1
|
Fisher E, Patel P, Wouk KG, Neupane B, Alkhalifah F, Bartholmae MM, Tang C, Zhang Q. Breastfeeding Perceptions and Decisions among Hispanic Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children: A Qualitative Study. Nutrients 2024; 16:1565. [PMID: 38892499 PMCID: PMC11173851 DOI: 10.3390/nu16111565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 05/19/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a nutrition assistance program in the U.S. WIC served 2.5 million eligible Hispanic women, infants, and children under the age of five in 2021, which is WIC's largest racial/ethnic group. However, limited research has been conducted to understand Hispanic WIC participants' perceptions of WIC breastfeeding recommendations and their breastfeeding decisions. For this qualitative study, we interviewed 18 of these pregnant and postpartum WIC participants on their experiences and decision-making processes related to breastfeeding. Hispanic cultures and home country norms were identified as prominent influences on breastfeeding decisions, along with perceptions of WIC's breastfeeding support. These results can help the WIC program to refine its breastfeeding education to better meet the needs of Hispanic participants.
Collapse
Affiliation(s)
- Emily Fisher
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA 23529, USA; (E.F.); (P.P.); (B.N.); (F.A.); (M.M.B.)
| | - Priyanka Patel
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA 23529, USA; (E.F.); (P.P.); (B.N.); (F.A.); (M.M.B.)
| | - Kathryn G. Wouk
- Pacific Institute for Research and Evaluation, Chapel Hill, NC 27514, USA;
| | - Bidusha Neupane
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA 23529, USA; (E.F.); (P.P.); (B.N.); (F.A.); (M.M.B.)
| | - Futun Alkhalifah
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA 23529, USA; (E.F.); (P.P.); (B.N.); (F.A.); (M.M.B.)
| | - Marilyn M. Bartholmae
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA 23529, USA; (E.F.); (P.P.); (B.N.); (F.A.); (M.M.B.)
- Department of Psychiatry and Behavioral Health, Eastern Virginia Medical School, Norfolk, VA 23510, USA
| | - Chuanyi Tang
- Department of Marketing, Old Dominion University, Norfolk, VA 23529, USA;
| | - Qi Zhang
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA 23529, USA; (E.F.); (P.P.); (B.N.); (F.A.); (M.M.B.)
| |
Collapse
|
2
|
Thoma ME, De Silva DA, Kim J, Hodges L, Guthrie J. Breastfeeding Initiation Trends by Special Supplemental Nutrition Program for Women, Infants, and Children Participation and Race/Ethnicity Among Medicaid Births. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:170-181. [PMID: 36642586 DOI: 10.1016/j.jneb.2022.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 09/23/2022] [Accepted: 09/23/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Describe long-term breastfeeding initiation trends by prenatal Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation and race/ethnicity. DESIGN Cross-sectional study of birth certificate data from 2009 to 2017 in 24 states that adopted the 2003 birth certificate revision by 2009. PARTICIPANTS Term births with hospital costs covered by Medicaid (N = 6,402,704). MAIN OUTCOME MEASURES Breastfeeding initiation. ANALYSIS The descriptive characteristics of WIC participants and WIC-eligible nonparticipants were compared by year and race/ethnicity using the chi-square test of independence or t tests. Adjusted breastfeeding initiation prevalence was estimated using linear regression models with county fixed effects, controlling for sociodemographic and obstetric/health factors. Trends were compared by WIC status overall and within racial/ethnic groups. Differences and P values were assessed using interaction terms between WIC and year. RESULTS Breastfeeding initiation increased for WIC participants and nonparticipants. Special Supplemental Nutrition Program for Women, Infants, and Children participants had lower adjusted breastfeeding initiation (2009: 69.0%; 2017: 78.5%) than nonparticipants (2009: 70.8%; 2017: 80.1%) (P < 0.001 per year). Breastfeeding initiation increased more rapidly in WIC participants than in nonparticipants for non-Hispanic Asian/Pacific Islander (21.4% and 8.6%, respectively; P < 0.001) and American Indian/Alaskan Native (13.6% and 8.1%, respectively; P = 0.02)-narrowing the gap between WIC participants and nonparticipants over time. CONCLUSIONS AND IMPLICATIONS Annual birth certificate data provide detailed information for monitoring trends and disparities in breastfeeding initiation by prenatal WIC status. These findings can inform WIC and maternal child health program efforts to improve breastfeeding promotion for populations with low-income and racial/ethnic groups.
Collapse
Affiliation(s)
- Marie E Thoma
- Department of Family Science, School of Public Health, College Park, MD.
| | - Dane A De Silva
- Division of Population Health Data, Office of Family Health Services, Virginia Department of Health, Richmond, VA
| | - Jinhee Kim
- Department of Family Science, School of Public Health, College Park, MD
| | - Leslie Hodges
- Economic Research Service, US Department of Agriculture, Washington, DC
| | - Joanne Guthrie
- Economic Research Service, US Department of Agriculture, Washington, DC
| |
Collapse
|
3
|
Fisher E, Wouk K, Patel P, Tang C, Zhang Q. Forming the Perception of WIC Infant Feeding Recommendations: A Qualitative Study. Nutrients 2023; 15:nu15030527. [PMID: 36771234 PMCID: PMC9920282 DOI: 10.3390/nu15030527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/28/2022] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
Nearly half of newborns in the United States are enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Promoting breastfeeding is a programmatic priority, although formula vouchers are provided for those who do not exclusively breastfeed. Previous literature suggests that participant perception of WIC's breastfeeding recommendations is a significant factor predicting breastfeeding initiation, duration, and exclusivity outcomes. However, little is known about how participants' perceptions of WIC's breastfeeding recommendations are formed. To address this knowledge gap, we conducted a qualitative pilot study in Nevada, interviewing 10 postpartum WIC mothers and 12 WIC staff who had interacted with participants regarding infant feeding. Results showed participants and staff reported various perceptions of what WIC recommends, the factors that contribute to these perceptions, and how these perceptions affect breastfeeding practices. Respondents also described that WIC has a negative legacy as the "free formula program," and that environmental factors, such as the recent formula recall, have had an impact on participants' infant feeding practices. More effective public campaigns and programmatic strategies are needed to target participants' prenatal self-efficacy and to communicate the availability of skilled lactation support in the early postpartum period to improve participants' perceptions of WIC's position on breastfeeding.
Collapse
Affiliation(s)
- Emily Fisher
- School of Community and Environmental Health, College of Health Sciences, Old Dominion University, Norfolk, VA 23529, USA
| | - Kathryn Wouk
- Pacific Institute for Research and Evaluation, Chapel Hill, NC 27514, USA
| | - Priyanka Patel
- School of Community and Environmental Health, College of Health Sciences, Old Dominion University, Norfolk, VA 23529, USA
| | - Chuanyi Tang
- Department of Marketing, Strome College of Business, Old Dominion University, Norfolk, VA 23529, USA
| | - Qi Zhang
- School of Community and Environmental Health, College of Health Sciences, Old Dominion University, Norfolk, VA 23529, USA
- Correspondence: ; Tel.: +1-757-683-6890
| |
Collapse
|
4
|
Shipton EV, Callaway L, Foxcroft K, Lee N, de Jersey SJ. Midwife-Led Continuity of Antenatal Care and Breastfeeding Duration Beyond Postpartum Hospital Discharge: A Systematic Review. J Hum Lact 2022:8903344221126644. [PMID: 36197006 DOI: 10.1177/08903344221126644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The World Health Organization recommends that infants should be exclusively breastfed for the first 6 months of life and that breastfeeding should continue for 2 years and beyond. Most women initiate breastfeeding, but many do not continue for the recommended duration. While midwife-led continuity of antenatal care is linked to improved mother and infant outcomes, the influence on breastfeeding duration has not been previously reviewed. RESEARCH AIM To critically analyze the literature that compared midwife-led continuity of antenatal care with other models of care where researchers have measured breastfeeding duration beyond postpartum hospital discharge. METHODS A systematic literature review with critical analysis was used to answer the research aim. We systematically searched and screened five databases for quantitative studies where researchers had reported breastfeeding duration beyond postpartum hospital discharge after midwife-led continuity of antenatal care, compared with another model of antenatal care. Methodological quality was assessed using tools from the Cochrane Collaboration (RoB2 and ROBINS-I). In total, nine studies met the inclusion criteria. RESULTS Clear conclusions about the association between midwife-led continuity of antenatal care and breastfeeding duration were not found. The risk of bias within non-randomized studies ranged from serious to critical, and a judgement of "some concerns" of risk of bias in the one randomized study. CONCLUSION To date, the question of whether midwife-led continuity of antenatal care improves breastfeeding duration has not been established. There has been a lack of consistency in definitions of breastfeeding and descriptions of models of care, which has weakened the evidence-based of literature reviewed.Our review protocol was registered with PROSPERO; although due to COVID-19, this registration was not checked for eligibility by the PROSPERO team (CRD42020151276). https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020151276.
Collapse
Affiliation(s)
- Emma V Shipton
- University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Metro North Hospital and Health Service, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Leonie Callaway
- University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Metro North Hospital and Health Service, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Katie Foxcroft
- University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Metro North Hospital and Health Service, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Nigel Lee
- School of Nursing, Midwifery and Social Work, The University of Queensland, South Brisbane, QLD, Australia
| | - Susan J de Jersey
- University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Metro North Hospital and Health Service, Royal Brisbane and Women's Hospital, Brisbane, Australia
| |
Collapse
|
5
|
Zhang Q, Li K, Wouk K, Lamichhane R, Guthrie J. Prenatal Perception of WIC Breastfeeding Recommendations Predicts Breastfeeding Exclusivity and Duration in the Infants' First Year. J Nutr 2022; 152:2931-2940. [PMID: 36149318 PMCID: PMC9839998 DOI: 10.1093/jn/nxac221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/01/2022] [Accepted: 09/20/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Pregnant participants who perceived that the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) recommends breastfeeding only were more likely to have better early breastfeeding outcomes. OBJECTIVES Our objective was to examine the association between prenatal perception of WIC's breastfeeding recommendations and breastfeeding duration through the first year of infant life. METHODS This observational study used a national longitudinal sample of 1594 pregnant participants in the WIC Infant and Toddler Feeding Practices Study-2 in 2013. Four measures of breastfeeding duration were used: 1) a discrete measure of exclusive breastfeeding through 5 mo; 2) a continuous measure of exclusive breastfeeding (in days up to 7 mo); 3) a discrete measure of any breastfeeding through 11 mo; and 4) a continuous measure of any breastfeeding (in days up to 13 mo). The primary explanatory variable was the participant's prenatal perception of whether WIC recommended breastfeeding only. The univariate analyses of time to breastfeeding cessation were performed using Kaplan-Meier curves. The Cox regression model was adopted to estimate the likelihood of breastfeeding outcomes over time. All analyses accounted for complex survey design effects. RESULTS Compared with their peers who perceived WIC to recommend formula only or both breastfeeding and formula equally, participants who perceived WIC as recommending breastfeeding only were less likely to stop exclusive breastfeeding through 5 mo (HR = 0.83; 95% CI: 0.69, 0.99) or to stop any breastfeeding through 11 mo (HR = 0.80; 95% CI: 0.69, 0.92), without controlling for prenatal infant feeding intentions. Similar patterns were observed in the 2 continuous measures, as they were also less likely to stop exclusive breastfeeding by 7 mo (HR = 0.78; 95% CI: 0.69, 0.90) or to stop any breastfeeding by 13 mo (HR = 0.82; 95% CI: 0.71, 0.95). CONCLUSIONS Prenatal perception of WIC's breastfeeding recommendation can be a useful predictor of breastfeeding duration in WIC participants.
Collapse
Affiliation(s)
- Qi Zhang
- Address correspondence to QZ (e-mail: )
| | - Kelin Li
- Department of Sociology, California State University-Dominguez Hills, Carson, CA, USA
| | - Kathryn Wouk
- Pacific Institute for Research and Evaluation, Chapel Hill, NC, USA
| | - Rajan Lamichhane
- Department of Clinical and Translational Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Joanne Guthrie
- US Department of Agriculture/Economic Research Service, Washington, DC, USA
| |
Collapse
|