Shannon E Whaley

• PhD
• Director at PHFE WIC

Background/Objective: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides breastfeeding support to participating women in low-income households. This study aimed to determine the relationships between prenatal maternal and household characteristics and breastfeeding duration, as well as whether these character...

Background The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) issues infant formula to infants who are not fully breastfed, and prior research found elevated obesity risk among children receiving lactose-reduced infant formula with corn syrup solids (CSSF) issued by WIC. This study was conducted to evaluate association...

Background Fruits and vegetables (FV) are a critical source of nutrients, yet children in the United States are not meeting the Dietary Guidelines for Americans (DGA). The monthly FV cash value benefit (CVB) included in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)’s food package to support child FV intake (FVI)...

Early detection and access to interventions for developmental delays in young children have been shown to improve health, social, and academic outcomes later in life. The purpose of this study is to examine the factors associated with caregivers' perception of child developmental concerns in low-income communities. A countywide survey was conducted...

Introduction: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutrition support for racially and ethnically diverse populations. In 2021, the monthly cash value benefit (CVB) for the purchase of fruits and vegetables increased from $9 to $35 and was later adjusted to $24. This study investigated, by racia...

Objective To help inform decisions regarding the equitable implementation of obesity interventions, we examined whether interventions were equitably reaching the most vulnerable communities, identified communities that received fewer interventions than expected, and estimated the effect of ‘dose’ of interventions on obesity prevalence. Methods We...

Background The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutrition assistance to low-income households, including infant formula for infants not fully breastfeeding. Issuance of lactose-reduced infant formula made with corn syrup solids (CSSF) is associated with elevated risk of obesity in early life, bu...

Purpose To determine associations between child and household characteristics and sleep duration among low-income children in Los Angeles County. Design Cross-sectional study. Setting Survey data collected in 2017 and 2020 in Los Angeles County, California. Sample Special Supplemental Nutrition Program for Women, Infants and Children (WIC) house...

Objective To determine whether Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food benefit redemption is associated with discontinuing WIC participation, failure to recertify, overall and by race/ethnicity-language preference and participant category. Design Retrospective cohort study, using multivariable modified Po...

Background: Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food packages for children ages 1 to 4 y include a cash value benefit (CVB) redeemable for fruits and vegetables (FVs) with participating vendors. The CVB value was increased beginning in June 2021. Objectives: This study evaluated associations of the augme...

Background: In Los Angeles County (LAC), California, the demand for Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) services increased during the COVID-19 pandemic, concurrent with the shift to fully remote WIC service delivery in March, 2020. Technologies for facilitating remote services were critical for accommodati...

Background: WIC is a critical source of nutrition support for young children in low-income families, providing access to healthy foods and a cash value benefit (CVB) for the purchase of fruits and vegetables (FV). In 2021, the WIC CVB increased substantially for women and children ages 1 to 5. Objective: To investigate whether the increased WIC...

Understanding satisfaction of nutrition education and other services provided in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is needed to ensure the program is responsive to the needs of diverse populations. This study examined the variation of WIC participants’ perceptions and satisfaction with WIC nutrition ed...

Purpose Identify the prevalence and predictors of substantial postpartum weight retention (SPPWR) among WIC mothers in Southern California during their first postpartum year. Design Secondary data analysis. Setting The 2020 Los Angeles County WIC Survey. Subjects Mothers of children up to 1-year-old (N = 1019). Measures Outcome variable: SPPWR...

Child physical activity and play are critical for healthy development, and parks/playgrounds are important public spaces that provide physical activity/play opportunities. This study was conducted to assess changes in park/playground utilization by Special Supplemental Nutrition Program for Women, Infants and Children (WIC)-participating children f...

The United States Department of Agriculture approved an increase to the Cash Value Benefit (CVB) for the purchase of fruits and vegetables issued to participants receiving an eligible Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package. In order to understand satisfaction, perceptions, and the overall impact o...

Background The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a federal nutrition assistance program supporting low-income families, serves half of United States–born infants, most of whom are issued infant formula by age 2 mo. Obesity prevalence is high among children of low-income households, particularly formula-f...

Background The U.S. Department of Agriculture granted waivers to allow flexibility in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) operations during the COVID-19 pandemic, however research examining the associations between waiver introduction and changes in perceptions, practices, and challenges of WIC particip...

Objectives Economic impacts of COVID-19 have intensified the burden of food insecurity amongst low-income minority populations, especially women and children. This study aimed to understand the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participant and local agency director experiences with the adoption of USDA fe...

Objectives In response to the COVID-19 pandemic, the USDA announced a temporary augmentation of the cash value benefit (CVB) for vegetables and fruits across all Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) agencies nationally, increasing the child CVB from $9 to $35/month for 4 months in the summer of 2021. The aug...

Background: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides supplemental healthy foods and nutrition education to children under age 5 years in low-income households. Objective: To identify characteristics associated with duration of WIC participation and assess how participation duration relates to hou...

Compared to other food groups, vegetable intakes are lowest relative to recommendations. Breastfeeding and initial introduction to vegetables may help infants establish long-lasting taste preferences. We examined the relationship between breastfeeding and initial vegetable introduction and vegetable intake in early childhood (ages 13–60 months). Th...

Many Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics implemented alternatives to in-person service delivery in response to the COVID-19 pandemic, including virtual visits and electronic document sharing. The objective of this cross-sectional study was to describe WIC participants’ experiences with remote servic...

This study assessed relationships of duration of family Special Supplemental Nutrition Program for Women, Infants and Children (WIC) participation with racial/ethnic disparities in child sugar-sweetened beverage (SSB) and water intake. Child beverage intake and family duration on WIC were collected during three cross-sectional surveys of WIC-partic...

Background Infants with greater temperamental negative affectivity are at higher risk for overfeeding and excess weight gain. Objective To examine whether strategies to promote responsive bottle‐feeding within WIC promoted healthier maternal feeding practices and infant weight status among infants with greater negative affectivity. Methods Second...

Affordable housing is necessary for the health and well-being of children and families. The coronavirus disease 2019 (COVID-19) pandemic affected the ability of low-income families to pay for housing. The aim of this study is to evaluate associations between household characteristics of participants of the Special Supplemental Nutrition Program for...

Objective: To evaluate if children of families with a longer duration of participation in the Special Supple-mentation Nutrition Program for Women, Infants, and Children(WIC) consume fewer sugar-sweetened bever-ages (SSB) and more water. Design: A repeated cross-sectional study. Setting: Conducted among representative samples of WIC-participating f...

Objective: To examine the impact of the coronavirus disease 2019 (COVID-19) pandemic on breastfeeding outcomes among participants of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Southern California. Materials and Methods: Data from the 2020 Los Angeles County triennial WIC Survey were used to examine the impa...

Early in the COVID-19 pandemic, the U.S. Department of Agriculture (USDA), State governments, and school districts took unprecedented steps to mitigate the pandemic’s impact on students’ nutrition. To examine the effect of emergency responses on 6-year-old children’s nutritional outcomes, this study analyzed longitudinal data from a national study...

Background: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutrition assistance to half of infants born in the United States. The nationally representative WIC Infants and Toddler Feeding Practices Study-2 (ITFPS-2) reported a caloric deficit at 7 months among infants receiving WIC mixed feeding packages,...

Objectives The COVID-19 pandemic has changed the way that the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) delivers services. The USDA granted multiple waivers to allow flexibility in WIC operations during the pandemic. The objective of this study was to hear from WIC participants about the impact of changes due to C...

Objectives By the end of the session, attendees will be able to: (1) Articulate the methodology of and notable findings from the USDA WIC Infant and Toddler Feeding Practices Study-2 (WIC ITFPS-2); and (2) Summarize the major domains of data available through age 5 in the WIC ITFPS-2 public use dataset. Methods The Special Supplemental Nutrition P...

Background Bottle-fed infants are at greater risk for overfeeding and rapid weight gain (RWG); evidence-based strategies for promoting healthy bottle-feeding practices are needed. Objective Our aim was to assess whether policy, systems, and environmental (PSE) strategies for promoting responsive bottle-feeding practices within the Special Suppleme...

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is a nutrition assistance program that promotes the health of pregnant and postpartum women, infants, and children up to aged five years who are nutritionally at risk and live in households below 185% of the federal poverty level (FPL). ¹ Unlike other federal nutrition...

Objective Substantial literature has documented adverse childhood experiences’ (ACEs) link with poor health in childhood and adulthood. Despite many American low-income families spending more than a third of their income toward housing costs, little research has been published about a link between severe housing-cost burden and ACEs. The objective...

Objective To determine whether a previously reported association between the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) food package change and reduced child obesity risk among WIC-participating children in Los Angeles County holds across levels of family income and neighborhood poverty. Design Analysis of prospec...

Objective Assess alignment of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participant preferences with the National Academies of Sciences, Engineering, and Medicine WIC child food package recommendations and compare differences by race/ethnicity. Methods Cross-sectional examination of survey responses collected be...

We estimated longitudinal trajectories of body mass index (BMI) z-score and percentile, weight for height (WFH) z-score and percentile, and percentage of the 95th BMI percentile (BMIp95) among low-income Hispanic children ages 2–5 years to provide normative data for this population and compare the behavior of different measures. Longitudinal height...

Background Research has found breastfeeding to be protective of obesity; however, this link remains contentious. We examined longitudinal associations between exclusive breastfeeding duration, growth trajectories and obesity at 4 years among children participating in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC),...

Background The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides enough formula to meet the known nutritional needs of infants up to 6 months of age whose mothers report not breastfeeding, but many mothers report WIC providing insufficient formula, indicating potential overfeeding. Objective To estimate the prev...

Background: Food packages provided by the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) were revised in 2009 to better align them with the Dietary Guidelines for Americans. This study was conducted to evaluate whether the effect of the food package change on childhood obesity varied by the food environment in the nei...

Background Breastfeeding has clear benefits. Yet, breastfeeding practices fall short of recommendations in low-income populations including participants of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). To promote breastfeeding, it is important to understand breastfeeding-related behaviors such as initiation and...

Objective To describe Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) site-level breastfeeding support practices and associations with breastfeeding outcomes. Design Secondary analysis of WIC Infant and Toddler Feeding Practices Study–2, including data from interviews with caregivers of infants and interviews and surv...

Abstract Background The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) changed the food packages provided to its participants in 2009, to better align them with the Dietary Guidelines for Americans. Previous research found that the 2009 WIC food package change was associated with reduced obesity risk, particularly amon...

Objective: To examine factors associated with Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation through 2 years of age. Design: Longitudinal data from the WIC Infant and Toddler Feeding Practices Study-2. Setting: Eighty WIC sites. Participants: The WIC Infant and Toddler Feeding Practices Study-2 pa...

Background: Little is known about duration of exposure to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in relation to children's diet quality. Objective: The objective of the study was to examine the association between duration of WIC participation and diet quality of 24-month-old children. Design: A natio...

Objective: To explore Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants' perspectives about why formula-fed infants are less likely to be recertified at 1 year compared with breastfed infants. Design: Four focus groups of WIC mothers, stratified by language spoken (English or Spanish) and feeding mode (br...

Background: In 2009, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food packages were updated. WIC-participating children in Los Angeles County receiving the new food package, compared with the old, had lower obesity risk at age 4. Objective: To determine if the association between the new WIC food package and...

Background: The relationship of gestational diabetes mellitus (GDM), exclusive breastfeeding (EBF), and sugar-sweetened beverages (SSBs) on obesity prevalence in children has rarely been evaluated. Objective: This study examined the association of GDM status, EBF, and SSB with obesity prevalence in children (1-5 y). Methods: Data are from the...

Objectives: Prenatal and early life factors such as Gestational Diabetes Mellitus (GDM), exclusive breastfeeding (EBF), and early exposure to sugar-sweetened beverages (SSBs) may contribute to obesity in children. The relationship of EBF and SSBs with obesity prevalence in children exposed to GDM has rarely been evaluated. This study examined the...

Objectives: This study examined how duration of participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is associated with dietary quality at age 24 months using Healthy Eating Index-2015 (HEI-2015) scores. Methods: Data from the WIC Infant and Toddler Feeding Practices Study-2 (WIC ITFPS-2), a longitud...

Background: Breastfeeding rates among low-income children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) lag behind national rates. In Los Angeles County (LAC), recent efforts have been made to increase the number of Baby-Friendly designated hospitals. This study examines changes in Baby-Friendly...

Background In 2009, for the first time since the program's inception in 1974, the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) changed their food packages, providing food options better aligned with the 2005 Dietary Guidelines for Americans. Objective The aim of this study was to evaluate whether the 2009 WIC food p...

Objective To assess whether the effect of the 2009 women, infants, and children (WIC) food package change on obesity outcomes varies by initial weight status and gender. Methods Using 2003 to 2016 data from Los Angeles County, we compared growth trajectories and obesity at age 4 years among children exposed to WIC after the food package change (n...

There is growing evidence that prenatal participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) reduces the risk of adverse birth outcomes. With recent changes in health care, rising health care costs, and increasing rates of prematurity in the U.S., there is urgency to estimate the potential cost savings a...

Background: The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is a federal nutrition assistance program which provides supplemental food and nutrition services to children 0-5 years and their mothers, living in low-income households. In October of 2009, WIC food packages were changed to be better aligned to the Dietar...

Background: The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides supplemental foods to assist participants in meeting their dietary needs. Few studies have described the extent to which WIC-eligible foods contribute to the overall diet of children who were enrolled in WIC prenatally or in early infancy. Object...

Despite high rates of housing-cost burden in the United States, little is known regarding its impact on childhood obesity. In this article, we determine whether low-income 2–5-year-olds living in housing-cost burdened households are more likely to be obese and examine the potential moderators and behavioral and psychosocial mediators of this relati...

Background: Despite the important implications of childhood dietary intakes on lifelong eating habits and health, data are lacking on the diet quality of low-income infants and toddlers. Objective: The objective of this study was to characterize diet quality in low-income US infants and toddlers. Methods: A national observational study was con...

Poor sleep habits have been shown to increase the risk of developing illnesses in childhood. Children under the age of five who do not reach the advised sleep duration have an increased risk of obesity, social/ behavioral problems, and poor cognitive development (Touchette et al., 2009). According to the National Sleep Foundation (NSF), recommended...

Objectives Household stressors, such as food insecurity, contribute to the home emotional environment and negatively affect child development. Little research on this topic has been conducted among very young children. This study aimed to examine the relationship between food insecurity and the home emotional environment, as well the extent to whic...

Objectives The present study sought to examine the association between maternal depressive symptoms and characteristics of offspring physical health, including health status, health behaviors, and healthcare utilization, among low-income families. Maternal engagement was explored as a mediator of observed effects. Methods Cross-sectional survey dat...

Background: Obesity prevalence among low-income preschool-aged children in the United States decreased between 2010 and 2014. However, this decreasing trend may be varied across socioeconomic subgroups. This study examined trends in obesity prevalence among low-income children from 2003 to 2014 by child's age and household and neighborhood socioec...

Objective While economic crises can increase socio-economic disparities in health, little is known about the impact of the 2008–09 Great Recession on obesity prevalence among children, especially low-income children. The present study examined whether socio-economic disparities in obesity among children of pre-school age participating in a federal...

The recognition of the role of the environment in contributing to the obesity epidemic has led to increasing efforts to address obesity through environmental or place-based approaches in the past decade. This has challenged the use of the quasi-experimental design for evaluating community interventions. The objective of this study is to describe th...

Background and Purpose: Studies have shown that maternal obesity and excessive gestational weight gain (GWG) lead to adverse health outcomes for the mother and her offspring. Yet, knowledge of the best way to intervene is still lacking. The objective of this study was to develop, pilot and evaluate a sustainable intervention to prevent excessive GW...

Purpose of Review This paper seeks to answer the following two questions: (1) Is participation in the Supplemental Nutrition Program for Women, Infants and Children (WIC) associated with changes in obesity and overweight? and (2) What obesity prevention interventions in the WIC setting may be most effective for obesity prevention? Recent Findings...

Objective: Examine factors associated with retention on the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) after 1 year of age. Setting: A large California WIC program. Participants: WIC participants 14 months old (9,632) between July and September, 2016. Main outcome measure: Recertification in WIC by 14 month...

Background: Breastfeeding rates among low-income infants lag behind national rates. Policies such as the Baby-Friendly Hospital Initiative (BFHI) improve breastfeeding and may benefit low-income populations such as those who participate in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). A recent effort exists to...

Objective: To examine the relationship between breastfeeding (BF) and odds of childhood obesity in a large, primarily Hispanic Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) population. Setting: A large urban WIC program in California. Participants: Infants enrolled in WIC born between 2004 and 2007 and observed...

Although breastfeeding (BF) is the recommended way to feed infants, this may be difficult for the low-income women served by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The 2017 recommended revisions to the WIC food packages provide substantial support to both exclusively and partially BF dyads, remove barrier...

Background: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) differs from other federal nutrition programs in that nutrition education is a required component. WIC programs traditionally provide in-person education, but recently some WIC sites have started offering online education. Education focused on reducing sa...

Objective: The Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are two of the more well-known food assistance programmes in the USA. The current study describes food consumption patterns of children aged 1-5 years living in households dually enrolled in these tw...

Background: It is difficult to evaluate the effectiveness of interventions aimed at reducing early childhood obesity using randomized trials. Objective To illustrate how observational data can be analysed using causal inference methods to estimate the potential impact of behavioural 'interventions' on early childhood adiposity. Methods We used lon...

High blood pressure is one of the leading causes of preventable morbidity and mortality in the U.S., and low‐income populations are at increased risk. The purpose of this randomized controlled trial was to examine the impacts of online and in‐person group nutrition education on changes in knowledge, self‐efficacy, and behaviors related to sodium re...

Objective: To examine satisfaction with in-person group and online nutrition education and compare findings based on language preference by Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants. Methods: A total of 1,170 WIC participants were randomly assigned to 2 nutrition education modalities between March...

Background: Fruits, vegetables, sweetened foods, and beverages have been found to have positive and negative associations with obesity in early childhood, yet no rapid assessment tools are available to measure intake of these foods among preschoolers. Objective: This study examines the test-retest reliability and validity of a 10-item Child Food...

The aim of this study was to examine the relationship between screen time (TV viewing and video game playing), dietary intake and overweight/obesity prevalence in low-income, primarily Hispanic young children. Data were obtained via a 2011 phone survey from caregivers of children enrolled in the Women, Infants and Children (WIC) program in Los Ange...

Women of reproductive age are particularly at risk of obesity because of excessive gestational weight gain (GWG) and postpartum weight retention, resulting in poor health outcomes for both mothers and infants. The purpose of this qualitative study was to examine perceptions and barriers to GWG among low-income women in the WIC program to inform the...

While mother's perception of child's weight is important for the success of early childhood obesity prevention programs, few studies have examined that of Asian Americans. Our study examined their perception and compared it to that of mothers of other racial/ethnic groups. Cross-sectional study of 2,051 randomly selected mothers of children aged 2-...

Background: Although in-person education is expected to remain central to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) service delivery, effective online nutrition education has the potential for increased exposure to quality education and a positive influence on nutrition behaviors in WIC participants. Educati...

Childhood obesity is a complex multifactorial condition. Focusing on the relationship between the recent changes of the WIC food package and obesity without considering the constellation of variables thought to be associated with obesity will only tell part of the story. The objective of this study is to assess whether the effects of the recent rev...

The goal of this study is to develop, pilot and evaluate a generalizable and sustainable intervention to prevent excessive gestational weight gain (GWG) among WIC participants in Southern California. Studies have shown that maternal obesity and excessive GWG lead to adverse health outcomes for the mother and her offspring, and intervention during p...

The aim of this study was to assess potential prepregnancy risk factors for preterm birth in a low-income, Hispanic population in Southern California. Additionally, the study assessed whether the prevalence of preterm birth and any associations between risk factors and preterm birth differed between U.S.- and foreign-born mothers. The study sample...

Background and Purpose: Studies have shown that maternal obesity and excessive gestational weight gain (GWG) lead to adverse health outcomes for the mother and her offspring. Yet, knowledge of the best way to intervene is still lacking. The objective of this study was to develop, pilot and evaluate a sustainable intervention to prevent excessive GW...

As technology advances, users are shifting from desktop computers to mobile phones as tools for online learning. With these advances, there is demand for health educators to develop new platforms for learning which are tailored to individual needs. WIC is a national program that reaches more than 8.5 million low‐income mothers and children monthly...

The purpose of this randomized‐controlled trial was to compare the impact of online to in‐person group nutrition education on changes in knowledge, beliefs, and behaviors related to breakfast eating. The content of the lesson focused on ways to reduce breakfast skipping and promoted healthy options at breakfast for parents and their 1‐5 year‐old ch...