Participation in the Supplemental Nutrition Program for Women, Infants and Children (WIC) and breastfeeding: National, regional, and state level analyses

Objective: Using the 2007 National Immunization Survey data set, this study builds on literature that suggests a negative association between WIC participation and breastfeeding by including a national, regional, and state level analysis.

Methods: Chi-square, ANOVA, and adjusted regression modeling techniques examined the relationship between WIC participation and breastfeeding initiation and duration. Several potential confounders were included in the adjusted models, including mother's age, child's race/ethnicity, mother's marital status and mother's education. A secondary analysis, at the national and regional level, was conducted to adjust for the potential confounding effect of poverty status.

Results: Adjusted regression models suggest a negative association between WIC participation and breastfeeding initiation rates (OR=0.67, p<.001). Of those who initiated breastfeeding, WIC participation was associated with a mean breastfeeding duration decrease of 0.63 months (p<.001). There was variability in this association at the regional and state levels, although no region or state showed a positive association between WIC participation and breastfeeding.

Discussion: Half of all formula distributed in the United States is distributed through the WIC program. WIC receives rebates from formula manufactures for each can of formula distributed. These rebates provide the WIC program with resources to serve 25 percent of the families served. Research is needed to understand the role of national, regional and state level policies and how these policies may undermine WIC's breastfeeding promotion efforts.