O43 Timing of WIC Enrollment and Exclusive Breastfeeding: Results from the National WIC Infant Toddler Feeding Practices Study 2

Background Participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is associated with lower breastfeeding rates, compared to similar income non-participants. Breastfeeding decisions are often made before birth hence; the prenatal period may be critical for breastfeeding support. Objective To explore whether timing of WIC enrollment has an effect on breastfeeding exclusivity at 3, 5, and 7 months. As there are racial/ethnic disparities in breastfeeding, the association of timing of enrollment and race/ethnicity with breastfeeding outcomes was also assessed. Study Design, Setting, Participants This is a secondary analysis of data collected from the WIC Infant Toddler Feeding Practices Study-2, the most recent longitudinal assessment of mother-child dyads participating in WIC nationally. Only data collected from the prenatal through 7-months post-partum were included. Measurable Outcome/Analysis Logistic regression models analyzed the association between the timing of WIC enrollment - categorized as prenatal (1st, 2nd or 3rd trimester) or post-partum and exclusive breastfeeding - defined as being fed “only breastmilk” at each time point. Covariates included race/ethnicity, maternal age, education, parity, nativity, and poverty level. Results Prenatal WIC enrollment was associated with a 1.51 (95% CI: 1.08-2.17) and 1.37 (1.01-1.89) increased likelihood of exclusive breastfeeding at 5 and 7 months, respectively, as compared to post-partum enrollment. There were no significant differences at 3 months or by trimester of pregnancy. Mothers who were Hispanic and enrolled during the 2nd trimester had a 0.55 (0.33-0.91) decreased odds of breastfeeding at 3 months, with a similar trend observed (P = 0.062) during the third trimester for breastfeeding at 7 months. Conclusion Timing of WIC enrollment was associated with mother's infant feeding choice hence, supporting the prenatal period as an opportune time for breastfeeding education. A focus on prenatal breastfeeding education for Hispanic women who enroll during the 2nd trimester or later may be warranted. Funding None.