Despite the many benefits of breastfeeding—fewer ear infections, fewer bouts of diarrhea, less risk of asthma, less risk of Sudden Infant Death Syndrome (SIDS)—fewer mothers are breastfeeding exclusively and/or for longer periods of time. According to data from the Centers for Disease Control and Prevention (CDC), a record number of US women initiated breastfeeding in 2005 (74 percent), but only 11 percent breastfed exclusively for 6 months.

Factors associated with shorter duration of breastfeeding were the subject of a review article published in the February issue of JOGNN. A variety of physical, social, psychological, and demographic variables were identified. Among the demographic variables was—participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), age, race, socioeconomic status, and marital status. In other words, the authors found that women who were black, young, single, less educated, poor, and enrolled in WIC were less likely to breastfeed their babies for 6 months or more, compared with women who did not meet these criteria.  

A prior study published in 2005 found that women eligible for WIC but not enrolled in WIC were more likely to breastfeed compared to those actually enrolled in WIC. Li and colleagues reported that 63 percent of WIC children were breastfed compared to 86 percent of children eligible for WIC but not enrolled. The authors theorized that, “Because WIC provides free formula for eligible children it is possible that women who are determined to breastfeed feel less need to participate in WIC.”

This raises the question—Does WIC discourage breastfeeding?

As a government program administered by the United States Department of Agriculture (USDA) Food and Nutrition Service (FNS), WIC has long been criticized for giving free formula to babies. But to fully understand WIC’s role in formula distribution, you need to understand the origin of WIC. Established in 1972 and permanently authorized in 1974, WIC was designed to meet the nutritional needs of low-income pregnant, breastfeeding, and postpartum women, infants and children up to five years of age who are considered at risk for poor nutrition.

The WIC program began as a pilot project and was eventually expanded to include all 50 states, the District of Columbia, 5 territories (Northern Mariana, Puerto Rico, Guam, American Samoa, the US Virgin Islands), and 34 Indian Tribal Organizations. WIC participants are given supplemental foods, nutrition education, breastfeeding support, and referrals to health and social services. WIC serves nearly 9 million women, infants, and children each month—more than 50 percent of US infants, 25 percent of US children ages 1 through 4 years, and many of their mothers. In 2007, WIC was among the 17 percent of government programs given the highest effectiveness rating. (Makes you wonder how the remaining 83 percent were rated?)

In 1971, shortly before WIC was established, US breastfeeding rates were at a record low, with 24 percent of US mothers initiating breastfeeding and only 5 percent breastfeeding at 6 months.  A steady increase in breastfeeding rates was reported from 1971 to 1982, followed by a sharp decline of 13 percent between 1984 and 1989. Since 1989 breastfeeding rates have increased significantly, with the greatest gains among women least likely to breastfeed—those who are black, less than 25 years of age, low-income, less-educated, living in the Southeastern US, employed full-time outside the home, and enrolled in WIC.

It would appear that WIC is doing something right. Since its inception, WIC has expanded its breastfeeding promotion efforts—appointing state breastfeeding coordinators, launching a series of campaigns targeting mothers, fathers, and communities, enacting breastfeeding legislation, establishing breastfeeding peer counselor programs, and most recently, revising its food packages. For the first time, WIC food packages reward those moms who breastfeed exclusively and for longer periods of time.

The more fully a mother breastfeeds (exclusively, partially, minimally, or not at all) the more foods she and her baby receive each month. Mothers who breastfeed exclusively for 6 months get the most food and the greatest variety—milk, cheese, cereal, juice, eggs, beans, peanut butter, whole grains, fruits, vegetables, and fish! Also, mothers who breastfeed get nutrition education and breastfeeding support services for up to 1 year after their babies are born, compared to only 6 months of WIC services for those who formula-feed.

Babies benefit too! Not only do babies get all the benefits that come with exclusive breastfeeding, but babies exclusively breastfed for 6 months receive twice as many jars of fruits and vegetables as formula-fed babies (64 jars instead of 32). As an added bonus, babies exclusively breastfed get 31 jars of meats compared to 0 jars for babies partially breastfed or formula-fed.

More food. More services. Healthier moms. Healthier babies. That’s one way to quiet the critics. Kudos to WIC!