Pediatricians, Obstetricians, and Family Practice Physicians
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has recently instituted monumental changes to its food packages to improve the nutritional intake of mothers and children as well as to promote breastfeeding. Pediatricians, obstetricians, and family practice physicians can partner with WIC to ensure that these food package changes benefit families, increase breastfeeding rates, and reduce the risks of obesity and other chronic diseases. Currently, more than 50 percent of women, infants, and children in the United States are eligible for WIC. In San Diego County, there are approximately 100,000 WIC participants.
Food Package Changes
The new WIC food packages are based on recommendations from the Institute of Medicine (1) and were introduced in California on Oct. 1, 2009. The food packages align with the Dietary Guidelines for Americans (2) and infant feeding practice guidelines of the American Academy of Pediatrics (3). WIC has been educating its participants about the new foods for several months. Some of the major changes to the WIC food packages include the following:
- Enhanced food package for mothers who choose to breastfeed, including baby foods for children over six months of age, and fish for the mother.
- Cash value vouchers to purchase fresh fruits and vegetables.
- Whole-grain bread and tortillas.
- Whole milk for children ages 12–23 months; 1 percent or fat-free milk for children 2–4 years of age (whole milk for older children requires a physician’s prescription).
- Required documentation of a qualifying condition from a physician for special formulas or diets.
- Less formula after six months of age for partially breastfed infants and older babies.
Breastfeeding Support
Along with enhanced food packages for breastfeeding mothers, WIC provides additional information, incentives, and support services to encourage breastfeeding. To help new mothers establish their milk supply, WIC encourages mothers to exclusively breastfeed in the first month of their baby’s life. Formula is not routinely provided to breastfeeding mothers in the first month of the baby’s life unless there is a medical reason for formula supplementation. All newborn babies are screened for feeding problems upon enrollment in the WIC program and are referred to their healthcare provider if problems are evident.
Many new mothers wonder if they have enough breast milk for their baby, especially if their baby cries or wakes up more often than they expected (4). To help reassure new mothers that their baby is getting enough milk, WIC provides them with information about normal baby behavior, including crying and sleep patterns.
Reinforcing Nutrition and Breastfeeding Messages
WIC and physicians can work together to build healthier families and communities. Physicians can reinforce the following nutrition messages that families receive from WIC:
- Eat a rainbow of fruits and vegetables every day.
- Make half your grains whole.
- Lose the fat, keep the vitamins — drink low-fat milk.
Physicians can also support a mother’s decision to breastfeed by:
- Encouraging her to exclusively breastfeed for at least the first four weeks to build up a full milk supply.
- Reassuring her that it is normal for newborn infants to wake up frequently to breastfeed.
- Encouraging her to seek breastfeeding support from her WIC office.
Conclusion
The introduction of the new WIC food packages provides an important opportunity to improve the health of mothers and children and to promote breastfeeding. Physicians can incorporate similar messages into their counseling to reinforce the nutritional information that families receive from WIC and to maximize the benefits of the new food packages for thousands of families in San Diego County.
References
- Institute of Medicine of the National Academies Committee to Review WIC Food Packages Food and Nutrition Board. WIC food packages: Time for a change. National Academies Press: Washington DC. 2006.
- www.health.gov/DietaryGuidelines
- Breastfeeding and the Use of Human Milk. Policy Statement. Section on Breastfeeding. Pediatrics Vol. 115 No. 2 February 2005, pp. 496-506.
- Heinig et al. Barriers to Compliance With Infant-Feeding Recommendations Among Low-income Women. J Hum Lact 2006 Feb;22(1):27-38.
Additional Resources