Inclusive care: Strategies to support infant feeding for parents with disabilities through WIC

Philadelphia, June 19, 2024 – Infant feeding, involving breastfeeding, formula feeding, and the introduction of solid foods, is crucial for parenting. Pregnant and postpartum individuals with intellectual and developmental disabilities face challenges in infant feeding compared to parents without intellectual and developmental disabilities, often due to ableism and inaccessible care. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program, a federal nutrition initiative, can address these disparities by offering inclusive and accessible support and counseling.

A recent research article in the Journal of Nutrition Education and Behavior, published by Elsevier, explored WIC staff experiences, perceptions, and training needs surrounding the provision of infant feeding support for pregnant and postpartum individuals with intellectual and developmental disabilities.

Lead author Noelene K. Jeffers, PhD, CNM, IBCLC, Johns Hopkins School of Nursing, explained, “Improving infant feeding communication through universal design or accommodations can improve access and quality of services for pregnant and postpartum individuals with intellectual and developmental disabilities."

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

The research team audio-recorded, transcribed, and analyzed interviews using MAXQDA software. They employed qualitative conventional content analysis to generate codes directly from the data, a method particularly useful for topics with little prior research. Then, they collaboratively refined and organized codes into categories, ensuring reliability through regular meetings and consensus to develop and finalize themes.

Three themes were identified: identifying and documenting intellectual and developmental disabilities, facilitating effective communication and infant feeding education, and assessing WIC staff competence and readiness. Identification of intellectual and developmental disabilities often relied on staff perceptions rather than formal diagnoses, leading to discomfort about potentially mislabeling WIC participants. While staff saw potential benefits in systematic screening, such as better preparation for appointments, they also expressed concerns about stigma, bias, and the practicality of implementing such procedures.

The interviews during the study suggest it is necessary to examine the risks and benefits for identifying and documenting parental disability. They also emphasized the importance of creating accessible teaching materials that enable understanding and engagement. Furthermore, formally educating and training WIC staff to offer care that is respectful and responsive to the needs of disabled parents is crucial. 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 staff teaching resources in a variety of modalities such as handouts, props, and videos. This is an important strategy to accommodate the different ways that WIC participants may process and receive information. However, specific guidelines, developed in partnership with disabled parents, to support staff with adapting communication and modifying teaching aids to better support disabled WIC participants are lacking. Using easy-to-read written materials, which entail plain language and clear images, might be one promising strategy among many to enhance accessibility.”