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Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report (2016)

Chapter: Appendix D: Composition of the WIC Food Packages

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Suggested Citation:"Appendix D: Composition of the WIC Food Packages." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
Suggested Citation:"Appendix D: Composition of the WIC Food Packages." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×

TABLE D-1 Full Nutrition Benefit and Maximum Monthly Allowances of Supplemental Foods for Infants in Food Packages I, II, and III

Foods Fully Formula Fed (FF) Partially (Mostly) Breastfed (BF/FF) Fully Breastfed (BF)
FP I–FF & III–FF A: 0 Through 3 Months B: 4 Through 5 Months FP II–FF & III–FF 6 Through 11 Months FP I–BF/FF & III BF/F (A: 0 to 1 Montha,b) B: 1 Through 3 Months C: 4 Through 5 Months FP II–BF/FF & III BF/FF 6 Through 11 Months FP I–BF 0 Through 5 Months FP II–BF 6 Through 11 Months
WIC Formulac,d,e,f A: FNB = 806 fl oz, MMA = 823 fl oz, reconstituted liquid concentrate or 832 fl oz RTF or 870 fl oz reconstituted powder FNB = 624 fl oz, MMA = 630 fl oz, reconstituted liquid concentrate or 643 fl oz RTF or 696 fl oz reconstituted powder A: 104 fl oz reconstituted powder FNB = 312 fl oz, MMA = 315 fl oz, reconstituted liquid concentrate or 338 fl oz RTF or 384 fl oz reconstituted powder No formula No formula
B: FNB = 884 fl oz, MMA = 896 fl oz, reconstituted liquid concentrate or 913 fl oz RTF or 960 fl oz reconstituted powder B: FNB = 364 fl oz, MMA = 388 fl oz, reconstituted liquid concentrate or 384 fl oz RTF or 435 fl oz reconstituted powder
C: FNB = 442 fl oz, MMA = 460 fl oz, reconstituted liquid concentrate or 474 fl oz RTF or 522 fl oz reconstituted powder
Suggested Citation:"Appendix D: Composition of the WIC Food Packages." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
Infant cereal N/A 24 oz N/A 24 oz N/A 24 oz
Infant food fruits and vegetables N/A 128 oz N/A 128 oz N/A 256 oz
Infant food meat N/A N/A N/A N/A N/A 77.5 oz

NOTES: BF = fully breastfed; BF/FF = partially (mostly) breastfed; FF = fully formula fed; FNB = full nutrition benefit; FP = food package; MMA = maximum monthly allowance; N/A = the supplemental food is not authorized in the corresponding food package; RTF = ready-to-feed.

a State agencies have the option to issue not more than one can of powder infant formula in the container size that provides closest to 104 reconstituted fluid ounces to breastfed infants on a case-by-case basis.

b Liquid concentrate and ready-to-feed (RTF) may be substituted at rates that provide comparable nutritive value.

c WIC formula means infant formula, exempt infant formula, or WIC-eligible nutritionals. Infant formula may be issued for infants in Food Packages I, II, and III. Medical documentation is required for issuance of infant formula, exempt infant formula, WIC-eligible nutritionals, and other supplemental foods in Food Package III. Only infant formula may be issued for infants in Food Packages I and II.

d The full nutrition benefit is defined as the minimum amount of reconstituted fluid ounces of liquid concentrate infant formula as specified for each infant food package category and feeding variation (e.g., Food Package IA-fully formula fed).

e The maximum monthly allowance is specified in reconstituted fluid ounces for liquid concentrate, RTF liquid, and powder forms of infant formula and exempt infant formula. Reconstituted fluid ounce is the form prepared for consumption as directed on the container.

f State agencies must provide at least the full nutrition benefit authorized to non-breastfed infants up to the maximum monthly allowance for the physical form of the product specified for each food package category. State agencies must issue whole containers that are all the same size of the same physical form. Infant formula amounts for breastfed infants, even those in the fully formula fed category should be individually tailored to the amounts that meet their nutritional needs.

SOURCE: Modified from 7 C.F.R. § 246 (USDA/FNS, 2014).

Suggested Citation:"Appendix D: Composition of the WIC Food Packages." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×

TABLE D-2 Maximum Monthly Allowances of Supplemental Foods for Children and Women in Food Packages IV, V, VI, VII

Children Women
Foods FP IV: 1 Through 4 Years FP V: Pregnant and Partially (Mostly) BF (Up to 1 Year PP)a FP VI: Postpartum (Up to 6 Months PP)b FP VII: Fully Breastfeeding (Up to 1 Year PP)c,d
Juice, single strengthe 128 fl oz 144 fl oz 96 fl oz 144 fl oz
Milk, fluid 16 qtf,g,h,i,k 22 qtf,g,h,i,k 16 qtf,g,h,i,k 24 qtf,g,h,i,k
Breakfast cereall 36 oz 36 oz 36 oz 36 oz
Cheese N/A N/A N/A 1 lb
Eggs 1 dozen 1 dozen 1 dozen 2 dozen
Fresh fruits and vegetablesm,n $8.00 in CVV $10.00 in CVV $11.00 in CVV $11.00 in CVV
Whole wheat or whole grain breado 2 lb 1 lb N/A 1 lb
Fish (canned) N/A N/A N/A 30 oz
Legumes, dryp and/or peanut butter 1 lb or 18 oz 1 lb and 18 oz 1 lb or 18 oz 1 lb and 18 oz

NOTES: BF = breastfeeding; CVV = cash value voucher; FP = food package; N/A = the supplemental food is not authorized in the corresponding food package; PP = postpartum.

a Food Package V is issued to two categories of WIC participants: Women participants with singleton pregnancies; breastfeeding women whose partially (mostly) breastfed infants receive formula from the WIC program in amounts that do not exceed the maximum formula allowances, as appropriate for the age of the infant as described in Table 1 of paragraph (e)(9) of this section.

b Food Package VI is issued to two categories of WIC participants: Non-breastfeeding postpartum women and breastfeeding postpartum women whose infants receive more than the maximum infant formula allowances, as appropriate for the age of the infant as described in Table 1 of paragraph (e)(9) of this section.

c Food Package VII is issued to four categories of WIC participants: Fully breastfeeding women whose infants do not receive formula from the WIC program; women pregnant with two or more fetuses; women partially (mostly) breastfeeding multiple infants from the same pregnancy; and pregnant women who are also fully or partially (mostly) breastfeeding singleton infants.

d Women fully breastfeeding multiple infants from the same pregnancy are prescribed 1.5 times the maximum allowances.

Suggested Citation:"Appendix D: Composition of the WIC Food Packages." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×

e Combinations of single-strength and concentrated juices may be issued provided that the total volume does not exceed the maximum monthly allowance for single-strength juice.

f Whole milk is the standard milk for issuance to 1-year-old children (12 through 23 months). At state agency option, fat-reduced milks may be issued to 1-year-old children for whom overweight or obesity is a concern. The need for fat-reduced milks for 1-year-old children must be based on an individual nutritional assessment and consultation with the child’s health care provider if necessary, as established by state agency policy. Low-fat (1%) or nonfat milks are the standard milk for issuance to children ≥ 24 months of age and women. Reduced-fat (2%) milk is authorized only for participants with certain conditions, including but not limited to, underweight and maternal weight loss during pregnancy. The need for reduced-fat (2%) milk for children ≥ 24 months of age (Food Package IV) and women (Food Packages V–VII) must be based on an individual nutritional assessment as established by state agency policy.

g Evaporated milk may be substituted at the rate of 16 fluid ounces of evaporated milk per 32 fluid ounces of fluid milk or a 1:2 fluid ounce substitution ratio. Dry milk may be substituted at an equal reconstituted rate to fluid milk.

h For children and women, cheese may be substituted for milk at the rate of 1 pound of cheese per 3 quarts of milk. For children and women in Food Packages IV–VI, no more than 1 pound of cheese may be substituted. For fully breastfeeding women in Food Package VII, no more than 2 pounds of cheese may be substituted for milk. State agencies do not have the option to issue additional amounts of cheese beyond these maximums even with medical documentation. (No more than a total of 4 quarts of milk may be substituted for a combination of cheese, yogurt, or tofu for children and women in Food Packages IV–VI. No more than a total of 6 quarts of milk may be substituted for a combination of cheese, yogurt, or tofu for women in Food Package VII.)

i For children and women, yogurt may be substituted for fluid milk at the rate of 1 quart of yogurt per 1 quart of milk; a maximum of 1 quart of milk can be substituted. Additional amounts of yogurt are not authorized. Whole yogurt is the standard yogurt for issuance to 1-year-old children (12 through 23 months). At state agency option, lowfat or nonfat yogurt may be issued to 1-year-old children for whom overweight and obesity is a concern. The need for lowfat or nonfat yogurt for 1-year-old children must be based on an individual nutritional assessment and consultation with the child’s health care provider if necessary, as established by State agency policy. Lowfat or nonfat yogurts are the only types of yogurt authorized for children 24 months of age and women. (No more than a total of 4 quarts of milk may be substituted for a combination of cheese, yogurt, or tofu for children and women in Food Packages IV–VI. No more than a total of 6 quarts of milk may be substituted for a combination of cheese, yogurt, or tofu for women in Food Package VII.)

j For children, issuance of tofu and soy-based beverage as substitutes for milk must be based on an individual nutritional assessment and consultation with the participant’s health care provider if necessary, as established by state agency policy. Such determination can be made for situations that include, but are not limited to, milk allergy, lactose intolerance, and vegan diets. Soy-based beverage may be substituted for milk for children on a quart-for-quart basis up to the total maximum allowance of milk. Tofu may be substituted for milk for children at the rate of 1 pound of tofu per 1 quart of milk. (No more than a total of 4 quarts of milk may be substituted for a combination of cheese, yogurt, or tofu for children in Food Package IV.) Additional amounts of tofu may be substituted, up to the maximum allowance for fluid milk for lactose intolerance or other reasons, as established by state agency policy.

Suggested Citation:"Appendix D: Composition of the WIC Food Packages." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×

k For women, soy-based beverage may be substituted for milk on a quart-for-quart basis up to the total maximum allowance of milk. Tofu may be substituted for milk at the rate of 1 pound of tofu per 1 quart of milk. (No more than a total of 4 quarts of milk may be substituted for a combination of cheese, yogurt, or tofu for women in Food Packages V and VI. No more than a total of 6 quarts of milk may be substituted for a combination of cheese, yogurt, or tofu for women in Food Package VII). Additional amounts of tofu may be substituted, up to the maximum allowances for fluid milk, for lactose intolerance or other reasons, as established by state agency policy.

l At least one-half of the total number of breakfast cereals on the state agency’s authorized food list must have whole grain as the primary ingredient and meet labeling requirements for making a health claim as a “whole grain food with moderate fat content” as defined in Table 4 of paragraph (e)(12) of this section.

m Both fresh fruits and fresh vegetables must be authorized by state agencies. Processed fruits and vegetables, i.e., canned (shelf-stable), frozen, and/or dried fruits and vegetables may also be authorized to offer a wider variety and choice for participants. State agencies may choose to authorize one or more of the following processed fruits and vegetables: canned fruit, canned vegetables, frozen fruit, frozen vegetables, dried fruit, and/or dried vegetables. The cash value voucher may be redeemed for any eligible fruit and vegetable (refer to Table 4 of paragraph

(e)(12) of this section and its footnotes). Except as authorized in paragraph (b)(1)(i) of this section, state agencies may not selectively choose which fruits and vegetables are available to participants. For example, if a state agency chooses to offer dried fruits, it must authorize all WIC-eligible dried fruits.

n The monthly value of the fruit/vegetable cash value vouchers will be adjusted annually for inflation as described in § 246.16(j).

o Whole wheat and/or whole grain bread must be authorized. State agencies have the option to also authorize brown rice, bulgur, oatmeal, wholegrain barley, whole wheat macaroni products, or soft corn or whole wheat tortillas on an equal weight basis.

p Canned legumes may be substituted for dry legumes at the rate of 64 oz (e.g., four 16-oz cans) of canned beans for 1 pound dry beans. In

Food Packages V and VII, both beans and peanut butter must be provided. However, when individually tailoring Food Packages V or VII for nutritional reasons (e.g., food allergy, underweight, participant preference), state agencies have the option to authorize the following substitutions: 1 pound dry and 64 oz canned beans/peas (and no peanut butter); or 2 pounds dry or 128 oz canned beans/peas (and no peanut butter); or 36 oz peanut butter (and no beans).

SOURCES: Modified from 7 C.F.R. § 246 (2014), updated with WIC Policy Memorandum #2015-3 and WIC Policy Memorandum #2015-4 (USDA/FNS, 2015a,b).

Suggested Citation:"Appendix D: Composition of the WIC Food Packages." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×

REFERENCES

USDA/FNS (U.S. Department of Agriculture/Food and Nutrition Service). 2014. Special Supplemental Nutrition Program for Women, Infants and Children (WIC): Revisions in the WIC food packages; final rule, 7 C.F.R. § 246.

USDA/FNS. 2015a. WIC policy memorandum #2015-3 to WIC state agency directors: Eligibility of white potatoes for purchase with the cash value voucher. Alexandria, VA.

USDA/FNS. 2015b. WIC policy memorandum #2015-4 to WIC state agency directors: Increase in the cash value voucher for pregnant, postpartum, and breastfeeding women. Alexandria, VA.

Suggested Citation:"Appendix D: Composition of the WIC Food Packages." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×

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Suggested Citation:"Appendix D: Composition of the WIC Food Packages." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
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Suggested Citation:"Appendix D: Composition of the WIC Food Packages." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
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Suggested Citation:"Appendix D: Composition of the WIC Food Packages." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
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Suggested Citation:"Appendix D: Composition of the WIC Food Packages." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
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Suggested Citation:"Appendix D: Composition of the WIC Food Packages." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
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Suggested Citation:"Appendix D: Composition of the WIC Food Packages." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
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Suggested Citation:"Appendix D: Composition of the WIC Food Packages." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
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Suggested Citation:"Appendix D: Composition of the WIC Food Packages." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
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The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) began 40 years ago as a pilot program and has since grown to serve over 8 million pregnant women, and mothers of and their infants and young children. Today the program serves more than a quarter of the pregnant women and half of the infants in the United States, at an annual cost of about $6.2 billion. Through its contribution to the nutritional needs of pregnant, breastfeeding, and post-partum women; infants; and children under 5 years of age; this federally supported nutrition assistance program is integral to meeting national nutrition policy goals for a significant portion of the U.S. population.

To assure the continued success of the WIC, Congress mandated that the Food and Nutrition Service of the U.S. Department of Agriculture (USDA) reevaluate the program's food packages every 10 years. In 2014, the USDA asked the Institute of Medicine to undertake this reevaluation to ensure continued alignment with the goals of the Dietary Guidelines for Americans. This, the second report of this series, provides a summary of the work of phase I of the study, and serves as the analytical underpinning for phase II in which the committee will report its final conclusions and recommendations.

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