Online Program

Maternal WIC participation improves breastfeeding rates: A statewide analysis of WIC participants

Wednesday, November 6, 2013 : 11:24 a.m. - 11:42 a.m.

Elizabeth Metallinos-Katsaras, PhD, RD, Department of Nutrition, Simmons College, Boston, MA
Rachel Colchamiro, MPH, RD, LDN, CLC, Nutrition Division, Massachusetts Department of Public Health, Boston, MA
Lisa Brown, PhD, RD, Department of Nutrition, Simmons College, Boston, MA
Objectives: To examine the association between length of exposure to WIC services and breastfeeding initiation and duration and to identify factors associated with breastfeeding in the Massachusetts WIC population.

Methods: All women with singleton live births, first certified into Massachusetts WIC prenatally or post-partum during 2001-2009, and whose infants had complete breastfeeding and covariate data (maternal race, age, education, smoking status, BMI, household income and size, birthweight and gender) were included in the analysis (n=122,506). Multivariate logistic and general linear model regressions were used to examine timing of WIC entry (i.e., prenatal trimester of entry or postpartum) in relation to: 1) breastfeeding initiation, and 2) mean duration. In addition, factors associated with breastfeeding initiation and duration within this population were indentified.

Results: Among prenatal WIC entrants, first (vs. third) trimester entry was associated with a higher likelihood of initiation, 10% for primiparous, 32% for multiparous mothers (p < .01). Prenatal entrants were more likely than PP entrants (p < .0001) to initiate breastfeeding (13% primi and 23% multiparous). Prenatal WIC entrants breastfed 1.7 (primiparous), and 3.4 (multiparious) weeks longer than PP entrants (p < .0001). Several socio-demographic factors were associated with breastfeeding initiation and duration including maternal race with Hispanic and non-Hispanic black women more likely to breastfeed and Asian women less likely to breastfeed compared to Caucasian women. Greater maternal age and education were also associated with higher likelihood of breastfeeding, whereas positive smoking status and obese/underweight BMI were associated with lower likelihood; overweight BMI was not significantly different from normal weight. Conclusions: The WIC program is in a unique position to promote and support breastfeeding within a high-risk population. Greater exposure to WIC services was associated with higher likelihood of breastfeeding initiation and longer duration. Factors associated with breastfeeding behavior should be given special attention for intervention.

Learning Areas:

Assessment of individual and community needs for health education
Conduct evaluation related to programs, research, and other areas of practice
Public health or related research

Learning Objectives:
Describe the association between duration of WIC participation and breastfeeding initiation and duration within a single pregnancy for women with and without older children. Identify significant factors that are associated with breastfeeding behavior in the Massachusetts WIC population.

Keyword(s): Breastfeeding, WIC

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a coinvestigator on a USDA grant investigating the relationship between WIC participation and food insecurity, breastfeeding status and other factors. I was also the senior nutritionist of a local WIC program during the period of data collection and have expertise on how the data was collected and how it can be applied.
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.