Issue: The Special Supplemental Nutrition Program for

Women, Infants, and Children (WIC) promotes breastfeeding as the preferred method for feeding infants. The

breastfeeding rates among women participating in WIC,

although improving, continue to be significantly lower

than the Healthy People 2010 target established by the

U.S. Department of Health and Human Services—that at

least 75 percent of women initiate breastfeeding and at

least 50 percent continue breastfeeding for at least 6

months. WIC faces several challenges in increasing breastfeeding among program participants. 

Background: The American Academy of Pediatrics

(AAP) recognizes breastfeeding as the preferred method

of feeding infants and achieving optimal infant and child

health, growth, and development. AAP recommends exclusive breastfeeding for approximately the first 6 months

after birth and the gradual introduction of iron-enriched

foods in the second half of the infant’s first year to complement the breastmilk diet. Breastfeeding is recommended for at least 12 months and thereafter for as long as

mutually desired. In addition to health benefits, a recent

Economic Research Service study estimates that a minimum $3.6 billion would be saved if the prevalence of

exclusive breastfeeding increased from 1998 rates to those

recommended by the Surgeon General. These savings

would result from reducing both direct costs (such as formula costs and physician fees) and indirect costs (such as

time lost by parents attending to an ill child). 

On average, 1.9 million infants per month, or almost half

of all infants in the United States, participate in the WIC

program. WIC, through its nutrition education and breastfeeding promotion programs, encourages mothers to

breastfeed their infants if possible. WIC State agencies are

required to hire a breastfeeding promotion coordinator,

educate local agency staff on the benefits of breastfeeding,

and coordinate promotion with programs in the State.

Breastfeeding women have a higher priority for certification into the program than nonbreastfeeding postpartum

women and they are eligible to participate in WIC longer

than non-breastfeeding mothers. Mothers who exclusively

breastfeed their infants receive an enhanced food package

containing additional foods and larger quantities of other

foods. Breastfeeding mothers can also receive breast

pumps and other breastfeeding aids to help support the initiation and continuation of breastfeeding. Meanwhile,

WIC provides infants who are not exclusively breastfeeding with up to 806 reconstituted fluid ounces of infant formula (the equivalent of over 100 8-ounce bottles) per

month. ERS estimates that infants participating in WIC

consume about 54 percent of all formula sold in the

United States.

Findings: Despite recent science on the benefits of breastfeeding, many women choose to formula-feed their children. Lack of public acceptance, maternity hospital practices, aggressive formula product marketing and difficulties and inconvenience associated with breastfeeding while

working outside the home are among the reasons that have

been cited as contributing to many women not breastfeeding their child. 

Breastfeeding rates among WIC women, both while they

and their infants are in the hospital immediately after the

babies’ birth as well as when their babies are 6 months of

age, have historically been significantly lower than those

of non-WIC women. For example, 57 percent of WIC

women initiated breastfeeding while in the hospital in

2000, compared to 78 percent of non-WIC women. Rates

of breastfeeding at 6 months of age were also lower for

WIC women than non-WIC women (20 percent versus 41

percent) (fig. 1).

WIC faces a number of challenges in increasing the prevalence of breastfeeding. The amount of time WIC staff have

to encourage and counsel pregnant women on breastfeeding is limited. In addition, a woman’s decision to breastUnited States

Department of

Agriculture

Economic 

Research

Service

WIC School

meals

CACPF General

Food Assistance and Nutrition Research Report Number 34-2 July 2003

WIC and Breastfeeding

Rates

Food Assistance Research Brief

Victor Oliveira, victoro@ers.usda.gov, (202) 694-5434
2 Economic Research Service / USDA

WIC and Breastfeeding Rates / FANRR-34-2

feed may be influenced by a number of other factors

beyond WIC’s control such as the attitudes of her family

and friends, her physician, and community views. An

additional challenge is the result of recent welfare reform

legislation that emphasizes working. A mother who works

outside the home must have a place and time to nurse her

baby or be able to express and store her milk for bottle

feeding. The types of businesses that employ WIC women

are believed to be less likely to have the facilities and procedures to accommodate these daily breastfeeding needs. 

Since the breastfeeding rate of women participating in

WIC is lower than that of women not in the program,

some have questioned whether WIC, by supplying infant

formula, provides a disincentive to breastfeeding.

However, women most likely to participate in WIC,

including mothers who are poor and have low education

levels, are generally less likely to breastfeed their children.

Summary: The prevalence of breastfeeding among WIC

women is on the rise. The percentage of WIC women who

initiated breastfeeding increased by 69 percent from 1990

to 2000 while the percentage who breastfed at 6 months

increased by 145 percent. Despite the increase, breastfeeding rates among WIC women remain far below the

Healthy People 2010 target. Furthermore, although the gap

in breastfeeding initiation rates while in the hospital

between WIC and non-WIC mothers decreased during the

1990’s, the gap at 6-months of age widened. WIC breastfeeding rates, although improving, continue to be significantly lower than the Healthy People 2010 target established by the U.S. Department of Health and Human

Services that at least 75 percent of women initiate breastfeeding and at least 50 percent continue breastfeeding for

at least six months. More research is needed to determine

the most effective breastfeeding promotion and support

measures to increase breastfeeding among WIC participants. ERS is funding a study of the impact of individualized professional lactation support upon child health care

costs, breastfeeding practices, and child health outcomes.

Information Sources:

Abbot Laboratories, Ross Products Division. Ross Mother

Survey: Breastfeeding Trends Through 2000. Unpublished

Report, 2001.

U.S. General Accounting Office. Breastfeeding: WIC’s Efforts to

Promote Breastfeeding Have Increased. GAO/HRD-94-13.

December 1993. 

Weimer, J.P. The Economic Benefits of Breastfeeding: A Review

and Analysis. FANRR-13. U.S. Department of Agriculture.

Economic Research Service. March 2001. 

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, sex,

religion, age, disability, political beliefs, sexual orientation, or marital or family status. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET

Center at (202) 720-2600 (voice and TDD).

To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 14th and Independence Avenue,

SW, Washington, DC 20250-9410, or call (202) 720-5964 (voice and TDD). USDA is an equal opportunity provider and employer.

Figure 1. Breastfeeding rates by WIC status in-hospital

and at 6 months, 1990-2000

Percent

0

10

20

30

40

50

60

70

80

90

WIC in-hospital

Non-WIC 6 months

WIC 6 months

Non-WIC in-hospital

1990 92 94 96 98 2000

Source: Ross Mothers Survey.