The federal Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) annually serves over 900,000 low-income pregnant women and 2.2 million infants (roughly half of those born in the United States).  While WIC encourages breastfeeding as the best source of infant nutrition, the breastfeeding rates continue to lag behind non-WIC participants by about 20 percentage points, with 59 percent of WIC women initiating breastfeeding and 22 percent continuing breastfeeding until their infants are six months of age. The U.S. Department of Agriculture Food and Nutrition Service (FNS), the administrator of the WIC Program, has invested considerable resources into increasing breastfeeding outcomes in WIC. One recent initiative implemented by FNS is to provide grants to states to fund breastfeeding peer counseling services in WIC agencies across the country. Abt Global will study the implementation of the peer counseling services funded by grants, and to test the effectiveness of higher-intensity (higher cost) versus lower-intensity (lower cost) peer counseling services on breastfeeding duration. The results of this study will be used to disseminate information on implementing peer counseling programs using a model developed by FNS; assess technical assistance and training needs of state agencies; and provide a report to Congress and other stakeholders demonstrating how state agencies are using the peer counseling funding Key features of the study approach include:

• A web-based methodology for the survey on peer counseling implementation for 86 state and Indian Tribal Organization grantees

• Comprehensive on-site data collection by experienced researchers for the implementation study, including interviews with staff of local WIC agencies and collaborating organizations (i.e., hospitals)

• Enlisting peer counselors to administer baseline information and client tracking forms to collect breastfeeding outcome data from WIC mothers

• In-depth telephone interviews with staff of WIC agencies included in the impact study