WIC: W e I nvest in C hildren

1. WIC: We Invest in Children Nutrition you need, when you need it most (also known as WIC: Women, Infants and Children)

2. Victor Oliveira, Elizabeth Racine, Jennifer Olmsted, Linda M. Ghelfi United States Department of Agriculture Economic Research Service Food Assistance and Nutrition Research Report Number 27 September 2002 The WIC Program Background, Trends, and Issues* *Source of much of the data presented here. USDA’s WIC website and personal experience in a WIC clinic is the source of the remaining. Amy Moore Giles, RD, CD

3. The Mission • The mission of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is to safeguard the health of low-income women, infants and children up to age 5 who are at nutritional risk, by providing nutritious foods to supplement diets, nutrition education, and referrals to health care and other social services.

4. The Premise • WIC is based on the premise that early intervention programs during critical times of growth and development can help prevent future medical and developmental problems.

5. To Be Eligible for WIC • A person must meet all these criteria: • Be categorically eligible • Be address eligible • Be income eligible • Have one or more nutrition risk factors • If one or more of these criteria are not met, the person is not eligible for WIC

6. WIC Eligibility • Categorical: to participate in WIC a person must be pregnant, breastfeeding (up to 1 year postpartum), non-breastfeeding (up to 6 months postpartum), an infant less that 1 year, or a child up to his/her fifth birthday • Residential: must live in the area where they are served

7. Income: up to 185% of poverty • Household size includes unborn baby • Based on gross income • Requires written documentation • Updated every July 1st with an increase in the limits

8. Nutrition risk: • As determined by a health professional • Can be 1 of 5 major types • Detrimental or abnormal nutritional condition detectable by biochemical or anthropometric measurements (anemia, inadequate weight gain) • Other documented nutritionally related medical conditions (gestation diabetes)

9. Nutrition risk: • Dietary deficiencies that impair or endanger health (inadequate diet or inappropriate infant feeding). • Conditions that directly affect the nutritional health of a person (drug and/or alcohol abuse) • Conditions that predispose persons to inadequate nutritional patterns (homelessness)

10. Where Can Families Find WIC? • WIC clinic addresses and phone numbers are listed in the government pages of most phone books • A telephone call to a local health department will also help a family locate a WIC clinic close to them • Searching for WIC and the state and city where the family lives on the Internet

11. How Do Families Apply for WIC? • When a potential client calls a WIC clinic they are prescreened on the phone for category, address and income • They are given an application appointment where they will need to provide proof of address, income, ID and completed WIC medical/diet history forms • Blank WIC medical/diet history forms can be mailed or printed off WIC websites

12. What Happens at the First WIC Appointment? • The family presents proof of address, income, ID and these are verified by WIC staff • The family members applying for WIC are weighed, measured and a blood test for anemia is done • The family meets with a Registered Dietitian or other nutrition professional for evaluation of growth, anemia risk and diet • The family receives their WIC vouchers and an appointment to return for a WIC class is made for 3 months in the future

13. The WIC Food Package • Provides nutrient dense foods such as: • Iron fortified cereals, may also be fortified with folic acid • 100% fruit/vegetable juices with vitamin C • Carrots (exclusively breastfeeding women) • Milk and cheese • Eggs • Dried beans, peas and lentils/peanut butter • Tuna (exclusively breastfeeding women) • Iron fortified infant formula to supplement or replace breastmilk feedings

14. Where Do WIC Clients Get WIC Foods? • WIC foods are purchased at regular grocery stores using WIC vouchers • A WIC voucher specifies the food and the amount of that food the WIC client can get with that voucher • A WIC food card lists the approved WIC foods, with brand names specified on cereals, some juices and infant formula, for other foods the WIC client must choose the least expensive brand. • A WIC voucher acts like a check at the grocery store, each voucher has a spending limit specified on it • No tax is charged on WIC foods and no change is given when using a WIC voucher

15. Who’s is Using WIC? • 1 in 4 pregnant women • 1 in 2 infants • 1 in 4 children

16. Is WIC Just “Food and Formula”? • WIC foods and WIC formula are meant to supplement a low income family’s diet, allowing the family to spend their limited food dollars on other nutritious foods • WIC is really about nutrition education that will make a difference when the short term benefits (the foods) are no longer available

17. Meal planning Shopping on a budget Preparing low cost protein foods like beans Buying fruits and vegetables in season What to do about picky eaters Fast meals at home instead of fast food Choosing appropriate serving sizes for age Enjoying family physical activity Targeting the growing problem of childhood obesity Pregnancy Nutrition How to breastfeed successfully Nutrition Education

18. Breastfeeding Support • Counseling from on-staff Certified Lactation Educators • A “Breastfeeding Your Newborn” class • Telephone calls from an experienced mom before and after baby’s birth • Free electric breastpump rentals if indicated by medical need (such as hospitalized infant) • Free manual (hand operated) breastpump for mothers returning to work or school

19. Referrals • To prenatal care: Baby Your Baby/Medicaid • To family planning: child spacing and pregnancy preparation, i.e. folic acid supplements • To well child care: Medicaid/CHIP • Referral to health care provider/health department after immunization screening • To Early Intervention Programs (developmental delays) • To Workforce Services: Food Stamps, Medicaid, Family Employment Program • To Child Support Enforcement • To Head Start

20. WIC Outcomes • Every dollar spent on a pregnant woman in WIC saves Medicaid $1.92 to $4.21, depending on the study parameters • Women enrolled in WIC are found to seek prenatal care earlier in pregnancy and consume more key nutrients such as protein, iron, calcium, Vitamin C, and Folic Acid • WIC results in fewer premature births and fewer low birth weight babies, with fewer deaths • WIC prenatal care benefits reduce the rate of very low birth weight babies by 44%

21. WIC Outcomes • Babies born to WIC mothers weighed more than their siblings born when mom did not receive WIC • A meta analysis concluded that for every dollar spent providing WIC prenatal benefits in 1990, an estimated $3.50 was saved over an 18-year period in Federal, State, local and private health costs, primarily in the health care area • Even in accounting for potential bias, research confirms that WIC has significant impact on birthweight and significantly lowers birth-related Medicaid costs

22. WIC Outcomes • Low income non-WIC children have more anemia than WIC enrolled children • The anemia rate at the six- month WIC visit is 16% lower than at the initial WIC screening • Children of mothers who participated in WIC during pregnancy had better vocabulary test scores at ages four to five • Children who continued WIC after their first birthday had better digit memory scores than those who did not continue

23. Who Works In WIC • Registered Dietitians • Registered Nurses • Health Educators with emphasis in nutrition • Home and Family Science majors with emphasis in nutrition • Lactation Educators and Consultants

24. Learn More About WIC • www.ers.usda.gov/publications/fanrr27/ • www.fns.usda.gov/fns/ • www.chn.org/issues/issue.asp?iss=32