Journal Article

Trends in Breastfeeding Disparities in US Infants by WIC Eligibility and Participation

By Zhang Q, Lamichhane R, Wright M, McLaughlin P, Stacy B

Abstract

Objective: To examine the trends in breastfeeding disparities across Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) eligibility and participation statuses in the last 2 decades.

Design: Secondary analyses from multiple cross-sectional surveys.

Setting: United States.

Participants: The National Health and Nutrition Examination Survey 1999–2014 included 10,696 children younger than 60 months. Birth cohorts in 4-year increments were created from 1994 to 2014.

Main Outcome Measures: Ever-breastfed status and breastfed-at-6-months status.

Analysis: The prevalence rates of ever-breastfed and breastfed at 6 months were estimated between WIC-eligible vs non-eligible children and WIC-eligible participants vs eligible nonparticipants. Prevalence rates and their 95% confidence intervals were plotted across birth cohorts. Log-binomial regression was conducted to test the trends of breastfeeding in each subgroup.

Results: Ever-breastfeeding rates increased from 52% (WIC participants) vs 57% (WIC-eligible nonparticipants) in the 1994–1997 birth cohort to 71% vs 77% in the 2010–2014 birth cohort—a 36% vs 34% relative increase for participants vs eligible nonparticipants, respectively (P < .001). Breastfeeding-at-6-month rates increased from 28% (participants) vs 30% (eligible nonparticipants) to 34% vs 49% in the same time period—a 21% vs 66% relative increase, respectively (P < .001).

Conclusion and Implications: To meet the Healthy People 2020’s goal for breastfeeding at 6 months, sustainable postpartum breastfeeding education and interventions may be needed among WIC participants. Future research focusing on identification of the causal relationship between WIC participation and breastfeeding outcomes is warranted.

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Date Added
February 11, 2019

Citation
Zhang Q, Lamichhane R, Wright M, McLaughlin P, Stacy B (2019) Trends in Breastfeeding Disparities in US Infants by WIC Eligibility and Participation. Journal of Nutrition Education and Behavior: Vol. 51, Issue 2, pp 182-189. Available online: https://www.jneb.org/article/S1499-4046(18)30849-2/fulltext