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Advocates of WIC-Funded Breastfeeding Programs Concerned About Funding Levels [1]

['Ava Kian']

Date: 2024-03-04

This story was originally published by MinnPost.

Minnesota’s federally funded breastfeeding support programs are at risk of not receiving enough funding next year, advocates of the initiative say, meaning new prospective participants could be turned away and that services could be reduced.

Many counties across the state already lack the support programs, which are part of the federal Supplemental Nutrition Program for Women, Infants and Children (WIC) that offers help to families with children under the age of 5, according to Alyssa Fritz, a researcher at the University of Minnesota’s School of Public Health.

Fritz, who worked on a study that analyzed the impacts of these programs, worries that a lack of funding for the WIC program will impact the state’s ability to provide the peer breastfeeding support program in those regions where research has shown its benefits. The USDA initially expected WIC to cost around $6.3 billion in 2024 but is now projecting the yearly cost to exceed $7 billion, with no guarantee that Congress will increase funding for the program.



A University of Minnesota study found that the breastfeeding support program helped grow breastfeeding rates and the duration for which people breastfed, particularly in rural areas of the state. It looked at the impacts on counties that rolled out peer breastfeeding support programs between 2012 and 2019.

Minnesota has 18 breastfeeding support programs around the state. In 2019, the program had around 7,000 participants, according to the Minnesota Department of Health.

Fritz said that the benefits to breastfeeding have been well researched, and include things like lower risk of ear infections for babies, lower rates of gastrointestinal illnesses and lower rates of Type 1 of diabetes and asthma, among other things. It also benefits the person breastfeeding, as studies have shown it reduces risk of breast and ovarian cancer later in life and reduces Type 2 diabetes.

Success in Greater Minnesota

Counties in Greater Minnesota with the peer support program had an increase from 42% to 45% in the proportion of participants breastfeeding for three months or longer and an increase from 30% to 33% in the proportion that breastfed for at least six months compared to counties without the program, the study found.

Peer counselors offer support to families. The counselors are local people who provide in-person, text and/or phone-based counseling to help people meet their breastfeeding goals.

Fritz said that when breastfeeding, people sometimes deal with clogged ducts that can lead to mastitis.

“It can be uncomfortable, especially for a first-time breastfeeding person. It can be kind of scary. Being able to pick up your phone and text your counselor or call them … something like that could be really valuable,” she said.

Families are usually referred into the WIC program by a physician and must qualify for the program based on its income and household size. Families who have children on Medicaid under age five can also qualify.

“Many individuals will say, ‘Well, I’d like to breastfeed, I’ll do it if I can, or I’m not sure about it, or maybe my mom tried and she couldn’t do it or my sister breastfed all breastfeed.’ We get a whole slew of answers there. But that opens up the door for us to provide a referral, you know, ‘If you are interested in this, we would love to provide some support and education for you,” said Jenny Barta, a public health nurse specialist and the WIC program’s coordinator for Carlton County Public Health & Human Services.

Jenny Barta with Logan in a lactation room. (Photo supplied by Jenny Barta)

There has never been enough federal funding to allow all agencies to offer the program, meaning that not all WIC offices have it. The study showed that being close to an area with a program had positive effects for counties that didn’t have their own programs.

“Counties that were bordering or even a little further out from that central county that had the program, those counties seem to have some increases in their breastfeeding rates too,” Fritz said.

Carlton County Public Health & Human Services covers a seven-county area that includes eight WIC agencies. There are nine peer counselors who offer the peer support through telephone, texting or sometimes in person to WIC participants.

“We have a few counties in our Northeast region that don’t even have a birthing hospital within their county borders. We know that families are traveling long distances already for their birthing and delivery care,” Barta said. “Once a patient is discharged and a family goes home with a newborn, sometimes there are more challenges that come up, especially when you’re breastfeeding or trying to pump.

While the study didn’t look into the reasons why the programs had bigger impacts in rural communities, Fritz said that past research has shown that rural communities have less access to maternal health supports, such as clinical lactation consultants and staff who help with breastfeeding. She also said workplace policies in those areas may be less supportive of breastfeeding.

Fritz, who worked with Dakota County’s WIC program from 2013 to 2016, said peer breastfeeding support programs are even more important in areas that lack those other supports, or ‘protective factors’ as she called them.

“A program like this couldn’t address all the barriers, but it could provide socially supportive peers who… have themselves potentially faced those challenges. They can be a problem solving coach or mentor for someone in their community to potentially mitigate some of the effects, some of the challenges that are faced by rural people that want to breastfeed,” Fritz said.

Barta said she’s seen high breastfeeding rates and higher rates of longer duration in the Northeast region.

“We feel this is, in part, due to the pure breastfeeding support program that we have for our WIC families because we know that women who are eligible for WIC have more potential for other disparities,” Barta said. “They might have some disparities in medical or health care access or access to healthier food choices.

The researchers weren’t able to look at what urban counties, however, because only three of them implemented new programs from 2012 to 2019, Fritz said. Many more rural programs were started in that timespan.

Fritz said the impacts were strongest in rural communities, with an increase from 40% to 44% of participants breastfeeding until at least three months, and the proportion who breastfed for six months or longer rising from 29% to 33% in rural counties that offered the program.

A program that works

Offices in certain areas of the state, like Southwest Health and Human Services, saw growth in program participants. That organization, which serves six counties in southwestern Minnesota, had the highest increase of people who were breastfeeding in the program and continued breastfeeding for six months – with the rates increasing from 37% to 44% in the service area. This was the largest increase during the study period.

“The implications of our study are that funding the peer breastfeeding counseling program could be a cost effective way to support breastfeeding rates, especially in rural places,” Fritz said.

Participation in Minnesota WIC Peer Breastfeeding Support Programs, 2019. (Graph by Minnesota Department of Health)

In 2022, Minnesota received additional peer breastfeeding funding from USDA – and the number of programs in the state increased from 14 to 18. Participation rates in WIC programs in Minnesota is higher than the national average, at just over 51%.

After dropping during the pandemic year of 2021, breastfeeding rates increased during 2022, according to the Minnesota Department of Health. The agency says that meeting the breastfeeding recommendations could save $13 billion in national annual medical costs and prevent more than 900 deaths.

The current funding levels that congress provides WIC will not cover all eligible participants and those seeking to join the WIC program for the full year. If the funding is not increased, WIC offices in the country might need to scale back their programs, which could impact the peer breastfeeding support program. They also may end up needing to turn away participants from other services too.

Earlier this month, U.S. Secretary of Agriculture Tom Vilsack visited a public assistance office in St. Paul and highlighted the need for Congress to fully fund WIC in 2024.

“If WIC does not get increased funding soon it will have to start turning away people from all their programs, not just the optional peer counseling program. But they won’t be able to serve everyone that applies to the program,” Fritz said. “Our study comes at a time where we’re showing that one of WIC’s programs is really effective, and could use more funding, and it’s coming at a time that actually funding for the full program is in jeopardy.”

Ava Kian is MinnPost’s Greater Minnesota reporter. Follow her on Twitter @kian_ava or email her at [email protected].

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