The WIC Infant and Toddler Feeding Practices Study-2 (WIC ITFPS-2) Through Age 5: What We've Learned, What Questions Remain, and How You Can Use This Longitudinal Dataset

Objectives By the end of the session, attendees will be able to: (1) Articulate the methodology of and notable findings from the USDA WIC Infant and Toddler Feeding Practices Study-2 (WIC ITFPS-2); and (2) Summarize the major domains of data available through age 5 in the WIC ITFPS-2 public use dataset. Methods The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is the premier public health nutrition program for low-income, nutritionally at-risk pregnant and post-partum women, infants, and children up to age five. To better understand how WIC participation is associated with the health and nutrition outcomes of young children, USDA funded the WIC Infant and Toddler Feeding Practices Study-2 (ITFPS-2) in 2011. WIC ITFPS-2 is a national, longitudinal study of 3775 mother-child dyads who enrolled in WIC either during the mother's pregnancy or shortly after the child was born. The study interviews participants every 2 to 6 months through the child's fifth birthday, with two additional follow-ups at ages 6 and 9 years. The study captures information on children's health and nutrition status, including 24 hour dietary recall data; mothers’ feeding practices and beliefs; household food security; and WIC participation patterns. Data are weighted to produce national estimates. As of June 2021, data through children's fifth birthday (i.e., all years during which children were categorically eligible for WIC) are publicly available. Results Using descriptive, univariate, and multivariate techniques, analyses across the first 6 study reports have demonstrated positive associations between WIC and diet outcomes among young children. After controlling for other factors, longer WIC participation was associated with higher Health Eating Index-2015 scores at various time points, with lower daily energy intake, and with meeting the Dietary Guidelines recommendation to limit added sugar. Conclusions Across children's first five years of life, WIC participation has been associated with improved dietary intake and better diet quality, among other positive outcomes. The WIC ITFPS-2 dataset is publicly available and should be leveraged by researchers to further explore the health and nutrition status of low-income children during the early years of life. Funding Sources WIC ITFPS-2 is funded by USDA contract number AG-3198-B-11–0020 with Westat.

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

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 <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.