Changes in the WIC Food Package: WIC Mothers Want The Option of Making Their Own Baby
Changing the WIC package in response to changes in dietary recommendations
The Special Supplemental Nutrition Program for Women Infants and Children (WIC) was designed in the 1970s to protect the nutrition and health of low-income pregnant and postpartum women, infants and children up to age five years1. WIC provides nutrition education, medical and social service referrals, breastfeeding promotion and support, and a supplemental food “package”. The WIC food packages were designed to provide nutrients thought to be most limited in the diets of low-income women and children in the 1970s, and until recently, had not been modified in any major way. The program has effectively reduced the risk for low birth weight and iron-defi ciency anemia of low-income children and currently serves over 50% of all infants born in the US2-4.
However, in the more than three decades since the inception of the program, there have been signifi cant changes in dietary recommendations and an epidemic rise in overweight and obesity, particularly among low-income and ethnic minority communities5-9. In 2003, the Institute of Medicine was charged with evaluating the diets of low-income women and children in the U.S. and recommending revisions to the WIC food packages. The recommended revisions were designed to reduce the prevalence of inadequate and excessive nutrient intakes among participants and to align the food packages with the current Dietary Guidelines for Americans and with accepted pediatric nutrition recommendations. In 2009 the food packages were revised program-wide10.
What the revised WIC packages mean in terms of diet quality
The revised WIC food packages represent a significant change in the resources available to improve diet quality for a large part of the low-income US population. The revised food packages provide signifi cantly less fat, saturated fat, cholesterol and simple sugars than the previous packages, both for women and children. They also contain higher amounts of whole grains, and consequently more dietary fiber. For women and children ages 1-5, the revised packages include cash value vouchers (CVVs) for the purchase of fruits and vegetables. For infants 6-11 months old, jarred baby fruit and vegetable (F/V) are included in the revised package and CVVs are not available. Older infants (9-11 months) who are formula-fed or partially breastfed receive a monthly allotment of jarred fruit and vegetable baby food and fully breastfed babies in the same age range receive even more jarred fruit and vegetable baby food in addition to jarred meat baby food. These jarred baby foods offer important supplemental nutrition for infants and represent a sizeable portion of the food package budget.
The 2002 Feeding Infants and Toddlers Study (FITS) found that more than 70% of infants four months and older consumed jarred baby foods11-12. That percentage increased to more than 87% from seven to twelve months of age. Hurley et al. reported 81% of Maryland WIC infants consumed jarred baby foods, which was associated with increased variety in fruit and vegetable intake13. Given such high rates of consumption of jarred baby foods, particularly among WIC infants, understanding infant feeding patterns and satisfaction with jarred baby foods is important for future revisions and policy programming of the new WIC food packages.
Evaluating the impact of the new food packages
The historic and unprecedented nature of this change in the food provision for WIC families warranted a detailed examination of the impact of the new food packages. To date, a handful of evaluations of the impact of the new food packages have been published14 but no published research to date has specifi cally focused on commercially prepared jarred baby food in the new WIC food package. The purpose of this study was to examine participant use and satisfaction with jarred baby F/V, assess preference for cash value vouchers (CVVs) for fruits and vegetables versus jarred baby F/V, and examine whether preferences varied among selected ethnic groups.
Two data sources were used in the study: The California Nutrition Education and Food Package Impact (NEFPI) survey and California WIC voucher redemption data. Participants reported high satisfaction with the CVV for fruits and vegetables and jarred baby foods, with statistically significant variation across ethnic groups. Our results indicated, however, that as infants get older, mothers wanted the option to choose between jarred baby foods and CVVs for fruits and vegetables. As a next step, we suggest a study to further examine redemption rates and explore the feasibility of allowing states to offer older infants the choice between CVVs for fruits and vegetables instead of jarred baby fruits and vegetables.
Based on: Kim LP, Whaley SE, Gradziel PH, Crocker NJ, Ritchie LD, Harrison GG. Mothers prefer fresh fruits and vegetables over jarred baby fruits and vegetables in the new Special Supplemental Nutrition Program for Women, Infants, and Children food package. J Nutr Educ Behav. 2013 Nov-Dec;45(6):723-7.
- Oliveira V, Frazao E. The WIC Program: Background, Trends, and Economic Issues, 2009 Edition. Economic Research Report Number 73. 2009; Washington, D.C.
- Buescher PA. Prenatal WIC participation can reduce low birth weight and newborn medical costs: a cost-benefi t analysis of WIC participation in North Carolina. J Am Diet Assoc. 1993; 93(2): 163-6.
- Buescher, PA, Horton S. Prenatal WIC participation in relation to low birth weight and Medicaid infant costs in North Carolina- A 1997 update. J Am Diet Assoc. 2001; 101(9): 997.
- Miller V, Swaney S, Deinard A. Impact of the WIC program on the iron status of infants. Pediatrics. 1985; 75(1): 100-5.
- USDA. USDA Dietary Guidelines. 2010 Available from: http://www.cnpp.usda.gov/dietaryguidelines.htm.
- Flegal KM. Overweight and obesity in the United States: prevalence and trends, 1960-1994. Int J Obes Relat Metab Disord. 1998; 22(1): 39-47.
- Manson JE, Bassuk SS. Obesity in the United States: A fresh look at its high toll. JAMA. 2003; 289(2): 229-30.
- Ogden CL. Prevalence of overweight 212 and obesity in the United States, 1999-2004. JAMA. 2006; 295(13): 1549-55.
- Hedley AA. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002. JAMA. 2004; 291(23): 2847-50.
- USDA. The New WIC Food Package. 2005 Available from: http://www.fns.usda.gov/wic/regspublished/foodpackages-interimrule.htm.
- Briefel R. Feeding Infants and Toddlers Study: characteristics and usual nutrient intake of Hispanic and non-Hispanic infants and toddlers. J Am Diet Assoc. 2006; 106(1 Suppl 1): S84-95.
- Briefel RR. Feeding infants and toddlers study: Improvements needed in meeting infant feeding recommendations. J Am Diet Assoc. 2004; 104(1 Suppl 1): S31-7.
- Hurley KM, Black MM. Commercial baby food consumption and dietary variety in a statewide sample of infants receiving benefi ts from the special supplemental nutrition program for women, infants, and children. J Am Diet Assoc. 2010; 110(10): 1537-41.
- Black MM. Participants’ comments on changes in the revised special supplemental nutrition program for women, infants, and children food packages: The Maryland food preference study. J Am Diet Assoc. 2009; 109(1): 116-23.