248495 Impact of WIC food package on breastfeeding rates by breastfeeding support in Maryland local WIC agencies

Wednesday, November 2, 2011: 1:30 PM

Susan Gross, PhD, MPH, RD , Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Amy Resnik, MS, RD, CSP, LDN , Maryland WIC Program, Maryland State Department of Health and Mental Hygiene, Balitmore, MD
Caitlin Cross-Barnet, PhD , Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Joy P. Nanda, DSc, MS, MHS, MBA , Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Marycatherine Augustyn, PhD , Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
David M. Paige, MD MPH , Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
Maryland WIC introduced an enhanced food package October 1, 2009. The package for exclusively breastfeeding mothers was designed to facilitate increased duration, and concurrently introduced policy prohibited issuance of formula for the first month of life. Maryland's local WIC Agencies (LWAs, n=23) offer 3 types of breastfeeding support services: breastfeeding peer counselors (PC), lactation consultants (LC) or standard care (SC). This paper identifies breastfeeding rates from 2007 to 2010 for these three services and examines the impact of the 2009 enhanced WIC food packages on these rates. At time of certification in the MD WIC program, exclusive breastfeeding rates increased from 6.2% in 2007 to 14.1% in 2010, with the largest jump between 2008 and 2009 (7.1% to 10.8%). All groups experienced a boost in breastfeeding rates coincident to the enhanced food package. However, the change in exclusive breastfeeding at certification in the PC group (7.0% to 16.0%) was greater than in the LC (5.4% to 11.6%) and SC (5.6% to 12.6%) groups. At age two months, the exclusive breastfeeding rates for all infants increased from 7.4% in 2007 to 11.1% in 2010, but differences by breastfeeding support group were not apparent. Introduction of enhanced food packages in Maryland was associated with an increase in exclusive breastfeeding at certification. Rates differed by breastfeeding support group, with the PC support having the highest rates. Results suggest that the enhanced WIC food package has influenced Maryland WIC exclusive breastfeeding rates. Further research is needed to evaluate long-term impact.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Public health or related education
Public health or related public policy
Public health or related research

Learning Objectives:
Describe the changes to the WIC food package that incentivize breastfeeding. Explain the impact of the WIC food package changes on rates of breastfeeding of MD WIC participants. Describe breastfeeding rates in the MD WIC program before and after changes to the WIC food package, and identify differences that may exist between the type of breastfeeding support provided by the local WIC agency.

Keywords: Breastfeeding, WIC

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am faculty in the Department of Population Reproductive and Family Health at the Bloomberg School of Public Health, I an investigator on the breastfeeding peer counselor evaluation research team and I am a high risk nutritionist for the Johns Hopkins WIC Program.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Maternal Health, Infant Feeding and Relationship to Infant Health
See more of: Food and Nutrition