Breastfeeding

The Department of Health and Human Services has set a goal, by the year 2000, of increasing the percentage of women who breastfeed their infants to at least 75 percent at hospital discharge and to at least 50 percent at five to six months postpartum. Poor women, such as those served by the Special Supplemental Food Program for Women, Infants, and Children (WIC), breastfeed less than other U.S. women. Concern about WIC mothers' low rates of breastfeeding prompted Congress to set aside $8 million annually to promote breastfeeding during fiscal years 1990-94. This report determines (1) how promotional funds for breastfeeding are being spent and what WIC is doing to promote breastfeeding, (2) to what degree breastfeeding promotion is an integral part of local WIC services, (3) whether encouraging WIC participants to breastfeed would reduce WIC food program costs at the program's current funding level or if WIC were funded so that all eligible participants could be served, (4) how effective current WIC efforts to promote breastfeeding are, and (5) whether any 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

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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