LAUSR

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) was established in 1972 by an amendment to the 1966 Child NutritionAct, andbecameapermanentprogram in 1974. Administered federally by the US Department of Agriculture (USDA) Food and Nutrition Service and typically managed by state health departments, WIC participation greatly expanded since its inception. The program is well recognized as an adjunct to health care during critical times of growth and development and is considered an entry point to other health and social services for low-income families. It serves nutritionally at-risk pregnant, breastfeeding (BF), and postpartum women, infants, and children age <5 years, providing supplemental nutritious food and nutrition education as well as referrals to social and health services. Collective findings of studies, reviews, and reports demonstrated thatWIC is cost-effective in protecting and improving the health and nutritional status of participants. The required nutrition education component is the benefit that sets WIC apart from other federal nutrition assistance programs. Historically, WIC included BF promotion and support as part of its supplemental food and nutrition education programming efforts. BF provides multiple health, nutritional, economical, and emotional benefits to mothers and babies. This led to both the issuance in 2011 of the Surgeon General's Call to Action to Support Breastfeeding and the establishment of Healthy People 2020 BF goals. Human milk is considered the best source of infant nutrition that also offers immunological and anti-inflammatory properties to protect infants from ear, respiratory, and gastrointestinal infections as well as other health issues. Furthermore, BF protects mothers against diseases such as breast and ovarian cancer, type 2 diabetes, and obesity, and postpartum depression. The US Department of Health and Human Service's Centers for Disease Control and Prevention collects BF data using the US National Immunization Survey. Table 1 lists the 2016 National Immunization Survey data, which indicate that the nation and WIC mothers fell short of the 2020 Healthy People BF goals. However, data from the 2014 WIC Participant and Program Characteristics Report 2014 showed a steady increase in WIC BF initiation rates from 48.3% in 2002 to 68.9% in 2014, indicating that more mothers chose BF as their first choice for infant feeding. Despite all known benefits, mothers enrolled in WIC continue to face multiple barriers in reaching their BF goals. The Social Ecological Model is used to illustrate the intrapersonal, interpersonal, community, and institutional levels intricately involved in successful BF. Human milk is the normative standard for infant feeding and nutrition and given that about one half of all US-born infants are enrolled inWIC,theUSDAiscommitted to strengthening efforts to promote and support BF for improved health outcomes. This commentary highlights USDA past national WIC BF activities and reflects on future efforts in BF promotion and support to safeguard the health of all infants and their mothers.