A Qualitative Study of Breastfeeding and Formula-Feeding Mothers' Perceptions of and Experiences in WIC

Abstract

Objective: To explore Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants' perspectives about why formula-fed infants are less likely to be recertified at 1 year compared with breastfed infants.

Design: Four focus groups of WIC mothers, stratified by language spoken (English or Spanish) and feeding mode (breastfeeding [BF] or formula-feeding [FF]).

Setting: Two WIC sites within Los Angeles County, CA.

Participants: Mothers of 6- to 12-month-old infants (n = 31) in the WIC program.

Phenomenon of interest: Mothers' perceptions of (1) how WIC supports BF and FF mothers; and (2) experiences of FF mothers in WIC, with a focus on how these experiences may affect desire to recertify their infant in WIC at age 1 year.

Analysis: Thematic analysis of verbatim transcripts.

Results: Mothers in all focus groups discussed the perceived positive value of BF support, food assistance, nutrition education, referrals, convenient WIC services, and social support from staff. Themes related to experiences of FF mothers included feeling judged for not BF, perceptions of WIC as a formula provider, and perceived difficulties obtaining formula. Mothers indicated that these experiences affected motivations to recertify.

Conclusions and implications: Although WIC provides important and effective support to low-income families, especially related to BF, some FF mothers may feel underserved with respect to support for their feeding decisions.

Keywords: Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); breastfeeding; formula-feeding; nutrition education; program retention.