Abstract
BACKGROUND/OBJECTIVE: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides breastfeeding support to participating women in low-income households. This study aimed to determine the relationships between prenatal maternal and household characteristics and breastfeeding duration, as well as whether these characteristics modify associations of prenatal breastfeeding intention with breastfeeding duration. METHODS: This is a prospective cohort study of pregnant respondents to Los Angeles County (LAC), California, WIC surveys conducted between 2005 and 2020 (n = 1014). Associations of prenatal breastfeeding intention with duration (months) of any or fully breastfeeding, determined by WIC infant food package issuance, were assessed with linear regression models. RESULTS: Most women reported the intention to breastfeed (67.7%) and perceived breastfeeding support during pregnancy from WIC and family/friends was associated with breastfeeding intention (both p-values < 0.0001). Stronger breastfeeding intention, lower maternal BMI, greater maternal age, greater maternal education, paternal cohabitation and employment, and greater breastfeeding support from family/friends were associated with longer duration of any or fully breastfeeding in multivariable models. Stronger breastfeeding intention was more strongly associated with longer duration of any breastfeeding among women with lower BMI (interaction p-value 0.03). CONCLUSIONS: Breastfeeding support from WIC is an important contributor to stronger breastfeeding intention. Given the robust association of breastfeeding intention with breastfeeding duration, regardless of maternal and household characteristics, WIC breastfeeding support during pregnancy represents an important mechanism to improve breastfeeding outcomes in this population. Further research is needed to understand the directionality of associations between breastfeeding support and intention among WIC participants.