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WIC Guidelines Add to Breastfeeding PushBy Kimberly St. Louis
Thursday, December 31, 2009
Just ask Karly Michelsen from Layton, Utah, who has a husband and two young children.
This year she has been able to experiment with fresh tropical fruit, such as papaya and pomegranate, and include more fresh vegetables, without breaking the family's food budget.
How'd she do it?
Michelsen and her children are among the approximately 9 million participants who receive monthly government food packages through the Special Supplemental Nutrition Program for Women, Infants and Children (up to age 5), commonly known as WIC.
As of Oct. 1, the guidelines for the food packages changed emphasis. Now there's more fresh fruit and vegetables, less infant formula. There are also special incentives for women who breastfeed exclusively for six months, in line with the government's latest health recommendations.
In the past, all WIC infant food packages included larger amounts of infant formula, except for mothers who fully breastfed. Now infants will receive less formula and more jarred fruit and vegetables.
Under the new rules, mothers of infants receive different packages depending on whether they breastfeed exclusively, partially-breastfeed or depend entirely on formula. Mothers and children receive cash vouchers specifically for purchasing a variety of fresh fruits and vegetables.
Monthly Allowances AdequateEven though the monthly vouchers are only worth about $8 per woman or eligible child, Michelsen said they made a big difference to her food budget.
"I am very happy with the changes WIC has made," Michelsen said. "Before, they gave you pieces of a meal, now they give you ingredients for a full meal, such as tuna and bread instead of just tuna. I also am happy with the fruit and vegetable vouchers. Living in Utah especially makes it difficult to buy the expensive fresh fruit and vegetables which in the past made us have to do without them unless there was a sale."
The cash value of vouchers varies, depending on whether a recipient is a child or a woman and whether or not the woman is pregnant. Values also range depending on a child's age.
The guidelines provide groundbreaking support for breastfeeding.
Women who choose exclusive breastfeeding receive an enhanced food package, with more food to help them meet their higher caloric needs. Fully-breastfeeding mothers also continue to receive food packages 12 months after delivery.
"I breastfeed my children until they are 1 year old," said Michelsen. "I start them on rice and oatmeal baby cereal at 4 months of age. WIC provides the baby cereal."
Michelsen said WIC didn't influence her decision to breastfeed, but it did enhance her sense of confidence about the choice. "I have been in the WIC program for almost four years and they have always promoted breastfeeding."
Karla Shephard Rubinger, executive director at the Academy of Breastfeeding Medicine, a physician membership organization New Rochelle, N.Y., says WIC is an important voice for breastfeeding and the new incentives could spread the health benefits of breastfeeding to more women and children.
Better Support for Breastfeeding"The food and nutritional support that they get for breastfeeding is better than if they don't breastfeed," Rubinger said. "And they get a trained staff so that they'd know about it. It should be a very important change."
Women who decline to breastfeed receive infant formula along with breastfeeding information packets.
Partially-breastfeeding women receive one can of formula in the first month and can receive up to four cans in the first six months.
"WIC encourages mothers to breastfeed by issuing only one can of powder to supplement breast milk," said Cecilia Richardson, staff and nutrition programs director at the National WIC Association, based in Washington, D.C.
The new food packages are supposed to align as closely as possible with national dietary standards issued by the American Academy of Pediatrics in 2005, which calls for diets with less fat, lower cholesterol and more whole grains and fiber.
WIC participants will now receive vouchers for one dozen eggs a month, down from two or two-and-a-half dozen in 2006.
In addition to promoting fresh fruits and vegetables and whole grains, the new guidelines are also designed to give WIC state agencies the flexibility to accommodate cultural food preferences.
Those who are lactose intolerant or have cultural preferences in New York State, for instance, will be able to substitute one quart of soy milk or a pound of calcium-set tofu for one quart of milk.
Participants also have the option to substitute whole-grain bread for whole-grain rice, corn tortillas, barley or bulgur. WIC is also offering more canned fish items, such as salmon, sardines and mackerel. Canned beans also are now available.
EBT Cards Well ReceivedWIC participants pick up vouchers in person at distribution centers either monthly or every three months.
Some states issue the vouchers as paper receipts, but many counties have begun providing plastic electronic benefit transfer, or EBT, cards that can be swiped through transaction gadgets at authorized stores.
Alethia Carr, director of Michigan's Bureau of Family, Maternal, and Child Health, based in Lansing, Mich., said her state implemented the changes in August. EBT cards were used in three counties and were well received and will be used statewide in May.
The changes in the food basket have been brewing since 2003, when the Institute of Medicine of the National Academies reviewed them with an eye to cost-neutral changes based upon scientifically-sound nutrition information. Two years later they released public recommendations.
"The goal of the study was to improve the quality of the diet of WIC participants while also promoting a healthy body weight that will reduce the risk of chronic diseases," says the institute's Web site.
In order to be eligible for WIC, participants must have an income level that is at or below 185 percent of the poverty level or receive Medicaid, the public health insurance system for low-income people.
The program, subject to an annual congressional funding authorization, is administered at the federal level by the Food and Nutrition Service of the U.S. Department of Agriculture and by 90 WIC state agencies.
In 1992, the secretary of agriculture established a national breastfeeding promotion program to foster wider public acceptance of breastfeeding in the United States and to assist in the distribution of breastfeeding equipment to breastfeeding women.
Kimberly St. Louis is an editorial intern at Women's eNews through the New York Arts Program. She is a senior at Ohio Wesleyan University studying journalism and politics and government.