read this post, “Is WIC shooting the CDC in the foot when it comes to breastfeeding rates?” It was an interesting take on a couple of new studies that have been released: racial and ethnic disparities in breastfeeding, and how breastfeeding (yes, even in America,) could save over 900 babies’ lives per year, and reduce diseases and health-related costs. One thing the blogger pointed out is that women who sign up for WIC have lower rates of breastfeeding (initially, at 6 months and at 12 months) than women who are eligible for WIC but don’t sign up for it [and both WIC-eligible groups have lower rates of breastfeeding than women who are not eligible for WIC at all]. So, it appears that women who are in the lower socio-economic bracket are less likely to breastfeed than women who are in higher brackets (not eligible at all for WIC); but also that women who could get WIC (but don’t) have more success with breastfeeding than women who are on WIC. Taken at face value, it does appear possible that WIC may be undermining breastfeeding efforts. However, “face value” may be incorrect.
One of my friends who, among other things works with WIC doing lactation support, wrote a post on this article on her blog, citing some of the reasons why women who are on WIC have low breastfeeding rates, including among other things that they are more likely to have the low-income jobs such as working at a fast-food joint, and may not be able to pump enough to feed their babies, or face other such obstacles.
From the comments on the original blog, I learned more about what WIC does and how it operates. I had a vague idea, but since I had never “crossed paths” with it before, didn’t know much beyond that. One of my friends was on WIC during or right after her divorce, and I knew she got food as well as food stamps, but I didn’t know how much food she got just for herself and how much just for her children (and I’m not sure if she was breastfeeding still at the time). [There may be others in my acquaintance who are also on WIC, but it’s just not a topic of conversation; I know that some of my friends when I was younger were also on WIC, welfare, and/or food stamps, but it’s just not something I’ve ever had to deal with personally.] So, “the more you know, the more you realize you don’t know” — the comments on that post had some specifics for how much food a breastfeeding woman could expect to receive, and how much less (or perhaps even none at all) she would receive if she switched to formula-feeding (although she would receive free formula and/or coupons for it). It’s possible that I would have qualified for WIC (but I don’t know, since I never really even thought about applying). Had someone suggested it to me, I probably would have declined, because I wouldn’t have needed any formula, since I was planning on breastfeeding and staying at home, and not needing anything they had to offer.
I wonder how many other people have that same idea of WIC — that it’s a source for free or reduced formula — which would be a sort of “selection bias” that might skew the data about women who are eligible for WIC but choose not to be on it (or don’t realize they’re eligible), vs. women who get on WIC. To be honest, the researchers may have looked at this, but I didn’t read the whole report since it is quite lengthy. If they didn’t look at that, I think it would definitely skew the results, because more women who never intended on breastfeeding to start with, or who had less of a commitment to breastfeed, may have gotten on WIC at the outset, while WIC-eligible women who were planning on breastfeeding so “didn’t need anything WIC had to offer” (or so they thought, as I did, erroneously) stayed off it. Definitely food for thought.
Another possible skewing would be the barriers to breastfeeding that women who need WIC face, that women who are eligible for WIC but don’t get on it, may not face. For example, a stay-at-home mom who is making it on her husband’s income, though it’s tight, would not need to pump while at work; while a single mom would of necessity have to work (and pump, if she is to continue breastfeeding), which could cause moderate to severe difficulty with continuing to breastfeed.
In other words, there are reasons why there might be a difference in the women who are all eligible for WIC, with some getting on it while others don’t, and it might be this “self-selection” that causes the difference in WIC-eligible breastfeeding, rather than WIC “shooting the CDC in the foot” when it comes to breastfeeding support.