Changes in Breastfeeding Among WIC Participants Following Implementation of the New Food Package

Abstract

In December of 2007, the Federal Register published an Interim Rule establishing revised food packages for participants in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) that was implemented by states in 2009. We analyze changes in breastfeeding among WIC participants from the period before to period after implementation of the new food package We used linear regression to analyze data from the Pregnancy Risk Assessment Monitoring System (PRAMS) in 19 states from 2004 to 2010, the Pediatric Nutrition Surveillance System (PedNSS) in 16 states monthly from January 2007 to October 2010 and the National Immunization Survey (NIS) from all 50 states and the District of Columbia from 2004 to 2010 for evidence of an association between time-series patterns of breastfeeding among women or children who participated in WIC and changes in the new food package. Data from all three sources evidenced steady upward trends in ever breastfed infants on WIC during the study period. In neither PRAMS nor the NIS were trends in breastfeeding after implementation of the new food package statistically different from trends in breastfeeding among low-income women not on WIC. We also uncovered no break in monthly breastfeeding rates by birth cohort associated with new food package in the PedNSS. Rates of ever breastfed children are rising nationally but the increase is not associated with changes in WIC's new food package as evidenced in national and state surveys of postpartum women.

Predicting Maintenance of Any Breastfeeding from Exclusive Breastfeeding Duration: A Replication Study

“…National rates for exclusive breastfeeding at 3 and 6 months are increasing but remain suboptimal (9, 10). In the United States, initiation, exclusivity, and duration of breastfeeding vary by maternal demographic factors including income, educational attainment, insurance status, race, and ethnicity (11–14). Lower income mothers, those with fewer years of education, those with public insurance and those who identify as a racial or ethnic minority are less likely to meet breastfeeding recommendations, indicating the need for continued efforts aimed at helping women breastfeed longer, especially those at risk of not meeting targets (14–17).…”

Associations between Governmental Policies to Improve the Nutritional Quality of Supermarket Purchases and Individual, Retailer, and Community Health Outcomes: An Integrative Review

“…Forty-four studies assessed the association between the 2009 WIC food package revisions and availability of foods and beverages in supermarkets; purchases, redemptions, or dietary intake among WIC participants; obesity in early childhood; perinatal and birth outcomes; or outcomes related to breastfeeding [ 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 , 118 , 119 , 120 , 121 , 122 , 123 , 124 , 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 , 133 , 134 , 135 , 136 , 137 , 138 , 139 , 140 , 141 , 142 , 143 , 144 , 145 , 146 , 147 , 148 , 149 , 150 , 151 , 152 , 153 ]. There is consistent evidence of an association between the WIC food package revisions and improvements in household food purchases and dietary intake among both adults and children [ 111 , 114 , 115 , 116 ...…”

“…The cash-value voucher, in particular, increased the perceived value of the program for many participants, although voucher redemption varied across communities and may be limited in some areas by poor access to fresh fruits and vegetables or negative store experiences [ 112 , 113 , 117 , 123 , 128 , 131 , 132 , 146 ]. Impacts of the revisions on breastfeeding are mixed, with some studies showing increases in breastfeeding initiation [ 129 , 153 ], others showing no effect [ 118 ], and none finding a relationship with breastfeeding at six months [ 129 , 153 ]. Recent research using interrupted time series or controlled quasi-experimental designs show improvements in maternal and child health outcomes resulting from the food package changes, including reductions in infant and young child obesity [ 125 , 126 , 127 , 130 ], improvements in infant birth weight outcomes (low birth weight, small for gestational age, and large for gestational age) [ 120 ], and reductions in maternal weight gain and preeclampsia [ 120 ].…”

Trends in Breastfeeding Among Infants Enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children — New York, 2002–2015

“…In 2009, the economic value of the food packages issued to fully breastfeeding mothers was enhanced ( 4 ). However, a recent study, using 2004–2010 data from multiple sources, demonstrated little effect of these changes on various breastfeeding measures ( 5 ). The analyses presented here, with an additional 5 years of New York PedNSS data, support those findings.…”