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WIC Food Packages: Time for a Change
formula is reduced to 312 fluid ounces of formula concentrate per month; the rationale is to provide an increasing amount of nutrients through complementary foods while reducing intake of formula.
Partially Breast-Fed Infants—The amounts of formula provided for partially breast-fed infants mirrors the amounts provided for fully formula-fed infants with the following important differences: (1) the partially breastfed option in not available in the first month postpartum—in order to promote breastfeeding as explained elsewhere; (2) the maximum amount provided approximates half of the amount provided to fully formula-fed infants—to provide about half of the infant’s nutritional needs to encourage the mother to breastfeed enough to provide at least half of the infant’s nutritional needs; and (3) powdered formula is recommended during ages 1 through 3.9 months—to promote food safety and discourage waste as explained elsewhere.
The revised infant food packages provide essential nutrients, limit food energy, and reinforce the nutrition education message to initiate the routine feeding of complementary foods beginning around 6 months of age (AAP, 2005).
Changes in the Types and Timing of Availability of Complementary Foods
The committee recommends that the WIC program not provide complementary foods until the infant is 6 months of age. This is the age at which most healthy infants are developmentally ready to handle complementary foods (Hammer, 1992; Morris and Klein, 2000; Naylor and Morrow, 2001). Infants ordinarily do not need complementary foods for nutritional reasons at younger ages—either breast milk or iron-fortified infant formula would entirely meet the nutritional needs of most infants (Brown et al., 1998; Dewey, 2001; Domellöf et al., 2001; Griffin and Abrams, 2001; Butte et al., 2002; WHO, 2001a, 2001c, 2002; Habicht, 2004). There are some exceptions in which nutrient supplementation is recommended.17 The committee’s intent is to design food packages that address the nutritional
Infants who will be fully breast-fed should receive vitamin K supplementation within the first six hours after birth (AAP, 2004, 2005). Infants who have inadequate iron stores (e.g., were born preterm, had low birth weight, have hematological disorders) generally require iron supplementation before 6 months of age (AAP, 2004, 2005). Vitamin D supplementation is recommended for fully breast-fed infants (and partially breast-fed infants if receiving less than 17 fluid ounces of iron-fortified formula per day) (AAP, 2004, 2005). Additional supplementation may be required for infants born preterm (see Schanler, 2001) or in underdeveloped countries (Greer, 2001).