Breastfeeding:

WIC's Efforts to Promote Breastfeeding Have Increased

HRD-94-13: Published: Dec 16, 1993. Publicly Released: Dec 20, 1993.

Additional Materials:

Contact:

William J. Scanlon
(202) 512-7114
contact@gao.gov

 

Office of Public Affairs
(202) 512-4800
youngc1@gao.gov

Pursuant to a congressional request, GAO reviewed the extent that the Department of Agriculture's (USDA) Special Supplemental Food Program for Women, Infants, and Children (WIC) promotes breastfeeding, focusing on: (1) how promotional funds for breastfeeding are spent and what WIC is doing to promote breastfeeding; (2) whether breastfeeding promotion is an integral part of local WIC services; (3) whether breastfeeding promotion would reduce WIC program costs; (4) the effectiveness of WIC efforts to promote breastfeeding; and (5) whether changes in federal laws or regulations could encourage breastfeeding.

GAO found that: (1) USDA and state WIC programs have substantially increased their breastfeeding promotional efforts since 1989; (2) state WIC programs have generally complied with requirements to designate a breastfeeding coordinator, plan and evaluate breastfeeding promotion and support, coordinate breastfeeding promotion activities with other state programs, provide breastfeeding education and promotion training to clinic staff, purchase breastfeeding aids, and provide breastfeeding materials in foreign languages; (3) most states have spent more than the minimum amount required on breastfeeding promotion; (4) local WIC programs have integrated breastfeeding education into their nutrition education services, but some programs lack educational materials printed in foreign languages; (5) USDA and state WIC programs have not developed comprehensive written guidance on when to advise women that breastfeeding is not recommended; (6) USDA is promoting breastfeeding because of its health benefits rather than its potential to reduce WIC program costs; (7) promoting breastfeeding may not reduce WIC food costs because the program provides enhanced food packages and supplemental formula to breastfeeding mothers, and costs will increase if WIC is fully funded to include all eligible persons; (8) although breastfeeding has increased more among WIC participants than nonparticipants, it is unclear whether WIC promotional efforts influenced WIC participants' decisions to breastfeed; (9) health care providers, families, work, and peer groups may discourage mothers from breastfeeding; and (10) changes in federal laws and regulations making breastfeeding aids and support services allowable Medicaid expenses could encourage breastfeeding.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: When GAO reviewed WIC's efforts to promote breastfeeding, it found that sites it visited lacked foreign-language materials in languages other than English or perhaps Spanish. Sometimes one site would have materials translated into less commonly used languages in the United States, such as Russian or French Haitian Creole, when other sites did not have such materials, reported needing them, and did not know they were available elsewhere. USDA's Food and Nutrition Information Center (FNIC) was available as a repository for such materials, but was not being fully utilized. Since then, the WIC program has developed new breastfeeding informational materials in English and Spanish. However, FNS has not made any efforts to improve its dissemination of breastfeeding educational materials in less commonly used languages, either through the FNIC or through other means, and reports no plans to begin doing so.

    Recommendation: The Secretary of Agriculture should direct the Administrator, Food and Nutrition Service, to work with state WIC directors to improve the dissemination of foreign-language breastfeeding education materials in the WIC program, either by publicizing and encouraging increased utilization of the Food and Nutrition Information Center or by other means.

    Agency Affected: Department of Agriculture

  2. Status: Closed - Implemented

    Comments: In November, 1997 DHHS and FNS sent a report, "A Review of the Medical Benefits and Contraindications to Breastfeeding in the United States," to all state health departments and every WIC state and local agency. The letter transmitting this report urged all state agencies to pursue the development of written policies with regard to contraindications to breastfeeding in conjunction with their state health departments. FNS pledged to continue to encourage states to develop policies defining when breastfeeding is contraindicated.

    Recommendation: The Secretaries of Agriculture and Health and Human Services should work with state WIC directors and state health directors to develop written policies defining when breastfeeding is contraindicated, including how and when to communicate this information to all pregnant and breastfeeding WIC participants.

    Agency Affected: Department of Agriculture

  3. Status: Closed - Implemented

    Comments: In November 1997, under the joint signatures of the Department of Health and Human Services (HHS) Associate Administrator for Maternal and Child Health, and the Acting Deputy Administrator, Special Nutrition Programs, the report, "A Review of the Medical Benefits and Contraindications to Breastfeeding in the United States," was sent to all state health departments and every WIC state and local agency. State agencies and others may obtain additional copies of this report by calling HHS, or by writing to the National Maternal and Child Health Clearinghouse. In the report's cover transmittal, the Department of Agriculture urged all state agencies to pursue the development of written policies with regard to breastfeeding contraindications with their state health departments. FNS will continue to encourage states to develop policies defining when breast feeding is contraindicated. GAO considers this action not fully responsive because FNS is delegating actual policy development to states and localities.

    Recommendation: The Secretaries of Agriculture and Health and Human Services should work with state WIC directors and state health directors to develop written policies defining when breastfeeding is contraindicated, including how and when to communicate this information to all pregnant and breastfeeding WIC participants.

    Agency Affected: Department of Health and Human Services

 

Explore the full database of GAO's Open Recommendations »

Sep 15, 2016

Sep 7, 2016

Jul 8, 2016

Mar 14, 2016

Mar 10, 2016

Feb 23, 2016

Nov 9, 2015

Sep 16, 2015

Jun 15, 2015

Jun 3, 2015

Looking for more? Browse all our products here