Women, Infants and Children (WIC)

Breastfeeding Promotion in WIC: Current Federal Requirements

Last Modified: 11/19/2013

The current federal WIC regulations contain provisions to encourage women to breastfeed and to provide appropriate nutritional support for breastfeeding participants.

CITATION

PROVISION

246.2

Definitions.
Breastfeeding means the practice of feeding a mother’s breast milk to her infant(s) on the average of at least once a day.

Breastfeeding women means women up to one year postpartum who are breastfeeding their infants.

246.3(e)(4)

State staffing standards.  
Each State agency shall designate a breastfeeding promotion coordinator, to coordinate breastfeeding promotion efforts identified in the State plan in accordance with the requirement of 246.4(a)(9).  The person to whom the State agency assigns this responsibility may perform other duties as well.

246.4(a)(9)

State Plan
The State Plan must include the State agency’s nutrition education goals and action plans, including a description of the methods that will be used to promote breastfeeding.

 

246.7  (e)(1)(iii)

  246.7 (e)(4)(i)

 

 

Certification of Participants.  
Breastfeeding Dyads.  A breastfeeding mother and her infant shall be placed in the highest priority level for which either is qualified.  

Nutritional risk priority system.  Priority I: pregnant women, breastfeeding women and infants at nutritional risk as demonstrated by hematological or anthropometric measurements or other documented nutritionally related medical conditions which demonstrate the need for supplemental foods. 

246.7(g)(1)(iii)

Certification Periods.  
Breastfeeding women shall be certified at intervals of approximately six months and ending with the breastfed infant’s first birthday.

246.10(e)(1)-(e)(9)

Supplemental Foods.  
Food Package categories distinguish between fully breastfeeding, partially breastfeeding, and fully formula feeding mother/infant pairs.

Whether or not a breastfeeding woman receives a food package and which food package she is assigned is based on the amount of infant formula received from WIC for her infant, and the age of the infant.

Fully breastfeeding food packages are for mothers and their babies who do not receive formula from WIC and are considered to be breastfeeding exclusively. Mothers and infants may receive this package until the infant is 12 months of age. For mothers, this package provides the largest quantity and variety of foods. For infants, this package provides twice the amount of infant food fruits and vegetables as the package for infants who receive formula, and also provides infant food meat.

Partially breastfeeding food packages are for mothers and their infants who mostly breastfeed but also receive some formula from WIC after the first month postpartum. Mothers and infants may receive this package until the infant is 12 months of age. For mothers, this package provides extra quantities and varieties of foods—more than for mothers who mostly formula feed. For infants, formula amounts are kept to a minimum to help mothers continue to successfully breastfeed.

Routine issuance of infant formula in the first month is not authorized to partially breastfeeding mothers to allow the establishment of successful breastfeeding.

Women who are not breastfeeding or only breastfeeding a minimal amount receive a WIC basic food package. Minimally breastfeeding women whose infants greater than 6 months of age receive more formula from WIC than is allowed for a partially breastfeeding infant do not receive a food package. They may receive other WIC benefits, however, such as breastfeeding support and breast pumps, nutrition education, and referrals to health and social services.
 

246.11(c)

 
246.11(c)(2)

 

246.11(c)(3)

 

   
246.11(c)(7)

 
246.11(e)(1)

 

Nutrition Education.  State agencies shall perform the following activities in carrying out nutrition education responsibilities:

Provide training on the promotion and management of breastfeeding to staff at local agencies who will provide information and assistance on this subject to participants. 

Identify or develop resources and educational materials for use in local agencies, including breastfeeding promotion and instruction materials; taking reasonable steps to include materials in languages other than English in areas where a significant number of or proportion of the populations needs the information in a language other than English.

Establish standards for breastfeeding promotion and support which include, at a minimum, the following:

(i)         A policy that creates a positive clinic environment which endorses breastfeeding as the preferred method of infant feeding;

(ii)         A requirement that each local agency designate a staff person to coordinate breastfeeding promotion and support activities;

(iii)        A requirement that each local agency incorporate task-appropriate breastfeeding promotion and support training into orientation programs for new staff involved in direct contact with WIC clients; and

(iv)        A plan to ensure that women have access to breastfeeding promotion and support activities during the prenatal and postpartum periods.

Participant Contacts.  
All pregnant participants shall be encouraged to breastfeed unless contraindicated for health reasons. 

246.14(b)(1)(iii)

 246.14(c)(1)

246.14(c)(10)

Program Costs.  
The State agency may use food funds to purchase or rent breast pumps.

Specified allowable nutrition services and administration (NSA) costs.  Each fiscal year, each state agency must spend, for nutrition education activities and breastfeeding promotion and support activities, an aggregate amount that is not less than the sum of one-sixth of the amount expended by the State agency for costs of NSA and an amount equal to its proportionate share of the national minimum expenditure for breastfeeding promotion and support activities.  The national minimum expenditure for breastfeeding promotion and support activities shall be equal to $21 multiplied by the number of pregnant and breastfeeding women in the Program, based on the average of the last three months for which USDA has final data.  On October 1, 1996 and each October 1 thereafter, the $21 will be adjusted annually using the same inflation percentage used to determine the national administrative grant per person. 

Costs of breastfeeding aids which directly support the initiation and continuation of breastfeeding are allowable.