Reviving an old art
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SUMMERSVILLE, W.Va. -- Swaying in a rocker at the WIC office, Webster County mom Sarah Selman breastfed 1-year-old Daniel as she chatted about the tomatoes, sausage and peppers she'd been canning. Daniel waved his hand and grabbed her finger.
"I almost gave up on trying to nurse him," Selman said. "Now look at him!
"Other babies his age get chest colds and earaches all the time, but he just hasn't gotten sick," she said with a big smile. "He got his first cold on his first birthday."
She looked around the Women Infants and Children office at toys and pictures of nursing mothers. "I can't prove it, but I think it's the breastfeeding," she said. "I owe that to WIC."
On cue, Daniel raised his head and beamed.
Whatever the Central West Virginia WIC program is doing, it's working. Since 2008, in their six counties (Clay, Nicholas, Webster, Pocahontas, Greenbrier, Calhoun), the percentage of mothers who breastfeed for at least six months has jumped 52 percent.
Almost one in three central West Virginia mothers now breastfeed their babies six months, compared with one in five statewide and one in 10 in the southern coalfields, the state's lowest rate.
"If the whole state could do that, we'd have less childhood obesity," said Jenny Morris of the Kanawha Valley WIC.
Children who are breastfed get fewer costly illnesses, from asthma and diabetes to leukemia and sudden infant death syndrome, 20 years of research shows. They are also less likely to be obese. "They have fewer doctor and hospital visits," Morris said.
WIC is a federal nutrition program for mothers and babies. In 2011, seven out of 10 West Virginia newborns -- 14,000 of 20,000 -- were enrolled in WIC. So WIC is influential where West Virginia babies are concerned.
The American Medical Association and national pediatrician, obstetrician and dietician associations now urge mothers to breastfeed six months if they can. The national WIC program is trying hard to raise the number of women who do.
Posters like "101 Reasons to Breastfeed" cover Summersville WIC's walls. Higher-income moms are more likely to breastfeed, studies show. "We want our babies to have those protections too," said Brenda Young, Central WIC's breastfeeding coordinator.
"I wanted that for my baby."
"Nobody should think it's easy for every mother to breastfeed six months," Young said. "Many mothers have a lot to deal with. Maybe their boss won't let them pump milk at work. Maybe they don't make enough at a part-time job to pay rent and utilities. Maybe the car broke down."
A medical problem almost stopped Sarah Selman.
Last year, she was laid off from her computer-processing job. Her husband works construction. At home with the baby, she was determined to breastfeed.
"The week he came home from the hospital, I took him to the pediatrician because he wasn't latching. The doctor looked at him and told me I must not have enough milk, and I should quit trying to breastfeed.
She went out to the car and cried. "My husband and I both knew this was something good we could give him. My mother-in-law breastfed both boys, and neither one ever had health problems or got overweight. I really wanted that for my baby."
A few hours after she saw the doctor, she had her first WIC appointment. She burst out crying again when Young asked if she planned to breastfeed. Young, a nurse, asked her to pump her milk. "I got eight ounces, so my milk wasn't the problem," she said.
Checking Daniel's mouth, Young found that a little skin flap held his tongue down, a common newborn problem. He was tongue-tied.
She made an appointment in Charleston. The next day, Daniel's tongue was freed. "It took 10 minutes," Selman said. "He's nursed like a champ ever since.
"I feel like I've done something for him that will help him his whole life," Selman said. "But if it hadn't been for WIC, I would've given up."
"Different mothers have different roadblocks," Young said. Sarah has support at home, "but if you don't have that support, it can be hard. Around here, most new mothers don't have mothers or grandmothers who breastfed. That wasn't recommended when they had their babies."
So "some young mothers run into real resistance if they say they want to breastfeed," she said. "The older generation still feels breastfeeding means you're too poor to buy formula. Then there's the belief that a fat baby is a healthy baby."
If a mom decides to bottle-feed, WIC supplies formula, food vouchers, bottle-feeding advice and support. "We know there are lots of reasons why moms decide not to breastfeed," Young said, "and formula is a lot more nutritious than something like Gatorade or sugar water.
How are they raising the numbers?
Four years ago, one in five Central West Virginia mothers breastfed six months. Now it's almost one in three, compared to one in five statewide. How did they do that?
"We train every staff person as a peer counselor," including clerks and receptionist, Young said. Each staffer also breastfed, so "when a mom chats with the receptionist, she gets real mom-to-mom encouragement. That helps," she said.
Selman stops by for that boost when she drives into Summersville to shop. "I like to talk with other moms," she said.
"A lot of young mothers, when they come to us, think bottlefeeding and breastfeeding are equal, that one's no better than the other," said lab assistant/counselor Kay Groves. "But when they hear what breastfeeding can do, many say, 'I want that for my baby.'
"They also like it that breastfeeding helps them lose weight and gives them breast cancer protection," she said.
Summersville's 29 percent already beats the statewide 20 percent average. "We can do better," Young said. She's concentrating on the workplace now.
"A lot of mothers quit when they go back to work, because their employers won't let them pump their milk during work time," she said. To keep milk flowing, a woman must nurse or pump milk every few hours.
The health-reform law says companies with more than 50 employees must provide a place to pump and let women take breaks, starting in 2013. But most West Virginians work at smaller businesses, Young said.
"We're trying everything we can think of to eliminate barriers," Young said.
• They loan breast pumps and teach working mothers how to pump and store their milk.
• They are encouraging local employers to allow pumping. Breastfed children get sick less often, they show them, so their mothers are absent less often.
• They give breastfeeding mothers their cell phone numbers, "so they can call or text 24/7."
• They connect moms with the state's Right from the Start program, which provides substantial help with pregnancy, child care, transportation, cribs and other needs.
• They invite grandmas and mothers of young mothers to appointments.
• They organized a local breastfeeding coalition, including pediatricians and obstetricians, that brings in speakers and raised money to train a hospital nurse as a breastfeeding specialist.
• They visit breastfeeding mothers in area hospitals to help them start smoothly.
• They are asking area businesses to set up areas where mothers can nurse.
• The Greenbrier Valley Hospital consultant set up a Facebook support group.
• They give breastfeeding mothers more food vouchers, nationwide.
In August, the Central WIC office launched an innovative collaboration with the Summersville Pediatric Practice. In an office inside that practice, a WIC breastfeeding counselor now sees patients, WIC or not. Obstetricians can send pregnant patients down the hall to see her.
The practice sees thousands of patients. The doctors recommend breastfeeding to all new mothers, said Joyce McClung, practice manager, "but don't have time to give the how-to details. They love it that we have a counselor now."
"Things are gradually changing," Young said. "Over time, our best advertisement will be the babies and moms themselves," Young said.
Sarah Selman agrees. In Webster County, "everyone knows I breastfed Daniel. They see how healthy he is, that he's not overweight, and they're interested. I really encourage them because it's worked out so well for us."
Reach Kate Long at firstname.lastname@example.org or 304-348-1798.
"The Shape We're In" continues a project begun with the help of a Dennis A. Hunt Fund for Health Journalism fellowship, administered by USC's California Endowment Health Journalism Fellowships.