Purpose: The U.S. Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides supplemental foods to assist low-income participants meet their dietary needs. Few studies have described the extent to which WIC-eligible foods contribute to the overall diet of children. The purpose of this study is to examine commonly consumed foods and estimate the proportion of dietary intake contributed by WIC-eligible foods among 13- and 24-month-old children; and to assess differences by WIC participation status at 24-months.

Methods: A national observational study of children participating in the WIC Infant and Toddler Feeding Practices Study-2 were included [13-month old (n=2,777) and 24-month old (n=2,450)] from 2013-2016. Dietary intakes were assessed using 24-hour dietary recalls at 13 and 24 months. The ten most commonly consumed foods were described using the What We Eat in America food category classification system. WIC-eligible foods were defined as meeting the WIC nutrient criteria set forth in WIC Federal regulation. The proportion of WIC-eligible foods to total daily intake was calculated for energy, macronutrients, and select micronutrients. Multiple linear regression, adjusted for confounders, was conducted to compare the estimated proportion of nutrient intake from WIC-eligible foods by WIC participation at 24 months.

Results: At 13 and 24 months, most (60% and 63%, respectively) of the commonly consumed foods were eligible for purchase as part of the child WIC food package. WIC-eligible foods provided over 40% of calories and close to 50% or more of other nutrients, and the contribution of WIC-eligible foods to overall micronutrient intake increased between 13 and 24 months. Children who remained on WIC at 24 months obtained a larger proportion of calories and most other nutrients from WIC-eligible foods than children no longer on WIC.

Conclusions: WIC-eligible foods contribute substantively to the overall diet of toddlers and appear to contribute nutritional benefits to the children who remain on the program longer.

Purpose: In 2017, the National Academies of Science, Engineering and Medicine (NASEM) released comprehensive recommendations for updates to the foods provided by the U.S. Special Supplemental Nutrition Program for Women, Infants and Children (WIC). These recommendations included providing supplemental amounts of most food groups, providing at least 50 percent of most priority nutrients, aligning with the 2015-2020 Dietary Guidelines for Americans, and enhancing responsiveness to cultural needs. The purpose of this study was to assess WIC participant satisfaction with the proposed NASEM WIC food package recommendations and to compare satisfaction by language preference (Spanish vs. English).

Methods: The study was a cross-sectional examination of 2,993 California, U.S. WIC participants’ satisfaction with the program. Interviewer-administered telephone surveys were conducted between January and May 2019 with WIC participants who had children between the ages of 1 to 4 years. Comparisons by language preference were conducted using Chi-square or ANOVA tests.

Results: The most common change requested by WIC participants related to fruits and vegetables. While many (69.6%) thought the amount of juice offered was just right, most participants (91.0%) wanted to substitute more fruit and vegetables in place of juice. ​Further, many (56.1%) wanted an increase in the cash value amount offered of $9/month. More English speakers (62.8%) wanted an increase in the cash value compared to Spanish speakers (43.2%), P<0.0001. Most participants were satisfied with the amount of beans (78.4%), peanut butter (78.7%), and milk (88.3%) offered by WIC. Differences were seen by language with more English speakers being dissatisfied in amounts of yogurt and peanut butter offered (P=0.005, P<0.0001, respectively). Spanish speakers were more dissatisfied with the amount of beans offered (P<0.0001).

Conclusions: This research suggests that many WIC participants are supportive of proposed NASEM policy changes to the WIC food package, including increasing the amount of the cash value for fruit and vegetables. Differences by language preference suggest the need for greater flexibility in the WIC food packages.

Purpose: Indequate infant feeding practices are known to impact on a child’s lifetime health trajectory. However, few longitudinal studies have investigated the determinants of overall feeding practices during the first year of life. We created an infant feeding index (IFI) to measure overall adherence to national infant feeding guidelines and examined associations with maternal sociodemographic and health behaviour characteristics.

Methods: Data were from 6,435 infants born in 2009-10, whose mothers participated in the 9-month face-to-face interview. Based on the Ministry of Health’s Food and Nutrition Guidelines (2008), the IFI included 12 indicators covering breastfeeding, introduction to complementary foods, and food/drinks intake at 9-months assessed with a food frequency questionnaire (score range 0-12). Associations of child and mother characteristics with IFI scores were examined using multivariable linear regression models (p<0.05), adjusted for maternal antenatal age, ethnicity, deprivation, diet, smoking, physical activity and pre-pregnancy BMI.

Results: Individual indicators with lowest adherence were exclusive breastfeeding to 6-months (32.8%), any breastfeeding to 12-months (36.3%), vegetables 2xdaily (32.8%) and fruit 2xdaily at 9-months (37.0%). The mean IFI score was 8.2 (SD: 2.1). In the fully adjusted model, compared to reference groups, infants of mothers aged under 20 years (β1.39, 95%CI:1.66-1.11), with no secondary school qualification (β1.19, 95%CI:1.45-0.93), who smoked before and during pregnancy (β1.03, 95%CI:1.22-0.84), or lived in a deprived neighbourhood (β 0.91, 95%CI:1.08-0.74) scored lower on the IFI. Compared to European infants, Māori, Pacific and Asian infants scored on average 0.62 (β, 95%CI:0.80-0.44); 0.89 (β, 95%CI:0.07-0.71), 0.46 (β, 95%CI:0.63-0.29) adjusted points lower on the IFI, respectively.

Conclusions: This study highlights the impact maternal education, neighbourhood deprivation and ethnicity have on infant feeding practices in New Zealand. Culturally appropriate policies are needed that specifically address infant nutrition inequities (particularly, to support breastfeeding, introduction of complementary foods, and increased fruit and vegetable intake). Additionally, policies that support women to be well educated and smokefree may help to improve infant nutrition.