Page 172

Official source

Prod ID Product RFO Description Qualifying Conditions Staff Guidance Manufacturer/ Packaging 219 (CI) MMA/PA Anamix Early Years (14.1 oz. Powder) 80.00 Special Medical Conditions - Metabolic: methionine, threonine, and valine-free, low isoleucine with a prebiotic fiber, iron and DHA/ARA; nutritionally incomplete. Provides 13.5 g of protein equivalent per 100 g of powder.

Mixing Instructions: To make a standard dilution (21 kcal/fl oz), add 1 unpacked level scoop (5 g) of powder to each fluid ounce of water.

Allergens by Nature: Milk, Coconut and Soy 1. Methylmalonic acidemia (MMA) 2. Propionic acidemia (PA) Limitations: Can only issue to infants and children

Requirements: Metabolic formulas must be approved by District Nutrition Director or State WIC Office Nutricia 6 cans/case 232 (CI) MMA/PA Anamix Next (14.1 oz. Powder) 78.00 Special Medical Conditions - Metabolic: methionine, threonine, and valine-free, low isoleucine with a prebiotic and DHA; nutritionally incomplete.

Dilution: 18 g powder (approx. 2 scoops) with 3.5 fl oz water, final 3.9 fl oz, 0.6 kcal/mL product

Allergens by Nature: Coconut and Soy 1. Methylmalonic acidemia (MMA) 2. Propionic acidemia (PA) 3. For oral and tube feeding Limitations: Can only issue to children 12 months to 5 years old and women.

Requirements: Metabolic formulas must be approved by District Nutrition Director or State WIC Office Nutricia 6 cans/case 233 (CI) MMA/PA Maxamum (16 oz. Powder) 84.00 Special Medical Conditions - Metabolic: methionine, threonine, valine and fat-free, low isoleucine; nutritionally incomplete; 40 g protein equivalents/100 g powder

Dilution: Add 38 g (approx. ¼ cup) of powder to 6 - 8 fl oz of water.

Allergens by Nature: Soy 1. Methylmalonic acidemia (MMA) 2. Propionic acidemia (PA) Limitations: Can only issue to women.

Requirements: Metabolic formulas must be approved by District Nutrition Director or State WIC Office Nutricia 6 cans/case 234 (CI) Monogen (14.1 oz. Powder) 71.00 Special Medical Conditions - Chylothorax or Metabolic: milk-based; 90% of fat is MCT oil. Nutritionally complete, formula low in long chain triglycerides (LCT) and high in medium chain triglycerides (MCT); containing linoleic acid (LA) and alpha-linolenic acid (ALA); supplemented with DHA/ARA.

Mix 16.8 g (3 scoops – 5.6g/scoop) with 90 ml (3 fl oz.) water, final 100 ml. Final concentration 22 kcal/oz. The scoop provided in the can measures 5.6 g

Allergens by Nature: Milk, Walnut, Coconut 1. Chylothorax 2. Condition that impairs digestion/absorption 3. Fat and long chain fatty acid oxidation disorders, e.g., decreased pancreatic lipase, decreased bile salts, defective mucosal fat absorption, and/or defective lymphatic anomalies, hyperlipoproteinemia Type 1, or long chain 3-hydroxyacyl-CoA dehydrogenase deficiency (LCHAD) 4. High MCT oil needs Limitations: Can only issue to children 12 months to 5 years and women.

Requirements: Metabolic formulas must be approved by District Nutrition Director or State WIC Office Nutricia 6 cans/case 220 (CI) MSUD Anamix Early Years (14.1 oz. Powder) 80.00 Special Medical Conditions - Metabolic: valine, leucine, and isoleucine-free; contains DHA/ARA and prebiotics; nutritionally incomplete.

Dilution: add 1 unpacked level scoop (5 g) of powder to each fluid ounce of water (21 kcal/fl oz.)

Allergens by Nature: Milk, Coconut and Soy Maple syrup urine disease (MSUD) Limitations: Can only issue to infants and children.

Requirements: Metabolic formulas must be approved by District Nutrition Director or State WIC Office Nutricia 6 cans/case