WIC Food Packages Time for a Change (2006) / Chapter Skim
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4 Revised Food Packages
4 Revised Food Packages
Pages 87-123
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From page 87... ...
See Chapter 7 -- Recommendations for Evaluation and Implementation -- for details. DESCRIPTION OF THE REVISED FOOD PACKAGES In addressing proposed changes to the WIC food packages, the committee retained the basic numbering system used for the current food packages.
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From page 88... ...
Persons receiving Food Package III also would receive the foods allowed for other participants in the same life stage if those foods were medically and developmentally appropriate for them. cIn most cases, the maximum monthly allowance of infant formula is stated as fl oz of liquid concentrate.
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From page 89... ...
NOTES (abbreviations in order of appearance in table) : FF = fully formula-fed; BF/FF = partially breast-fed (i.e., the infant is breast-fed but also receives some formula through the WIC program)
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From page 90... ...
and Table B-1 in Appendix B -- Nutrient Profiles of Current and Revised Food Packages -- for allowed types and forms of foods. b Food Package V is available to two groups: pregnant women and breastfeeding women whose infants participate in the WIC program and receive formula in amounts that do not exceed the maximum allowances for Food Packages I-BF/FF-A, I-BF/FF-B, or II-BF/FF, as appropriate for the age of the infant.
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From page 91... ...
A maximum of 4 qt of milk can be substituted for in this manner in Food Packages V and VI. A maximum of 6 qt of milk can be substituted for in this manner in Food Package VII for fully breastfeeding women.
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See Table 4-3 (Proposed Specifications for Foods) and Table B-1 in Appendix B -- Nutrient Profiles of Current and Revised Food Packages -- for additional information.
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(For further information, see Table B-6 in Appendix B -- Nutrient Profiles of Current and Revised Food Packages.) The committee recommends powdered formula for partially breast-fed infants because the amount prepared can be tailored closely to the amount needed.
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From page 94... ...
Due to rounding to whole cans of powdered formula, the amount of formula may not increase at four months of age, depending on the can sizes of formula provided (see Table B-6 in Appendix B -- Nutrient Profiles of Current and Revised Food Packages)
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From page 95... ...
4For details on specific nutrients, compare nutrients provided in Tables B-2 and B-3 (Appendix B -- Nutrient Profiles of Current and Revised Food Packages) to recommended levels of nutrients in Table F-1 (Appendix F -- Supplementary Information)
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From page 96... ...
, all three revised food packages for women provide smaller amounts of milk products, eggs, and juice; the same amount of iron-fortified cereal (now whole grain only) ; and fruits and vegetables as an addition.
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From page 97... ...
, which is higher in mercury content, is not. Other low-mercury fish options are included in Table 4-3 for participants preferring to avoid tuna (see Table B-1 in Appendix B -- Nutrient Profiles of Current and Revised Food Packages -- for details)
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From page 98... ...
. Compared with the current package, the revised food package includes smaller amounts of milk and juice but adds fruits, vegetables, and whole grains.
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From page 99... ...
Food Package III for Infants9 -- The revised food package would include special formula that is documented to be medically necessary for an infant or infant formula in developmentally advanced forms (e.g., thickened)
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The major changes the committee proposes for the revised WIC food packages are: · Including fruits and vegetables for all participants 6 months of age and older; · Including more whole grain products; · Reducing the amounts of saturated fat provided for participants two years of age and older (this also reduces the amounts of cholesterol and total fat provided) ; · Promoting and supporting breastfeeding, especially full breastfeeding; BOX 4-1 Definitions of Food Instruments · Standard WIC Food Instrument -- a check, voucher, electronic benefit transfer (EBT)
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From page 101... ...
Including Fruits and Vegetables in the WIC Food Packages The single most fundamental change in the revised WIC food packages is the inclusion of a variety of fruits and vegetables in all packages for individuals 6 months of age and older. The forms vary from commercial baby food fruits and vegetables to fresh produce for children and women.
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From page 102... ...
. The committee received many public comments from health professionals, consumers, WIC program staff, and others advocating for the inclusion of fruits and vegetables in the WIC food packages.
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From page 103... ...
In contrast, juice is not provided in the revised food packages for infants at any age and the quantity of juice is reduced in food packages for children and women. Deleting or reducing the quantity of juice in the set of food packages helps allow for the inclusion of whole fruits and vegetables while containing food costs.
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From page 104... ...
with input from the client, the CPA would specify the types and amounts of processed fruits and vegetables selected from the list of choices allowed by the WIC state agency. (For specifications of allowable products from which the state agency could choose, see Table 4-3 and Table B-1 in Appendix B -- Nutrient Profiles of Current and Revised Food Packages.)
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From page 105... ...
It is anticipated that retail food vendors will sell more fresh fruits and vegetables as a result of the inclusion of these products in the children's and women's food packages. Because fresh produce is a relatively high margin department in retail food stores, this is expected to be a welcome change.
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From page 106... ...
and Table B-1 (Appendix B -- Nutrient Profiles of Current and Revised Food Packages) and other resources to determine which types and brands of whole-grain products would be allowed.
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From page 107... ...
One is a modest reduction in the recommended maximum amounts of milk in packages for children and women. Another change, and perhaps the most fundamental, is that the revised food packages specify reduced-fat, low-fat, or nonfat fluid milk (i.e., maximum of 2 percent milk fat)
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From page 108... ...
Reducing the maximum amount of cheese reduces the amount of saturated fat, total fat, and cholesterol. The revised food packages for children and women provide less cholesterol than the current package because they provide fewer eggs, but the major reason for decreasing the quantity of eggs was to help make it possible for the packages to provide a wider variety of foods.
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From page 109... ...
Because the proposed changes are substantial and untested, the committee also calls for pilot studies before full-scale implementation. Market Value of the Packages for the Mother/Infant Pair Proposed changes to help support breastfeeding address packages for the infant as well as the mother since both the new mother and the infant ordinarily are eligible to receive a WIC food package.
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From page 110... ...
also provides commercial baby food meat, a good source of iron and zinc. Compared with the revised Food Package VI for fully formula-feeding mothers, the revised Food Package VII for fully breastfeeding mothers provides more milk and eggs; it also provides canned fish, whole grains, cheese (in addition to cheese as a substitute for milk)
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From page 111... ...
Minimizing Early Supplementation Proposed Policy Change Related to Initial Food Package Options for Mothers/Infant Pairs After Delivery -- Because early supplementation with formula may contribute to the short duration of breastfeeding of those who choose to breastfeed, the committee recommends that only two infant feeding options be offered initially after delivery -- either full breastfeeding or full formula feeding -- and that WIC staff continue or increase their efforts to encourage and support breastfeeding. Women who choose to breastfeed, whether they intend to continue fully breastfeeding or intend to move to partial breastfeeding, would receive the enhanced fully breastfeeding food package (Food Package VII)
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Addressing Developmental Needs of Infants and Young Children The revised food packages consider specific developmental and physiological needs through the amounts of infant formula provided, the types
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.16 (See Appendix B for detailed information.) Thus, compared with the current Food Package II, the revised Food Package I-FF-B provides slightly less energy to infants 4 through 5 months of age.
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powdered formula is recommended during ages 1 through 3.9 months -- to promote food safety and discourage waste as explained elsewhere. The revised infant food packages provide essential nutrients, limit food energy, and reinforce the nutrition education message to initiate the routine feeding of complementary foods beginning around 6 months of age (AAP, 2005)
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From page 115... ...
and common guidelines for clinical practice in the field of pediatrics (Hendricks et al., 2001; Morris and Klein, 2000; AAP, 2001c; Rudolph and Rudolph, 2003) .18 To make possible the gradual introduction of a variety of fruits and vegetables, the committee recommends the deletion of fruit juice and the addition of commercial baby food fruits and vegetables and fresh bananas to Food Package II for infants ages 6 months and older.
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From page 116... ...
The emphasis is on nutrient-dense foods and beverages and limitations on added sugars for all, and an increase in fiber and decrease in saturated fat content of the packages for children and women. Compared with the current food packages, the revised food packages for infants provide less food energy after the age of four months (except for fully breastfed infants)
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From page 117... ...
The proposed WIC food packages provide a variety of nutrient-dense foods in moderate amounts and can contribute to developing healthy eating patterns, reinforcing nutrition education, and promoting positive changes in dietary behaviors. Providing More Flexibility for WIC States Agencies and More Variety and Choice for WIC Participants The cultural diversity and heterogeneity of the WIC participant population pose special challenges for a supplemental nutrition program.
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From page 118... ...
However, the limited available evidence from pilot studies shows that, when provided with a fresh fruit and vegetable supplement to the WIC food package, participants chose a wide variety of different items (Herman, 2004; Runnings, 2004)
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From page 119... ...
as a partial substitute for milk for women, and calcium- and vitamin D-rich soy beverage ("soy milk") as an alternative for all or part of the fluid milk for adult women.19 These new choices may be viewed by some 19Soy products (i.e., tofu, soy beverage ["soy milk"]
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From page 120... ...
In doing so, the committee gave special attention to revising the food packages to: · Include fruits and vegetables for all participants 6 months of age and older; · Include more whole-grain products; · Reduce the amount of saturated fat for participants 2 years of age and older; · Promote and support breastfeeding, especially full breastfeeding; · Address the developmental needs of infants and young children; · Address obesity concerns; and · Provide more flexibility for the WIC states agencies and more variety and choice for the WIC participants. Additionally, the committee recommends that the revised food packages be provided in full, except to the extent that the packages are tailored to the needs of individual WIC participants.
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From page 121... ...
Baby food fruits Infants, Commercial baby food fruits and vegetables and vegetables 611.9 mo without added sugars, starches, or salt (i.e., sodium) -- Texture may range from strained through diced.
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women The committee does not recommend any substitutions for cheese in Food Package VII. Yogurt, Children and Plain or flavored; 17 g of total sugars per fat-reduced women 100 g yogurt -- Yogurt for those age 2 y and older may not contain more than 2% milk fat.
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Peanut butter Children and No change from current specifications. women aSee Table B-1 (Appendix-B -- Nutrient Profiles of Current and Revised Food Packages)
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