Breastfeeding Duration Is Associated With WIC Site-Level Breastfeeding Support Practices

Objective: To describe Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) site - level breastfeeding support practices and associations with breastfeeding outcomes. Design: Secondary analysis of WIC Infant and Toddler Feeding Practices Study -2, including data from in- terviews with caregivers of infants and interviews and surveys with staff from 27 WIC state agencies and 80 study sites. Participants: A total of 1,235 mothers of breastfed infants participating in the WIC Infant and Toddler Feeding Practices Study -2. Main Outcome Measure: Any and fully breastfeeding 2, 6, and 12 months postpartum. Analysis: Descriptive statistics described WIC site -level breastfeeding supports. Multilevel mixed modeling of breastfeeding at 2, 6, and 12 months, controlling for site- and participant -level characteristics. Results: Five WIC site -level supports were significantly and independently associated with any and fully breastfeeding: access to breastfeeding peer counselors, access to International Board Certified Lactation Consultants, postnatal home visits, allowing any WIC staff member to provide breast pump education, and having a policy not to provide formula during the first 30 days postpartum. Likelihood of any and fully breastfeeding increased with each additional site -level support present (odds ratio = 1.09, 95% confidence interval, 1.06 -1.12; and odds ratio = 1.26, 95% confidence interval, 1.21 -1.31, respectively). Conclusions and Implications: Positive associations between site -level supports and breastfeeding at 2, 6, and 12 months were observed. Additional research is needed to understand how site -level supports interre- late and whether specific combinations are more effective, and to identify variations in implementation of breastfeeding supports.