A
Allowed Nutrition Risk Criteria
ANTHROPOMETRIC |
|
100 |
Low Weight for Height |
101 |
Pre-pregnancy Underweight |
102 |
Postpartum Underweight |
103 |
Underweight or At Risk of Becoming Underweight (Infants and Children)* |
110 |
High Weight for Height |
111 |
Pre-pregnancy Overweight |
112 |
Postpartum Overweight |
113 |
Overweight (Children 2–5 years of Age)* |
114 |
At Risk of Becoming Overweight (Infants and Children)* |
120 |
Short Stature |
121 |
Short Stature (infants, children) |
130 |
Inappropriate Growth/Weight Gain Pattern |
131 |
Low Maternal Weight Gain* |
132 |
Maternal Weight Loss During Pregnancy |
133 |
High Maternal Weight Gain* |
134 |
Failure to Thrive |
135 |
Inadequate Growth |
140 |
Low Birth Weight/Premature Birth |
141 |
Low Birth Weight |
142 |
Prematurity |
150 |
Other Anthropometric Risk |
151 |
Small for Gestational Age |
152 |
Low Head Circumference |
153 |
Large for Gestational Age |
BIOCHEMICAL |
|
200 |
Hematocrit or Hemog1obin Below State Criteria |
201 |
Low Hematocrit/Low Hemoglobin [formerly entitled Anemia] |
210 |
Other Biochemical Test Results Which Indicate Nutritional Abnormality |
211 |
Elevated Blood Lead Levels |
CLINICAL/HEALTH/MEDICAL |
|
300 |
Pregnancy-Induced Conditions |
301 |
Hyperemesis Gravidarum |
302 |
Gestational Diabetes |
303 |
History of Gestational Diabetes |
310 |
Delivery of Low-Birthright/Premature Infant |
311 |
History of Preterm Delivery |
312 |
History of Low Birthweight |
320 |
Prior Stillbirth, Fetal, or Neonatal Death |
321 |
History of Spontaneous Abortion, Fetal or Neonatal Loss |
330 |
General Obstetrical Risks |
331 |
Pregnancy at a Young Age |
332 |
Closely Spaced Pregnancies |
333 |
High Parity and Young Age |
334 |
Lack of Adequate Prenatal Care |
335 |
Multifetal Gestation |
336 |
Fetal Growth Restriction |
337 |
History of Birth of a Large for Gestational Age Infant |
338 |
Pregnant Woman Currently Breastfeeding |
339 |
History of Birth with Nutrition-Related Congenital or Birth Defect |
340 |
Nutrition-Related Risk Conditions (e.g.. Chronic Disease, Genetic Disorder Infection) |
341 |
Nutrient Deficiency Diseases |
342 |
Gastro-Intestinal Disorders |
343 |
Diabetes Mellitus |
344 |
Thyroid Disorders |
345 |
Hypertension (Includes Chronic and Pregnancy Induced) |
346 |
Renal Disease |
347 |
Cancer |
348 |
Central Nervous System Disorders |
349 |
Genetic and Congenital Disorders |
350 |
Pyloric Stenosis |
351 |
Inborn Errors of Metabolism |
352 |
Infectious Diseases (Bronchiolitis added) |
353 |
Food Allergies |
354 |
Celiac Disease |
355 |
Lactose Intolerance |
356 |
Hypoglycemia |
357 |
Drug-Nutrient Interactions |
358 |
Eating Disorders |
359 |
Recent Major Surgery, Trauma, Burns |
360 |
Other Medical Conditions |
361 |
Depression |
362 |
Developmental, Sensory, or Motor Disabilities Interfering with the Ability to Eat |
370 |
Substance Abuse (Drugs, Alcohol, Tobacco) |
371 |
Maternal Smoking |
372 |
Alcohol and Illegal Drug Use |
380 |
Other Health Risks |
381 |
Dental Problems |
382 |
Fetal Alcohol Syndrome |
DIETARY |
|
400 |
Inadequate/Inappropriate Nutrient Intake |
401 |
Failure to Meet USDA/DHHS Dietary Guidelines for Americans |
402 |
Vegan Diets |
403 |
Highly Restrictive Diets |
410 |
Other Dietary Risk |
411 |
Inappropriate Infant Feeding |
412 |
Early Introduction of Solid Foods |
413 |
Feeding Cow’s Milk During First 12 Months |
414 |
No Dependable Source of Iron for Infants at 6 Months of Age or Later |
415 |
Improper Dilution of Formula |
416 |
Feeding Other Foods Low in Essential Nutrients |
417 |
Lack of Sanitation in Preparation/Handling of Nursing Bottles |
418 |
Infrequent Breastfeeding as Sole Source of Nutrients |
419 |
Inappropriate Use of Nursing Bottles |
420 |
Excessive Caffeine Intake (Breastfeeding Women) |
421 |
Pica |
422 |
Inadequate Diet |
423 |
Inappropriate or Excessive Intake of Dietary Supplements Including Vitamins, Minerals and Herbal Remedies |
424 |
Inadequate Vitamin/Mineral Supplementation |
425 |
Inappropriate Feeding Practices for Children |
426 |
Inadequate Folic Acid Intake to Prevent NTD’s, Spina Bifida and Anencephaly |
OTHER RISKS |
|
500 |
Regression/Transfer/Presumptive Eligibility |
501 |
Possibility of Regression |
502 |
Transfer of Certification |
503 |
Presumptive Eligibility for Pregnant Women |
600 |
Breastfeeding Mother/Infant Dyad |
601 |
Breastfeeding Mother of Infant at Nutritional Risk |
602 |
Breastfeeding Complications (Women) |
603 |
Breastfeeding Complications (Infants) |
700 |
Infant of a WIC-Eligible Mother or Mother at Risk During Pregnancy |
701 |
Infant Up to 6 Months Old of WIC Mother, or of a Woman Who Would Have Been Eligible During Pregnancy |
702 |
Breastfeeding Infant of Woman at Nutritional Risk |
703 |
Infant Born of Woman with Mental Retardation or Alcohol or Drug Abuse During Most Recent Pregnancy |
800 |
Homelessness/Migrancy |
801 |
Homelessness |
802 |
Migrancy |
900 |
Other Nutritional Risks |
901 |
Recipient of Abuse |
902 |
Woman, or Infant/Child of Primary Caregiver with Limited Ability to Make Feeding Decisions and/or Prepare Food |
903 |
Foster Care |