Abstract
In this study, we examined the association between participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and breastfeeding outcomes before and after the 2009 revisions. Four-thousand-three-hundred-and-eight WIC-eligible children younger than 60 months were included from the 2005–2014 National Health and Nutrition Examination Survey (NHANES). We compared two birth cohorts with regard to their associations between WIC participation and being ever-breastfed and breastfed at 6 months. We estimated the average effect of the treatment for the treated to assess the causal effect of WIC participation on breastfeeding based on propensity score matching. The results showed that WIC-eligible participating children born between 2000 and 2008 were significantly less likely than WIC-eligible nonparticipating children to ever receive breastfeeding (p < 0.05) or to be breastfed at 6 months (p < 0.05). Among children born between 2009 and 2014, WIC-eligible participating children were no longer less likely to ever receive breastfeeding compared to WIC-eligible nonparticipating children; the gap remained in breastfeeding at 6-months (p < 0.05). The disparities in prevalence of ever breastfed between WIC-eligible participants and nonparticipants have been eliminated since the 2009 WIC revision. More efforts are needed to improve breastfeeding persistence among WIC-participating mother–infant dyads.
Highlights
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a federally supported nutrition assistance program targeting low-income women, infants, and children in the United States (U.S.)
We estimated the average effect of the treatment for the treated to assess the causal effect of WIC participation on breastfeeding based on propensity score matching
The WIC program has been applauded for its overarching goal of breastfeeding support, the availability and distribution of formula to nonfully-breastfed infants have continuously raised questions about the association between WIC participation and breastfeeding outcomes
Summary
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a federally supported nutrition assistance program targeting low-income women, infants, and children in the United States (U.S.). This program was serving more than a quarter of the pregnant women and half of the newborn infants nationwide in 2016, at an annual cost of about $6.2 billion [1]. Previous studies have found that breastfeeding rates were lower among eligible WIC participants than among eligible WIC nonparticipants. This finding has emerged from studies including the Pregnancy Nutrition
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