For Immediate Release
August 21, 2003
Contact: Steven J. Haider
Michigan State University
517-862-6608
haider@msu.edu
Welfare Work Requirements Limit Breastfeeding (August 2003)
If welfare reform's work requirements had not been adopted beginning in 1996, national breastfeeding rates six months after birth would have been 5.5 percent higher than they were in 2000, according to a study published in the August issue of the journal Demography.
By 2000, states with the most stringent welfare work requirements for new mothers had breastfeeding rates 9 percent lower than expected based on trends in states with more lenient policies, the study found.
The policy changes appear to have had a pronounced impact on low-income mothers' breastfeeding practices, report demographers Steven Haider of Michigan State University, Alison Jacknowitz of the RAND Graduate School, and Robert Schoeni of the University of Michigan.
They also examined breastfeeding rates of mothers enrolled in the Women, Infants, and Children (WIC) nutrition program, a federal program aimed at low-income women eligible for welfare. Among WIC mothers living in states with the most stringent welfare work requirements, breastfeeding rates six months after birth were 22 percent lower than those of WIC mothers in other states.
The American Academy of Pediatrics recommends six to 12 months of breastfeeding for child health and development. Before the 1996 welfare reforms, mothers with infants were exempt from any work requirements. Numerous studies show breastfeeding declines dramatically when mothers work full time, they report.
"Assessing welfare reform's impact on children and families is difficult, considering how recently the changes were adopted," said Haider. "But we understand the impact of breastfeeding. A large body of research strongly links breastfeeding to good health outcomes for mothers and children. We can measure the prevalence of breastfeeding and identify specific welfare policies likely to affect feeding practices."
The team based their study on annual state breastfeeding rates for the years 1990 to 2000 from the Ross Labs Mothers Survey, an annual mail survey of more than 100,000 new mothers.
Their analysis took into account the wide variety of state policies and the different dates in which those policies were enacted. They focused on whether states required new mothers to work, the number of work hours required, and the penalties faced if the work requirements were not met. States with the most stringent policies in 2000 required 32 hours or more of work and withheld the entire family's benefits if the requirement was unmet; those states were Arizona, New Jersey, Tennessee, and Wisconsin
The researchers examined state level breastfeeding patterns before and after the welfare work policies were instituted, tracking the growing difference between states with the strictest work policies and those with more lenient policies.
They suggest that as states refine their welfare programs, they "weigh the potential health costs of requiring work for mothers with infants against the benefits of moving families toward self-sufficiency through employment."
"Studies have shown that breastfeeding decreases health care costs, and a reduction in breastfeeding may put a greater financial burden on the Medicaid program," said Schoeni.
The combination of requiring at least 17 hours of work a week and sanction policies that withhold a families' entire benefit if work hours are not met — as is done in 28 states — had the most dramatic impact on breastfeeding rates, they found. If states avoided this combination of policies, the "vast majority of harmful effects would be eliminated," they reported.
States that required 17 to 31 hours of work for mothers with a 6-month old and also withheld the entire family's benefits if the work requirement was unmet were Arkansas, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Kansas, Kentucky, Louisiana, Mississippi, North Dakota, Nebraska, New Mexico, Michigan, Nevada, Ohio, Oklahoma, South Carolina, South Dakota, Virginia, West Virginia, and Wyoming.
Demography is a peer-reviewed journal published by the Population Association of America.
The full article, "Welfare Work Requirements and Child Well-Being: Evidence from the Effects on Breast-Feeding," is available on www.prb.org/cpipr. Or call the Center for Public Information on Population Research, 202-939-5414. The Center, a project of the Population Reference Bureau, is funded by the National Institute on Child Health and Human Development.