5 reasons doctors should love the Healthy, Hunger-Free Kids Act

The Healthy, Hunger-Free Kids Act provides increased funding beyond inflation for school meals for the first time in 30 years and addresses both food insecurity and obesity in children.  Here are the details:

1.  Growing bodies and brains need good nutrition, the best medicine for our patients.  Children at or below 185% of the poverty level qualify for free or reduced cost meals.  Although children compose only 25% of the US population, 35% of those living in poverty are kids.  This act will hopefully reach more children by simplifying enrollment in the program.  Children can receive breakfast and lunch.  High risk children can receive an additional meal in the after school program.

2.  Nearly one in 3 children are overweight or obese and the problem affects children of all socioeconomic backgrounds.  This program mandates healthier foods in schools and after school programs.  Therefore, all children even those who do not qualify for free or reduced priced meals will be eating healthier due to the new requirements.

3.  Children will be offered more fruits and vegetables.  Lower fat milk and water will be available all of which are simple ways to improve the quality of the diet and are recommended by the Institute of Medicine.

4.  Our youngest patients will benefit too as daycare centers will need to meet improved nutritional guidelines.  Obesity can start as young as two years old if healthy options are not provided to kids.  Starting at kindergarten can be too late.  According to the CDC obese kids are likely to become obese adults which leads to increase health problems and dollars spent on preventable diseases like diabetes, hypertension, and heart disease.

5.  Organic food will be piloted in schools.  Currently there is limited data to suggest that organic food is best, but evidence accumulates daily that this may be a healthier choice especially for developing bodies.

That is all the good news.  Thanks, First Lady Obama.

But what about WIC, Supplemental Nutrition Program for Women Infant and Children?

WIC began in 1972 to supplement the diets of pregnant, post-partum and breastfeeding women as well as their young children (less than 5 years old).  There are so many regulations on what is permitted that both mothers and nutritionists can spend valuable time reviewing the regulations rather than discussing lactation and healthy food.  According to the new legislation, increased dollars will be given to state WIC programs that successfully promote breastfeeding.  Nice try but maybe a little hypocritical.  If WIC purchases more than half of all infant formula, how can breastfeeding be a priority?  In my state, mothers can easily obtain formula provided by the corporation that has a contract with the state, but if they want an off brand or even generic, they ask me for a prescription which is not necessarily honored by the WIC office and is not always a good use of my time.  I cannot write a prescription for a breast pump or send a mother to WIC for adequate lactation counseling.

I also wonder about the value of mandating visits every 3 months to provide vouchers for food.  The new legislation mandates that states provide debit cards by 2020 but does little to change the mandatory visits.  Those who receive food stamps in my state get a debit card for 12 to 24 months and do not have to appear in person to apply.  I think single working mothers with children may have just as many transportation obstacles as the seniors or disabled persons who receive food stamps.

Furthermore, the USDA does not restrict what food can be purchased with food stamps, but check out the complicated list of what is covered by WIC.  Although offering certain large food categories like dairy, produce, legumes makes sense, many of the restrictions are not logical.  For instance, WIC provides meat baby food but no chicken and only canned fish.  It provides fruit baby food but only about ten bucks a month for produce.  Personally, I think it makes more sense to mince organic chicken and fresh bananas for a 7 month old rather than provide meat and fruit baby food.  In spite of the recognition of the value of organic food in the new legislation, many states prohibit the purchase of organic food with WIC.  With food stamps you can buy organic food or soda pop.

WIC does blood work to look for anemia and sometimes for lead poisoning, but in a child who is growing well with a medical home, I am not sure this is valuable and is likely to be repeated by the physician anyway because official documentation is seldom provided to the mother.

The U.S. Office on Women’s Health, proclaims the benefits of breastfeeding including improved immunity in the child and decreased risk of diabetes or breast cancer in the mother.  These benefits result in health care savings and should be as valued as good nutrition.  Mothers who make the choice to breastfeed are proud of their decision; often it results in increased mother-infant attachment in the most vulnerable population, resulting in immeasurable value to society.

Maybe WIC should stop paying for formula and let women have the freedom to purchase food instead.  Do a handful of formula corporations: Mead Johnson (Bristol-Myers Squibb), Abbott Laboratories, Carnation (Nestle) deserve to have such tremendous influence on what is fed to babies?    Furthermore, if the government aims to promote health promotion, why haven’t the recipients of food stamps been subject to the same nutritional aims as WIC.  I cannot help but wonder how these programs would look if more women were in Congress.

“dr_som” is a pediatrician who blogs a Pensive pediatrician.

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