Dataset Information

WIC Participation and Breastfeeding after the 2009 WIC Revision: A Propensity Score Approach.

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.

SUBMITTER: Li K

PROVIDER: S-EPMC6696206 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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WIC Participation and Breastfeeding after the 2009 WIC Revision: A Propensity Score Approach.

Li Kelin K Wen Ming M Reynolds Megan M Zhang Qi Q

International journal of environmental research and public health 20190724 15

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-breast ...[more]

PMID: 31344937

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Project description:IMPORTANCE:Potential effects of breast feeding on children's behaviour remains an elusive debate given inherent methodological challenges. Propensity score matching affords benefits by ensuring greater equivalence on observable social and health determinants, helping to reduce bias between groups. OBJECTIVES:We examined whether the duration of breast feeding had an impact on children's externalising and internalising behaviours. STUDY DESIGN:A cohort study (Encuesta Longitudinal de la Primera Infancia cohort) that included 3037 Chilean families who were enrolled in 2010. Follow-up data was collected in 2012. SETTING:General community. PARTICIPANTS:Population-based sample. Eligibility criteria: children born full-term with complete data on matching variables. Matching variables included: healthcare system as a proxy of income, presence of a partner/spouse in the household, maternal age, educational level, IQ, working status, type of work, diagnosis of prenatal depression by a healthcare professional, smoking during pregnancy, delivery type, child sex, weight at birth, incubation following delivery, and child age. EXPOSURE:Duration of breast feeding. MAIN OUTCOMES AND MEASURES:Externalising and internalising problems assessed using the Child Behaviour Checklist. RESULTS:Matched results revealed benefits of any breast feeding, up to 6 months, on emotional reactivity and somatic complaints (mean difference of -1.00, 95% CI, -1.84 to -0.16 and -1.02, 95% CI, -1.76 to -0.28, respectively). Children breast fed between 7 and 12 months also had reduced scores on emotional reactivity, in addition to attention problems (mean difference of -0.86, 95% CI, -1.66 to -0.06 and -0.50, 95% CI, -0.93 to -0.07, respectively). No benefits were observed for children breast fed 13 months or more. CONCLUSION:Reduced internalising difficulties and inattention were found in children breast fed up to a year, suggesting that breast feeding may have beneficial impacts on these areas of development. The magnitude of effect was modest. Extended durations of breast feeding did not appear to offer any benefits.

Project description:ImportanceThe Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is an important source of nutritional support and education for women and children living in poverty; although WIC participation confers clear health benefits, only 50% of eligible women and children currently receive WIC. In 2010, Congress mandated that states transition WIC benefits by 2020 from paper vouchers to electronic benefits transfer (EBT) cards, which are more convenient to use, are potentially less stigmatizing, and may improve WIC participation.ObjectiveTo estimate the state-level association between transition from paper vouchers to EBT and subsequent WIC participation.Design, setting, and participantsThis economic evaluation of state-level WIC monthly benefit summary administrative data regarding participation between October 1, 2014, and November 30, 2019, compared states that did and did not implement WIC EBT during this time period. Difference-in-differences regression modeling allowed associations to vary by time since policy implementation and included stratified analyses for key subgroups (pregnant and postpartum women, infants younger than 1 year, and children aged 1-4 years). All models included dummy variables denoting state, year, and month as covariates. Data analyses were performed between March 1 and June 15, 2020.ExposuresStatewide transition from WIC paper vouchers to WIC EBT cards, specified by month and year.Main outcomes and measuresMonthly number of state residents enrolled in WIC.ResultsA total of 36 states implemented WIC EBT before or during the study period. EBT and non-EBT states had similar baseline rates of poverty and food insecurity. Three years after statewide WIC EBT implementation, WIC participation increased by 7.78% (95% CI, 3.58%-12.15%) in exposed states compared with unexposed states. In stratified analyses, WIC participation increased by 7.22% among pregnant and postpartum women (95% CI, 2.54%-12.12%), 4.96% among infants younger than 1 year (95% CI, 0.95%-9.12%), and 9.12% among children aged 1 to 4 years (95% CI, 3.19%-15.39%; P for interaction = .20). Results were robust to adjustment for state unemployment and poverty rates, population, and Medicaid expansion status.Conclusions and relevanceIn this study, the transition from paper vouchers to WIC EBT was associated with a significant and sustained increase in enrollment. Interventions that simplify the process of redeeming benefits may be critical for addressing low rates of enrollment in WIC and other government benefit programs.

Dataset Information

WIC Participation and Breastfeeding after the 2009 WIC Revision: A Propensity Score Approach.

Publications

WIC Participation and Breastfeeding after the 2009 WIC Revision: A Propensity Score Approach.

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