Breastfeeding
Report 2021-2022

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  • Breastfeeding Report 2021-2022

Improve annual breastfeeding outcomes of Indiana WIC participants through promotion and support of breastfeeding mothers.

Introduction

The Indiana WIC program provides supplemental foods, health care referrals, breastfeeding support, and nutrition education for low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age five who are found to be at nutritional risk. WIC promotes breastfeeding as the optimal method of infant nutrition.

Breastfeeding support and promotion continue to be one of the main goals for the Indiana WIC Program. Parents who breastfeed are eligible for a larger food package and longer participation in the program. The Indiana WIC program provides several breastfeeding supports for clients including breastfeeding education, breastfeeding supplies and aids, and access to Peer Counselors and Designated Breastfeeding Experts.

As part of the requirements for administering the WIC program, Indiana WIC reports client breastfeeding data to USDA’s Food & Nutrition Service (FNS), which is included in the Breastfeeding Data by Local Agency (BFDLA) report each year. The BFDLA report compares all local WIC agencies across the country on their client breastfeeding status by certification category, specifically looking at the infants who participated in the program in a given fiscal year.

WIC infant categories include:
– Fully Breastfeeding (IBE)
– Breastfeeding Partial (IBP)
– Fully Formula (IFF)

The goal of WIC Breastfeeding Promotion & Support is to improve the percentage of clients who fall within the Fully and Partial Breastfeeding categories, with an emphasis on improving exclusivity.

This report presents Indiana WIC client breastfeeding data statewide by individual county and agency.

breastfedding

Figure 1. Indiana WIC Program Trends in Breastfeeding, 2012-2022

Breastfeeding Charts

Figure 2. Trends in Breastfeeding Initiation by Race/Ethnicity, 2012-2022

Breastfeeding Charts
Figure 3. Percentage of Infants Breastfed for at Least 3, 6 And 12 Months by Race and Ethnicity, FY22
Breastfeeding Charts 2022
Breastfed
Duration Among
Figure 4. Prevalence of Breastfeeding Duration Among Ever Breastfed Infants, FY22
Breastfeeding Charts 2022

Initiation and Duration

TABLE 1. Prevalence of Breastfeeding Initiation and Duration to 3, 6 and 12 Months Among Indiana WIC Infants by Selected Maternal Characteristics, FY22
Maternal Age Ever Breastfed BF 3 Mo. BF 6 Mo. BF 12 Mo.
<15 yrs 62.8% 8.1% 4.8% 2.3%
15-19 yrs 74.6% 22.1% 12.6% 5.3%
20-29 yrs 72.4% 33.7% 22.3% 11.1%
30-39 yrs 77.5% 32.0% 30.0% 16.6%
39+ yrs 78.0% 45.0% 32.1% 20.7%
Maternal Marital
Status
Ever Breastfed BF 3 Mo. BF 6 Mo. BF 12 Mo.
Single 74.2% 30.5% 19.1% 9.1%
Married 81.6% 37.9% 32.5% 20.6%
Maternal
Education
Ever Breastfed BF 3 Mo. BF 6 Mo. BF 12 Mo.
8th grade and less 76.6% 30.3% 28.1% 16.4%
9th to 11th grade 69.1% 25.1% 15.5% 6.7%
High school 75.4% 31.6% 20.0% 9.9%
Some college 82.5% 42.3% 29.7% 15.7%
College graduate 83.0% 43.2% 36.3% 26.2%
Smoking During
Pregnancy
Ever Breastfed BF 3 Mo. BF 6 Mo. BF 12 Mo.
No 78.4% 36.0% 22.6% 12.2%
Yes 65.3% 22.2% 10.0% 4.0%
Household Smoking
During Pregnancy
Ever Breastfed BF 3 Mo. BF 6 Mo. BF 12 Mo.
No 75.4% 36.1% 20.9% 12.1%
Yes 68.2% 18.0% 9.9% 4.3%
Anemia During
Pregnancy
Ever Breastfed BF 3 Mo. BF 6 Mo. BF 12 Mo.
No 76.5% 32.2% 24.2% 11.4%
Yes 82.0% 27.5% 12.1% 2.5%
Trimester at
Enrollment
Ever Breastfed BF 3 Mo. BF 6 Mo. BF 12 Mo.
1st Trimester 75.3% 36.6% 25.1% 12.8%
2nd Trimester 76.8% 32.5% 24.1% 11.4%
3rd Trimester 72.4% 31.1% 20.0% 7.6%
TABLE 2. Prevalence of Fully Breastfeeding Rates at 3 and 6 Months Among Indiana WIC Fully Breastfed Infants by Selected Maternal Characteristics, FY22
Maternal Age Fully Breastfed 3 Mo. Fully Breastfed 6 Mo.
<15 yrs 0.0% 0.0%
15-19 yrs 43.3% 39.2%
20-29 yrs 54.3% 54.3%
30-39 yrs 61.0% 54.2%
39+ yrs 75.3% 66.3%
Maternal Marital
Status
Fully Breastfed 3 Mo. Fully Breastfed 6 Mo.
Single 60.8% 50.7%
Married 73.3% 57.8%
Maternal
Education
Fully Breastfed 3 Mo. Fully Breastfed 6 Mo.
8th grade and less 52.0% 49.0%
9th to 11th grade 55.3% 43.4%
High school 61.5% 52.5%
Some college 66.9% 61.7%
College graduate 77.7% 72.2%
Smoking During
Pregnancy
Fully Breastfed 3 Mo. Fully Breastfed 6 Mo.
No 64.2% 51.0%
Yes 53.1% 36.1%
Household Smoking
During Pregnancy
Fully Breastfed 3 Mo. Fully Breastfed 6 Mo.
No 64.1% 50.4%
Yes 50.1% 36.0%
Anemia During
Pregnancy
Fully Breastfed 3 Mo. Fully Breastfed 6 Mo.
No 63.1% 50.0%
Yes 43.7% 40.2%
Trimester at
Enrollment
Fully Breastfed 3 Mo. Fully Breastfed 6 Mo.
1st Trimester 64.0% 51.1%
2nd Trimester 63.1% 49.7%
3rd Trimester 62.0% 46.2%
Clients enrolled in the first trimester of pregnancy have higher rates of breastfeeding compared to those enrolled during the second and third trimesters.
heart-increase

Total infants served that were breastfed increased from

29.0%

in FY21

TO

32.3%

in FY22

Governor Holcomb has challenged Indiana to reduce the rate of infant deaths and be the “best in the Midwest” for infant mortality by 2024.

Breastfed babies have a 21% lower risk of death in their first year compared with babies never breastfed, and risk reduction increases with breastfeeding duration of three months or more.

flag

One local agency, Whitley County WIC Program, has exceeded the Healthy People 2020 objective to increase the proportion of ever breastfed infants to 81.9%.

TABLE 3. Prevalence of Breastfeeding Initiation and Breastfeeding Duration to 3, 6 and 12 Months in Top Five Indiana WIC Local Agencies, FY22
Highest Prevalence of Breastfeeding Initiation
1
PORTER
82.8%
2

MONROE

82.7%
3
BROWN
82.7%
4
ADAMS
81.8%
5
ELKHART
81.7%
Highest Prevalence of Breastfeeding to 3 Months
1
HANCOCK

43.7%

2
STEUBEN
43.4%
3
WHITLEY

41.3%

4
MONROE
41.1%
5
MARTIN

40.6%

Highest Prevalence of Breastfeeding to 6 Months
1
LAGRANGE
35.9%
2
OWEN
33.3%
3
STEUBEN

33.2%

4
HENDRICKS

32.0%

5
MARTIN
31.1%
Highest Prevalence of Breastfeeding to 12 Months
1
BROWN
30.7%
2
HANCOCK

19.4%

3
LAGRANGE
19.1%
4
WHITLEY
18.3%
5
STEUBEN
18.1%
TABLE 3. Prevalence of Breastfeeding Initiation and Breastfeeding Duration to 3, 6 and 12 Months in Top Five Indiana WIC Local Agencies, FY22
Highest Prevalence of Breastfeeding Initiation
1
PORTER I.D. 22
82.8%
2
MONROE I.D. 25
82.7%
3
BROWN I.D. 58
82.7%
4
ADAMS I.D. 12
81.8%
5
ELKHART I.D. 8
81.7%
Highest Prevalence of Breastfeeding to 3 Months
1
HANCOCK I.D. 11

43.7%

2
STEUBEN I.D. 50
43.4%
3

WHITLEY
I.D. 1

41.3%

4
MONROE I.D. 25
41.1%
5
MARTIN I.D. 62

40.6%

Highest Prevalence of Breastfeeding to 6 Months
1
LAGRANGE I.D. 49
35.9%
2
OWEN I.D. 17
33.3%
3
STEUBEN I.D. 50

33.2%

4
HENDRICKS I.D. 32

32.0%

5

MARTIN
I.D. 62

31.1%
Highest Prevalence of Breastfeeding to 12 Months
1
BROWN I.D. 58
30.7%
2
HANCOCK I.D. 11

19.4%

3
LAGRANGE I.D. 49
19.1%
4
WHITLEY I.D. 1
18.3%
5
STEUBEN I.D. 50
18.1%
Map Pin

Breastfeeding Statistics by County

Indiana WIC Breastfeeding Initiation by County, FY2021

Indiana WIC Breastfeeding Initiation by County, FY2022

Indiana WIC Prevalence of Breastfeeding at 3 Months by County, FY2021

Indiana WIC Prevalence of Breastfeeding at 3 Months by County, FY2022

Indiana WIC Prevalence of Breastfeeding at 6 Months by County, FY2021

Indiana WIC Prevalence of Breastfeeding at 6 Months by County, FY2022

Indiana WIC Prevalence of Breastfeeding at 12 Months by County, FY2021

Indiana WIC Prevalence of Breastfeeding at 12 Months by County, FY2022

Breastfeeding Cessation

Figure 5. Reasons for Breastfeeding Cessation, FY22
Breastfed

Biggest Changes from FY2020

Reasons for discontinuing breastfeeding:

Since 2018 10% increase in clients reporting that they met their breastfeeding goal.

Fewer women reporting stopping due to:

+5.8%

increase in women meeting their breastfeeding goal

-5.2%

decrease in reporting that they did not have enough milk

Biggest Changes from FY2020

Since 2018, Indiana WIC has seen a 10% increase in clients reporting that they met their breastfeeding goal.

Reasons for discontinuing breastfeeding:

Fewer women reporting stopping due to:

+5.8%

increase in women meeting their breastfeeding goal

-5.2%

decrease in reporting that they did not have enough milk

training

Breastfeeding Support & Training

Breastfeeding support is prioritized in our Annual State and Nutrition Education Plans. We ensure quality staff training so that clients are provided current, evidence-based education to make informed decisions around their infant feeding goals. We develop tools and trainings for new clinic staff that ensure staff education and training is consistent around the state.
FY22 Lactation Education Opportunities:

66

staff
attended

LEC’s Diversity, Equity, and Inclusion training

25

staff
attended

A Certified Lactation Specialist course

50

staff
attended

The Advanced Course in Clinical Lactation

These trainings allow staff to gain skills, feel more confident helping our breastfeeding clients and improve our breastfeeding outcomes around the state.

Breastfeeding Talk
Calendar

298

staff attended a WIC Breastfeeding Support Curriculum Training with Cathy Carothers.

Peer Counselor Support

WIC Peer Counselors are paraprofessionals who provide breastfeeding promotion, education and support to WIC participants. Peer Counselors are mothers from WIC’s target population who have similar racial/ethnic backgrounds to the mothers they support. Peer Counselors have experience breastfeeding at least one baby and are accessible to WIC clients during and outside usual clinic hours, as well as in or outside of the WIC clinic environment.

training

50,897 in FY21
52,135 in FY22

Peer Counselor Referrals for New WIC Clients

mountain flag

272,451 in FY21
281,412 in FY22

Contacts Made by Peer Counselors for Support

Indiana-Heart

100+

Peer Counselors Support Clients Across the State

peer counselor

WIC breastfeeding moms are more likely to continue breastfeeding at 6 and 12 months if they’ve been contacted by a peer counselor.

WIC Support During the Pandemic

Indiana WIC remains committed to serving families and continuing daily operations during the COVID-19 pandemic. Local agency staff have adapted services during the pandemic to provide flexibility and easy access to WIC participants. The information below tells the story of how WIC staff have stepped up to the plate during the pandemic. 

pandemic talk

Peer Counselors have followed safety guidelines by wearing PPE masks for home and in-person visits.

Indiana WIC Response
pandemic work

Local agencies set new highs in prevalence of breastfeeding in 3 Month, 6 Month and 12 Month categories from 2019!

Indiana WIC remains committed to serving families and continuing daily operations during the COVID-19 pandemic.

Local agencies have offered virtual classes and phone support by call or text and added more breastfeeding content to the WIC Nutrition Education app.

An additional 69,953 contacts were made by Peer Counselors for support compared to 2019.

support
services

Local agencies increased the issuance of breast pumps to mothers.

International Board Certified Lactation Consultant pilot expanded into two agencies, Tippecanoe and New Hope Services.

Breastfeeding Cessation

Figure 5. Reasons for Breastfeeding Cessation, FY22
Breastfeeding Cessation Reasons chart

Biggest Changes from FY2020

Reasons for discontinuing breastfeeding:

Since 2018 10% increase in clients reporting that they met their breastfeeding goal.

Fewer women reporting stopping due to:

+5.8%

increase in women meeting their breastfeeding goal

-5.2%

decrease in reporting that they did not have enough milk

award

Awards

logo

USDA FNS established the Loving Support Award of Excellence in 2014 “to recognize local WIC agencies that have provided exemplary breastfeeding promotion and support activities.” The intent is to provide models and motivate local agencies to strengthen their breastfeeding promotion and support activities and ultimately increase breastfeeding initiation, exclusivity and duration rates among WIC participants.

The award is given at three levels of performance that build on one another:

Gold · Gold Premiere · Gold elite

This approach recognizes three groups of agencies that include those that are demonstrating model practices, as well as those who are at varying stages of implementing exemplary breastfeeding promotion and support practices.

WIC Breastfeeding Award of Excellence Winners

Gold
Premiere
Award

The Gold Premiere and Gold Elite Awards require local agencies to submit an additional application to be considered, in addition to achieving a Fully Breastfeeding category of at least 15% for Premiere and 40% for Elite.

Gold
Award

To receive the Gold Award, local WIC agencies must complete an application which evaluates the policies and procedures surrounding breastfeeding promotion and support, the Breastfeeding Peer Counselor program and partnerships with local hospitals and other organizations working toward similar breastfeeding goals.

This institution is an equal opportunity provider.

Side Lying Hold

Side-Lying Hold

  1. For the right breast, lie on your right side with your baby facing you.
  2. Pull your baby close. Your baby’s mouth should be level with your nipple.
  3. In this position, you can cradle your baby’s back with your left arm and support yourself with your right arm and/or pillows.
  4. Keep loose clothing and bedding away from your baby.
  5. Reverse for the left breast.

This hold is useful when:

Cross Cradle Hold

Cross-Cradle Hold

  1. For the right breast, use your left arm to hold your baby’s head at your right breast and baby’s body toward your left side. A pillow across your lap can help support your left arm.
  2. Gently place your left hand behind your baby’s ears and neck, with your thumb and index finger behind each ear and your palm between baby’s shoulder blades. Turn your baby’s body toward yours so your tummies are touching.
  3. Hold your breast as if you are squeezing a sandwich. To protect your back, avoid leaning down to your baby. Instead, bring your baby to you.
  4. As your baby’s mouth opens, push gently with your left palm on baby’s head to help them latch on. Make sure you keep your fingers out of the way.
  5. Reverse for the left breast.

This hold is useful when:

Football Hold

Clutch or “Football” Hold

  1. For the right breast, hold your baby level, facing up, at your right side.
  2. Put your baby’s head near your right nipple and support their back and legs under your right arm.
  3. Hold the base of your baby’s head with your right palm. A pillow underneath your right arm can help support your baby’s weight.
  4. To protect your back, avoid leaning down to your baby. Bring baby to you instead.
  5. Reverse for the left breast.

This hold is useful when:

Breastfeeding Holds

Cradle Hold

  1. For the right breast, cradle your baby with your right arm. Your baby will be on their left side across your lap, facing you at nipple level.
  2. Your baby’s head will rest on your right forearm with your baby’s back along your inner arm and palm.
  3. Turn your baby’s tummy toward your tummy. Your left hand is free to support your breast, if needed. Pillows can help support your arm and elbow.
  4. To protect your back, avoid leaning down to your baby. Instead, bring your baby to you.
  5. Reverse for the left breast.

This hold is useful when:

Breastfeeding Holds

Laid-Back Hold

  1. Lean back on a pillow with your baby’s tummy touching yours and their head at breast level. Some moms find that sitting up nearly straight works well. Others prefer to lean back and lie almost flat.
  2. You can place your baby’s cheek near your breast, or you may want to use one hand to hold your breast near your baby. It’s up to you and what you think feels best.
  3. Your baby will naturally find your nipple, latch, and begin to suckle.

This hold is useful when: