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Changes in Breastfeeding Among WIC Participants Following Implementation of the New Food Package


In December of 2007, the Federal Register published an Interim Rule establishing revised food packages for participants in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) that was implemented by states in 2009. We analyze changes in breastfeeding among WIC participants from the period before to period after implementation of the new food package We used linear regression to analyze data from the Pregnancy Risk Assessment Monitoring System (PRAMS) in 19 states from 2004 to 2010, the Pediatric Nutrition Surveillance System (PedNSS) in 16 states monthly from January 2007 to October 2010 and the National Immunization Survey (NIS) from all 50 states and the District of Columbia from 2004 to 2010 for evidence of an association between time-series patterns of breastfeeding among women or children who participated in WIC and changes in the new food package. Data from all three sources evidenced steady upward trends in ever breastfed infants on WIC during the study period. In neither PRAMS nor the NIS were trends in breastfeeding after implementation of the new food package statistically different from trends in breastfeeding among low-income women not on WIC. We also uncovered no break in monthly breastfeeding rates by birth cohort associated with new food package in the PedNSS. Rates of ever breastfed children are rising nationally but the increase is not associated with changes in WIC’s new food package as evidenced in national and state surveys of postpartum women.

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This research was funded by a grant from the United States Department of Agriculture, Economic Research Service (ERS), Food Economics Division (#59-5000-1-0030) to the National Bureau of Economics Research. We are indebted to Ann Collins, Elizabeth Frazao, Shannon Whaley and Parke Wilde for comments on earlier drafts and for research support Ruo-Ding Tan, Onur Altindag, and Alice Zulkarnain. We thank the WIC administrators of the 16 states included in the study who enabled us to access their PedNSS file from the CDC and Karen Dalenius who facilitated our access to the PedNSS. We also thank the PRAMS Working group: Alabama—Izza Afgan, MPH; Alaska—Kathy Perham-Hester, MS, MPH; Arkansas— Mary; McGehee, PhD; Colorado—Alyson Shupe, PhD; Connecticut—Jennifer Morin,MPH; Delaware— George Yocher, MS; Florida— Avalon Adams-Thames, MPH, CHES; Georgia— Chinelo Ogbuanu, MD, MPH, PhD; Hawaii— Emily Roberson, MPH; Illinois—Theresa Sandidge, MA; Iowa —Sarah Mauch, MPH; Louisiana— Amy Zapata, MPH; Maine—Tom Patenaude, MPH; Maryland—Diana Cheng, MD; Massachusetts— Emily Lu, MPH; Michigan— Cristin Larder, MS; Minnesota—Judy Punyko, PhD, MPH; Mississippi— Brenda Hughes, MPPA; Missouri—Venkata Garikapaty, MSc, MS, PhD, MPH; Montana—JoAnn Dotson; Nebraska—Brenda Coufal; New Hampshire—David J. Laflamme, PhD, MPH; New Jersey—Lakota Kruse, MD; New Mexico—Eirian Coronado, MPH; New York State—Anne Radigan-Garcia; New York City—Candace Mulready-Ward, MPH; North Carolina— Kathleen Jones-Vessey, MS; North Dakota—Sandra Anseth; Ohio—Connie Geidenberger, PhD; Oklahoma—Alicia Lincoln, MSW, MSPH; Oregon—Kenneth Rosenberg, MD, MPH; Pennsylvania—Tony Norwood; Rhode Island—Sam Viner-Brown, PhD; South Carolina—Mike Smith, MSPH; Texas— Rochelle Kingsley, MPH; Tennessee—David Law, PhD; Utah—Lynsey Gammon, MPH; Vermont—Peggy Brozicevic; Virginia—Marilyn Wenner; Washington—Linda Lohdefinck; West Virginia—Melissa Baker, MA; Wisconsin—Katherine Kvale, PhD; Wyoming—Amy Spieker, MPH; CDC PRAMS Team, Applied Sciences Branch, Division of Reproductive Health.

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Joyce, T., Reeder, J. Changes in Breastfeeding Among WIC Participants Following Implementation of the New Food Package. Matern Child Health J 19, 868–876 (2015).

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  • WIC
  • Breastfeeding
  • Trends
  • Interim rule