Federal nutrition initiatives could provide infant feeding support and counseling to parents with disabilities

Infant nutrition, including breastfeeding, formula, and the introduction of solid foods, is a critical part of parenting. Pregnant and postpartum people with intellectual and developmental disabilities face challenges with infant feeding compared to parents without intellectual and developmental disabilities, often due to disability discrimination and poor access to care. The federal government nutrition initiative, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), can address these disparities by providing comprehensive, accessible support and counseling.

In a recent research paper, Journal of Nutrition Education and ActionPublished by Elsevier, “WIC 2010: International Survey Report on Infant Nutrition Support” explored the experiences, perceptions, and training needs of WIC staff regarding the provision of infant feeding support to pregnant and postpartum women with intellectual and developmental disabilities.

Lead author Noelen K. Jeffers, PhD, CNM, IBCLC, Johns Hopkins School of Nursing, explained:Improving infant feeding communication through universal design and facilities can improve access to and quality of services for pregnant and postpartum women with intellectual and developmental disabilities.”

Researchers from the Johns Hopkins University School of Nursing and the Bloomberg School of Public Health conducted in-depth semi-structured interviews with Maryland WIC staff who provide infant feeding counseling and support in October and November 2021. The interviews gathered comprehensive insights into staff experiences and perspectives.

The research team audio-recorded, transcribed, and analyzed the interviews using MAXQDA software. We used qualitative traditional content analysis to generate codes directly from the data, a method that is particularly useful for topics with little prior research. We then collaboratively refined the codes and organized them into categories, developing and finalizing themes while ensuring reliability through regular meetings and consensus.

Three themes were identified: identifying and documenting intellectual and developmental disabilities, promoting effective communication and infant feeding education, and assessing WIC staff competency and readiness. Identifying intellectual and developmental disabilities often relied on staff perceptions rather than formal diagnoses, leading to fears about potentially mislabeling WIC participants. Staff saw potential benefits to systematic screening, such as being better prepared for appointments, but also expressed concerns about bias, stigma, and the practicality of implementing such procedures.

Interviews during the study suggest the need to explore the risks and benefits of identifying and documenting parental disabilities. They also highlighted the importance of creating accessible educational materials that enable understanding and engagement. Additionally, it is critical to formally educate and train WIC staff so they can provide care that respects and responds to the needs of parents with disabilities. Future efforts to improve inclusivity and accessibility should be guided by actively engaging parents with intellectual and developmental disabilities to understand their perspectives and lived experiences.

Dr Jeffers commented: “WIC provides educational resources to staff in a variety of ways, including handouts, props, and videos, which is an important strategy for addressing the different ways WIC participants process and receive information. However, specific guidelines, developed in collaboration with parents with disabilities, are lacking to assist staff in tailoring communications and modifying educational materials to better support WIC participants with disabilities. Using easy-to-read written materials with plain language and clear images may be one promising strategy among many to improve accessibility.”