studies, flexibility, workable procedures, breastfeeding promotion and support, nutrition education, and product availability.
Studies Prior to Implementation of the Revised Packages—The committee urges that pilot tests and randomized, controlled trials be conducted prior to the full-scale implementation of the revised food packages. High-priority topics include the effects of recommendations regarding infant-feeding options during the first month after birth, the age for transferring to Food Package II, and changes in the contents of Food Package II.
Flexibility and Variety—The committee urges the Food and Nutrition Service to retain, and possibly expand, the flexibility proposed for the revised food packages, so as to allow state and local agencies to adapt the packages to the needs of their WIC populations. It further recommends that WIC state agencies aim for the maximum variety and participant choice in food selections consistent with foods available in their area and with cost containment.
Workable Procedures—The committee recommends that WIC state agencies use input from Competent Professional Authorities,5 vendors, and participants to inform the design of new food vouchers; implement cash-value vouchers issued in small denominations for fresh produce; and work with vendors to ease the transition to cash-value vouchers for fresh produce.
Breastfeeding Promotion and Support—In tandem with the proposed package changes for breastfeeding mother/infant pairs, the committee strongly recommends intensive support for breastfeeding mothers, particularly in the first few weeks after delivery, and further support to extend the duration of breastfeeding for at least one year postpartum. In view of a recent recommendation by the American Academy of Pediatrics that a daily vitamin D supplement be given to many breast-fed infants, it would be useful for the WIC program to work with mothers and health care providers to facilitate providing the recommended supplement for these breast-fed infants.
Nutrition Education—The committee recommends adapting nutrition education to address changes in the food packages related to food choices, shopping, handling foods in the home, incentives for breastfeeding, and feeding infants and young children. To realize fully the potential of these revised food packages to improve the nutritional status of the WIC population, a revised system for providing nutrition education may be