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WIC Nutrition Risk Criteria

System Assigned (SA); System or CPA Assigned (SA/CPA); CPA Assigned (CPA); Automatic High Risk* (HR) Code Category [Priority] Risk Criteria/Definition Required Documentation 3

At Risk of Short Stature: Height for age >5th percentile and < 10th percentile. 131 (CPA) PG [1] Low Maternal Weight Gain: A low rate of weight gain such that in the 2nd and 3rd trimesters, for singleton pregnancies: •Underweight women gain < 1.0 pound per week •Normal weight women gain < 0.8 pounds per week •Overweight women gain < 0.5 pounds per week •Obese women gain < 0.4 pounds per week OR Low weight gain at any point in pregnancy; pregnant woman’s weight plots at any point beneath bottom line of weight gain grid for her prepregnancy weight category/[BMI]: •Underweight [<18.5]: total weight gain range 28-40 pounds •Normal [18.5 to 24.9]: total weight gain range 25-35 pounds •Overweight [25.0 to 29.9]: total weight gain range 15-25 pounds •Obese [>30.0]: total weight gain range 11-20 pounds At least two weight measurements done by WIC clinic or healthcare provider during second or third trimester. (Do not use self-reported weights.) Documented on Anthro/Lab Screen in Crossroads. Criteria are based on pounds per month weight gain per prepregnancy BMI category. 133 (SA) PG [1] BF [1] NBF [3-6] High Maternal Weight Gain: Pregnant women: A high rate of weight gain, such that in the 2nd and 3rd trimester, for singleton pregnancies: •Underweight [<18.5]: gain more than 1.3 pounds/week •Normal [18.5 to 24.9]: gain more than 1.0 pound/week •Overweight [25.0 to 29.9]: gain more than 0.7 pounds/week •Obese [>30.0]: gain more than 0.6 pounds/week

High weight gain at any point in pregnancy whereby a pregnant women’s weight plots at any point above the top line of the appropriate weight gain range for her respective prepregnancy weight category.

Breastfeeding or Non-Breastfeeding (most recent pregnancy only): Total gestational weight gain as follows: •Underweight [<18.5]: gain > 40 pounds •Normal [18.5 to 24.9]: gain > 35 pounds •Overweight [25.0 to 29.9]: gain > 25 pounds Self-reported prepregnancy weight documented on Health Information Screen compared with subsequent weight measurements done by WIC clinic or healthcare provider documented on Anthro/Lab Screen in Crossroads. Criteria based on pounds per month weight gain.

Prepregnancy weight documented on Health Information Screen; measured height documented on Anthro/Lab Screen; and weight at delivery documented on Health Information Screen in Crossroads. Total