This report examines the impact of using Medicaid data to directly certify students for free and reduced-price school meals in the NSLP and SBP in fifteen states in school year 2019-20. It assesses outcomes related to certification, participation, federal reimbursement, and state administrative costs in SY 2019-20 and over the course of the demonstration.

In 2006, FNS asked the Institute of Medicine to review the WIC food packages. The IOM proposed major changes to improve nutrition and encourage breastfeeding but also expressed the concern that changes related to partial breastfeeding may have unintended consequences. The IOM recommended that FNS conduct an impact study evaluating the birth month breastfeeding changes to the WIC food packages. 

The analysis conducted in this study builds on these two strands of the literature and uses three alternate definitions of breakfast: Consumption of any food or beverage. Breakfast intake of food energy greater than 10 percent of the Recommended Dietary Allowance (RDA). Consumption of foods from at least two of five main food groups and intake of food energy greater than 10 percent of the RDA.