Maternal and child nutrition support in the food environment

Abstract

Infant feeding resources are often found within food environments yet have not been a main focus of food environment investigations. Food options in the retail environment are important, complex factor in dietary choices that can either be promotional or preventative of healthy behaviors. At the same time, breastfeeding is considered a top public health priority due to its unparalleled, favorable health outcomes that impact infants, mothers, and entire communities. For this reason the American Academy of Pediatrics recommends that breastfeeding continue for at least one year after birth. There are multiple practical and social barriers to breastfeeding for women that support the need for appropriate formula varieties in the food environment to support infant nutrition. The United States Department of Agriculture's (USDA) Food and Nutrition Service Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) promotes breastfeeding as an optimal source of nutrition for infants, and offers breastfeeding incentives for enrolled mother-infant pairs resulting in higher assistance allotment for foods, or formula supplements for non-breastfed infants. This research includes a systematic review of literature conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement guidelines in order to identify factors associated with increased likelihood of breastfeeding among WIC participants. This research also introduces a measure adapted from the Nutrition Environment Measure in Stores (NEMS-S) formulated to capture infant feeding support in the food environment. The Infant Feeding Resource Survey (IFRS) captures WIC-supported brand formulas and alternate brand varieties in addition to resource support necessary for breast or formula feeding in store settings. Review findings indicate sociodemographic characteristics, environmental and media support, government policy, intent to breastfeed, attitudes toward breastfeeding, social support, and time exposed to WIC program are correlated with increasing breastfeeding rates within this population. Application of the IFRS indicated a reduced variety of infant feeding resource options in more rural locations in Montana. Data provides valuable information in extension of the state of the science of food environment focused research.