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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 23

Examples of dietary supplements which when fed in excess of recommended dosage may be toxic or have harmful consequences: • Single or multi-vitamins. • Mineral supplements. • Herbal or botanical supplements/remedies/teas 425.8

Routinely not providing dietary supplements recognized as essential by national public health policy when a child’s diet alone cannot meet nutrient requirements: • Providing children under 36 months of age less than 0.25 mg of fluoride daily when the water supply contains less than 0.3 ppm fluoride. • Providing children 36-60 months of age less than 0.50 mg of fluoride daily when the water supply contains less than 0.3 ppm fluoride. • Not providing 400 IU of vitamin D if a child consumes less than 1 liter (or 1 quart) of vitamin D fortified milk or formula.

425.9

Routine ingestion of non-food items (pica): Examples include: • Ashes • Carpet fibers • Cigarettes or cigarette butts • Clay • Dust • Foam rubber • Paint chips • Soil • Starch (laundry and cornstarch)

427 (SA/CPA) PG [4] BF [4] NBF [6] Inappropriate Nutrition Practices for Woman: Routine use of feeding practices that may result in impaired nutrient status, disease, or health problems. Refer to Codes 427.1 through 427.5 for examples. Document the inappropriate nutrition practice on Dietary and Health Screen in Crossroads. Document details regarding specific risk(s) on Care Plan Summary – Nutrition Assessment in Crossroads. Pertains to 427.1 thru 427.5. 427.1

Consuming dietary supplements with potentially harmful consequences: