WIC for Clinicians

Why is WIC important?

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. See additional information: Connecting Families to WIC: A Practical Toolkit for Health Care Providers

What are the requirements for a family to qualify 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

Note: Families can learn more about how WIC can support families with food allergies on the FAMPIT Family WIC page.

WIC: Spreading awareness

The American Academy of Pediatrics (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 the WIC website.

Provider Intervention in WIC (WIC Medical Documentation Form)

Should a prospective participant need a therapeutic formula or food based on their medical conditions, WIC requires that the clinician fill out a WIC Medical Documentation Form

Each state has its own medical documentation form; simply look up the [YOUR STATE] WIC medical documentation form or Physician Authorization Form.

After Visit Summary Template

WIC is the 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. To see if you qualify, please follow the link or use the QR code: https://www.fns.usda.gov/wic/eligibility-tool

The assessed criteria are: 

• Women are currently pregnant, postpartum (up to 6 months after the end of a pregnancy, or breastfeeding (up to the infant’s first birthday). Must be below or at WIC income limits for the program.  
• Infants and children (up to their fifth birthday) who are deemed to be at nutritional risk
• Must reside in the state or territory in which they wish to apply, and finally, if an interested participant or their child 
• Be considered to have a nutritional risk from a WIC professional

If you or your child currently receives Medicaid, SNAP (Supplemental Nutrition Assistance Program), or TANF (Temporary Assistance for Needy Families, you may already be eligible for WIC. 

Select the following link to access program contacts for your state: WIC Program Contacts, should you want to learn more about the program.

What screenings might WIC need from Clinicians?

WIC and Clinicians may exchange information related to screening participants for WIC records. They might include: 

Growth Screening 

As part of the WIC Growth assessment process, weight, length/height measurements are required. 

Iron Screening 

It is requested that iron screening tests (hematocrit or hemoglobin) be performed at the following time points: 

• Pregnant people – ASAP for the current pregnancy 
• Postpartum – during the postpartum period, roughly 6 weeks after delivery 
• Infants – between 9 and 13 months 
• Children – between 15 and 18 months and thereafter every 12 months, if blood values are normal, or every 6 months, if values are low

Lead Screening

As part of WIC enrollment, a lead screen is required. If a child has not yet had a blood lead test, they will be referred back to the clinician for testing. 

Medicare and WIC Participants

Medicare and WIC have important intersections. Individuals who are eligible for Medicare, SNAP, and TANF, are automatically eligible for WIC. Medicaid can provide extra funding and incentives for healthcare providers to focus on nutrition and food insecurity. For food insecurity and nutrition risk improvement, clinicians are eligible for Merit-Based Incentive Payment System (MIPS) incentives for screening and outcomes for food insecurity.

For WIC Staff: Food Allergen Introduction in Infants

When should complementary foods be introduced?

Current recommendations state that infants be introduced to nutrient-dense and baby-friendly complementary foods at around 6 months of age, or as early as 4 to 6 months if developmentally ready. The common allergenic foods, including peanuts, egg, cow’s milk products, tree nuts, sesame seeds, shellfish, fish, wheat, and soy, should be introduced when other complementary foods are introduced.

Note: Family-friendly resources on Early Introduction can be found on FAMPIT Family. These resources provide detailed and easy-to-understand information on when and how to introduce potentially allergenic foods to infants.

When is a baby ready for solids?

Signs a baby is developmentally ready for solid/complementary foods:

• They can sit up with limited support.
• They can control their head and neck.
• They try to grasp small objects.
• They bring objects to their mouth.
• They open their mouths when food is offered.
• They swallow food instead of pushing it out.

How do caregivers 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 for any signs and symptoms of a reaction. 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 be introduced?

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). In addition to peanut, early introduction of egg during infancy may help reduce the risk of developing egg allergy. Recent population-based research from Australia found lower rates of egg allergy among children following implementation of national early egg introduction guidelines.

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. Caregivers can wash hands after handling foods and before changing diapers and applying lotions/creams to help mitigate this issue. Learn more about the Dual Exposure Hypothesis.

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.

Note: Share FAMPIT Family resources on Anaphylaxis in Infants and Toddlers for more information on symptoms, epinephrine, and more.

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. Current guidance also supports introducing egg during infancy, around the time other complementary foods are introduced, as part of an overall food allergy prevention strategy. 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.

Resources to Share with Families

1. 3-Video Series: Preventing Food Allergies

This 3-part video series shares tips on what families can do to prevent food allergies in their baby. It covers topics such as early allergen introduction, skin management, and mother’s diet.

2. Poster: Wall Poster Linking to Family Site

3. Handout: Early Introduction Information for Families

4. Blog on SignUpWIC

Protecting Your Baby – What You Need to Know About Food Allergies

When to Introduce Egg, Peanut Butter & Other Common Food Allergens to a Baby

This article from HealthyChildren.org provides guideline-based tips on introducing common food allergens like peanut and egg. This family-friendly resource can be shared with parents during visits.

New Podcast Episode: Guidance on Early Food Introduction and Food Allergy Prevention 

Families of infants often have questions about when and how to introduce new foods — especially regarding peanut allergies and allergy prevention. This episode of the American Academy of Pediatrics’ Healthy Children Podcast offers a lively conversation between Dr. Edith Bracho-Sanchez and Dr. Pistiner covering:

• The connection between eczema and food allergies
• Practical strategies for introducing allergenic foods early
• Evidence-based advice to support families during the early feeding journey

Listen to the Healthy Children Podcast episode: 

National WIC Association Webinar:
Advice for Food Allergy Prevention – Empowering WIC Providers with Early Feeding Strategies (June 2026)

Association of State and Public Health Nutritionists (ASPHN) Webinar:
Practical Food Allergy Prevention: Translating Guidelines for WIC and Public Health Nutrition Programs

Part 1 – Lecture Recording

Part 2 – Q/A Recording

Slides

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

Video 1: Training Webinar

Video 2: Cases and Q+A

Test your knowledge

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