title: First- and second-trimester WIC participation is associated with lower rates of breastfeeding and early introduction of cow's milk during infancy.
abstract: BACKGROUND
  Existing literature suggests prenatal participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) may reduce breastfeeding among low-income mothers. However, little is known about whether the timing of WIC entrance during pregnancy influences infant feeding decisions.
  
  
  OBJECTIVE
  This study assesses the association between the timing of prenatal participation in WIC and various infant feeding practices, including breastfeeding initiation, breastfeeding for at least 4 months, exclusive breastfeeding, formula feeding, and early introduction of cow's milk and solid food.
  
  
  METHODS
  Cross-sectional survey matching of birth certificate data to mothers' interviews 9 months after the child's birth. Mothers provided information on participation in the WIC program, infant feeding practices, and sociodemographic characteristics.
  
  
  METHODS
  A nationally representative sample of 4,450 births in 2001 from the Early Childhood Longitudinal Survey-Birth Cohort.
  
  
  METHODS
  Multivariate logistic regression techniques (using STATA 9.0 SE, Stata Company, College Station, TX) estimated the relationship between the timing of prenatal WIC participation and infant feeding practices.
  
  
  RESULTS
  Entry into the WIC program during the first or second trimester of pregnancy is associated with reduced likelihood of initiation of breastfeeding and early cow's milk introduction; and entry during the first trimester is associated with reduced duration of breastfeeding. WIC participation at any trimester is positively related to formula feeding.
  
  
  CONCLUSIONS
  Prenatal WIC participation is associated with a greater likelihood of providing babies infant formula rather than breastmilk after birth. Findings also indicate that there are critical prenatal periods for educating women about the health risks of early cow's milk introduction. Given the health implications of feeding infants cow's milk too early, WIC may be successful in educating women on the health risks of introducing complementary foods early, even if direct counseling on cow's milk is not provided.
authors.affiliation: Institute for Children and Poverty, New York, NY 10003, USA. kziol-guest@icpny.org
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Ziol-Guest
authors.forename: Daphne C
authors.initials: DC
authors.lastname: Hernandez
mesh_terms: D000328:Adult; D000818:Animals; D001942:Breast Feeding / Q000453:epidemiology* / Q000523:psychology*; D053198:Child Nutrition Sciences / Q000193:education*; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000523:psychology*; D041943:Infant Formula / Q000008:administration & dosage / Q000706:statistics & numerical data; D007227:Infant Nutritional Physiological Phenomena / Q000502:physiology; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008892:Milk / Q000009:adverse effects / Q000276:immunology; D009035:Mothers / Q000193:education / Q000523:psychology*; D015999:Multivariate Analysis; D011203:Poverty; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000523:psychology; D011262:Pregnancy Trimester, Second / Q000523:psychology; D011632:Public Assistance; D013997:Time Factors; D055815:Young Adult