Using Text Messaging to Support Breastfeeding in WIC

Written by Maryanne Perrin, MBA, Graduate student in Nutrition Science, and ILCA volunteer

Recently, we talked to a private practice IBCLC and several of her clients about using mobile* phone based text messaging to support breastfeeding.  We’re continuing the exploration of this innovative topic by talking to IBCLCs within the Women, Infants and Children (WIC) program about how they use text messaging to help low-income mothers succeed with breastfeeding. (NOTE: WIC provides nutritional support to over 50% of infants born each year in theUnited   States which means that this federally funded program has a unique opportunity to play a significant role in promoting and supporting breastfeeding.)

The American Red Cross WIC office inSan Diego,California and the Shasta County WIC office in Redding,California both recently began using text messaging within their Breastfeeding Peer Counselor (PC) programs. Jennifer Nolan, Peer Counselor Supervisor and IBCLC (American Red Cross), and Sara Stone, Lead Peer Counselor and IBCLC (ShastaCounty), shared their stories with us…

Getting Started

Shasta County WIC PCs

Both WIC offices received federal grant funding which they used to purchase mobile phones for their Peer counselors (PCs).  American Red Cross has 3 people on the peer counseling team and Shasta County has 8.  When a new mother enrolls in the peer counselor service, each office asks the mother about her communication preferences and no one ever initiates text messaging without first receiving the mother’s approval (depending on an individual’s phone plan, they could potentially incur additional expenses for receiving unwanted text messages).

ShastaCounty also had to request a modification to the contacts database so that “text messaging” was an option for tracking contacts. (Note: they only count the text message as a contact if they get a reply from the mother; unreturned texts are not counted.)  Once the database modifications were made, they became available to other California WIC agencies as well, allowing them to track text messaging use.

A lesson learned in Shasta County was the importance of having an effective phone for text messaging.  Initially they got very basic phones for their PCs, but soon upgraded to phones with full keyboards so that the PCs could be efficient in sending texts.

How Text Messaging Is Used

Both Jennifer and Sara stressed that text messaging is never a starting point for building a relationship with a client, but instead a complementary communication method they use after first establishing face-to-face or phone contact. “We get better participation in our program by using a communication mode that is most comfortable for mothers,” says Jennifer.  Sara echoed this sentiment, describing text messaging as a cultural shift that allows WIC PCs to stay better connected with their clients.  Examples of the types of messages exchanged between PC and mother include:

• Prenatal contacts that involve inviting the mother to classes or scheduling/confirming appointments
• Sharing tips about baby’s development and checking in during pregnancy to help build rapport
• Receiving texts from mother while she is in the hospital to learn about baby’s arrival
• Asking and answering simple breastfeeding questions or scheduling calls to follow-up on more complicated breastfeeding issues
• Checking in on postpartum status and sending encourage messages

Why Use Text Messaging?

San Diego WIC office

Text messaging is portable (mobile phones are typically with mothers at home, at work, and in the hospital) and also non-invasive (won’t wake a sleeping baby or interrupt someone during an important meeting at work).  One WIC mother, upon receiving a call from her PC, whispered into the phone, “I’m at work, can you please text me?”

Jennifer says that the majority of their clients use text messaging, and she thinks it has the potential to prolong breastfeeding because it keeps mothers engaged and gets them the information they need (a critical mass of WIC data should allow future analysis of this).  ForShastaCounty, “It’s taken off like wildfire,” says Sara.  Text messaging has grown from 7% of their non face-to-face contacts (phone, email or text) in July 2011, to almost 25% as of February 2012.  Sara’s words of advice to other WIC agencies – “Just jump in and do it!”

Are you using text messaging or alternative technologies in creative ways to promote and support breastfeeding within WIC or other settings (e.g. third-world countries)?  If so, we’d love to hear your story!

* Other terms used around the world including cell phone, cellular phone, and hand phone.

By Maryanne Perrin

MBA, Graduate student in Nutrition Science, and ILCA volunteer