Addressing the Impacts of Water Insecurity on Infant Feeding: Policy Solutions for the US.

Household water security is the consistent access to sufficient, safe water that promotes health. Approximately 2 million people in the US cannot realize the human right to water, which is exacerbated by our climate crisis. Lack of safe drinking water has adverse health effects, especially for pregnant women and infants. This policy analysis investigated options to improve water security among participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), whose infants are particularly vulnerable to water insecurity. The Centers for Disease Control and Prevention's (CDC) Policy Analytical Framework and the Commonwealth Fund's Racial Equity and Policy (REAP) Framework were utilized to analyze the federal policy landscape related to safe water, climate change, and breastfeeding support and to identify possible policy solutions. Findings highlight that effective policy solutions entail consideration of infant physiological vulnerabilities. Formula-reliant infants are particularly vulnerable to disruptions to safe water for mixing formula and cleaning feeding equipment. Breastfeeding helps buffer infants against these vulnerabilities but requires structural support. Policies that (1) implement water security data collection, linkage to water testing and filters and scale-up of funding for WIC breastfeeding and safe infant feeding; and (2) incorporate WIC into disaster planning and response efforts would reduce vulnerability, enhance resilience, and improve health equity. Water insecurity, exacerbated by climate change, harms the health of women, infants, and children. Through integration with WIC, equitable policy solutions exist to help address this issue in the US. Policy solutions must consider the vulnerabilities of women and infants to prevent negative health outcomes associated with water insecurity.