Introduction

January 18, 2012

Lea:

I personally know that most groups who are run by IBCLCs (as opposed to groups

where there is a center where IBCLCs must comply with the center's restrictions)

allow women to attend groups at a lower fee if they are on WIC or Medicaid. I

charge a token $5 per visit in the group and recently had a major coup with a

mother who really needed a pump. She was trapped in a bureaucratic loup where

she was labeled as a formula feeder because she was told to supplement because

of jaundice. On her own she built the supply back up to ALMOST enough. Since

she was classified as a formula feeder, she couldn't get the pump. Actually the

amount of formula she needed made it not worthwhile to accept the formula

package. She had a long talk with the WIC coordinator and mentioned my name and

magically got the pump. I was so relieved for her. A little bit of pumping

should push her up over the top. There is a great group of IBCLCs in New York

City that are definitely willing to accommodate lower income clients.

I also know very few IBCLCs who charge $300. Most charge $250. Even there,

some IBCLCs will drop the fee. This can be tricky because there are mothers who

can very well afford a visit that will want visits for a reduced fee and try to

negotiate in ways that they never would with another health care practitioner.

sburgernutr@...

January 18, 2012

I recently worked with a mother who was on WIC who discontinued her WIC

appointments for her entire family because she was so frustrated with the

staff's persistence related to breastfeeding when she had a history of 2

previous baby's, no lact II, and insufficient milk. She never saw an LC so I

meet her with number 3....lo and behold she has PCOS and hypoplastic

breasts...she was lovely, and VERY burned out with people trying to pressure her

to breastfeed....I just listened to her.......we talked about the PCOS and

hypoplasia....she's in tears, relieved to know she wasn't 'not trying hard

enough' or 'doing it wrong' I referred her to MOBI and of course offered to help

her breastfeed (SNS etc.) however I could but she was so belittled by the WIC

staff she dropped WIC services entirely.

I also had a pt. recently who had 3# of breast tissue removed for a reduction

with outer areola key hole incisions whose WIC certifier was really pressuring

her to elect the 'exclusive breastfeeding' column....this is number 2 for her

and she had a baby that lost excessive weight....etc. you all know the

story....the certifier was telling her it would probably be different for her

and she shouldn't supplement just pump and not give her baby any food from a

bottle...just use a spoon (this is sound advice when given in appropriate

CONTEXT)....and this mother had an 11# baby!

I work with WIC and there are very excellent WIC staff...and I understand their

intention but I think they need training in counseling methods and in

lactation....my area just sends the staff to any old breastfeeding training

which is not specific to WIC work and sometimes completely irrelevant to their

job functions (stem cells in breastmilk is fascinating but probably not the

ideal topic for WIC staff)....

Anywho

>

> Lea:

>

> I personally know that most groups who are run by IBCLCs (as opposed to groups