Forming the Perception of WIC Infant Feeding Recommendations: A Qualitative Study

Abstract

Nearly half of newborns in the United States are enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Promoting breastfeeding is a programmatic priority, although formula vouchers are provided for those who do not exclusively breastfeed. Previous literature suggests that participant perception of WIC’s breastfeeding recommendations is a significant factor predicting breastfeeding initiation, duration, and exclusivity outcomes. However, little is known about how participants’ perceptions of WIC’s breastfeeding recommendations are formed. To address this knowledge gap, we conducted a qualitative pilot study in Nevada, interviewing 10 postpartum WIC mothers and 12 WIC staff who had interacted with participants regarding infant feeding. Results showed participants and staff reported various perceptions of what WIC recommends, the factors that contribute to these perceptions, and how these perceptions affect breastfeeding practices. Respondents also described that WIC has a negative legacy as the “free formula program,” and that environmental factors, such as the recent formula recall, have had an impact on participants’ infant feeding practices. More effective public campaigns and programmatic strategies are needed to target participants’ prenatal self-efficacy and to communicate the availability of skilled lactation support in the early postpartum period to improve participants’ perceptions of WIC’s position on breastfeeding.

WIC Peer Counselors Support Breastfeeding Among WIC Participants

“…6 In previous research, WIC staff viewed breastfeeding as the ideal nutrition for infants yet acknowledged that barriers such as nipple pain, lack of support, interpersonal influences to provide the infant formula, timidity about exposing breasts to breastfeed, and perceived low breastmilk supply contributed to the client discontinuing breastfeeding. [7][8][9] WPCs are paid paraprofessionals 10 who promote breastfeeding by discouraging formula feeding at least for the first postnatal month, although the mother's infant feeding decision is respected. In addition, the WPC must be a present or former WIC participant who is breastfeeding or has breastfed at least 1 infant for 6 months or longer.…”

“…6 In previous research, WIC staff viewed breastfeeding as the ideal nutrition for infants yet acknowledged that barriers such as nipple pain, lack of support, interpersonal influences to provide the infant formula, timidity about exposing breasts to breastfeed, and perceived low breastmilk supply contributed to the client discontinuing breastfeeding. 7 - 9 …”