Abstract
Background: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutrition assistance to half of infants born in the United States. The nationally representative WIC Infants and Toddler Feeding Practices Study-2 (ITFPS-2) reported a caloric deficit at 7 months among infants receiving WIC mixed feeding packages, suggesting these infants may be at risk for growth deceleration/faltering.Methods: Longitudinal administrative data collected prospectively from WIC participants in Southern California between 2010 and 2019 were used (n = 16,255). Infant lengths and weights were used to calculate weight-for-length (WLZ), weight-for-age (WAZ) and length-for-age (LAZ) z-scores at different time points. Growth deceleration/faltering was determined at 9, 12, 18, and 24 months by the change in z-score from the last measurement taken ≤ 6 months of age. Infant feeding was categorized by the food package (breastfeeding, mixed feeding, and formula feeding) infants received from WIC at 7 months. Poisson regression models were used to evaluate the association between WIC infant package at 7 months and deceleration/faltering at 9, 12, 18, and 24 months.Results: The proportion of infants displaying decelerated/faltering growth was low for all infant food package groups. Receiving the WIC mixed feeding package at 7 months of age was not associated with WLZ, WAZ, and LAZ deceleration/faltering growth.Conclusions: Growth deceleration/faltering rates were very low among WIC participating children in Southern California, highlighting the critical role of nutrition assistance in supporting adequate growth in early childhood.
Highlights
The first 1,000 days of a child’s life represent a critical period, with adequate nutrition imperative for healthy growth and development [1]
The breastfeeding package did not include infant formula; the mixed feeding package included some formula, with quantities varying based on the amount of breastfeeding reported; and the formula feeding package contained enough formula to meet the infant’s age-specific nutritional needs, taking into account nutritional needs expected to be met by complementary foods beginning at 6 months of age [9]
WIC infant package received at 7 months of age Formula feeding Mixed feeding Breastfeeding
Summary
The first 1,000 days of a child’s life represent a critical period, with adequate nutrition imperative for healthy growth and development [1]. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is a nutrition assistance program of the federal government of the United States and is administered by the United States Department of Agriculture, serving over 6.2 million participants monthly in 2020 [6]. WIC provides supplemental foods to eligible mothers and children in households with incomes below 185% of the federal poverty level (FPL), in addition to nutrition education, breastfeeding promotion and social/medical service referrals [7]. Food packages are tailored based on the amount of breastfeeding reported by their mothers, with infant formula provided to supplement breastmilk for infants who are not exclusively breastfed, or as the main source of feeding for those exclusively formula fed [8]. The nationally representative WIC Infants and Toddler Feeding Practices Study-2 (ITFPS-2) reported a caloric deficit at 7 months among infants receiving WIC mixed feeding packages, suggesting these infants may be at risk for growth deceleration/faltering
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