Highly Restrictive Diets as an Indicator of Nutrition and Health Benefit

Given the clear health and nutrition risks associated with highly restrictive diets and the motivation of most women to optimize their own and their infant's health during the critical periods targeted by the WIC program, one might predict a good potential for benefit from WIC program participation. Essentially no evidence in the published literature supports this conclusion, however, perhaps because the prevalence of the patterns mentioned is low enough to make systematic study difficult.

Tools and Cutoff Points to Assess Highly Restrictive Diets

Several conditions indicating highly restrictive diets in women are assessed by asking a few well-targeted questions (e.g., see IOM, 1992). Dieting is so prevalent among U.S. women that it likely requires some specific probing to identify high-risk behaviors such as prolonged fasting, purging, or very low calorie diets.

Recommendation for Highly Restrictive Diets

There is theoretical evidence that highly restrictive diets pose health and nutrition risks. Potential for benefit from participation in the WIC program is expected to be good on theoretical grounds. Therefore, the committee recommends use of highly restrictive diets as a risk criterion in the WIC program.

Inappropriate Infant Feeding

Infant feeding practices include breastfeeding habits, the type of formula or milk fed, and the timing and contents of the supplemental foods and fluids introduced. The Committee on Nutrition of the American Academy of Pediatrics (CN-AAP) has set forth recommendations for feeding healthy infants (CN-AAP, 1980, 1992a, 1993), which are summarized briefly below.

During infancy, breast milk or an appropriate formula is the major source of nutrients. Breastfeeding is the preferred method of feeding infants (CN-AAP, 1993; IOM, 1991). Pediatricians and family physicians generally recommend the use of iron-fortified formulas if infants are fed formula (Fomon, 1993). American Academy of Pediatrics guidelines help breastfeeding mothers know that they are providing sufficient milk for their baby's health and growth (CN-AAP, 1993).

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