For Clinicians: WIC Information

Why WIC?

In 2023, about half of infants and children in the US were eligible to enroll in WIC, but only half of those actually participated. That means that while many families are being reached successfully, there are still more that can benefit from this program.

Participation in WIC has been shown to be associated with decreased rates of preterm birth, reduced infant mortality, and better childhood diet quality. 

WIC is the USDA’s Special Supplemental Nutrition Program for Women, Infants, and Children. WIC offers many different services for participating families, such as supplemental food assistance, nutrition education, breastfeeding support, and health and community resources.

How to know if a family qualifies for WIC?

If an interested participant or their child currently receives Medicaid, Supplemental Nutrition Assistance Program, or Temporary Assistance for Needy Families, they may already be eligible for WIC. 

Otherwise, they need to meet the following criteria: 

• Categorical Requirement:
  • Pregnant women
  • Breastfeeding women (up to infant’s first birthday)
  • Non-breastfeeding postpartum women (up to 6 months after the end of pregnancy)
  • Infants
  • Toddlers and children (up to age 5)
•  Residential Requirement:
  • Applicants must live in the state in which they apply.
  • Applicants residing in areas where WIC is administered by an Indian Tribal Organizations (ITO) must meet residency requirements enacted by the ITO.
• Income Requirement:
  • Applicants must be at or below an income level standardized by the state agency
• Nutrition Risk Requirement:
  • “Nutrition risk” means that an individual has medical- or dietary-based conditions (i.e., anemia, underweight, poor pregnancy outcome).
  • Applicants must be seen by a healthcare provider to determine whether the individual is at nutrition risk. This can be done by the applicant’s physician or in the WIC clinic at no cost to the applicant.

If I have discussed the program with my patient and believe they may qualify, can I refer them to WIC?

Yes, based on your state, you may be able to fill out a referral form for your state’s WIC office. Referral forms may help identify medical and nutritional risk factors to help enroll your patient enroll in WIC. 

You can access the link to find the respective state, and access the referral form for each state: https://www.fns.usda.gov/fns-contacts?f%5B0%5D=program%3A32

WIC: Spreading awareness

The American Academy of Pediatricians (AAP) suggests that pediatricians provide information about the nutritional and educational benefits of WIC to potentially eligible patients and families while also working collaboratively with local WIC agencies to ensure the most effective treatments and dietary guidance for patients. The AAP also recommends that pediatricians work with state and local WIC agencies to maximize efforts to promote, support, and manage breastfeeding methods for infants. Following breastfeeding guidelines goes hand in hand with the early introduction of common allergens, such as peanut. Pediatricians can help increase awareness about the benefits and resources provided by WIC by sharing information about WIC to eligible patients and families.
For more information on WIC, please visit: https://www.fns.usda.gov/wic

For WIC Staff Tips: Food Allergen Introduction in Infants

When should complementary foods be introduced?

USDA/HHS Dietary Guidelines for Americans recommends: At about 6 months, introduce infants to nutrient-dense complementary foods. Foods like peanuts, egg, dairy products, tree nuts, wheat, shellfish, fish, and soy should be introduced when other complementary foods are introduced.

When is my baby ready for solids?

Signs your baby is ready for solid foods:

• They can sit up.
• They can control their head and neck.
• They bring objects to their mouth.
• They swallow food instead of pushing it out.

Some infants may show signs of readiness before age 6 months, but complementary food introduction before age 4 months or waiting until after 6 months is not recommended.

How do I introduce possibly allergenic foods?

Start with a small tip of a spoon amount. Wait for about 10 to 15 minutes and then slowly feed the rest. Set two hours aside to watch your child. Avoid whole nuts and loose seeds as these are choking hazards. Make sure to thin out nut butters and tahini with fruit or vegetable purees, infant cereals, breast milk or formula to avoid choking.


How much allergen should I introduce?

NIAID Peanut Introduction Guidelines recommend two teaspoons of smoothed-out peanut butter (about 2 grams of peanut protein) three times a week. At this time there are no quantitative guidelines for other allergenic foods, but consider a goal of 2 grams of the food protein twice a week (e.g. 1/3 of an egg or 2 tsp of smoothed-out nut butters/tahini).

What is the Dual Allergen Exposure Hypothesis?

The theory that regular exposure to food allergens through the skin can lead to allergy, while consumption of these foods at an early age may result in tolerance of these foods.

What does an allergic reaction look like?

Mild reaction:

• A new rash or a few hives around the mouth or face.

More severe reaction:

• Lip swelling
• Vomiting
• Hives over the body
• Face or tongue swelling
• Difficulty breathing
• Repetitive cough
• Change in skin color
• Sudden tiredness or turning limp

If this happens, call 911.

If an infant has severe eczema, egg allergy, or both, families should discuss with their pediatrician how and when to introduce peanuts. Ideally, peanut-containing foods should be introduced as early as age 4-6 months as developmentally appropriate to help reduce the risk of developing a peanut allergy. Keep in mind that family history of food allergy, mild to moderate eczema, and milk or soy proctocolitis do not require any screening before adding peanut to an infant’s diet.

Massachusetts WIC Program Advanced Nutrition Training: Food Allergy Prevention (Archived Training; October 20, 2022)

Video 1: Training Webinar

Video 2: Cases and Q+A

References: