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WIC Anthropometrics and Laboratory Guidance 7

Blood Test Requirements for WIC Certification ANEMIA SCREENING SCHEDULE Infants 0-6 months Not allowed.

7-8 months Not allowed.

9-12 months Required for initial certification but may be deferred until 12 months of age. It is recommended to defer the blood test until age 12 months so that a finger stick may be used for collection. Hemoglobin collected prior to 12 months of age must be done via heel stick. Blood collection via heel stick requires a specific training. Hemoglobin testing is not allowed before 9 months of age with one exception: CPA may request a hemoglobin from an outside provider on pre-term and low birth weight infants who are not fed iron- fortified formula.

12 months Required as routine infant hemoglobin check at initial certification or 1-year subsequent certification.

Children 1-2 years One hemoglobin check is required in addition to the infant 12-month hemoglobin check (12- 24 months) for a total of 2 hemoglobin checks between the ages of 9 and 24 months. Typically, the second hemoglobin check would be done at the mid certification visit.

*For all children initially certified between 13-18 months of age, a blood test is required at the initial certification.

2-5 years Required at all initial certifications. Required annually if the last hemoglobin check was normal.

All children Any abnormal hemoglobin screening result whether at a certification visit or mid-certification visit, requires a blood test at 6-month intervals until an anemia screening result within normal range is documented. Abnormal hemoglobin values and high-risk values can be found in the Nutritional Risk Criteria Manual. Refer to Nutrition Risk 201 Low Hematocrit/Low Hemoglobin.

NOTE: If the child's eligibility has expired and the expiration date is greater than or equal to 30 days, a new hemoglobin is required. If the eligibility end date is less than 30 days, a new hemoglobin is not required unless the previous hemoglobin was abnormal.

Women Pregnant

Required Non-Breastfeeding

Required after delivery Breastfeeding, 0-12 months postpartum Required after delivery

Please NOTE the following: If a documented medical condition, i.e., hemophilia or religious beliefs prevents an individual from having blood drawn, the blood test may be omitted. The exempt reason should be documented in Crossroads on the Anthro/Lab screen (Exempt Reason drop down). If a hemoglobin needs to be deferred, document the reason for the deferral in Crossroads on the Anthro/Lab screen (Deferred Reason drop down).

This document refers to hemoglobin testing since this is the common hematological test in Alabama WIC clinics. The same time frame applies to other hematological tests such as hematocrit.