Women, Infants and Children (WIC) Participation and Breastfeeding Behavior: Comparing Foreign-Born to US-Born Mothers

This cross-sectional study compared rates of breastfeeding initiation and exclusive breastfeeding among foreign-born mothers who utilized the Women, Infants and Children (WIC) program with foreign-born non-participants and US-born WIC participants.

Sample children from the nationally representative dataset, the National Survey of Children's Health 2016-2022, ages 6 months to 1 year were included. Descriptive statistics and logistic regressions were executed for analysis.

91.8% of foreign-born women who utilized WIC initiated breastfeeding and 34.8% exclusively breastfed for 6 months. By comparison, 68.2% of US-born women who utilized WIC initiated breastfeeding and 10.4% exclusively breastfed for 6 months. Foreign-born women who utilized WIC had 4.04 times the odds [95% CI (1.49, 10.97)] of initiating breastfeeding relative to foreign-born women who did not utilize WIC. Foreign-born women who utilized WIC also had 7.42 times the odds [95% CI (3.22, 17.11)] of initiating breastfeeding and 3.47 times the odds [95% CI (1.52, 7.95)] of exclusive breastfeeding for 6 months relative to US-born women who utilized WIC (adjusted for household federal poverty level, preterm birth, birth order of sample child, sample child's race and mother's age, education, and marital status).

Foreign-born women who utilized WIC had increased breastfeeding behavior relative to both foreign-born women who did not utilize WIC and US-born women who utilized WIC. This suggests that, rather than WIC contributing to lower breastfeeding rates, there is an unobserved characteristic that is correlated with lower breastfeeding rates among US-born women who utilize WIC that also encourages selection into the program.