Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report (2016)
Chapter: Appendix S: Breastfeeding Literature Findings
NOTES: BF = breastfeeding; d = days; LA = Los Angeles; mo = months; NA = Native American; NY = New York; y = years. Overweight = body mass index (BMI) for age ≥ 85 percentile based on Centers for Disease Control and Prevention (CDC) growth chart and obesity = BMI for age ≥ 95 percentile based on CDC growth chart, with one exception indicated below.
a Unadjusted analysis. All other analyses are adjusted.
b Criteria for obesity using the World Health Organization growth standards (BMI ≥ 30).
TABLE S-1 Summary of Factors Associated with Breastfeeding Initiation, Duration, and Exclusivity Among WIC Participants
| Factor Associated with BF | BF Initiation | |
|---|---|---|
| Study | Association | |
| BF beliefs/attitudes | ||
| BF in first hour | Ma and Magnus, 2012 | ↑ |
| BF in hospital | Ma and Magnus, 2012 | ↑ |
| BF information in hospital | Ma et al., 2014 | ↔ |
| Ma and Magnus, 2012 | ↑ | |
| BF support groups | Gross et al., 2011 | ↑ |
| Peer counseling | Gross et al., 2009 | Reference: standard care Peer counselor: ↑↑ Lactation consultant: ↔ |
| Yun et al., 2010 | PC has other positions in WIC: ↔ BF coordinator is BF PC task force member: ↔ |
|
| Birth weight | Ma and Magnus, 2012 | ↔ |
| Gross et al., 2009 | Reference: normal weight Very low: ↑↑ Low: ↓↓ Very preterm birth: ↔ Unknown birth weight: ↔ |
|
| Child age | ||
| BF Duration | BF Exclusivity | ||
|---|---|---|---|
| Study | Association | Study | Association |
| Wojcicki et al., 2010 | Embarrassing or difficult in public ↔ | ||
| Difficult if someone else feeds the child ↔ | |||
| Physically painful and uncomfortable ↑↑ | |||
| If friends and family do not approve of breastfeeding impacts attitudes ↔ | |||
| If husband/partner does not approve of breastfeeding impacts attitudes ↔ | |||
| Langellier et al., 2012 | BF 6 months ↑↑ BF 12 months ↑↑ |
Langellier et al., 2012 | Exclusive BF 6 months ↑↑ |
| BF 24 months ↑↑ | Exclusive BF 12 months ↑↑ | ||
| Exclusive BF 24 months ↑↑ | |||
| Haughton et al., 2010 | ↔ | ||
| Langellier et al., 2012 | BF 6 months ↑↑ BF 12 months ↔ BF 24 months ↔ |
Langellier et al., 2012 | Exclusive BF 6 months ↔ |
| Factor Associated with BF | BF Initiation | |
|---|---|---|
| Study | Association | |
| Child care arrangement | ||
| Child gender | Ziol-Guest and Hernandez, 2010 | Boy vs. girl ↔ |
| Employed | Darfour-Oduro and | ↔ |
| Kim, 2014 | ||
| Foreign born | Ziol-Guest and Hernandez, 2010 | ↑↑ |
| Formula at hospital | ||
| Gestational diabetes mellitus | Ma et al., 2014 | ↔ |
| Jacobson et al., 2015 | ↔ | |
| Government assistance | Darfour-Oduro and Kim, 2014 | ↔ |
| Gross et al., 2009 | Food stamps ↓ | |
| Hypertension | Jacobson et al., 2015 | ↔ |
| Incentives | Murimi et al., 2010 | Incentives to encourage breastfeeding ↔ |
| BF Duration | BF Exclusivity | ||
|---|---|---|---|
| Study | Association | Study | Association |
| Shim et al., 2012 | Reference: parental care | ||
| Center-based care: ↔ | |||
| Nonrelative care: ↔ | |||
| Relative care: ↑ | |||
| Ziol-Guest and Hernandez, 2010 | BF 4 months boy vs. girl ↔ | Ziol-Guest and Hernandez, 2010 | Boy vs. girl ↔ |
| Haughton et al., 2010 | BF 6 months boy vs. girl ↔ | ||
| BF > 6 months boy vs. girl ↔ | |||
| Langellier et al., 2012 | BF 6 months boy vs. girl ↔ | ||
| BF 12 months boy vs. girl ↔ | |||
| BF 24 months boy vs. girl ↔ | |||
| Darfour-Oduro and Kim, 2014 | BF 3 months ↔ | Darfour-Oduro and Kim, 2014 | ↔ |
| Haughton et al., 2010 | BF 6 months ↔ BF > 6 months ↔ |
Wojcicki et al., 2010 | Early introduction to formula ↔ |
| Ziol-Guest and Hernandez, 2010 | BF 4 months ↑↑ | Ziol-Guest and Hernandez, 2010; | ↔ |
| Langellier et al., 2012 | BF 6 months ↑↑ BF 12 months ↑↑ |
Langellier et al., 2012 | Exclusive BF 6 months ↔ |
| BF 24 months ↔ | |||
| Langellier et al., 2012 | BF 6 months ↔ BF 12 months ↔ |
Langellier et al., 2012 | Exclusive BF 6 months ↓↓ |
| BF 24 months ↔ | |||
| Darfour-Oduro and Kim, 2014 | BF 3 months ↔ | Darfour-Oduro and Kim, 2014 | ↔ |
| Factor Associated with BF | BF Initiation | |
|---|---|---|
| Study | Association | |
| Income | Jacobson et al., 2015 | Reference: annual income ≥ 25,000 |
| Annual income < 4,999 urban: ↑ | ||
| Annual income < 4,999 rural: ↔ | ||
| Annual income 5,000–9,999 urban: ↑ | ||
| Annual income 5,000–9,999 rural: ↔ | ||
| Annual income 10,000–14,999: ↔ | ||
| Annual income 15,000–19,999: ↔ | ||
| Annual income 20,000–24,999: ↔ | ||
| Intention to BF | ||
| Married | Ma et al., 2014 | ↔ |
| Ziol-Guest and Hernandez, 2010 | ↑↑ | |
| Darfour-Oduro and Kim, 2014 | ↑↑ | |
| Ma and Magnus, 2012 | ↑↑ | |
| Maternal age | Ma et al., 2014 | ↔ |
| Ziol-Guest and Hernandez, 2010 | ↔ | |
| Jacobson et al., 2015 | Reference: 30 and older 17 and younger: ↔ | |
| 18–19: ↑↑ | ||
| 20–29: ↔ | ||
| BF Duration | BF Exclusivity | ||
|---|---|---|---|
| Study | Association | Study | Association |
| Wojcicki et al., 2010 | ↑ | ||
| Haughton et al., 2010 | BF 6 months ↔ BF > 6 months ↔ | Tenfelde et al., 2011 | Prenatal intention to exclusive BF ↑↑ |
| Ziol-Guest and Hernandez, 2010 | BF 4 months ↑↑ | Ziol-Guest and Hernandez, 2010 | ↔ |
| Darfour-Oduro and Kim, 2014 | BF 3 months ↑↑ | Darfour-Oduro and Kim, 2014 | ↔ |
| Dodgson et al., 2007 | Duration any BF ↑↑ | Dodgson et al., 2007 | ↔ |
| Wojcicki et al., 2010 | Early introduction to formula ↔ | ||
| Ziol-Guest and Hernandez, 2010 | BF 4 months ↔ | Ziol-Guest and Hernandez, 2010 | ↑↑ |
| Dodgson et al., 2007 | |||
| Tenfelde et al., 2012 | BF cessation: ↓↓ | ||
| Dodgson et al., 2007 | Duration any BF | Dodgson et al., 2007 | Duration of exclusive BF |
| Reference: 22–29 | Reference: 22–29 | ||
| 21 and younger: ↑↑ | 21 and younger: ↔ | ||
| 30 and older: ↔ | 30 and older: ↔ | ||
| BF Duration | BF Exclusivity | ||
|---|---|---|---|
| Study | Association | Study | Association |
| Haughton et al., 2010 | ↑↑ | ||
| Langellier et al., 2012 | BF 6 months ↑↑ | Langellier et al., 2012 | Exclusive BF 6 months ↔ |
| BF 12 months ↔ | |||
| BF 24 months ↔ | |||
| Wojcicki et al., 2010 | Early introduction to formula ↔ | ||
| Haughton et al., 2010 | Maternal weight ↔ | ||
| Langellier et al., 2012 | BF 6 months, Reference: ≥ 7 months until work | Langellier et al., 2012 | Exclusive BF 6 months, Reference: ≥ 7 months until work |
| 4–6 months: ↔ | 4–6 months: ↔ | ||
| 0–3 months: ↓↓ | 0–3 months: ↓↓ | ||
| Not employed: ↔ | Not employed: ↔ | ||
| BF 12 months: | |||
| 4–6 months: ↔ | |||
| 0–3 months: ↓↓ | |||
| Not employed: ↔ | |||
| BF 24 months: | |||
| 4–6 months: ↔ | |||
| 0–3 months: ↓↓ | |||
| Not employed: ↔ | |||
| Factor Associated with BF | BF Initiation | |
|---|---|---|
| Study | Association | |
| Number of children | Ziol-Guest and Hernandez, 2010 | ↔ |
| Postpartum health/ depression | Darfour-Oduro and Kim, 2014 | ↔ |
| Poverty | Ziol-Guest and Hernandez, 2010 | Poverty ratio: ↑↑ |
| Gross et al., 2009 | At or below poverty: ↓↓ | |
| Pregnancy intent | ||
| Prenatal WIC enrollment duration | Yun et al., 2010 | Non-PC agencies Reference: < 3 months |
| 3–6 months: ↑↑ | ||
| ≥ 6 months: ↑↑ | ||
| PC agencies | ||
| < 3 months: ↔ | ||
| 3–6 months: ↑↑ | ||
| ≥ 6 months: ↑↑ | ||
| Prenatal WIC participation | ||
| Prepregnancy BMI | ||
| Previous BF experience | ||
| Race | Ma et al., 2014 | Reference: Non-Hispanic black |
| Non-Hispanic white: ↑↑ | ||
| Other: ↑↑ | ||
| Ziol-Guest and Hernandez, 2010 | Reference: white | |
| Non-Hispanic black: ↓↓ | ||
| Hispanic: ↔ | ||
| Non-Hispanic other: ↓↓ | ||
| BF Duration | BF Exclusivity | ||
|---|---|---|---|
| Study | Association | Study | Association |
| Ziol-Guest and Hernandez, 2010 | BF 4 months ↔ | Ziol-Guest and Hernandez, 2010 | ↔ |
| Dodgson et al., 2007 | Duration any BF: ↔ | Dodgson et al., 2007 | ↔ |
| Wojcicki et al., 2010 | ↔ | ||
| Darfour-Oduro and Kim, 2014 | BF 3 months: ↔ | Darfour-Oduro and Kim, 2014 | ↔ |
| Ziol-Guest and Hernandez, 2010 | PIR, BF 4 months: ↑↑ | Ziol-Guest and Hernandez, 2010 | PIR: ↑↑ |
| Haughton et al., 2010 | ↔ | ||
| Dodgson et al., 2007 | Duration any BF: ↔ | Dodgson et al., 2007 | ↔ |
| Tenfelde et al., 2011 | Prepregnancy overweight/obese ↓↓ | ||
| Tenfelde et al., 2012 | BF cessation: ↓↓ | ||
| Ziol-Guest and Hernandez, 2010 | BF 4 months, Reference: white | Ziol-Guest and Hernandez, 2010 | Reference: white |
| Non-Hispanic black: ↓ | Non-Hispanic black: ↓↓ | ||
| Hispanic: ↓↓ | Hispanic: ↔ | ||
| Non-Hispanic other: ↓↓ | Non-Hispanic other: ↓↓ | ||
| Factor Associated with BF | BF Initiation | |
|---|---|---|
| Study | Association | |
| Jacobson et al., 2015 | Reference: Non-Hispanic white | |
| Non-Hispanic black: ↓↓ | ||
| Hispanic: ↑↑ | ||
| American Indian: ↔ | ||
| Asian/Pacific Islander: ↔ | ||
| Ma and Magnus, 2012 | Reference: white | |
| Black: ↓↓ | ||
| Gross et al., 2009 | Reference: Non-Hispanic African American | |
| Non-Hispanic white: ↔ | ||
| Non-Hispanic other: ↑↑ | ||
| Hispanic: ↑↑ | ||
| Unknown: ↑↑ | ||
| Evans et al., 2011 | African American: ↓ | |
| White: ↑ | ||
| Hispanic: ↑ | ||
| BF Duration | BF Exclusivity | ||
|---|---|---|---|
| Study | Association | Study | Association |
| Tenfelde et al., 2012 | BF cessation, Mexican: | ↓↓ | |
| Haughton et al., 2010 | ↔ | ||
| Langellier et al., 2012 | BF 6 months ↔ | Langellier et al., 2012 | Exclusive BF 6 months, Reference: Hispanic |
| BF 12 months ↔ | Non-Hispanic white: ↑↑ | ||
| BF 24 months ↔ | Non-Hisapnic black: ↔ | ||
| Other: ↔ | |||
| Wojcicki et al., 2010 | Early introduction to formula | ||
| Reference: white | |||
| Asian/Pacific Islander: ↑↑ | |||
| Black/African | |||
| American: ↔ | |||
| Latino: ↔ | |||
| Factor Associated with BF | BF Initiation | |
|---|---|---|
| Study | Association | |
| Region of the United States | Ziol-Guest and Hernandez, 2010 | Reference: East |
| Midwest: ↔ | ||
| South: ↔ | ||
| West: ↑↑ | ||
| Stress factors at home | Ma and Magnus, 2012 | Number of stress factors at 12 months before baby was born ↑↑ |
| Time in the United States | ||
| Trimester medical care began | Jacobson et al., 2015 | Reference: 1st trimester 2nd trimester: ↔ |
| 3rd trimester urban: ↓↓ | ||
| 3rd trimester rural: ↔ | ||
| No medical care: ↔ | ||
| Ma and Magnus, 2012 | Prenatal care in 1st trimester: ↓ | |
| Trimester WIC entry | Ziol-Guest and Hernandez, 2010 | Reference: No participation 1st trimester: ↓↓ |
| 2nd trimester: ↔ | ||
| 3rd trimester: ↔ | ||
| Jacobson et al., 2015 | Reference: 1st trimester | |
| 2nd trimester urban: ↓↓ | ||
| 2nd trimester rural: ↔ | ||
| 3rd trimester urban: ↓↓ | ||
| 3rd trimester rural: ↔ | ||
| Postpartum urban: ↔ | ||
| BF Duration | BF Exclusivity | ||
|---|---|---|---|
| Study | Association | Study | Association |
| Ziol-Guest and Hernandez, 2010 | BF 4 months, Reference: East | Ziol-Guest and Hernandez, 2010 | Reference: East |
| Midwest: ↔ | Midwest: ↔ | ||
| South: ↔ | South: ↔ | ||
| West: ↑↑ | West: ↑↑ | ||
| Haughton et al., 2010 | Years in the United States ↓↓ | ||
| Ziol-Guest and Hernandez, 2010 | Reference: No participation | Ziol-Guest and Hernandez, 2010 | Reference: No participation |
| 1st trimester: ↓↓ | 1st trimester: ↔ | ||
| 2nd trimester: ↔ | 2nd trimester: ↔ | ||
| 3rd trimester: ↔ | 3rd trimester: ↔ | ||
| Tenfelde et al., 2011 | 1st trimester entry: ↑↑ | ||
| Langellier et al., 2012 | BF 6 months: ↔ | Langellier et al., 2012 | ↔ |
| BF 12 months: ↔ | |||
| BF 24 months: ↔ | |||
| Factor Associated with BF | BF Initiation | |
|---|---|---|
| Study | Association | |
| Metallinos-Katsaras et al., 2015 | No previous live birth 1st vs. 3rd: ↑↑ | |
| 2nd vs. 3rd: ↑↑ | ||
| 1st vs. 2nd: ↔ | ||
| 1 or more previous live births | ||
| 1st vs. 3rd: ↑↑ | ||
| 2nd vs. 3rd: ↑↑ | ||
| 1st vs. 2nd: ↑↑ | ||
| No previous live birth | ||
| Prenatal vs. postpartum: ↔ | ||
| 1st trimester vs. postpartum: ↔ | ||
| 1 or more previous live births | ||
| Prenatal vs. postpartum: ↑↑ | ||
| 1st trimester vs. postpartum: ↑↑ | ||
| BF Duration | BF Exclusivity | ||
|---|---|---|---|
| Study | Association | Study | Association |
| Metallinos-Katsaras et al., 2015 | First birth First vs. third: | ||
| BF 3 months: ↔ | |||
| BF 6 months: ↔ | |||
| BF 12 months: ↔ | |||
| Prenatal vs. postpartum | |||
| BF 3 months: ↔ | |||
| BF 6 months: ↔ | |||
| BF 12 months: ↔ | |||
| Subsequent birth | |||
| First vs. third: | |||
| BF 3 months: ↔ | |||
| BF 6 months: ↔ | |||
| BF 12 months: ↔ | |||
| Second vs. third: | |||
| BF 3 months: ↑↑ | |||
| BF 6 months: ↑↑ | |||
| BF 12 months: ↔ | |||
| First vs. second: | |||
| BF 3 months: ↓↓ | |||
| BF 6 months: ↔ | |||
| BF 12 months: ↑↑ | |||
| Subsequent birth | |||
| First vs. third: | |||
| BF 3 months: ↑↑ | |||
| BF 6 months: ↑↑ | |||
| BF 12 months: ↑↑ | |||
| Second vs. third: | |||
| BF 3 months: ↑↑ | |||
| BF 6 months: ↑↑ | |||
| BF 12 months: ↑↑ | |||
| First vs. second: | |||
| BF 3 months: ↔ | |||
| BF 6 months: ↔ | |||
| BF 12 months: ↑↑ | |||
| Factor Associated with BF | BF Initiation | |
|---|---|---|
| Study | Association | |
| Joyce et al., 2008 | 1st vs. 3rd: ↑↑ | |
| 1st vs. 2nd: ↑↑ | ||
NOTES: BF = breastfeeding; BMI = body mass index; PC = peer counselor; PIR = poverty-to-income ratio. ↑↑ Factor was significantly associated with higher BF initiation, longer duration (continuous or categorical outcomes), or exclusivity in adjusted analysis; ↑ Factor was significantly associated with higher BF initiation, longer duration (continuous or categorical outcomes), or exclusivity in unadjusted/crude analysis; ↔ no significant association; ↓ Factor was significantly associated with lower BF initiation, shorter duration (continuous or categorical outcomes), or shorter exclusivity in unadjusted/crude analysis; ↓↓ Factor was significantly associated with lower BF initiation, longer duration (continuous or categorical outcomes), or exclusivity in unadjusted/crude analysis; data excluded in summary if no significance tests were performed.
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