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Strengthening the evidence base for maternal and child health programs

New: MCH Best strategies database for sample ESMs

Evidence Tools
MCH Best. NPM 4: Breastfeeding

MCH Best Logo baby feeding at it's mother's breast

Strategy. WIC Food Package Change

Approach. Enhance the number of families participating in the fully-breastfed WIC food package change.

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Overview. There is preliminary evidence to suggest that family leave, workplace policies, and state laws such as the WIC food package change could contribute to increased breastfeeding rates. More research is needed for conclusive results.1

Evidence. Mixed Evidence. There is a mixture of both positive and inconclusive evidence on WIC food package change and its influence on increasing breastfeeding initiation and exclusivity at 6 months. However, this strategy still appears to trend positive across multiple studies. Access the emerging peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. State/National.

Outcome. Initiation, Duration, and Exclusivity. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.

Examples from the Field. There are currently no ESMs across all states/jurisdictions that use this strategy directly or intervention components that align with this strategy.

Sample ESMs. Using the approach “Enhance the number of families participating in the fully breastfed WIC food package change,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of WIC clients who participate in the fully breastfeeding food package change program.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of WIC clients who  participate in the fully breastfeeding food package change program.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of WIC clients who have participated in the fully breastfeeding food package change program that report this program had a positive impact on their breastfeeding habits.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of WIC clients who have participated in the fully breastfeeding food package change program that report this program had a positive impact on their breastfeeding habits.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


Reference:

1 Joyce T, Reeder J. Changes in breastfeeding among WIC participants following implementation of the new food package. Matern Child Health J. 2015;19(4):868-876.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.