Participation in the Supplemental Nutrition Program for Women, Infants and Children (WIC) and Breastfeeding: National, Regional, and State Level Analyses

This research builds on literature that suggests a negative association between participation in the Supplemental Nutrition
Program for Women, Infants, and Children (WIC) and breastfeeding. Variation in results at the national, regional, and state
level has important policy implications for breastfeeding promotion through WIC. Using the 2007 National Immunization Survey
dataset, Chi-square, ANOVA, and adjusted regression modeling techniques assess the relationship between WIC participation
and breastfeeding initiation and duration. Adjusted regression models suggest a negative association between WIC participation
and breastfeeding initiation rates (OR = 0.67, 95% CI: 0.61, 0.72). Of those who initiated breastfeeding, WIC participation
was associated with a mean breastfeeding duration decrease of 0.63 months (95% CI: −0.86, −0.39). At the regional level, 3
of 7 regions showed a negative association between WIC participation and breastfeeding initiation. All of the regions indicated
a negative association between WIC participation and breastfeeding duration. Out of 50 states, 13 had a statistically significant
reduction in odds of initiation of breastfeeding and 10 had reduced duration of breastfeeding among participants of WIC when
compared to non-participants. No state showed a positive association between WIC participation and breastfeeding. Regional
and state differences in breastfeeding rates suggest that further research is needed to understand the role of national, regional,
and state level policies which may undermine WIC’s breastfeeding promotion efforts. Although WIC revised the food packages
to create a stronger incentive for breastfeeding, a disincentive for breastfeeding may exist given the higher market value
of the formula packages.