Published online February 1, 2007
PEDIATRICS Vol. 119 No. 2 February 2007, pp. 281-289 (doi:10.1542/peds.2006-1486)
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ARTICLE

Special Supplemental Nutrition Program for Women, Infants, and Children and Infant Feeding Practices

Alison Jacknowitz, PhDa, Daniel Novillo, MPPb and Laura Tiehen, PhDc

a Department of Public Administration and Policy, American University, Washington, DC
b US Government Accountability Office, Washington, DC
c Economic Research Service, US Department of Agriculture, Washington, DC

OBJECTIVE. This study examined the association between participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and adherence to 4 American Academy of Pediatrics recommendations on infant feeding.

METHODS. We used data from the Early Childhood Longitudinal Study-Birth Cohort, which is nationally representative of children born in 2001. We estimated regression models to assess relationships between program participation and adherence to American Academy of Pediatrics recommendations on exclusive breastfeeding and the introduction of infant formula, cow's milk, and solid foods.

RESULTS. Regression results indicated that WIC participation was associated with a 5.9-percentage point decrease in the likelihood of exclusive breastfeeding for ≥4 months and a 1.9-percentage point decrease in the likelihood of exclusive breastfeeding for ≥6 months. Program mothers were 8.5 percentage points less likely than nonparticipants to adhere to the American Academy of Pediatrics recommendation to delay introduction of infant formula until month 6. Program mothers were 2.5 percentage points more likely than nonparticipants to delay the introduction of cow's milk until month 8. Program participants were 4.5 percentage points less likely than nonparticipants to delay the introduction of solid foods for ≥4 months. However, the difference between participants and nonparticipants disappeared by month 6.

CONCLUSIONS. Results suggest that, although program participants are less likely to breastfeed exclusively than eligible nonparticipants, program-provided infant formula is an important option for mothers who do not breastfeed exclusively. The program faces the challenge to encourage breastfeeding without undermining incentives to follow other recommended infant feeding practices. Recent changes proposed to the food packages by the US Department of Agriculture Food and Nutrition Service are consistent with the goal of increasing adherence to recommended infant feeding practices among participants.


Key Words: breastfeeding • guidelines • demographic characteristics • infant feeding • WIC • Special Supplemental Nutrition Program for Women • Infants • and Children

Abbreviations: AAP—American Academy of Pediatrics • ECLS-B—Early Childhood Longitudinal Study-Birth Cohort • WIC—Special Supplemental Nutrition Program for Women, Infants, and Children


Accepted Oct 2, 2006.


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