Frequently Asked Questions About WIC

1. What is WIC?

WIC is the Special Supplemental Nutrition Program for Women, Infants and Children. It is funded by the United States Department of Agriculture Food and Nutrition Service (USDA FNS) and administrated in Maine by the State of Maine WIC Agency in the Department of Health and Human Services, Maine CDC. Services are provided by Local WIC agencies statewide operated by

2. Who can participate in the Maine WIC Nutrition Program?

The Maine WIC Nutrition Program serves income-eligible women who are pregnant, breastfeeding an infant from birth to 12 months, or less then 6 months postpartum, as well as infants and children up to their fifth birthday. Participants must live in Maine, and have income less then 185% of the current federal poverty guideline (seecurrent income guidelines) or be enrolled in the MaineCare, TANF or SNAP (formerly Food Stamps) programs. Working families, single dads, foster parents, and custodial grandparents may all be eligible to apply for WIC!

3. How many Maine citizens receive WIC benefits?

Approximately 27,000 Maine citizens currently receive WIC Nutrition Program benefits.

4. Where are WIC services provided in Maine?

WIC is provided atalmost 100 sites in Mainethrough contracts the State has with eight local agency providers.!

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5. What services does WIC provide?

  • All participants receive a nutrition and health risk assessment.
  • Infants are weighed and measured frequently during the first year to assess growth.
  • All children are weighed and measured at least every 6 months, and have a hemoglobin screening test done at least once per year.
  • All pregnant women are weighed frequently during their pregnancy to assess for proper weight gain.
  • All participants receive personalized nutrition education directed to specific nutrition risks or their personal request for information.
  • Pregnant and breastfeeding women receive education and support about breastfeeding. When needed, a breastfeeding mother may receive an electric breast pump to help her continue to provide breastmilk for her infant.
  • All participants receive food benefits tailored to their specific needs.

6. Why were WIC benefits recently changed?

USDA required all states to implement food benefit changes by October 1, 2009. The changes were designed to:

  • Strengthen WIC's breastfeeding promotion and support
  • Meet the 2005 Dietary Guidelines for Americans and the Healthy People 2010 goals and objectives
  • Provide consistency with American Academy of Pediatrics recommendations on infant feeding
  • Add greater variety and choice, and foods that appeal to diverse populations

7. What food benefits does WIC provide for women and children?

Women and children receive food benefits tailored according to their needs. The Maine WIC Nutrition Program has maximum food amounts set by the United States Department of Agriculture Food & Nutrition Services (USDA FNS), which funds the program nationwide. Foods and maximum amounts provided to WIC participants are listed below:

Milk (when needed, substitution with fortified soy beverage and/or calcium-set tofu may be provided when prescribed for children or requested by women):

  • Children: ~16 ounces/day
  • Pregnant women: ~23 ounces/day
  • Exclusively breastfeeding women: ~25 ounces/day
  • Postpartum women: ~16 ounces/day
  • Breastfeeding women exclusively nursing 2 or more infants from same pregnancy: ~37 ounces/day

Cheese: up to 1 pound per month (substitutes for 3 quarts of milk; more cheese may be provided if prescribed by the health care provider)

Eggs

  • Pregnant and postpartum women, children: 1 dozen per month
  • Exclusively breastfeeding women: 2 dozen per month
  • Breastfeeding women exclusively nursing 2 or more infants from same pregnancy: 3 dozen per month

100% fruit juice:

  • Children: ~4 ounces/day
  • Pregnant and exclusively breastfeeding women: ~4.5 ounces per day
  • Postpartum women: ~3 ounces per day
  • Breastfeeding women exclusively nursing >2 infants from same pregnancy: ~6 ounces per day

Fruits and vegetables: fresh, frozen and/or canned

  • Children: $6 per month
  • Pregnant, postpartum and breastfeeding women: $10 per month
  • Breastfeeding women exclusively nursing 2 or more infants from same pregnancy: $15 per month

Breakfast cereals: 36 ounces per month (all children and women) (at least half of choices are primarily whole grain; all cereals must meet criteria for low sugar content and minimum iron fortification level; in addition, the Maine WIC food list identifies cereals which provide 400 gm folic acid per serving in order to help all women of childbearing age to obtain the necessary amount per day for birth defect prevention)

Whole grains: whole wheat bread, brown rice, oatmeal, and/or whole wheat or soft corn tortillas

  • Children: 2 pounds/month
  • Pregnant, breastfeeding and postpartum women: 1 pound/month
  • Breastfeeding women exclusively nursing 2 or more infants from same pregnancy: 1.5 pounds per month

Peanut butter and/or legumes

  • Children and postpartum women: choice of 18 ounces peanut butter or legumes (1 pound dried or 4 cans) per month
  • Pregnant and exclusively breastfeeding women: 18 ounces peanut butter and choice of legumes (1 pound dried or 4 cans) per month
  • Breastfeeding women exclusively nursing 2 or more infants from same pregnancy: 2-18 ounce jars of peanut butter and choice of legumes (1 pound dried or 4 cans) per month

Canned fish: light tuna, salmon, sardines (all water packed)

  • Exclusively breastfeeding women, partially breastfeeding women with 2 or more infants from same pregnancy who are partially breastfed, pregnant women with more than 1 fetus: 30 ounces per month
  • Breastfeeding women exclusively nursing 2 or more infants from same pregnancy: 45 ounces per month

8. What food benefits does WIC provide for infants?

Infants receive food benefits according to individual need, feeding choice (exclusive breastfed, partial breastfed, non-breastfed) and age:

Feeding Choice Age Food Item Maximum amount WIC can provide
Exclusively breastfed Birth-5 months No formula or food
  6-12 months Infant fruits and vegetables 2 jars (4 oz.) per day
    Infant meats 1 jar (2.5 oz.) per day
    Infant cereal 24 oz. per month
Partially breastfed 0-30 days Formula 1 can powder
  1-3 months Formula 12-14 oz. per day
  4-5 months Formula 14-17 oz. per day
  6-12 months* Formula 10-12 oz. per day
    Infant fruits and vegetables 1 jar (4 oz.) per day
    Infant cereal 24 oz. per month
Non-breastfed 0-3 months Formula 26-28 oz. per day
  4-5 months Formula 28-31 oz. per day
  6-12 months* Formula 20-22 oz. per day
    Infant fruits and vegetables 1 jar (4 oz.) per day
    Infant cereal 24 oz. per month

* Infants 6 months and older who are prescribed a medical formula (hydrolysate, elemental, metabolic, or premature) may receive the 4-5 month formula amount if a medical condition exists that prevents them from initiating solid foods. The higher formula amount may be provided until they begin to eat solids.

9. When WIC benefits do not provide enough infant formula for a baby, can the WIC client receive more formula from the Maine WIC Nutrition Program if the health care provider prescribes it?

Unfortunately, WIC can only provide up to the maximum amounts of infant formula listed above. WIC has always been a "supplemental" program and was never intended to meet all of a baby's nutrition needs. Those who need additional formula and cannot afford to buy it should check with their local WIC office to see if there is a food bank or other place in the community that can help.

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10. What does WIC offer for breastfeeding support and advice?

The Maine WIC Nutrition Program supports the American Academy of Pediatrics position on breastfeeding.* Unless medically contraindicated, WIC counseling staff members encourage pregnant women to consider breastfeeding for the first year of their infant's life, and to continue to breastfeed as long as it is mutually desired by mother and child. WIC supports exclusive breastfeeding and establishment of adequate milk supply by limiting the amount of supplemental formula provided in the first 30 days of an infant's life to no more than 1 can of powdered infant formula. WIC counseling staff members assist parents with breastfeeding problems or barriers, and refer mothers to qualified lactation counselors as needed. WIC can provide a manual or electric breast pump when needed to help a mother continue to breastfeed. WIC food benefits for breastfeeding women provides the maximum monetary value per month. * American Academy of Pediatrics, Section on Breastfeeding, Breastfeeding and the Use of Human Milk, Pediatrics: 2005; 115; 496-506.

11. What formula can be provided for a partially breastfed or nonbreastfed infant enrolled in WIC?

To contain program costs, USDA requires the Maine WIC Nutrition Program to have a rebate contract with a sole source provider for standard cow's milk and soy infant formulas. Maine WIC is part of a multi-state consortium for the infant formula rebate contract. This increases the program's ability to get the best price possible for infant formula, thus significantly saving financial resources which can be used to provide services to more Maine families.The current rebate contract is with Nestle for the provision of Gerber Good Start formulas (Gerber Good Start Gentle Plus, Gerber Good Start Protect Plus, Gerber Good Start Soy Plus). Partially breastfed and nonbreastfed infants who have a qualifying medical condition may receive a medical formula (hydrolysate, elemental, metabolic, hypercaloric or premature) if the medical condition warrants the use of such a product. Examples of qualifying medical conditions include but are not limited to:

  • Prematurity
  • Low birth weight
  • Failure to thrive
  • Malabsorption
  • Severe allergies, including allergic vomiting
  • Metabolic disorder, including genetic conditions WIC infants enrolled with MaineCare who need a medical formula (hydrolysate, elemental, metabolic, hypercaloric or premature) will have their medical formula covered by that program. See below for more information. WIC infants not enrolled with MaineCare will receive their medical formula from the Maine WIC Nutrition Program. Monthly maximum amounts (above) apply for all medical formulas. Maine WIC will provide Similac Sensitive for documented lactose intolerance. Since the majority of lactose intolerance in infancy is transient, this should be a short term prescription request. Maine WIC will provide Enfamil AR for Spit Up or Similac Sensitive RS for Spit Up for documented GERD when it is determined that a parent is unable to follow the recipe in the clinical resource guide for mixing rice cereal into standard formula for thickening. See Clinical Resource Guide for more information.

12. What does a health care provider need to do in order to obtain a medical formula for a WIC infant who is enrolled in the MaineCare Program?

Fill out the form Maine WIC Nutrition Program Medical Documentation for WIC Medical Formula or Medical Food. This form includes information needed for the MaineCare Prior Authorization process. Mail or fax the form to the WIC office which provides services for the WIC infant. WIC staff will process the request upon receipt and provide the parent with the WIC maximum amount of formula for one month if the request is approved. The request will then be sent to Goold Health Services (GHS) for MaineCare prior authorization. The infant will have a supply of formula while GHS processes the request. If GHS gives MaineCare approval for the formula request, the infant will begin to receive the formula through a pharmacy. MaineCare will approve formula prescription requests for a maximum of 6 months. If the formula has been approved by MaineCare, and more formula is needed than what was originally prescribed, the health care provider must update the request with GHS. If the medical formula is being provided by WIC, and an amount greater than what the WIC program can provide is needed, initiate a request for additional formula to be provided by MaineCare. Note: If the infant is receiving standard cow's milk or soy-based formula, MaineCare will not provide formula above the amount that WIC provides.

13. Who can prescribe medical formula in Maine?

Only health care providers with prescriptive authority in Maine may prescribe medical formulas. This includes those with the following credentials: MD, DO, PA, NP

14. What is the maximum amount of time a request for medical formula is approved?

A medical formula request is approved for up to 6 months. WIC staff will inform the parent when a renewal is needed, and ask the parent to contact the provider, or will send a blank form to the prescriber's office.

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15. Can children less then 12 months and women who require a medical formula get WIC benefits?

Yes, a medical formula can be provided for children and women who have a qualifying medical condition which warrants the use of such a product. If the child or woman is enrolled in the MaineCare Program, the formula will be provided by that program. If the child or woman is not enrolled in the MaineCare Program, WIC will provide the necessary formula.

16. What foods does WIC provide for children and women who need a medical formula?

Maine WIC can provide all other WIC foods as prescribed by the health care provider to a child or woman who receives a medical formula. The health care provider must indicate on the Maine WIC Nutrition Program Medical Documentation for WIC Medical Formula or Medical Food form if there are any foods that must be excluded from the WIC food benefits.

17. What can WIC provide for children or women with cow's milk protein allergy?

Fortified soy beverage and/or tofu can be provided for children with cow's milk protein allergy who are able to consume soy products. These items are available by prescription only for children in order to ensure that the health care provider is aware of the special health needs of the child. Soy products may be provided to women upon their request. Goat milk (whole and 1%) may also be prescribed for children or women who are able to use it as an alternative to cow's milk.

18. Who can a health care provider call if more information is needed about a medical formula prescription?

The health care provider may contact the local WIC office if there are questions about a formula prescription request. The health care provider may also contact the State Agency Nutrition Coordinator at 1-800-437-9300.

19. Can WIC provide lowfat milk for children aged 12-23 months if medical justification is provided?

Whole milk is the only type of milk allowed for 1-year-old children (12 through 23 months).  Lowfat or skim milk may be provided beginning at the age of 24 months.

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20. Can a child less then 24 months or a woman receive whole milk if medical justification is provided?

Yes; however, the child or woman must also be receiving a medical formula or food. Whole milk may not be issued solely for the purpose of managing or enhancing body weight.

21. What feeding products are not provided by the Maine WIC Nutrition Program?

According to USDA federal regulations, the following items cannot be provided by the WIC Program:

  • An apparatus or device (enteral feeding tubes, bags, or pumps) used to administer *WIC formulas
  • Thickening agents
  • Flavor packets
  • Parenteral or intravenous nutrition products
  • Enzymes
  • Oral rehydration or electrolyte solutions
  • Medicines or drugs

22. Why does the Maine WIC Nutrition Program perform hematological testing?

USDA, which funds the Maine WIC Nutrition Program, requires a complete nutrition assessment at enrollment. Part of that assessment process includes information on hematological parameters. A hemoglobin level is done or requested from the health care provider to determine if nutrition risk may be present for iron-deficiency anemia. Referral for a lead screening test is also provided to the parents of children who are 12 and/or 24 months of age.

23. How often does the Maine WIC Program perform hematological testing for hemoglobin?

WIC obtains a hemoglobin value during the initial certification visit for each WIC applicant. Pregnant women are tested once during their certification as a pregnant woman; if the hemoglobin is available from the health care provider, WIC staff will send for the test result. Breastfeeding women are tested once during their certification as a breastfeeding woman. Postpartum women are tested once during their certification as a postpartum woman. Infants are not tested between the ages of 9-12 months.? Children are tested once a year.

24. Can WIC use a physician's hemoglobin or hematocrit test result?

WIC can use a hemoglobin or hematocrit test result obtained by the health care provider when the value and date are provided by the health care provider's office. The hemoglobin value must be no older than 90 days before the WIC certification visit, and must reflect the WIC participant's category (i.e., a test result for a pregnant woman must have been done after the beginning of the pregnancy).

25. Why does the Maine WIC Nutrition Program only provide iron-fortified infant formula for WIC participants?

The Maine WIC Nutrition Program supports the American Academy of Pediatrics (AAP) policy that exclusive breastfeeding is the ideal nutrition for infants in the first year of life. Human milk is sufficient to support optimal growth and development for full-term infants during the first 6 months after birth, and should be continued with the addition of age-appropriate of solid foods at least through the first 12 months, and thereafter for as long as mutually desired (AAP, Work Group on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 1997; 100: 1035-1039). In the absence of human milk, iron-fortified infant formula is an appropriate substitute for feeding the full-term infant during the first year of life. Low-iron formulas exist because iron is perceived by some to cause constipation and other feeding problems. Well-controlled studies have consistently failed to show any increased risk of feeding intolerance with the use of iron-fortified formulas (Pediatric Nutrition Handbook, 4th edition, 1998).

26. Why does the Maine WIC Nutrition Program not allow cow's milk for WIC participants until one year of age?

The Maine WIC Nutrition Program cannot provide cow's milk before the age of one, according to USDA Federal Regulations. The Committee on Nutrition of the American Academy of Pediatrics (AAP) recommends the consumption of breast milk or iron-fortified infant formula, along with age-appropriate solid foods, during the first twelve months of life. The AAP recommends that whole cow's milk and low-iron formulas not be used during the first year of life (AAP, The Use of Whole Cow's Milk in Infancy, Pediatrics, 1992, 89:1105-1109).

27. Why does the Maine WIC Nutrition Program not encourage reduced-fat milk for WIC participants until two years of age?

The Maine WIC Nutrition Program provides whole milk for children age 12 to 23 months. Recommendations of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents (National Cholesterol Education Program/NIH), The American Academy of Pediatrics Committee on Nutrition, and The American Heart Association Nutrition Committee state that fat and cholesterol should not be restricted during the first two years of life (AAP, Pediatric Nutrition Handbook, 1993, page 44; NIH, Report of the Expert panel on Blood Cholesterol Levels in Children and Adolescents, 1991, page 1)

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