Introduction Breastfeeding rates among women participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are lower compared with those of nonparticipants. The objective of this study was to assess racial and ethnic differences in self‐reported reasons for breastfeeding cessation during the first year postpartum. Methods This was a secondary analysis of data from women participating in the WIC Infant and Toddler Feeding Practices Study‐2. Women specified reasons that influenced their decision to stop breastfeeding during telephone interviews between 1 and 13 months postpartum. Logistic regression models for each racial and ethnic group explored the effects of sociodemographic variables on each reason. Results The sample for this analysis included 4095 women (34.1% non‐Hispanic white, 25.5% non‐Hispanic black, and 40.4% Hispanic). Across all race and ethnic groups, food security status was a predictor of some but not all reasons for breastfeeding cessation. Compared with their counterparts who were food secure, white women with low food security and black women with very low food security were more likely (odds ratio [OR], 1.86; 95% CI, 1.04‐3.35 and OR, 1.86; 95% CI, 1.19‐2.90, respectively) to stop breastfeeding because they wanted or needed someone else to feed their infants. Hispanic women with very low food security were more likely to stop breastfeeding because they felt they did not have enough milk. Compared with their multiparous counterparts, primiparous black and white women were almost twice as likely to stop breastfeeding because of trouble sucking or latching. Hispanic and black women born outside the United States had significantly higher odds of breastfeeding cessation because of the infant losing interest compared with US‐born women. Education and marital status significantly predicted reasons for breastfeeding cessation among Hispanic and white women. Discussion Among women participating in WIC, food security, parity, country of birth, education, and marital status were significant predictors of reasons for breastfeeding cessation across racial and /ethnic groups. Incorporating these findings in education, counseling, and interventions may help overcome breastfeeding barriers.

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Breastfeeding rates among infants participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are consistently lower than those of WIC nonparticipants. The 2009 WIC food package revisions were intended to incentivize breastfeeding among the WIC population. To examine the effectiveness of this policy change, we estimated an intent-to-treat regression-adjusted difference-in-difference model with propensity score weighting, an approach that allowed us to control for both secular trends in breastfeeding and selection bias. We used novel data from the Feeding Infants and Toddlers Survey from 2008 and 2016. We defined our treatment group as infants eligible for WIC based on household income and our control group as infants in households with incomes just above the WIC eligibility threshold. The breastfeeding outcomes we analyzed were whether the infants were ever breastfed, breastfed through 6 months, and breastfed exclusively through 6 months. We observed significant increases in infants that were ever breastfed in both the treatment group (10 percentage points; p < 0.01) and the control group (15 percentage points; p < 0.05); however, we did not find evidence that the difference between the two groups was statistically significant, suggesting that the 2009 revisions may not have had an effect on any of these breastfeeding outcomes.

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Objectives To determine the relative validity of a food screener compared with two 24-hour joint parent-child dietary recalls for measuring dietary intakes in low-income Latino children who are overweight/obese. Methods Dietary intake of children participating in a pediatric obesity weight management program was measured at baseline using both the Spanish-language version of the Block Food Screener for Ages 2–17 (BFS2–17) for the last week and two 24-hour recall interviews (24Hrs) conducted in Spanish on separate days (reference method). Intake data from each 24HR were entered into the Nutritionist Pro software (Axxya Systems) to determine nutrient content of food items. Median intakes were compared for each method by Wilcoxon signed rank test. Reproducibility and relative validity of the BFS2–17 was assessed by Cohen's weighted kappa. Agreement was further assessed using cross-classification by quartiles and Bland-Altman plots. Results Complete data on energy and six macronutrients of interest were obtained from 30 participants. Median daily intakes of energy, protein, carbohydrates, and total and saturated fats estimated from the 24Hrs were significantly different than intakes from the BFS2–17 except, for sugar and fiber (Table 1). Cross-classification showed some agreement, with 47%–67% of the participants classified into identical or contiguous quartiles although, none of the results were statistically significant. Bland-Altman plots showed systematic overestimation of the measures assessed by BFS2–17 compared to 24HRs as well as, large amounts of variability around the mean constants. Conclusions Results showed poor agreement between the two dietary assessment methods in assessing energy and macronutrient intake among a sample of young Latino children who are overweight/obese. There is a need for culturally-adapted dietary assessment tools for this population. Funding Sources Potomac Health Foundation. Supporting Tables, Images and/or Graphs