1. WIC Infant Toddler Feeding Practices Study – 2: Infant Year Report
2017 National WIC Association
Annual Education and Training Conference & Exhibits
Courtney Paolicelli, USDA FNS
Nancy Weinfield, Westat
Shannon Whaley, PHFE WIC

2. Purpose The Feeding My Baby Study (WIC ITFPS-2) addresses:
Infants’ and children’s feeding practices
Associations between WIC services and:
feeding practices
Health and nutrition outcomes of children receiving WIC.
Infant Year Report Focus:
Breastfeeding initiation and duration, and
Introduction of complementary foods.
Comparisons with the 1997 WIC Infant Feeding Practices Study–1 (WIC IFPS-1).

3. Methodology Longitudinal study
Follows infants enrolled in WIC from birth to age 5
Nationally representative
Began Fall 2013

4. Study Participants Eligibility Requirements
Pregnant or infant less than 2.5 months old
First time enrolling in WIC for this pregnancy or child
At least 16 years old
Speaks English or Spanish
3,777 infants in sample for this report

5. Study States (27) and Sites (80)

6. Data Collection WIC Site Data Site visits
Key Informant Interviews (State and Local Agency)
WIC staff survey
WIC Participant Data
Enrollment on site
Follow-up telephone interviews
WIC Administrative Data
Height/weight data for those off WIC

7. Data Collection

8. Infant Data Collection
Interviews conducted every 2 months
Incentive for completing telephone interview
N=3,777 caregivers (completed at least a 1 or 3 month interview)
Birth 1 3 5 7 9 11 13

10. Study Sample

11. Demographic Characteristics
Racial and Ethnic Distributions
Hispanic/ Latino
38%
Non-Hispanic
62%

12. Demographic Characteristics
Mother’s Age
Parity
Third or
Subsequent
born
16-19
years
26+
years
First born
Second born

13. Breastfeeding Beliefs and Intentions

14. Prenatal Views: Benefits of Breastfeeding
Maternal Attitudes and Beliefs
Percentage of Mothers Agreeing with Statement
WIC IFPS-1
( )
WIC ITFPS-2
( )
Direction
of Change
Benefits of Breastfeeding
Breastfed babies are healthier than formula-fed babies. 61
79.7 ↑
Breastfeeding helps protect the baby from diseases. 77
81.2
Breastfeeding is easier than formula feeding. 50
55.3
Breastfeeding brings a mother closer to her baby. 81
87.9
Breastmilk alone gives a new baby all he/she needs to eat. 71
71.3
Breastfeeding reduces the risk of a child becoming overweight.
Not Asked
50.0 --
Breastfeeding helps women lose weight. 53
74.5

15. Prenatal Views: Barriers to Breastfeeding
Maternal Attitudes and Beliefs
Percentage of Mothers Agreeing with Statement
WIC IFPS-1
( )
WIC ITFPS-2
( )
Direction
of Change
Barriers to Breastfeeding
Breastfeeding ties you down. 41
17.3 ↓
Breastfeeding takes too much time. 34
14.7
Breastmilk leaking onto your clothes is something that I worry about. 46
27.4
Breastfeeding in public is not something that I want to do. 61
36.9
Breastfeeding is painful. 39
43.6 ↑
Breastfeeding means no one else can feed your baby. 48
50.8
With bottle feeding, the mother knows that the baby is getting enough to eat. 76
67.0

16. Infant Feeding Intention (IFI) Scale Scores
0-16 point scale composed from five questions
Higher scores = stronger intention to breastfeed
Nearly ¾ of prenatal WIC participants have a moderate to very strong intention to exclusively breastfeed.

17. Breastfeeding Behaviors

18. Breastfeeding Rates Increased Since 1994
NOTE: Similar slopes in trend lines between studies.

19. Breastfeeding Initiation by Race and EthnicityNA

20. Expressing Breastmilk
Percentage of Breastfeeding Mothers Who Report Expressing Breastmilk During the Past Week

21. Rates of Exclusive Breastfeeding and Combination Feeding
Healthy People 2020 Goals: 46% exclusively breastfeeding through 3 months; 26% exclusively feeding through 6 months

22. Top Reasons for Breastfeeding Cessation
At 3 months, top reasons why mothers stopped breastfeeding:
Breastmilk alone did not satisfy baby (57%)
I didn’t produce enough breastmilk (56%)
Baby lost interest in nursing (34%)

23. Moms Not Breastfeeding As Long As They Intended

24. Introduction of Complementary Foods

25. Early Introduction of Complementary Foods is Less Prevalent
WIC IFPS-1 ( )
WIC ITFPS-2 ( )

26. Complementary Foods Are Being Introduced Later
Mean Age (in Months) Infants Were Introduced to Complementary Foods

27. Caregivers’ Perceptions of WIC

28. WIC Positively Impacts Breastfeeding Behaviors
For > 95% of breastfeeding mothers, WIC played an important role in breastfeeding decision
61% identified the enhanced food package as an important factor in their breastfeeding decision
Moms aware of the enhanced food package breastfed for 1.5 months longer

29. WIC is a Trusted Source of Information on Infant Feeding

30. Additional Support Provided by WIC
Postpartum women who received support calls from WIC were more likely to be breastfeeding exclusively at 1 month

31. Perceived Influence of WIC on Feeding
About 60% of study mothers indicate they made positive changes in feeding practices because of something they learned at WIC.
Most common changes at 13 months were:
Know how to choose more healthy foods for myself/family (34%)
Eat more fruits and vegetables (27%)

32. Key Findings
Breastfeeding rates have risen dramatically over the past 20 years.
Early introduction of complementary foods is less prevalent among WIC participants than previously.
Caregivers credited WIC with making positive changes in how they feed their infants and themselves.
Participants reported extensive support from WIC.

33. Future Directions

34. Next Steps Analyzing toddler data through 24 months
Currently collecting 36 & 42 month data (48 month data collection starts in late April!)

35. How You Can Stay Involved
Download the full report

36. How You Can Stay Involved

37. How You Can Stay Involved

38. How You Can Stay Involved

39. How You Can Stay Involved
Download the full report
Share the infographic
You can also check out the fabulous infographic that our partners at Westat created for the Infant Year REport.

40. How You Can Stay Involved

41. How You Can Stay Involved
Download the full report
Check out the infographic
Support the study team with final rounds of data collection
Of course, if you’re one of the lucky folks who works at a WIC clinic or state agency that is involved in the study, first off, we sincerely THANK YOU for your support and your cooperation, and we encourage you to continue supporting these study activities.
As some of you may already be aware, our state agencies and sites help with a number aspects of data collection. Several of them assist us with putting together our IRB packets.

42. Height/Weight Card
Additionally, study participants who are no longer receiving WIC are still eligible to participate in the study. But in order to obtain accurate height/weight data, we send them this card and ask them to go back to their WIC clinic and get this information completed. We truly appreciate the dedication and commitment of staff who help us by getting this info from non-participants.
The study will be done with data collection in just a couple years, so we’re almost there! We truly do appreciate the help of our folks on the ground that are making sure we get this data so we can tell the story of how WIC is impacting so many participants.

43. Courtney.Paolicelli@fns.usda.gov 703.605.4370
Thank you!