title: WIC participation and breastfeeding among White and Black mothers: data from Mississippi.
abstract: Participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has been associated with lower rates of breastfeeding; studies have suggested this relationship may be modified by race. The purpose of this study is to examine the association between WIC participation and breastfeeding behaviors among white and black women in Mississippi. Using data from the 2004-2008 Mississippi Pregnancy Risk Assessment Monitoring System, we calculated multivariable prevalence and hazard ratios to assess the relationships among WIC participation during pregnancy and breastfeeding initiation and duration through 10 weeks postpartum. Stratified analyses were performed for white and black women. 52.2 % of white and 82.1 % of black women participated in WIC. 60.4 % of white and 39.7 % of black women initiated breastfeeding, and 26.5 % and 21.9 %, respectively, were breastfeeding at 10 weeks postpartum. WIC participation was negatively associated with breastfeeding initiation among whites (APR: 0.87; 95 % CI 0.77-0.99), but not blacks (APR: 0.99; 95 % CI 0.28-1.21). WIC participation was not associated with breastfeeding duration for women of either race (white: AHR: 1.05, 95 % CI 0.80-1.38; black: AHR: 0.91, 95 % CI 0.65-1.26). The results among white women suggest that Mississippi WIC might benefit from an in depth evaluation of the program's breastfeeding promotional activities to determine if aspects of the program are undermining breastfeeding initiation. High rates of participation in the WIC program among black women, and the overall low rates of breastfeeding in this population point to the potential the program has to increase breastfeeding rates among blacks.
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA, cassiejm@berkeley.edu.
authors.forename: Cassondra
authors.initials: C
authors.lastname: Marshall
authors.forename: Loretta
authors.initials: L
authors.lastname: Gavin
authors.forename: Connie
authors.initials: C
authors.lastname: Bish
authors.forename: Amy
authors.initials: A
authors.lastname: Winter
authors.forename: Letitia
authors.initials: L
authors.lastname: Williams
authors.forename: Mary
authors.initials: M
authors.lastname: Wesley
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D001942:Breast Feeding / Q000208:ethnology / Q000706:statistics & numerical data*; D005260:Female; D006293:Health Promotion; D006801:Humans; D007223:Infant; D008922:Mississippi / Q000453:epidemiology; D009035:Mothers / Q000706:statistics & numerical data*; D011203:Poverty; D011632:Public Assistance / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult