• and lactation, assessment and treatment of substance abuse, public policy, nutrition, and epidemiology.
  • Identify the specific drugs that place individuals at nutrition risk with prolonged use and for which WIC program interventions could provide some benefit. The current nutrition risk criteria drug-nutrient interactions and inappropriate use of medications are too broadly defined and likely to produce very low yield of benefit.
  • Disseminate information about risk criteria widely.
  • Consider changing the current WIC priority system to give higher priority to those nutrition risk criteria identified in this report as having strong relationships to risk and potential to benefit and lower priority to nutrition risk criteria with weaker relationships to risk and potential to benefit.
  1. Risk criteria that merit higher priority: vegan diets, highly restrictive diets, selected aspects of inappropriate infant feeding, food insecurity, homelessness, child of a mentally retarded parent.
  2. Risk criteria that merit higher priority among children: nutrient deficiency diseases, failure to thrive, inborn errors of metabolism, gastrointestinal disorders.
  3. Risk criteria that merit lower priority: mild nausea and vomiting during pregnancy; lack of prenatal care; cigarette, alcohol, and illegal drug use.2

Such a change in the priority system would require disaggregating the current categories (anthropometric, medical, dietary, and predisposing) that are used for ranking each risk criterion into one of seven priorities. It would also mean that in some cases children could be given priority over pregnant women. Such a change should improve the targeting of the program in terms of both risk and benefit.

2  

Three committee members (Barbara Abrams, Barbara Devaney, and Roy Pitkin) prefer retaining high priority for the criteria alcohol use and illegal drug use. Barbara Abrams and Barbara Devaney prefer retaining the high-priority level for the criterion cigarette use as well. See footnote 1 concerning cutoff points for these criteria.



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