1. Arizona WIC Program – Making Meals More Nutritious Adrienne Udarbe Maternal and Child Health Program Manager Arizona Department of Health Services

2. Current Foods Formulas Milk Cereal (infant and adult) Juice Eggs Cheese Dried Beans or Peanut Butter Tuna Carrots

3. New/Revised Foods All current foods plus: –Fruits and Vegetables –Whole Wheat Bread or other Whole Grains –Soy-beverage and Tofu –Light Tuna, Salmon, Sardines, Mackerel –Canned Beans –Baby Foods

4. Food Packages Infant –Fully Breastfed –Partially Breastfed –Fully Formula Fed Children Women –Pregnant –Fully Breastfeeding –Partially Breastfeeding –Postpartum Medically Fragile

5. Infant Primary Goal of the Food Package Changes: –Correlate formula amounts to age of the infant and feeding practice; –Eliminate juice; –Add baby food fruits and vegetable for all infants; –Add baby food meat for fully breastfed babies.

6. Infant – Fully Breastfed Birth through five (5) months of age –Breastfeeding Support Six (6) through Eleven (11) months of age –Breastfeeding Support; –24 ounces of iron-fortified infant cereal; –256 ounces of baby food fruits and vegetables; and –77.5 ounces of baby food meat

7. Infant – Partially Breastfed Birth through one (1) months of age –Breastfeeding Support –Zero (0) to 104 fl ounces of reconstituted powder formula (?) One (1) through three (3) months of age –Breastfeeding Support –Up to 435 fl ounces reconstituted powder Four (4) through Five (5) months of age –Breastfeeding Support –Up to 522 fl ounces reconstituted powder Six (6) through Eleven (11) months of age –Breastfeeding Support –384 fl ounces reconstituted powder; –24 ounces of iron-fortified infant cereal; and –128 ounces of baby food fruits and vegetables.

8. Infant – Fully Formula Fed Birth through three (3) months of age –870 ounces of reconstituted powder formula Four (4) through Five (5) months of age –884 fl ounces reconstituted powder Six (6) through Eleven (11) months of age –696 fl ounces reconstituted powder; –24 ounces of iron-fortified infant cereal; and –128 ounces of baby food fruits and vegetables.

9. Child Primary goal of food package changes: –Help child maintain a healthy weight; –Offer a variety to help with picky eating habits; –Provide foods that are lower in fat and higher in fiber; and –Are consistent with Dietary Guidelines and MyPyramid recommendations.

10. Child, continued Food Package: –Grains: 36 ounces iron-fortified whole grain cereal AND 2 lbs whole wheat bread; 2 lbs of brown rice, bulgur, oatmeal, or 2 lbs of soft corn or whole wheat tortillas. –Fruits and Vegetables: 128 fluid ounces of vitamin C-rich juice; AND $6 cash-value voucher for fruits and vegetables –Dairy*: 16 quarts of milk; 16 quarts of soy beverage; or 5 pounds of tofu –Protein: 1 dozen eggs AND 1 pound dried beans*; 4, 15 ounce cans of beans or peas; or 18 ounces of peanut butter * - Combinations will be offered to suit the participants preference.

11. Woman - Pregnant Primary Goal of the Food Package: –Promote a healthy weight gain for mom and baby; –Improve variety of foods available; –Provide foods that are lower in fat and higher in fiber; and –Are consistent with Dietary Guidelines and MyPyramid recommendations.

12. Woman – Pregnant, continued Food Package: –Grains: 36 ounces iron-fortified whole grain cereal AND 1 pound whole wheat bread; 1 pound of brown rice, bulgur, oatmeal, or 1 pound of soft corn or whole wheat tortillas –Fruits and Vegetables: 144 fluid ounces of vitamin C-rich juice; AND $8 cash-value voucher for fruits and vegetables –Dairy*: 22 quarts of milk; 22 quarts of soy beverage; or 7 pounds of tofu –Protein*: 1 dozen eggs 1 pound dried beans* or 4, 15 ounce cans of beans or peas 18 ounces of peanut butter * - Combinations will be offered to suit the participants preference.

13. Woman – Fully Breastfeeding Primary Goals of the Food Package: –Support breastmilk supply; –Improve the variety of foods available; –Promote steady weight loss and/or help maintain a healthy weight after delivery; –Provide foods that are lower in fat and higher in fiber; and –Are consistent with Dietary Guidelines and MyPyramid recommendations.

14. Woman – Fully Breastfeeding Food Benefit: –Grains: 36 ounces iron-fortified whole grain cereal AND 1 pound whole wheat bread; 1 pound of brown rice, bulgur, oatmeal, or 1 pound of soft corn or whole wheat tortillas –Fruits and Vegetables: 144 fluid ounces of vitamin C- rich juice; AND $10 cash-value voucher for fruits and vegetables –Dairy*: 24 quarts of milk; 24 quarts of soy beverage; or 8 pounds of tofu AND 1 lb of cheese –Protein: 2 dozen eggs; 30 ounces of canned fish 1 pound dried beans* or 4, 15 ounce cans of beans or peas AND 18 ounces of peanut butter * - Combinations will be offered to suit the participants preference.

15. Woman – Partially Breastfeeding Primary Goals of Food Package: –Promote a steady weight loss and/or maintain a healthy weight after delivery. –Improve variety of foods available. –Provide foods that are lower in fat and higher in fiber; and –Are consistent with Dietary Guidelines and MyPyramid recommendations.

16. Woman – Partially Breastfeeding, continued Food Benefit: –Grains: 36 ounces iron-fortified whole grain cereal AND 1 pound whole wheat bread; 1 pound of brown rice, bulgur, oatmeal, or 1 pound of soft corn or whole wheat tortillas –Fruits and Vegetables: 144 fluid ounces of vitamin C-rich juice; AND $8 cash-value voucher for fruits and vegetables –Dairy*: 22 quarts of milk; 22 quarts of soy beverage; or 7 pounds of tofu –Protein*: 1 dozen eggs 1 pound dried beans* or 4, 15 ounce cans of beans or peas 18 ounces of peanut butter * - Combinations will be offered to suit the participants preference.

17. Woman – Postpartum –Helps maintain the strength needed to care for an infant. –Improve variety of foods available. –Provide foods that are lower in fat and higher in fiber; and –Are consistent with Dietary Guidelines and MyPyramid recommendations.

18. Woman - Postpartum Food Benefit: –Grains: 36 ounces iron-fortified whole grain cereal AND 1 pound whole wheat bread; 1 pound of brown rice, bulgur, oatmeal, or 1 pound of soft corn or whole wheat tortillas –Fruits and Vegetables: 96 fluid ounces of vitamin C-rich juice; AND $8 cash-value voucher for fruits and vegetables –Dairy*: 16 quarts of milk; 16 quarts of soy beverage; or 5 pounds of tofu –Protein*: 1 dozen eggs AND 1 pound dried beans*; 4, 15 ounce cans of beans or peas; or 18 ounces of peanut butter * - Combinations will be offered to suit the participants preference.

19. Medically Fragile The WIC Program will continue to serve the medically fragile participants by: –Continuing to provide exempt infant formula and medical foods AND – Offering a increased variety of WIC supplemental food.

20. Other Opportunities for Tailoring Pregnant with more than one infant Breastfeeding more than one infant

21. USDA Interim Final Rule http://www.fns.usda.gov/wic/regspublished /foodpackages-interimrule.htm

22. “The changes to the WIC food packages hold potential for improving the nutrition and health of the nation’s low-income pregnant women, new mothers, infants, and young children.” Institute of Medicine, 2005

23. Questions????