WIC Breastfeeding Policy Inventory

WIC Breastfeeding Policy Inventory

Published: Jan 15, 2015
Publisher: Cambridge, MA: Mathematica Policy Research
Associated Project

WIC Local Agency Breastfeeding Policy and Practices Inventory (WIC BPI)

Time frame: 2011-2014

Prepared for:

U.S. Department of Agriculture, Food and Nutrition Service


Ronette Briefel

Key Findings

Key Findings:

  • Most state and local WIC agencies had at least one staff member with a breastfeeding credential. Certified lactation counselors were the most prevalent, followed by international board-certified lactation consultants.
  • Nearly all state agencies operated or oversaw local agencies that had peer counseling programs. Two-thirds of local agencies operated a peer counseling program. Where enrollment in the peer counseling program was not automatic, nearly all agencies offered enrollment at a prenatal or postpartum certification visit or when participants were having breastfeeding problems.
  • Nearly all agencies reported that they collected information on breastfeeding initiation, duration, and exclusivity, whereas about half of all agencies collected information on breastfeeding intensity. Agencies could most easily provide breastfeeding estimates for initiation and duration (as they are currently required), but staff believed they could provide exclusivity estimates with more difficulty and intensity estimates only with great difficulty.
  • More than one-third of agencies reported storing breastfeeding information in an administrative system separate from the system used to certify WIC participants.

Breastfeeding promotion and support is a core component of the nutrition services provided by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) to low-income women and children up to 5 years of age. WIC promotes breastfeeding through state and local agency policies and practices designed to inform expectant and new mothers of the well-documented benefits of breastfeeding and, for mothers who choose to breastfeed, to provide services such as breastfeeding education and peer counseling through the infant’s first year.

The Food and Nutrition Service (FNS) of the U.S. Department of Agriculture administers the WIC Program and monitors trends in breastfeeding rates among WIC participants. As part of its ongoing efforts to increase breastfeeding exclusivity and duration, FNS contracted with Mathematica Policy Research to conduct the WIC Breastfeeding Policy Inventory (WIC BPI) Study. The study’s main objectives were to describe a census of breastfeeding policies and practices at state and local WIC agencies; the breastfeeding measures that agencies currently collect and report, and the data systems used to do so; and the correlations between breastfeeding outcomes and agencies’ policies and practices. The study also assessed the WIC BPI as an ongoing data collection tool for program monitoring and improvement. This report presents findings for each of these objectives except the analysis of correlations between breastfeeding outcomes and agencies’ policies and practices, which is described in a separate memo for FNS.

The WIC BPI was a census of 90 state, territory, and Indian Tribal Organization (ITO) WIC agencies as well as approximately 1,800 local WIC agencies. The web-based survey was conducted in two parts. Part 1, which covered policies and practices to promote breastfeeding, was fielded from February to April 2013. Part 2 covered breastfeeding measures, data systems, and reporting, and was fielded from July to October 2013. All 50 states, as well as the District of Columbia, completed both parts of the survey, as did 91 percent of local agencies. Response rates were more than 80 percent for territories and ITOs.

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