• How do the changes in the food packages affect the use of time by CPAs and the amount of time required by vendors to deal with each WIC participant after an initial adjustment period? What new skills and technology do they need to implement the revised food packages effectively?

FLEXIBILITY AND VARIETY

Food and Nutrition Service

A hallmark of the set of revised food packages is the increased flexibility to be offered to the WIC state and local agencies and the increased variety and choice to be offered to WIC participants. Flexibility provides a valuable means of responding to the needs of persons of different cultures and food preferences and/or with limited cooking facilities, skills, or time. The committee urges the Food and Nutrition Service (FNS) 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. Moreover, the committee recommends that FNS allow adjustments in the food packages consistent with newly developed scientific findings related to nutritional requirements, health promotion, and disease prevention. These might include working with food manufacturers to consider addressing the excessive sodium content of selected foods and fortification of selected foods with nutrients that are difficult to obtain in adequate amounts (e.g., fortification of milk products with vitamin D in an amount comparable to that provided by the fluid milk equivalent).

Special recommendation on vitamin D supplementation—Vitamin supplementation is outside the charge of this committee, and supplements are outside the purview of the WIC program. Nonetheless, because routine vitamin D supplementation of breast-fed infants (if ingesting less than 15 fluid ounces of vitamin D-fortified formula per day) is recommended by the American Academy of Pediatrics (AAP, 2005), the committee recommends that FNS find ways that breast-fed infants could be provided with vitamin D supplements. One possibility might be by means of the health referrals routinely provided for WIC participants.

Administrators in WIC State and Local Agencies

The committee recommends that state agencies aim for the maximum variety and choice in allowable food selections by participants, while remaining consistent with foods available in their area and with cost containment. Within the broad categories specified (e.g., breakfast cereals, milk products, whole wheat bread or other whole grains, fresh fruits and veg-



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