In any language breastfeeding is best for baby

Food and Nutrition, Dec, 1992 by Mary Jane Getlinger

Breastfeeding is how many WIC mothers in La Crosse County, Wisconsin, give their babies the best start in life. "In fact," says county WIC coordinator Linda Lee, "48 percent of WIC moms in La Crosse now breastfeed their babies.

"Increasing that percentage to 75 percent by the year 2000 is one of our challenges," she adds, "and we'd like to see at least half of breastfeeding mothers continue until their infants are 5 or 6 months old."

The La Crosse WIC program and its successful breastfeeding campaign are interesting for several reasons. One is the way WIC coordinators have tailored breastfeeding education and other services to their unique caseload--one-third of the approximately 1,900 WIC participants in La Crosse are Asian Hmong refugees who have settled in this western Wisconsin community.

Also of interest is how WIC staff work together as a team and involve other parts of the community to provide extra support to breastfeeding mothers.

Serving the county's special caseload

Hmong families began coming to La Crosse in the late 1970's, but their bond with Americans goes back to their homeland. During the Vietnam War, highland Loatian Hmong tribes had worked closely with the U.S. military, often rescuing American pilots shot down over North Vietnam and Laos.

After the April 1975 withdrawal of U.S. troops and the collapse of Laos' coalition government, more than 150,000 Hmong, fearing government persecution for their cooperation with American forces, fled to refugee camps in northeastern Thailand.

The refugees later resettled in 40 countries, including the United States, with about 70,000 settling in California, Minnesota, and Wisconsin.

When they came to this country, many Hmong had severe health problems because of the inadequate health care they had received. Only 25 percent were literate, making the adjustment to living in an industrialized America and gaining self-sufficiency difficult.

Once here, however, they demonstrated they can be exceptional students. Currently, for example, 45 percent of Hmong students at La Crosse Middle School are on the honor roll, even though many of them do not have total command of English.

Hmong WIC participants have been quick to learn what WIC staff have been teaching them about having healthy babies and the benefits of breastfeeding.

Peer counselors recruited to help

One of the ways WIC coordinator Lee and her staff have reached out to the Hmong community is by recruiting Hmong women to serve as peer counselors. "They identify with the culture and they have no communication barriers," Lee says.

Bilingual health aide May Vang, who came to La Crosse as a newly-wed, is one of the counselors. She works side-by-side with the registered dietician, serving as interpreter and teaching health, nutrition, and breastfeeding skills to Hmong mothers in their native language.

"In the old country," Vang explains, "Hmong mothers always breastfed their babies. But after resettling, the Southeast Asians observed Americans and viewed the formula and bottle as a freer or American way. They believed children were taller and bigger because they were bottlefed.

"But when Hmong women understand that breastfeeding is best, they breastfeed," Vang continues. "Likewise, if a pregnant Hmong woman understands she is feeding the baby growing inside her, she eats properly. By tradition, Hmong women eat only two meals every 24 hours."

Knowing how much their people love textiles, Vang and other peer counselors arranged for a special needlework story cloth to be made. The story cloth, a Hmong artform traditionally used for communication, depicts women breastfeeding their babies while participating in daily activities.

The cloth is on display in the La Crosse clinic and has also been reproduced as a poster to portray the breastfeeding message to WIC participants of many different backgrounds.

Other materials also developed

The La Crosse staff have also developed other educational materials for their Hmong constituents, including a prenatal outreach poster and an additional breastfeeding poster. Like other breastfeeding WIC mothers in La Crosse, the Hmong mothers also get a special T-shirt. On the shirt is a picture of a robust breastfed baby and the words: "I Eat At Mom's."

The La Crosse staff developed the posters and T-shirts as part of a breastfeeding promotion project sponsored by USDA's Food and Nutrition Service (FNS). La Crosse, which was one of seven WIC agencies across the country selected to participate, operated the breastfeeding promotion projects from 1988 to 1990.

During that time, breastfeeding among LaCrosse WIC mothers increased from 19 to 34 percent. It has continued to go up to the current 48 percent.

Lee attributes the success of breastfeeding education efforts to the excellent teamwork among her staff. "They not only are dedicated workers," she says, "they also truly believe in breastfeeding. Staff members who have breastfed their babies are a testimonial to WIC clients.

"And," she adds, "the staff offers conscientious prenatal and postpartum support. A contact person calls the mom 2 weeks before her due date, keeps in contact through delivery, and calls every couple of days for the first month. Our contact person is available, even on weekends, to provide encouragement and support."