Persuading Moms to Breastfeed

One of the federal government’s goals in tweaking the content of its food packages for the Women, Infants and Children (WIC) nutrition program was to encourage more new mothers to breastfeed. The changes, which took effect in 2009, produced mixed results, however.

For many years, WIC has provided low-income new mothers with monthly checks or vouchers to purchase healthy foods to supplement their diets and those of their infants. Mothers have also been offered supplies of infant formula.

WIC staffers, in consultation with the moms, assign food allotments to mothers based on their nutritional needs and whether they are breastfeeding or intend to breastfeed. Under the old guidelines, food allotments for women who did not breastfeed had the highest market value, because they included a full supply of infant formula.

To make breastfeeding more attractive, WIC offered more food for moms who breastfeed fully and lowered the amount of infant formula given to women who partially breastfeed. Vouchers for those monthly food allotments were offered for a year. WIC continued to offer a six-month allotment, with a full supply of infant formula and less food, to mothers who did not breastfeed.

An analysis published in the American Journal of Clinical Nutrition found that while the percentage of women taking advantage of the full breastfeeding allotment increased after the changes, the percentage given the full formula package also increased. Only the allotment for partially breastfeeding mothers had fewer takers.

Perhaps more important, the percent of new mothers who said they tried breastfeeding stayed the same, at about 65 percent.

“There had been some hope that breastfeeding initiation would increase after the policy change,” said Parke E. Wilde, corresponding author and an associate professor at the Friedman School. “While this did not happen, the good news is there was no decrease in breastfeeding initiation, and more mothers did, at least, adopt the full breastfeeding package.”

Wilde points out that some states and localities had better breastfeeding outcomes than others. Recent research out of California has found stronger increases in breastfeeding in agencies that vigorously reached out to WIC participants before they gave birth. It is during pregnancy, Wilde and his colleagues found, that three-quarters of the women decided how they wanted to feed their babies, suggesting that more outreach before delivery may be beneficial.

This article first appeared in the Winter 2013 issue of Tufts Nutrition magazine.