Breastfeeding Initiation, Duration, and Exclusivity Among WIC‐Eligible Populations

The benefits of breastfeeding are known to impact infant and maternal health outcomes. Healthy People 2020 designates several evidence‐based objectives for breastfeeding initiation, duration, and exclusivity. Despite these recommendations, rates of breastfeeding behaviors in the United States (U.S) fall short. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is required to promote and support breastfeeding practices, yet evidence of breastfeeding outcomes among WIC participants are mixed. This study uses nationally representative data to examine the association between breastfeeding initiation, duration, and exclusivity and family WIC participation status. We analyzed data using the combined 2016‐2018 National Survey of Children’s Health, administered by HRSA’s MCHB. Outcome measures included breastfeeding initiation, any breastfeeding at 6 months, and exclusive breastfeeding through 6 months. We conducted weighted bivariate analyses to examine prevalence of breastfeeding practices based on family WIC participation and sociodemographic characteristics, and multivariable logistic regression analyses to assess the association between WIC participation and breastfeeding outcomes. Adjusted analyses controlled for several sociodemographic and health status characteristics. The combined 2016‐2018 dataset contains completed questionnaires from 19,030 children ages 0‐3 years living in the United States. A total of 6,532 were considered to be WIC‐eligible, and 3,174 were from families reported to have participated in WIC within the past 12 months. Rates of breastfeeding outcomes among WIC participants were lower than national rates observed among the general U.S. population—72.8% of children were ever breastfed and 50.3% of children were breastfed ≥ 6 months (versus 83% and 58% nationally, respectively). When examining differences in breastfeeding outcomes between WIC‐eligible participants and non‐participants, we found that participants were less likely to report any breastfeeding ≥ 6 months than WIC‐eligible nonparticipants (Average Marginal Effect (AME) = ‐9.2, P