Jacknowitz Alison, Novillo Daniel, Tiehen Laura
Department of Public Administration and Policy, American University, Washington, DC, USA.
Pediatrics. 2007 Feb;119(2):281-9. doi: 10.1542/peds.2006-1486.
This study examined the association between participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and adherence to 4 American Academy of Pediatrics recommendations on infant feeding.
We used data from the Early Childhood Longitudinal Study-Birth Cohort, which is nationally representative of children born in 2001. We estimated regression models to assess relationships between program participation and adherence to American Academy of Pediatrics recommendations on exclusive breastfeeding and the introduction of infant formula, cow's milk, and solid foods.
Regression results indicated that WIC participation was associated with a 5.9-percentage point decrease in the likelihood of exclusive breastfeeding for > or = 4 months and a 1.9-percentage point decrease in the likelihood of exclusive breastfeeding for > or = 6 months. Program mothers were 8.5 percentage points less likely than nonparticipants to adhere to the American Academy of Pediatrics recommendation to delay introduction of infant formula until month 6. Program mothers were 2.5 percentage points more likely than nonparticipants to delay the introduction of cow's milk until month 8. Program participants were 4.5 percentage points less likely than nonparticipants to delay the introduction of solid foods for > or = 4 months. However, the difference between participants and nonparticipants disappeared by month 6.
Results suggest that, although program participants are less likely to breastfeed exclusively than eligible nonparticipants, program-provided infant formula is an important option for mothers who do not breastfeed exclusively. The program faces the challenge to encourage breastfeeding without undermining incentives to follow other recommended infant feeding practices. Recent changes proposed to the food packages by the US Department of Agriculture Food and Nutrition Service are consistent with the goal of increasing adherence to recommended infant feeding practices among participants.
本研究探讨了妇女、婴儿和儿童特别补充营养计划(WIC)的参与情况与遵循美国儿科学会关于婴儿喂养的4项建议之间的关联。
我们使用了来自儿童早期纵向研究——出生队列的数据,该数据具有2001年出生儿童的全国代表性。我们估计了回归模型,以评估该计划参与情况与遵循美国儿科学会关于纯母乳喂养以及引入婴儿配方奶粉、牛奶和固体食物的建议之间的关系。
回归结果表明,参与WIC计划与纯母乳喂养≥4个月的可能性降低5.9个百分点以及纯母乳喂养≥6个月的可能性降低1.9个百分点相关。参与该计划的母亲遵循美国儿科学会关于将婴儿配方奶粉的引入推迟到6个月的建议的可能性比未参与者低8.5个百分点。参与该计划的母亲将牛奶引入推迟到8个月的可能性比未参与者高2.5个百分点。参与该计划的参与者将固体食物的引入推迟≥4个月的可能性比未参与者低4.5个百分点。然而,到6个月时,参与者和未参与者之间的差异消失了。
结果表明,尽管参与该计划的参与者纯母乳喂养的可能性低于符合条件的未参与者,但该计划提供的婴儿配方奶粉是未进行纯母乳喂养的母亲的重要选择。该计划面临着鼓励母乳喂养而不削弱遵循其他推荐的婴儿喂养做法的激励措施的挑战。美国农业部食品和营养服务局最近提议对食品包进行的更改与提高参与者对推荐的婴儿喂养做法的遵循率的目标是一致的。