Breastfeeding rates increased after expansions to federal social safety net program
Expansions to Temporary Assistance for Needy Families (TANF)—a federal program providing cash assistance to low-income families with children—may help increase rates of breastfeeding in the U.S., according to a new study led by Harvard T.H. Chan School of Public Health.
The study was published August 8 in JAMA Health Forum. Rita Hamad, associate professor of social and behavioral sciences and director of the Social Policies for Health Equity Research (SPHERE) Center, was the corresponding author. Other co-authors included Emily Dore, research fellow, and Daniel Collin, senior statistical analyst, both in the Department of Social and Behavioral Sciences.
Breastfeeding, which is associated with better maternal and child health outcomes, is less common in the U.S. compared to peer countries. The researchers sought to explore how that lower rate may be impacted by social safety net programs such as TANF. To do so, they used data from the CDC’s Pregnancy Risk Assessment Monitoring System (PRAMS—shuttered this year by the federal government) to assess breastfeeding initiation and duration among nearly 139,000 TANF recipients between 2017 and 2020. In 2020, amid the COVID-19 public health emergency, TANF relaxed its stringent eligibility and administrative requirements—including work requirements—and increased cash benefits.
The study found that more TANF recipients began breastfeeding, and did so for longer, once these COVID-era expansions to the TANF program were put in place.
“Our findings show that TANF’s administrative burdens, including work requirements, can be harmful for health,” Hamad said. “This may be because they restrict access to benefits or force individuals to work instead of investing in maternal and child health.”
She added that the study proves “highly relevant” since the passage of the “One Big Beautiful Bill,” which implements new national work requirements for similar safety net programs like Medicaid and SNAP.
Read the study
Easing Cash Assistance Rules and Breastfeeding
