A healthy birth weight is an important indicator of infant health. 

Low birth weight (LBW), on the other hand, is one of the leading causes of neonatal death; those who survive are at higher risk for poor health, growth and developmental delays, and long-term disability and chronic disease later in life.

National studies have long confirmed that a woman's participation in WIC from early in her pregnancy is associated with improved birth outcomes, including better birth weights.

The most common causes of LBW are premature birth (less than 37 weeks' gestation) and restricted fetal growth.

The Institute of Medicine [IOM; see Notes, below] reported back in 1985 that the risk factors for low birth weight (LBW) are greatest among women of lower socioeconomic status - precisely the population served by WIC. [1]

For example, the prevalence of low birth weight is higher among teenaged and older moms (> 40 years of age), moms with less than a high school education, those receiving inadequate prenatal care, women who smoke or drink alcohol during pregnancy, non-Hispanic Black or African American mothers, and women with certain medical risk factors [2].

Data review:

The low birth weight rate among the general population in Connecticut is 7.6%, and 8.3% nationwide [3]. 

LBW rates among Connecticut WIC infants averaged 3.2% statewide, and ranged from 0.0% to 12.5% at the Local Agency level in 2022:

While fluctuating slightly, CT WIC has maintained LBW rates below its current target (less than or equal to 4.0%) throughout the 2022 reporting period, and continue well below the National Healthy People Objectives of 5.0% (HP2010) and 7.8% (HP2020); see respective Note, below.

CT WIC has served a monthly average of 1,500 - 1,600 women giving birth over the past three (3) years, with an annual average of at least 90% healthy-weight births. 

NOTES:

Data:  Connecticut WIC data are current as of year-end 2022 and are updated quarterly. 

Notes: 

• Data gap:  There is a data gap from December 2015 through March 2017 where the CT WIC Program had no access to data on this Performance Measure while the Program was building, then transitioning to, a new Management Information System (MIS).
• Low birth weight (LBW) = a birth weight of less than 2500 grams (= less than 5 pounds, 8 ounces).
• The Institute of Medicine (IOM) is now known as the National Academy of Sciences, Engineering and Medicine - NASEM.
• National Healthy People Objectives:  HP2010: 16-10a. Low birth weight (LBW), infants (<2500 grams); target = 5.0%.  HP2020: MICH-8.1. Reduce low birth weight (LBW); target = 7.8%.  HP2030:  no LBW target was set for 2030.

Data sources:

[1] IOM/NAS (Institute of Medicine/National Academies of Science), Committee to study the prevention of low birth weight. Preventing low birthweight. Washington, DC, 1985.  https://www.nap.edu/catalog/511/preventing-low-birthweight

[2] America's Health Rankings | AHR (americashealthrankings.org)

[3] National Vital Statistics Reports, Vol 68, No 13; 2018 data.

Principal partners:
- DSS Health Services (CT Department of Social Services - Medicaid / HUSKY A); local hospitals, medical clinis and healthcare providers; community health centers (CHCs), school-based health centers (SBHCs), federally qualified health centers (FQHCs), local medical and dental clinics and healthcare providers:  to provide prenatal care and delivery, primary health care, oral health care, smoking cessation, treatment for drug and alcohol misuse, family planning services, immunizations, etc.;
- DSS Social Services (CT Department of Social Services - SNAP, Section 8 Housing, TANF, SSI, etc.); local non-profits, and other health- and social-service programs:  to provide services to help address conditions of low socioeconomic status and the social determinants of health (e.g., housing, energy assistance, employment services, homeless shelters, domestic violence programs, fatherhood involvement initiatives, GED & literacy programs, food and diaper banks, etc.);
- Local health departments (e.g., lead abatement, other environmental health interventions);
- American Academy of Pediatrics / CT Chapter;
- CT DPH (Department of Public Health): Community, Family Health & Prevention Section (CFHPS - Maternal & Child Health, Office of Oral Health, Tobacco Prevention Program, etc.); Immunization Program; Environmental Health, etc.

Funding agency:
- US Department of Agriculture (USDA)

While some of the risk factors for low birth weight cannot be changed, such as maternal age or race, others can be detected and treated or controlled with adequate care prior to conception and birth. [1, 2]

WIC Program services helps address and resolve these modifiable risk factors for low birth weight deliveries [3], including Program benefits such as:

- Nutritional assessment, monitoring and education to ensure a woman gains appropriate weight during pregnancy;
- Nutritious foods to help supplement her diet, to help combat issues of food insecurity, and again, to ensure appropriate weight gain;
- Referrals to other health- and social-service programs to provide a medical home and primary care provider (e.g., to monitor and treat conditions such as gestational diabetes or hypertension), adequate prenatal care, treatment for drug and alcohol misuse, smoking cessation, and family planning services to help better plan and space pregnancies, etc.

[1] CT Department of Public Health, Family Health Section. Stone, C, et al. WIC participation and improved birth weight outcomes. Hartford, 2008.  https://portal.ct.gov/-/media/Departments-and-Agencies/DPH/family_health/WICBriefFinalpdf.pdf?la=en

[2] CT Department of Public Health, Family Health Section. Low birth weight in Connecticut: Factsheet, Winter 2009. Hartford, 2009.  https://portal.ct.gov/-/media/Departments-and-Agencies/DPH/family_health/LowBirthWeightWinter2009pdf.pdf?la=en

[3] Anderson DM. Nutritional implications of premature birth, birth weight, and gestational age classification. In: Nutritional care for high-risk newborns. Rev. 3rd Ed. Chicago: Precept Press, Inc.; 2000.

State WIC Agency (CT Dept of Public Health):

• Stay apprised of new and innovative strategies and interventions related to improved birth outcomes.  Ongoing.
• Provide supervision, technical assistance, and training to local agency staff.  Ongoing.
• Monitor and evaluate program interventions.  Annually.
• Monitor LBW rates by WIC Site, as well as by participants' town of residence and race/ethnicity.  Monthly.
• Track trends in LBW rates for all participants.  Monthly.
• Monitor access to clinic sites and to WIC-authorized vendors; adjust schedules and/or locations (budget permitting), as appropriate.  Ongoing.
• Ensure local WIC staff are as linguistically and culturally representative as possible of the population they serve.  Monitor annually.

Local WIC Agencies:

• Continue to provide program services.  Ongoing.
• Continue to strengthen referral networks.  Ongoing.
• Modify annual Local Agency plans as needed, based on program monitoring and evaluation results.  Ongoing.