The findings are based on an analysis of 1,851 participants in the nationally representative WIC Infant and Toddler Feeding Practices Study-2. The researchers examined families’ experiences with WIC during pregnancy and early infancy, then compared those experiences with whether participants remained enrolled through the child’s first year. Approximately 15 percent of the families in the analysis exited WIC early. The study offers a detailed look at engagement not simply as a measure of attendance, but as a collection of behaviors that may reveal whether families are successfully connecting with the resources WIC provides.

WIC is one of the largest public nutrition programs in the United States, supporting millions of pregnant and postpartum women, infants, and young children each month. Its services extend beyond the distribution of supplemental foods. Participants may receive individualized nutrition education, breastfeeding support, referrals to medical and social services, and guidance related to infant feeding and child development. Because the program is designed to operate throughout pregnancy, infancy, and early childhood, continued participation can provide an ongoing layer of nutritional and preventive support during a period of rapid growth.

The analysis showed that families who enrolled later in pregnancy were more likely to leave WIC before their child reached 13 months. Earlier enrollment may give participants more time to understand eligibility requirements, establish relationships with program staff, learn how benefits work, and connect with services before the demands of caring for a newborn intensify. It may also indicate that families who enter WIC earlier have fewer logistical barriers or are more likely to recognize the program as a continuing source of support rather than a short-term emergency resource.

Benefit redemption was another important marker. Participants who did not redeem all of their available WIC food benefits had a higher likelihood of exiting early. WIC benefits are carefully designed to provide foods such as fruits and vegetables, whole grains, milk, eggs, infant foods, and other items that support nutritional needs during pregnancy and early childhood. Failure to use benefits may reflect practical obstacles, including transportation problems, limited store access, changing household circumstances, confusion about eligible products, or difficulty fitting shopping into a family’s schedule. It may also signal that the program is not yet aligned with a household’s immediate needs.

The study also identified the importance of information and counseling. Families were more likely to leave early if they had not received breastfeeding information from WIC or had not relied on WIC for advice about feeding an infant. These findings suggest that nutrition education may influence retention in ways that are not captured by food assistance alone. When participants use WIC as a trusted source of technical guidance—particularly during the transition from pregnancy to newborn care—the program may become more relevant to daily decisions about breastfeeding, formula feeding, introducing solid foods, and responding to an infant’s changing nutritional requirements.

Infant feeding is a technically complex period for families. Newborn nutritional needs change quickly, breastfeeding can require skilled support, and caregivers must navigate questions about formula preparation, hunger and satiety cues, allergy prevention, and the timing and texture of complementary foods. WIC’s counseling and referral systems are intended to help families interpret this information and connect it to their own circumstances. The new findings do not prove that receiving counseling directly prevents families from leaving, but they indicate that early use of these services is linked with longer participation.

Participation in other public assistance programs also appeared to matter. Families who were not enrolled in other assistance programs were more likely to exit WIC early. This pattern may reflect differences in how households interact with public services, rather than a direct effect of receiving or not receiving another benefit. Families connected to multiple programs may have more established relationships with caseworkers, greater familiarity with eligibility procedures, or more frequent contact with systems that help them maintain enrollment. Those outside other assistance programs may face greater isolation from support networks or may encounter administrative barriers that make continued WIC participation more difficult.

The researchers emphasize that the results point toward opportunities to strengthen engagement during pregnancy and the earliest months of a child’s life. WIC agencies could potentially improve retention by offering clearer onboarding, making benefit redemption easier, expanding flexible appointment and communication options, and ensuring that breastfeeding and infant-feeding guidance is readily available. Early outreach may be especially valuable for families who enroll late, redeem few benefits, or do not initially seek nutrition information. Identifying these patterns quickly could allow staff to provide targeted assistance before a family disengages completely.

The study arrives as WIC marks its 50th anniversary and as public health researchers continue to examine how effectively the program reaches families over time. Its central message is that enrollment alone may not capture the quality of a family’s connection to nutrition assistance. The first months after birth can establish whether WIC becomes an integrated part of household health care or a benefit that is difficult to access and use. By helping families engage with food benefits, breastfeeding resources, nutrition education, and referrals early, the program may improve continuity of participation and increase the chance that children receive sustained nutritional support during a critical stage of development. The researchers caution, however, that the observed relationships are associations rather than proof of cause and effect; further studies will be needed to determine which specific interventions most effectively keep families enrolled.

Subject of Research: People

Article Title: Less Engagement With the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Early Infancy Predicts Early Exits from the Program

News Publication Date: August 12, 2026

Web References: Journal of Nutrition Education and Behavior; https://doi.org/10.1016/j.jneb.2025.12.013

References: Hodges et al., “Less Engagement With the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Early Infancy Predicts Early Exits from the Program,” Journal of Nutrition Education and Behavior, DOI: 10.1016/j.jneb.2025.12.013

Image Credits: Journal of Nutrition Education and Behavior

Keywords: WIC, maternal and infant nutrition, breastfeeding support, infant feeding, public health, nutrition education, food assistance, program retention, early infancy, child health

Historically, WIC infant food packages have been considered a powerful indirect measure for gauging breastfeeding status and duration among enrolled mothers and infants. The program’s allocations, which can reach up to 13,071 milliliters of infant formula per month for infants aged twelve months or younger, have conventionally mirrored individual feeding choices. Researchers have relied on these package data as a cost-effective and scalable means to approximate breastfeeding prevalence without subjecting families to extensive surveys or in-person assessments. However, with the advent of remote WIC services and the deployment of a new MIS platform, this reliability was thrown into question.

The 2026 study conducted by Anderson, Yang, and Whaley offers the first comprehensive evaluation of how these systemic changes have influenced the interpretability of WIC infant food package data. The authors highlight that telephone-based breastfeeding assessments, while increasing program reach and flexibility during the COVID-19 pandemic and its aftermath, introduced potentially complex nuances to data collection. Unlike direct observations or face-to-face interviews with lactation specialists, remote assessments rely on self-reports that could be subject to reporting biases or communication barriers, impacting the accuracy of recorded breastfeeding status.

Moreover, the new MIS system aimed to automate and enhance data capture and package assignment for enrolled infants. While improved digital infrastructure suggests greater efficiency and data integrity on the surface, the study illuminates the intricate coding of infant package options that underwent modification to accommodate the remote model. These changes, although operationally justified, complicated the straightforward interpretation of package data as a direct proxy for infant feeding behaviors due to an expanded variety of infant food package permutations.

The research investigated whether infant food package data collected under this modernized infrastructure could still reliably reflect true breastfeeding practices—specifically focusing on initiation, exclusivity, and duration. Using an extensive dataset from multiple WIC sites across diverse demographic settings, the study juxtaposed self-reported breastfeeding status with infant food package assignment records. By analyzing discrepancies and concordances, Anderson and colleagues methodically assessed the sensitivity and specificity of package data as a breastfeeding proxy in a post-2020 context.

Findings suggest a nuanced reality; although infant food package data continue to hold value as a proxy measure, their interpretation now demands greater contextual awareness of how remote service delivery impacts feeding support. The new MIS triggered a proliferation of alternative infant formula and human milk supplement packages designed to meet differing family needs remotely. Consequently, the simplistic binary assumption—formula versus breastmilk—became less applicable, necessitating refined analytical frameworks to decode package compositions correctly.

Another layer of complexity emerged around the telephone-based breastfeeding assessments themselves. The study highlights that these assessments, while beneficial for expanding participant accessibility and reducing logistical barriers, might introduce variabilities in how breastfeeding duration is reported. The reliance on remote communication potentially affected the granularity of breastfeeding stage information—such as distinguishing partial breastfeeding from exclusive breastfeeding—which is critical for sound epidemiological study and tailored nutritional guidance.

In addition, the authors emphasize external socioeconomic and behavioral factors that interplay with WIC package selection and breastfeeding practices. Remote assessments, in some cases, created challenges in rapport building between breastfeeding counselors and participants. This sometimes resulted in underreporting breastfeeding intention or over-reliance on formula provision as a precautionary measure, further diluting the proxy power of infant food package data. The report encourages ongoing training and improvements to remote assessment protocols to mitigate these issues.

Crucially, Anderson’s study advocates for the incorporation of mixed-methods research designs moving forward. Purely quantitative reliance on MIS infant food package records must be complemented with qualitative insights gleaned from participant interviews and counselor feedback. This integrative approach can resolve ambiguities and enhance confidence in interpreting WIC data for public health monitoring and breastfeeding promotion strategies.

The research also recommends that policymakers and WIC program administrators reconsider how infant package options are categorized and reported within the MIS ecosystem. Standardizing definitions and documentation of infant feeding categories—even within a remote service context—would strengthen longitudinal comparisons and national trend analyses. Adjusting the MIS to capture richer data on partial breastfeeding and mixed feeding practices stands out as a pivotal step.

Importantly, this study underscores WIC’s role as a bellwether for national infant nutrition trends, given its broad reach among vulnerable populations. Reliable measurement of breastfeeding via programmatic data influences not only health outcomes research but also funding priorities and the design of maternal-child health interventions. Ensuring the fidelity of breastfeeding proxies in the era of digital and remote health service delivery is therefore both a methodological and policy imperative.

As the world continues to embrace telehealth and remote services beyond pandemic exigencies, the implications of remote WIC assessments in infant nutrition research resonate globally. Anderson and colleagues’ work provides a valuable template for other countries and nutritional assistance programs grappling with similar challenges. It highlights the delicate balance between technological innovation and the nuanced realities of human health behavior assessment.

In conclusion, despite the challenges introduced by remote service transformations and new information technologies, WIC infant food package data remain a relevant proxy for infant feeding practices. However, their application must be cautious, contextually informed, and supplemented by richer, multidimensional data sources. This study paves the way for future research to optimize data accuracy and ultimately support better nutritional outcomes for millions of mother-infant dyads nationwide.

The findings represent a watershed moment in understanding how administrative program data can adapt to evolving healthcare delivery models while preserving their epidemiological value. They call for a renewed emphasis on training, system design, and analytic techniques that honor the complexity of infant feeding behaviors in a technologically progressive era. As WIC continues to evolve, its data will remain vital for illuminating infant nutrition landscapes but must be wielded with calibrated sophistication.

Subject of Research:
The reliability of WIC infant food package data as a proxy for breastfeeding status and duration in the context of remote service delivery and a new management information system.

Article Title:
Using Special Supplemental Nutrition Program for Women, Infants and Children infant food packages as a proxy for breastfeeding status and duration.

Article References:
Anderson, C.E., Yang, Fc. & Whaley, S.E. Using Special Supplemental Nutrition Program for Women, Infants and Children infant food packages as a proxy for breastfeeding status and duration. Pediatr Res (2026). https://doi.org/10.1038/s41390-026-04787-x

Image Credits: AI Generated

DOI: 28 January 2026