A Quasi-Experimental Assessment of the Effect of the 2009 WIC Food Package Revisions on Breastfeeding Outcomes.

Breastfeeding rates among infants participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are consistently lower than those of WIC nonparticipants. The 2009 WIC food package revisions were intended to incentivize breastfeeding among the WIC population. To examine the effectiveness of this policy change, we estimated an intent-to-treat regression-adjusted difference-in-difference model with propensity score weighting, an approach that allowed us to control for both secular trends in breastfeeding and selection bias. We used novel data from the Feeding Infants and Toddlers Survey from 2008 and 2016. We defined our treatment group as infants eligible for WIC based on household income and our control group as infants in households with incomes just above the WIC eligibility threshold. The breastfeeding outcomes we analyzed were whether the infants were ever breastfed, breastfed through 6 months, and breastfed exclusively through 6 months. We observed significant increases in infants that were ever breastfed in both the treatment group (10 percentage points; p < 0.01) and the control group (15 percentage points; p < 0.05); however, we did not find evidence that the difference between the two groups was statistically significant, suggesting that the 2009 revisions may not have had an effect on any of these breastfeeding outcomes.

Feasibility of a Multidisciplinary and Culturally Adapted Pediatric Weight Management Program for Latino Families: Results From the Vidas Activas y Familias Saludables Pilot Study.

OBJECTIVE: To determine the feasibility of a pediatric weight management program for low-income Latino families. METHODS: A pretest-posttest pilot study was conducted among 60 Latino children, aged 4-9, who were overweight/obese (body mass index-for-age ≥85th percentile). The 10-week group-based community program addressed diet, exercise, and behavior modification. Demand was assessed through recruitment and attendance, acceptability using postintervention surveys with participants, and limited efficacy testing of participant anthropometrics and cardiometabolic markers. RESULTS: Overall 65% of families were retained for follow-up. All families reported feeling more confident in making healthier food choices and would participate in the program again. Pre/post intervention testing found statistically significant decreases (P < .05) in body mass index for age z score, waist circumference, and % body fat. CONCLUSIONS AND IMPLICATIONS: This culturally adapted group intervention for Latino families was acceptable and shows promise for improved health status, although it needs to be replicated with a larger group and longer follow-up.

Racial and Ethnic Differences in Reasons for Breastfeeding Cessation Among Women Participating in the Special Supplemental Nutrition Program for Women, Infants, and Children.

INTRODUCTION: Breastfeeding rates among women participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are lower compared with those of nonparticipants. The objective of this study was to assess racial and ethnic differences in self-reported reasons for breastfeeding cessation during the first year postpartum. METHODS: This was a secondary analysis of data from women participating in the WIC Infant and Toddler Feeding Practices Study-2. Women specified reasons that influenced their decision to stop breastfeeding during telephone interviews between 1 and 13 months postpartum. Logistic regression models for each racial and ethnic group explored the effects of sociodemographic variables on each reason. RESULTS: The sample for this analysis included 4095 women (34.1% non-Hispanic white, 25.5% non-Hispanic black, and 40.4% Hispanic). Across all race and ethnic groups, food security status was a predictor of some but not all reasons for breastfeeding cessation. Compared with their counterparts who were food secure, white women with low food security and black women with very low food security were more likely (odds ratio [OR], 1.86; 95% CI, 1.04-3.35 and OR, 1.86; 95% CI, 1.19-2.90, respectively) to stop breastfeeding because they wanted or needed someone else to feed their infants. Hispanic women with very low food security were more likely to stop breastfeeding because they felt they did not have enough milk. Compared with their multiparous counterparts, primiparous black and white women were almost twice as likely to stop breastfeeding because of trouble sucking or latching. Hispanic and black women born outside the United States had significantly higher odds of breastfeeding cessation because of the infant losing interest compared with US-born women. Education and marital status significantly predicted reasons for breastfeeding cessation among Hispanic and white women. DISCUSSION: Among women participating in WIC, food security, parity, country of birth, education, and marital status were significant predictors of reasons for breastfeeding cessation across racial and /ethnic groups. Incorporating these findings in education, counseling, and interventions may help overcome breastfeeding barriers.