Exposure to Baby-Friendly Hospital Practices and Breastfeeding Outcomes of WIC Participants in Maryland

2021 ◽  
pp. 089033442199377
Author(s):  
Kirstie Ducharme-Smith ◽  
Susan M. Gross ◽  
Amy Resnik ◽  
Nadine Rosenblum ◽  
Chloe Dillaway ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
The United States ◽  
Infants And Children ◽  
Self Report ◽  
Supplemental Nutrition ◽  
Nutrition Program ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Breastfeeding Practices ◽  
Supplemental Nutrition Program

Background The Baby-Friendly Hospital Initiative is an effective intervention to support maternal practices around breastfeeding. However, adherence of hospitals to the Baby-Friendly 10 Steps, as determined from the perspective of women participating in the United States Special Supplemental Nutrition Program for Women, Infants, and Children, has not been assessed. Research Aims (1) To compare maternal perceptions about maternity practices in Baby-Friendly Hospitals and non-Baby-Friendly Hospitals; (2) to evaluate the associations between degree of exposure to the Baby-Friendly 10 Steps and breastfeeding practices through the first 6 months; and (3) to evaluate whether the receipt of specific Steps was associated with breastfeeding practices through 6 months. Methods This study was a cross-sectional 2 group comparison, using prospective data collected through a self-report telephone survey and retrospective data gathered from participants’ records. Women ( N = 182) participating in four Maryland Special Supplemental Nutrition Program for Women, Infants and Children agencies were recruited. One hundred and eight (59%) participants delivered at designated Baby-Friendly Hospitals; 74 (41%) delivered in non-Baby-Friendly designated hospitals. Logistic regression models were utilized to determine the influence of perceived Step adherence on exclusive breastfeeding. Results Reported adherence to 10-Steps policies ranged from 10%–85% (lowest for Step 9, highest for Step 10) and only Step 9 (give no pacifiers or artificial nipples to breastfeeding infants) differed according to Baby-Friendly Hospital status. Greater exposure to the 10 Steps was positively associated with exclusive breastfeeding during hospitalization. The lack of perceived adherence to Step 6 (no food or drink other than human milk), Step 9, and the International Code of Marketing of Breast-milk Substitutes (no formula, bottles, or artificial nipples) significantly decreased the likelihood of exclusive breastfeeding through 6 months. Conclusion Maternal perception of Baby-Friendly Step adherence was associated with exclusive breastfeeding.

scholarly journals Association Between Usage of an App to Redeem Prescribed Food Benefits and Redemption Behaviors Among the Special Supplemental Nutrition Program for Women, Infants, and Children Participants: Cross-Sectional Study (Preprint)

2020 ◽  
Author(s):  
Qi Zhang ◽  
Junzhou Zhang ◽  
Kayoung Park ◽  
Chuanyi Tang
Keyword(s):  
Infant Formula ◽  
Low Income ◽  
The United States ◽  
Cross Sectional Study ◽  
Infants And Children ◽  
Supplemental Nutrition ◽  
Nutrition Program ◽  
Cross Sectional ◽  
Supplemental Nutrition Program ◽  
The Difference

BACKGROUND The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is one of the most important food assistance programs in the United States, serving 6.4 million low-income, eligible women, infants, and children under 5 years of age in 2019. In the program, participants are prescribed a list of food benefits, which can be redeemed in WIC-authorized stores. However, there are multiple behavioral barriers in the program and the stores that prevent participants from redeeming the benefits fully. OBJECTIVE This study aims to examine the relationship between the use of a widely used mobile phone app, WICShopper, and the redemption of the prescribed food packages. METHODS WIC administrative data were obtained from West Virginia for the period January 2019 to January 2020 and included 30,440 WIC households that had received food benefits in that period. The redemption rates of 18 WIC food benefits were compared between app users and nonapp users, that is, those who never used the app in the study period. The use behaviors were defined for the app users, including the number of active use benefit cycles, active benefit cycle rates, number of active use days in the cycle, and proportion rates of daytime use. Panel linear regressions were applied to examine how the redemption rates were related to these behaviors over time. RESULTS App users consistently had higher average redemption rates than nonapp users; the difference ranged from 3.6% (4.8% relative) for infant formula to 14.3% (40.7% relative) for fish. After controlling for sociodemographics, the coefficients of app use were significantly positive for all benefit categories except for WIC-eligible nutritionals. More active cycles and active days in the cycle were significantly related to redemption rates for all categories, except for frozen juice (coefficient=−0.002, <i>P</i>=.09). Daytime app access was positively associated with redemption rates for most food benefits except only a few, such as infant formula (coefficient=−0.03, <i>P</i>&lt;.001). CONCLUSIONS Use of the WIC app was significantly related to higher redemption rates across food benefits, although the association varied across benefit categories. More active days were positively related to benefit redemptions across food categories, and the app’s daytime use was positively associated with the redemption of most benefit categories. These findings suggest that the WIC app can be an important tool for the promotion of benefit redemption among WIC participants.

scholarly journals Association Between Usage of an App to Redeem Prescribed Food Benefits and Redemption Behaviors Among the Special Supplemental Nutrition Program for Women, Infants, and Children Participants: Cross-Sectional Study

10.2196/20720 ◽  
2020 ◽  
Vol 8 (10) ◽  
pp. e20720 ◽  
Author(s):  
Qi Zhang ◽  
Junzhou Zhang ◽  
Kayoung Park ◽  
Chuanyi Tang
Keyword(s):  
Infant Formula ◽  
Low Income ◽  
The United States ◽  
Cross Sectional Study ◽  
Infants And Children ◽  
Supplemental Nutrition ◽  
Nutrition Program ◽  
Cross Sectional ◽  
Supplemental Nutrition Program ◽  
The Difference

Background The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is one of the most important food assistance programs in the United States, serving 6.4 million low-income, eligible women, infants, and children under 5 years of age in 2019. In the program, participants are prescribed a list of food benefits, which can be redeemed in WIC-authorized stores. However, there are multiple behavioral barriers in the program and the stores that prevent participants from redeeming the benefits fully. Objective This study aims to examine the relationship between the use of a widely used mobile phone app, WICShopper, and the redemption of the prescribed food packages. Methods WIC administrative data were obtained from West Virginia for the period January 2019 to January 2020 and included 30,440 WIC households that had received food benefits in that period. The redemption rates of 18 WIC food benefits were compared between app users and nonapp users, that is, those who never used the app in the study period. The use behaviors were defined for the app users, including the number of active use benefit cycles, active benefit cycle rates, number of active use days in the cycle, and proportion rates of daytime use. Panel linear regressions were applied to examine how the redemption rates were related to these behaviors over time. Results App users consistently had higher average redemption rates than nonapp users; the difference ranged from 3.6% (4.8% relative) for infant formula to 14.3% (40.7% relative) for fish. After controlling for sociodemographics, the coefficients of app use were significantly positive for all benefit categories except for WIC-eligible nutritionals. More active cycles and active days in the cycle were significantly related to redemption rates for all categories, except for frozen juice (coefficient=−0.002, P=.09). Daytime app access was positively associated with redemption rates for most food benefits except only a few, such as infant formula (coefficient=−0.03, P<.001). Conclusions Use of the WIC app was significantly related to higher redemption rates across food benefits, although the association varied across benefit categories. More active days were positively related to benefit redemptions across food categories, and the app’s daytime use was positively associated with the redemption of most benefit categories. These findings suggest that the WIC app can be an important tool for the promotion of benefit redemption among WIC participants.

Another Look at WIC’s Breastfeeding Data: State Totals Reveal More Than Regional Averages

2018 ◽  
Vol 35 (1) ◽  
pp. 37-41 ◽  
Author(s):  
Shari Salzhauer Berkowitz
Keyword(s):  
Native American ◽  
Local Level ◽  
The United States ◽  
Regional Level ◽  
Infants And Children ◽  
Fiscal Year ◽  
Future Research ◽  
Supplemental Nutrition ◽  
Nutrition Program ◽  
Supplemental Nutrition Program

Background: Breastfeeding is known to be the most beneficial way of feeding infants, but 68% of the infants enrolled in the U.S. Department of Agriculture’s Special Supplemental Nutrition Program for Women, Infants, and Children are fully formula fed. Mandated annual reports about breastfeeding aggregate data from the states into regions, which obscures important information. Research Aim: The aim of this study is to reexamine the data supplied by the Special Supplemental Nutrition Program for Women, Infants, and Children to identify which areas of the United States have the lowest incidence of breastfeeding infants. Methods: A retrospective cross-sectional observational study was conducted. Data from the Breastfeeding Data Local Agency Report were extracted, graphed, and analyzed. Results: Data provided from the Special Supplemental Nutrition Program for Women, Infants, and Children for fiscal year 2016 show that the range of fully formula fed infants at the regional level is 60% to 78%, while at the state level the range is wider, at 51% to 89%. The states with the largest numbers of fully formula fed infants were Mississippi (89%), Louisiana (88%), Alabama (88%), and Arkansas (87%). When examining data from all 90 reporting agencies, the range of fully formula fed infants was 38% to 95%. Conclusions: Aggregating state, Native American nation, and territorial data at the regional level resulted in a loss of important information. WIC’s current breastfeeding interventions may be more effective in some areas than others. Future research can examine successful and unsuccessful interventions on a state or local level.

The Special Supplemental Nutrition Program for Women, Infants, and Children is Associated with Several Changes in Nutrient Intakes and Food Consumption Patterns of Participating Infants and Young Children, 2008 Compared with 2016

2020 ◽  
Vol 150 (11) ◽  
pp. 2985-2993
Author(s):  
Joanne F Guthrie ◽  
Andrea S Anater ◽  
Joel C Hampton ◽  
Diane J Catellier ◽  
Alison L Eldridge ◽  
...  
Keyword(s):  
Saturated Fat ◽  
Food Group ◽  
Infants And Children ◽  
Baby Food ◽  
Food Groups ◽  
Supplemental Nutrition ◽  
Nutrition Program ◽  
Cross Sectional ◽  
Wic Participation ◽  
Supplemental Nutrition Program

ABSTRACT Background In 2009 the USDA's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) updated the food packages provided to participants. Objectives This study investigates associations between WIC participation and nutrients and food groups consumed using data from the Feeding Infants and Toddlers Study's 2008 and 2016 nationwide, cross-sectional surveys of children &lt;4 y, weighted to be representative of the US population. Methods The study data included 2892 children aged 6–47.9 mo in 2008 and 2635 in 2016. Differences were analyzed by WIC participation, survey year, and child age (infants 6–11.9 mo old, toddlers 12–23.9 mo old, preschoolers 24–47.9 mo old). Usual nutrient intake distributions were estimated using National Cancer Institute methodology. Daily food group consumption differences were tested via multivariate regression. All analyses controlled for income. Results In 2016 18.6% of infants had iron intakes below the estimated average requirement (EAR), compared to 7.6% in 2008; 87% of WIC infants met the EAR, compared with 69% of non-WIC infants. In 2016 37% of WIC preschoolers met saturated fat guidelines, compared with 25% in 2008; in both years, fewer than one-third of non-WIC preschoolers met the guidelines. More WIC infants than non-WIC infants consumed infant cereals in 2016 (58% compared with 45%, respectively). More WIC infants ate vegetables daily in 2016 than in 2008 (74% compared with 59%, respectively).  In 2016, as compared with 2008, more WIC infants consumed baby-food vegetables (55% compared with 29%, respectively) and fruits (56% compared with 41%, respectively). In 2016 47% of WIC preschoolers drank low-fat milk, compared with 19% of non-WIC preschoolers. Conclusions Infant iron intakes are concerning, although more WIC infants meet the EAR. WIC infants’ vegetable intakes have improved; baby-food vegetables have become important contributors to their intakes. In 2016 WIC children were more likely than non-WIC children to shift to lower-fat milks at 2 y of age, likely contributing to lower saturated fat intakes.

scholarly journals USDA Special Supplemental Nutrition Program for Women, Infants and Children (WIC) Vendor Criteria: An Examination of US Administrative Agency Variations

2021 ◽  
Vol 18 (7) ◽  
pp. 3545
Author(s):  
Matthew J. Landry ◽  
Kim Phan ◽  
Jared T. McGuirt ◽  
Alek Ostrander ◽  
Lilian Ademu ◽  
...  
Keyword(s):  
Local Community ◽  
Ethnic Disparities ◽  
The United States ◽  
Healthy Food ◽  
Infants And Children ◽  
United States Department ◽  
Supplemental Nutrition ◽  
Nutrition Program ◽  
Food And Beverage ◽  
Supplemental Nutrition Program

The food retail environment has been directly linked to disparities in dietary behaviors and may in part explain racial and ethnic disparities in pregnancy-related deaths. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC), administered by the United States Department of Agriculture, is associated with improved healthy food and beverage access due to its requirement for minimum stock of healthy foods and beverages in WIC-eligible stores. The selection and authorization criteria used to authorize WIC vendors varies widely from state to state with little known about the specific variations. This paper reviews and summarizes the differences across 16 of these criteria enacted by 89 WIC administrative agencies: the 50 states, the District of Columbia, five US Territories, and 33 Indian Tribal Organizations. Vendor selection and authorization criteria varied across WIC agencies without any consistent pattern. The wide variations in criteria and policies raise questions about the rational for inconsistency. Some of these variations, in combination, may result in reduced access to WIC-approved foods and beverages by WIC participants. For example, minimum square footage and/or number of cash register criteria may limit vendors to larger retail operations that are not typically located in high-risk, under-resourced communities where WIC vendors are most needed. Results highlight an opportunity to convene WIC stakeholders to review variations, their rationale, and implications thereof especially as this process could result in improved policies to ensure and improve healthy food and beverage access by WIC participants. More work remains to better understand the value of state WIC vendor authorization authority, particularly in states that have provided stronger monitoring requirements. This work might also examine if and how streamlining WIC vendor criteria (or at least certain components of them) across regional areas or across the country could provide an opportunity to advance interstate commerce and promote an equitable supply of food across the food system, while ensuring the protection for local, community-oriented WIC vendors.

scholarly journals Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) authorization of discount variety stores: leveraging the private sector to modestly increase availability of healthy foods

2020 ◽  
Vol 111 (6) ◽  
pp. 1278-1285
Author(s):  
Katelin M Hudak ◽  
Rajib Paul ◽  
Shafie Gholizadeh ◽  
Wlodek Zadrozny ◽  
Elizabeth F Racine
Keyword(s):  
Low Income ◽  
The United States ◽  
Grocery Store ◽  
Infants And Children ◽  
Healthy Foods ◽  
Supplemental Nutrition ◽  
Nutrition Program ◽  
Snack Foods ◽  
Supplemental Nutrition Program ◽  
Salty Snack

Abstract Background Many lower-income communities in the United States lack a full-line grocery store. There is evidence that the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) increases the availability of healthy foods in stores. One national discount variety store chain (DVS) that is often located in low-income neighborhoods became an authorized WIC vendor in 8 pilot stores. Objectives The objective of this study was to evaluate how implementing WIC in DVS pilot stores affected sales of healthy, WIC-eligible foods. Methods We used DVS sales data and difference-in-differences regression to evaluate how WIC authorization affected sales of WIC-eligible foods in 8 DVS pilot stores, compared with 8 matched comparison stores. Results DVS added 18 new WIC-approved foods to become an authorized vendor. Results indicate that becoming a WIC vendor significantly increased sales of healthy, WIC-eligible foods that DVS carried before authorization. WIC implementation in DVS led to a 31-unit increase in sales of the original WIC foods per week on average (P &lt; 0.01). Lower socioeconomic status, assessed using a summary measure, is associated with increased sales of WIC foods. Yet sales of non-WIC eligible foods (e.g., salty snack foods, candy bars, soda, and processed meats) were not affected by WIC authorization. Conclusions Encouraging DVS stores to become WIC-authorized vendors has the potential to modestly increase DVS sales and the availability of healthy foods in low-income neighborhoods. If WIC authorization is financially viable for small-format variety stores, encouraging similar small-format variety stores to become WIC-authorized has the potential to improve food access.

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