Breastfeeding Duration Is Associated With WIC Site-Level Breastfeeding Support Practices

Abstract

ObjectiveTo describe Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) site-level breastfeeding support practices and associations with breastfeeding outcomes. DesignSecondary analysis of WIC Infant and Toddler Feeding Practices Study–2, including data from interviews with caregivers of infants and interviews and surveys with staff from 27 WIC state agencies and 80 study sites. ParticipantsA total of 1,235 mothers of breastfed infants participating in the WIC Infant and Toddler Feeding Practices Study–2. Main Outcome MeasureAny and fully breastfeeding 2, 6, and 12 months postpartum. AnalysisDescriptive statistics described WIC site-level breastfeeding supports. Multilevel mixed modeling of breastfeeding at 2, 6, and 12 months, controlling for site- and participant-level characteristics. ResultsFive WIC site-level supports were significantly and independently associated with any and fully breastfeeding: access to breastfeeding peer counselors, access to International Board Certified Lactation Consultants, postnatal home visits, allowing any WIC staff member to provide breast pump education, and having a policy not to provide formula during the first 30 days postpartum. Likelihood of any and fully breastfeeding increased with each additional site-level support present (odds ratio = 1.09, 95% confidence interval, 1.06–1.12; and odds ratio = 1.26, 95% confidence interval, 1.21–1.31, respectively). Conclusions and ImplicationsPositive associations between site-level supports and breastfeeding at 2, 6, and 12 months were observed. Additional research is needed to understand how site-level supports interrelate and whether specific combinations are more effective, and to identify variations in implementation of breastfeeding supports.