The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) serves 53% of all infants born in the United States. The target WIC population is low-income, nutritionally at-risk pregnant women, breastfeeding women until the child's first birthday, nonbreastfeeding postpartum women for 6 months after birth, infants up to age one, and children up to age five (USDA Food and Nutrition Service, 2020a). WIC lists benefits for participants including supplemental nutritious foods, nutrition education and counseling at WIC clinics, screenings and referrals to other health, welfare, and social services (USDA Food and Nutrition Service, 2020b).
All WIC publications state that they encourage mothers to breastfeed their infants if possible; however, many individuals think of WIC as the place to get "free infant formula." In 2019, the National WIC Association announced a record setting $90 million in funding for WIC's Breastfeeding Peer Counselor Program. This investment is an exciting and necessary step to improve breastfeeding rates for low-income families (National WIC Association, 2019). However, is the U.S. government truly investing in breastfeeding or are they investing in agriculture? Based on their data, it is evident that there is a much larger investment in agriculture.
WIC state agencies are required by law to have competitively bid infant formula rebate contracts with formula companies (USDA Food and Nutrition Service, 2019). State agencies agree to provide only one brand of infant formula. In return the formula company gives the state a rebate for each can of formula purchased by WIC participants (USDA Food and Nutrition Service, 2019). Type of infant formula provided depends on which company has the rebate contract. WIC notes by negotiating rebates with formula manufacturers, states are able to serve more people. In fiscal year 2017, rebate savings were $1.72 billion, which in turn supported an average of 1.55 million participants each month or ~21% of average monthly caseload (USDA Food and Nutrition Service, 2019). It is important to consider that when the formula companies are kept in business, so too are dairy farmers and soybean farmers.
Current funding of WIC state agencies can be viewed by anyone on the U.S. Department of Agriculture Food and Nutrition Service Web site (USDA Food and Nutrition Service, 2020b). WIC Food and Nutrition Services and Administration (NSA) grant levels for the current fiscal year are posted ~30 days after an Agriculture appropriations bill has been signed into law (USDA Food and Nutrition Service, 2020b). Per publicly available data, during fiscal year 2020, spending is over $3.6 billion for food and over $2.1 billion for NSA grants for a total of $5,804,653,545 (USDA Food and Nutrition Service, 2020b).
Considering that over half of infants are enrolled in the WIC program and that tremendous health disparities exist in breastfeeding initiation and duration rates for low-income families, is there adequate investment in breastfeeding education, promotion, and technical assistance? As some people may have contraindications to be able to breastfeed or some may not be able to achieve a complete milk supply, some families need infant formula. However, considering the biological function of the breast, to make milk for a child. Mothers (those with the XX chromosome) are biologically prepared to breastfeed their children following birth. Knowing that low-resource families are at risk for suboptimal breastfeeding outcomes and the current challenging time for birth and breastfeeding families due to the COVID-19 pandemic, now seems like the time to invest in breastfeeding. All families deserve to receive evidence-based breastfeeding education, technical assistance, and support regardless of their economic status.
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