Prenatal WIC Is Associated with Increased Birth Weight of Infants Born in the United States with Immigrant Mothers

Published:February 10, 2022DOI:



      The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) improves health outcomes for participating mothers and children. Recent immigration policy changes increased chilling effects on WIC access and utilization. Associations between WIC participation and neonatal outcomes among infants born to immigrant parents—23% of all births in the United States—are understudied.


      Our aim was to examine relationships between prenatal participation in WIC and birth weight among infants of income-eligible immigrant mothers.


      The study design was repeat cross-sectional in-person surveys.


      Participants were 9,083 immigrant mothers of publicly insured or uninsured US-born children younger than 48 months accessing emergency departments or primary care in Baltimore, MD; Boston, MA; Little Rock, AR; Minneapolis, MN; and Philadelphia, PA interviewed from 2007 through 2017.

      Main outcome measures

      Outcomes were mean birth weight (in grams) and low birth weight (<2,500 g).

      Statistical analyses

      Multivariable linear regression assessed associations between prenatal WIC participation and mean birth weight; multivariable logistic regression examined association between prenatal WIC participation and low birth weight.


      Most of the immigrant mothers (84.6%) reported prenatal WIC participation. Maternal ethnicities were as follows: 67.4% were Latina, 27.0% were Black non-Latina, 2.2% were White non-Latina, and 3.5% were other/multiple races non-Latina. Infants of prenatal WIC-participant immigrant mothers had higher adjusted mean birth weight (3,231.1 g vs 3,149.8 g; P < .001) and lower adjusted odds of low birth weight (adjusted odds ratio 0.79, 95% CI 0.65 to 0.97; P = .02) compared with infants of nonparticipants. Associations were similar among groups when stratified by mother’s length of stay in United States.


      Prenatal WIC participation for income-eligible immigrant mothers is associated with healthier birth weights among infants born in the United States, including for those who arrived most recently.


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      S. Ettinger de Cuba is executive director, Children’s HealthWatch, Boston Medical Center, Boston, MA and Executive Director, Children's HealthWatch, Department of Pediatrics, Boston University School of Medicine, Boston, MA.


      M. Mbamalu is a fellow, Developmental and Behavioral Pediatrics, Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, MA.


      A. Bovell-Ammon is director of policy strategy, Children’s HealthWatch, Boston Medical Center, Boston, MA.


      M. M. Black is professor, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, and a Distinguished Fellow, RTI International, Research Triangle Park, NC.


      D. B. Cutts is chief of pediatrics, Department of Pediatrics, Hennepin County Medical Center, Minneapolis, MN.


      F. Lê-Scherban is an associate professor, Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA.


      S. M. Coleman is a research manager, Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA.


      E. R. Ochoa Jr is an associate professor and section chief of community pediatrics, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR.


      T. C. Heeren is a professor, Department of Biostatistics, Boston University School of Public Health, Boston, MA.


      A. Poblacion is a research scientist, Children’s HealthWatch, Boston Medical Center, Boston, MA.


      M. Sandel is an associate professor, Department of Pediatrics, Boston University School of Medicine, and Co-Lead Principal Investigator, Children’s HealthWatch, Boston Medical Center, Boston, MA.


      C. Bruce is a research and policy analyst, Children’s HealthWatch, Boston Medical Center, Boston, MA.


      L. J. Rateau is a statistical programmer II, Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA.


      D. A. Frank is a professor of child health and well-being, Department of Pediatrics, Boston University School of Medicine, and a Founding Principal Investigator, Children’s HealthWatch, Boston Medical Center, Boston, MA.