Barriers to Breastfeeding in the WIC Population
By Hedberg I
Background: Breastfeeding (BF) initiation rates in the United States have increased over the past 11 years by 3.6%. However, women who participate in the Women, Infants, and Children (WIC) program are almost 12% less likely to initiate BF than the general population, and less likely to continue for a year.
Purpose: To identify barriers to BF in order to recommend guidelines for the WIC population.
Study Design and Methods: A systematic review using the search words WIC and BF was conducted using the CINAHL, PubMed, and Cochrane Library databases. Inclusion criteria were articles studying the WIC population alone and/or relative to other populations. Twenty-four articles from the last 5 years were reviewed and graded according to the Evans’ hierarchy of evidence.
Results: Barriers to BF in the WIC population were sorted into five categories: lack of support inside/outside the hospital, returning to work, practical issues, WIC-related issues, and social/cultural barriers. Factors predisposing to lower BF rates include non-Hispanic ethnicity, obesity, depression, younger age, or an incomplete high school education. Interventions trialed with positive outcomes include peer counseling, improved communication between hospital lactation consultants and WIC staff, breast-pump programs, and discouraging routine formula provision in the hospital and by WIC.
Clinical Implications: Reasons for low BF rates in the WIC population are complex. More research is needed into interventions tailored for WIC participants. Recommendations for clinicians include initiating peer-counseling programs, prenatal/ postpartum education, in-hospital BF support, and changing the focus of WIC from formula to BF promoting.
November 15, 2017
Hedberg I (2013) 'Barriers to Breastfeeding in the WIC Population'. The American Journal Of Maternal-Child Nursing: Vol. 38, Issue 4, pp. 244-249. Available online: http://journals.lww.com/mcnjournal/Abstract/2013/07000/Barriers_to_Breastfeeding_in_the_WIC_Population.11.aspx