Wendy Sims-Moten: It’s my pleasure to interview Susan Liles, MS RDN CLEC. Susan is the director of Nutrition Services/WIC for the Santa Barbara County Public Health Department.
Susan Liles: I’m excited to share more about what we do! We have a multitude of programs and initiatives that help promote a healthier lifestyle and community through education, support and empowerment in the areas of healthy eating, physical activity and breastfeeding.
WSM: Let’s jump in. Tell us a little about the WIC program.
SL: Our largest and most familiar program is the Women, Infants and Children (WIC) program, which serves a little more than 16,700 individuals, about half of the infants born in Santa Barbara County and about a quarter of children under the age of 5. WIC is a nutrition program for women, infants and children. WIC helps families by providing checks for buying healthy foods, nutrition and breastfeeding education and support, and referrals to health care and community services.
WIC serves pregnant women, postpartum women until six months, breastfeeding women until one year, as well as infants and children under the age of 5. This includes foster children. These families have an income below 185 percent of the federal poverty level or receive Medi-Cal, CalFresh or Cash Aid.
WIC recipients do not have to be documented citizens, and many families may be surprised to find out they qualify. Many of our families are working parents who come in to find out they qualify for our services. Extensive research of this 40-year-old program has found WIC to be a cost-effective investment that improves the nutrition and health of low-income families — leading to healthier infants, more nutritious diets and better health care for children, and subsequently to higher academic achievement for students.
WSM: Why does Nutrition Services promote breastfeeding?
SL: In addition to WIC’s breastfeeding support, we do have additional programs specifically dedicated to promoting breastfeeding. It is extremely important to us to encourage breastfeeding because it can help “level the playing field” between those born into poverty or affluence. Breastfeeding is a public health, social justice and equity issue.
It is one of the most effective measures a mother can take to prevent disease and protect the health of her infant. A mother’s breastmilk has more than 250 components, such as hormones and anti-viruses, that cannot be found in artificial infant milk (formula).
Breastfeeding not only affects an individual, but it also has an impact on the larger community through missed work/school days and medical bills. A mother not breastfeeding does not boil down to just an individual choice or lack of knowledge; policy, systems and the environment play a role in our counties’ breastfeeding rates. We aim to promote breastfeeding as the norm and help ensure mothers have the necessary tools and environment to succeed.
WSM: What programs do you offer for parents seeking breastfeeding support?
SL: In order to build lasting changes, we always strive for a multiprong approach of direct education and creating an environment of support. The Regional Breastfeeding Liaison Program facilitates seamless breastfeeding support by collaborating with health care providers, hospitals, employers and the community. The Breastfeeding Peer Counselor Program is based on the USDA Loving Support Model to utilize peers to encourage and support WIC mothers to breastfeed their infants via a mother-to-mother connection. We also offer one-on-one visits with our International Board Certified Lactation Consultants where the IBCLCs can sit with a mom during an entire feeding to help with any breastfeeding issues. This service is offered through the Breastfeeding Program at each of our counties’ Health Care Centers and some WIC locations.
WSM: What other programs and services do you offer?
SL: Just like breastfeeding, healthy eating and active living are equally important to address. It is reported that about 678,000 deaths each year in the United States are because of nutrition- and obesity-related diseases, such as heart disease, cancer and Type 2 diabetes. In the past 30 years, obesity rates have doubled in adults, tripled in children and quadrupled in adolescents. We have Registered Dietitian Nutritionists (RDNs) who can provide medical nutrition therapy to a wide range of individuals. The RDNs work with them to develop a safe and realistic plan to help reach their individual goals related to disease, weight or a healthy lifestyle. This service is offered at each of our counties’ Health Care Centers.
We also collaborate with many programs in the area to provide nutritional expertise and support. The Cal Fresh Healthy Living Program is a Public Health Department program that addresses rising obesity rates through statewide, regional and local programs and partnerships that promote healthy eating, active living and food security with an emphasis on communities with the greater health disparities. They also assist schools in developing and implementing systemic policies that foster environments where students are healthy and ready to learn.
We work hard to deliver direct services but also to inform and improve the larger systems that affect the nutrition and health of our county. Some of the initiatives that we are focusing on are reducing food waste, decreasing childhood obesity, increasing food security and access to healthy foods, and increasing the use of farmers markets.
WSM: What has been encouraging to you?
SL: I’m always impressed by the passion that I experience every day — not only from my own team but from community partners who really collaborate and work together to create a safety net to improve health for our community and especially in the early years. Every time I meet with community partners or attend collaboration meetings, I am reinvigorated and know that Nutrition Services is not in this alone. It takes a village to raise a child, and I think SBC is focusing on breaking down silos and working together to help raise a healthy child/community.
A few years ago, we received the USDA Loving Support Award of Excellence gold premiere, which could not have been possible without the great work being done by all to support breastfeeding mothers. Currently, the SBC WIC program has 52.3 percent of infants at six months receiving breastmilk, whereas statewide rates are around 35 percent. This takes the whole community to support breastfeeding as the norm, not just one program.
In January, the WIC program was able to reach 15,120 individuals. This is about 80 percent of the individuals we can provide service to, which is a little more than 10 percent higher than the state average, sometimes 20 percent higher than other regions in California. Again, this is only possible because of the referrals and support we receive from community partners and providers.
WSM: Why do you personally work to build a network of support for children and families in Santa Barbara County?
SL: During my education to become a Registered Dietitian Nutritionist, I was working in a typical hospital setting and was fortunate enough to have an opportunity to spend a month with an RDN IBCLC who was working for programs within schools and hospitals teaching nutrition and breastfeeding to a variety of audiences. After spending only a week going to the various locations, I realized that working with new moms and children to prevent the majority of reasons that patients were in the hospital was a much better use of resources.
After I received my credentials, I worked for a school district in the Bay Area before coming to SBC PHD. Personally, I am nuts for nutrition! I love talking about anything to do with food, the food system and how it affects everything around us. I truly believe food is our medicine, and in my personal life, I choose many choices that align with that. When I see or hear parents and children starting to make those behavior changes that I know will provide them with a strong foundation and building blocks for the rest of their life, it brings me so much happiness. There isn’t a greater feeling than helping teach someone tools that will help them create a healthier, happier and longer life.
WSM: Since September is National Childhood Obesity Awareness Month, tell us a little about what childhood obesity looks like in SBC and why it is so important.
SL: On Sept. 10, the Board of Supervisors is proclaiming the month of September as National Childhood Obesity Awareness Month in Santa Barbara County. This is an important issue because the number of children affected by obesity has more than tripled in the United States since the 1970s. Last year, 40.3 percent of fifth-graders were identified as overweight and obese, and 23.8 percent of children age 4 in the WIC program were identified as obese in Santa Barbara County.
Children with obesity are at a higher risk for having other chronic health conditions and diseases, such as asthma, sleep apnea, bone and joint problems, and Type 2 diabetes. Children with obesity can be bullied and teased and are more likely to suffer from social isolation, depression and lower self-esteem. Childhood obesity is multifactorial in its cause and takes a community to address the issues. The percent of children affected by childhood obesity did not happen overnight, and it will take a change in the social norms toward healthy eating and active living to reduce childhood obesity.
WSM: Where can families learn more about any of the programs or receive help?
SL: If parents are interested in direct services for nutrition or breastfeeding help, they can call our phone center at 877.275.8805 or come into any of the WIC locations. We have a no-wrong-door policy, and even if we are not the exact organization that can help, we will connect them with resources within the community.
WSM: Where did you attend kindergarten, and what was your favorite part?
SL: I attended Holy Rosary School in Antioch. I should say my favorite part of kindergarten was snack time since I’m a dietician, but it was probably finger-painting. I enjoy getting dirty and being creative, so that’s the best combination of the two worlds.