A new study led by Johns Hopkins Medicine researchers shows that mothers and their offspring who participate in a federal government-led nutrition program may experience better outcomes during and after pregnancy. Outcomes include a lower risk of preterm birth, lower risk of low birth weight and lower risk of infant mortality.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) served approximately 6.2 million participants each month in fiscal year 2021, according to the U.S. Department of Agriculture’s Economic Research Service. The program provides nutrition counseling, parenting advice, breastfeeding support, food assistance and referrals to promote the health of low-income women and children. WIC is a short-term program designed to improve lifetime nutrition and health. It provides services to pregnant and postpartum women and to children up to the age of 5.

In a study published Oct. 18 in the Annals of Internal Medicine, Johns Hopkins Medicine researchers identified 20 studies about WIC. They summarized the evidence on how participation in the WIC program may be associated with better health outcomes for women, infants and children. In addition, the study reviewed evidence regarding WIC participation and its impact on maternal, infant and child receipt of health care services.

The research team, which included internists, pediatricians and nutritionists, qualitatively synthesized the data to assess the evidence’s strength.

Study author S. Michelle Ogunwole, M.D., Ph.D., an assistant professor of medicine at the Johns Hopkins University School of Medicine, says national WIC participation has been declining over the past several years.

“The research shows the importance of connections to social services,” Ogunwole says. “For example, there are profound racial disparities in maternal health outcomes. We know from a broader sense that communities experiencing disparities are impacted by structural racism. Safety net programs like WIC are even more important for these communities. WIC is an important service, and it’s vital to understand how federal safety net programs can improve health outcomes.”

Study author Wendy Bennett, M.D., M.P.H., an associate professor of medicine at the Johns Hopkins University School of Medicine, says the team saw value in all the evidence as it shows both the gaps as well as where there was more substantial evidence.

“Low or insufficient strength of evidence is an important finding in evaluating a public program,” Bennett says. “We found low strength of evidence on gestational weight gain, increased well-child visits and childhood immunizations. In addition, there was insufficient evidence on maternal mortality, as well as whether the duration of enrollment made a difference.”

Study author Maya Venkataramani, M.D., M.P.H., an assistant professor of medicine and pediatrics at the Johns Hopkins University School of Medicine, says she hopes future research can build on the evidence that has been reported. For example, she hopes to learn more about the association between WIC participation and health outcomes and health care receipt when more high-quality studies are funded and published.

“WIC is an important and long-standing program,” Venkataramani says. “It is designed to support the health of low-income women and children. People may associate WIC with nutrition support, but there are many other services offered, including referrals for women and children to other resources and clinical services.”

Venkataramani says that for pediatricians, this review highlights the importance of referring eligible families to WIC. It may also help promote efforts to sustain WIC participation both among the children pediatricians care for and the mothers of their patients.

Study authors also included Laura E. Caulfield, Ph.D., Ritu Sharma, B.Sc., Allen Zhang, B.S., Susan M. Gross, Ph.D., M.P.H., R.D.N., Kristen M. Hurley, M.P.H, Ph.D., Jennifer Lerman, M.P.H., R.D.N., and Eric B. Bass, M.D., M.P.H.

The United States Department of Agriculture funded the review through an interagency agreement with the Agency for Healthcare Research and Quality. Neither agency had a direct role in selecting or assessing studies, but they reviewed and offered feedback on the protocol and the synthesis of the evidence.