Premature formulas may be provided to premature infants up to their corrected age of 12 months.The Medical Documentation Form is available at: Medical documentation includes an appropriate qualifying medical condition for the formula, quantity (ounces/day), length of use, and food restrictions.Children and women with WIC-eligible nutritionals.Infants and children with exempt formula.Infants 6 months or older with greater amounts of contract formula in lieu of infant foods.Special Formula/Food Request form as well as revisions to the List of Authorized WIC Formulas are available at /wic medical providers tab. WIC-Eligible Nutritionals Calorie and Nutrient Dense Products Click on your state in the map below to see which Gerber infant formulas are available for your patients through WIC, Medicaid & the. These formulas can be issued in cases of prematurity up to one year adjusted age.
#Wic formulas portable
New York State WIC Approved Formulas is also available in Portable Document Format (PDF)Įffective October 2021 Contract Formulas Contract Infant Formulasġ2.5 oz.SD DOH Medical Documentation Form valid effective January 29, 2021.Approved Formulas in the New York State WIC Program Formulary List of all formulas available to participants effective January 29, 2021. WIC agency staff will review and fill requests for formulas and supplemental foods according to federal regulations and New York WIC program policies and. Non-contract formulas, exempt infant formulas and medical foods with written request and appropriate medical documentation. Women & Children (W & C) on Food Package III-Formula Amounts Includes. WIC cannot provide a formula other than the contract formula to a WIC infant due to physician or caregiver preference. WIC offers approximately 30 special formulas for participants with special medical needs. Infants who are not breastfed will receive the Contract Infant Formulas.
#Wic formulas pro
If WIC receives a written request for a standard non-contract infant formula, such as Enfamil Infant or Similac Pro Advance, or if the written request lists no specific medical reason, a Registered Dietitian or Nurse will contact the physician’s office for clarification. View the WIC Approved Formulas list (PDF) to see all formulas you can purchase with your WIC benefits. Children one year and older and women must have a prescription to get a standard formula. All flavors are approved for NYS WIC eligible formula products. Standard formulas are for infants less than one year old. Note for health care providers: Medical documentation is not needed for infants under 12 months of age to receive a WIC contract formula. Please use the South Dakota Department of Health (SD DOH) Medical Documentation Form to request a special formula.Īll such requests must be reviewed and approved by a WIC Registered Dietitian. Premature formulas may be provided to premature infants up to their corrected age of 12 months.
#Wic formulas trial
WIC can only provide formula other than the contract when a physician determines the child has a medical condition that contraindicates use of the contract formula and writes a prescription for another formula. A trial of at least two contract formulas must be completed before prescribing a non-contract formula such as Nutramigen or Alimentum. Standard formulas are for infants less than one-year-old and do not require. The new standard formulas for South Dakota are: WIC Approved Foods WIC food packages are based on the Dietary Guidelines for. For your WIC mothers who are unable to breastfeed or choose not to, we ask that you recommend the standard contract WIC formula unless a medical condition contraindicates its use.Įffective January 29, 2021, the South Dakota WIC infant formula rebate contract for standard milk-based and soy-based formulas changed from Mead Johnson Nutrition Enfamil products to Abbott Similac products. We recognize that parents look to their family physician in their decisions regarding feeding their infants. If a mother is unable or chooses not to breastfeed, WIC will provide infant formula. We understand formula is a crucial ingredient to starting life. Standard Contract Infant Formulas (20 kcal/oz) are available by parent/caregiver request: Similac Advance (milk -based) or Similac Soy Isomil This does not include Similac Pro products or Similac Non-GMO products. You can also call ahead of time to schedule a prescription pick up, even before your prescription has been approved by the WIC clinic. The South Dakota WIC Program supports breastfeeding as the ideal method of infant feeding for the first twelve months of life or as long as mutually agreeable between mother and child. Find WIC-approved formulas in Austin by visiting Lone Star Family Market.
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