Page 1 of 10

Policy 730 – Bid Formula: Use and Description Revised April 01, 2026 Policy Local WIC programs shall issue bid formulas to full-term non-breastfeeding and partially breastfeeding infants as a breast milk substitute. Policy To meet the nutritional needs of full-term infants while maximizing the number of participants served in the WIC program. Relevant Regulations 7 CFR §246.16 ¶(k)—Requirements for Infant Formula Procurement 7 CFR §246.10 ¶(c)(1)&(2)—Food packages Oregon WIC PPM References 760—Medical Formulas and Nutritionals 765—Medical Documentation Appendices • Appendix A: Bid Infant Formula: Contact Summary

Policy 730 – Bid Formula: Use and Description

Page 2 of 10

Definitions

Bid formula: Standard infant formula provided by the Oregon WIC program through a competitive bid process. Standard formula is also called “term formula” and “non-exempt” formulas. The bid formula currently in use in Oregon WIC may change based on contract renewals. According to federal requirements, standard infant formulas must meet the Standard of Identify set by the Food and Drug Administration (FDA) of 20 calories per fluid ounce at standard dilution. Medical (exempt) formula: A formula in which the composition meets the special nutrient requirements of infants, children or adults diagnosed with various medical diseases and conditions. For infants, the medical formula may not meet the complete nutrient specifications defined by the FDA in the Infant Formula Act. Standard infant formulas which contain 19 calories per ounce instead of the required 20 calories per ounce are considered medical formulas. All medical formulas require medical documentation. WIC eligible nutritionals: Enteral products that are specifically formulated to provide nutrition support for children over 1 year of age and women with a diagnosed medical condition, when the use of conventional foods is precluded, restricted, or inadequate. Nutritionals may be nutritionally complete or incomplete (e.g. Duocal). WIC Nutritionist: A nutrition professional who meets one or more of the following qualifications: a master’s degree in nutrition; a registered dietitian nutritionist (RDN) with the Commission on Dietetic Registration (CDR) or eligible for CDR registration. For exceptions, see Policy 660. WIC medical documentation: Documentation which includes the federal technical requirements to ensure a licensed health care professional authorized to write medical prescriptions under Oregon law has determined a medical

Policy 730 – Bid Formula: Use and Description

Page 3 of 10

condition/diagnosis which requires the use of a medical formula, nutritionals and changes to the participant’s supplemental food package. This form is a request for provision, not a prescription and it replaces prescriptions from health care providers. Background The WIC program is federally required to use a competitive bid process to contract with formula companies to obtain significant rebates on cow’s milk- based and soy-based infant formulas. The majority of infants can thrive on any brand of formula. To maximize the number of eligible women, infants and children served, the Oregon WIC program has a policy of “no exception” to the standard bid formulas. Other than the current standard infant bid formulas, no other standard infant formulas are allowed. Procedure 1. Information for pregnant participants 1.1 Inform pregnant participants who choose not to breastfeed their infants that bid formulas are available through WIC. 1.2 Provide anticipatory guidance to pregnant participants on feeding their full-term baby. See the WIC Breastfeeding Training Program - Level 1 for more information. 2. Bid cow’s milk-based formula 2.1 For full-term formula fed infants, provide the bid cow’s milk-based formula as the first choice.

Policy 730 – Bid Formula: Use and Description

Page 4 of 10

3. Bid soy-based formula 3.1 Assign the bid soy-based formula as a first choice for the few specific purposes identified below. 3.1.1 Full term infants in vegetarian families in which animal protein formulas are not desired (vegan). 3.1.2 Infants with galactosemia and hereditary lactase deficiency (an extremely rare condition). 3.1.3 According to the American Academy of Pediatrics (AAP), soy- based formulas: • Are not for feeding of premature infants who weigh less than 1800 grams. • Have no proven value in the prevention or management of infantile colic. • Have no proven value in the prevention of atopic disease in healthy or high-risk infants. 3.1.4 Soy-based formulas should not be given to infants with documented cow’s milk allergy or enterocolitis, since these infants may be sensitive to soy-based formula as well. The AAP’s current recommendation is to use hydrolyzed protein formulas or elemental amino-acid based formulas in these instances rather than soy formula. 4. Medical formulas 4.1 Medical formulas which are approved by the United States Department of Agriculture (USDA) for use by WIC participants and are included in

Policy 730 – Bid Formula: Use and Description

Page 5 of 10

the Oregon WIC formulary can be issued with medical documentation. See  760—Medical Formulas for more information on medical formula issuance. 5. Infant formulas issued to children 5.1 Bid infant formulas and medical formulas may be issued to children over the age of 12 months for certain medical conditions such as prematurity or continued intolerance to cow’s milk protein. Contact your nutrition consultant for assignment of an infant formula to a child, 24 months or older. 5.1.1 All formulas issued to a child over the age of 12 months must have a valid medical documentation form from a medical provider. See  760—Medical Formulas and  765—Medical Documentation for required medical documentation and documentation in the WIC data system.

6. Coordination with hospitals 6.1 State and local WIC staff shall work with local hospitals to promote and support breastfeeding. For those infants who are not breastfed, WIC can work with hospitals to use the WIC bid formulas to avoid infants having to change formulas in the early postpartum period. 7. Transition to bid formula 7.1 If a full-term infant enters the WIC program using a non-bid formula, counsel the parent or caretaker on how to transition the infant to a bid formula. 7.1.1 Take a formula history and decide whether the bid cow’s milk- based formula is appropriate. See ¶2.0 and ¶3.0 of this policy.

Policy 730 – Bid Formula: Use and Description

Page 6 of 10

7.1.2 Provide instructions on blending new and old formulas to ease the infant through the transition. Refer to Oregon WIC Infant Formula module for more information. 7.1.3 Inform the parent or caretaker of the possible results of switching formulas. For example, there may be a change in feeding frequency or stool type. 7.1.4 Enroll the infant in the WIC program and issue benefits for the appropriate bid formula. 8. Description of bid formulas 8.1 The table below lists the current bid cow’s milk-based and soy-based standard infant formulas. Bid Formulas Descriptions Similac® Advance® Infant Formula (Abbott) Iron fortified cow’s milk-based, whey, and casein CARBOHYDRATE: 100% Lactose Contains prebiotic Galactooligosaccharide (GOS)* FAT: High oleic safflower, soy, and coconut oils, DHA/ARA Similac® Soy Isomil® (Abbott) Iron-fortified, milk-free, lactose free, soy-based formula. Soy Protein Isolate, L- Methionine CARBOHYDRATE: corn syrup solids FAT: High Oleic Safflower, soy, coconut oils, DHA

Policy 730 – Bid Formula: Use and Description

Page 7 of 10

Bid Formulas Descriptions Similac® Sensitive (Abbott) Iron fortified, cow’s milk based, low lactose formula CARBOHYDRATE: corn syrup, sucrose FAT: High oleic safflower oil, soy oil, coconut oil, DHA

Similac® Total Comfort (Abbott) Iron fortified, cow’s milk based, partially hydrolyzed whey protein, low lactose CARBOHYDRATE: maltodextrin, sucrose FAT: High oleic safflower oil, soy oil, coconut oil, DHA

9. Formula intolerance 9.1 If an infant is unable to tolerate the cow’s milk-based or soy-based bid formulas, consult your local program’s WIC nutritionist and coordinate care with the infant’s medical provider to determine an appropriate WIC- approved medical formula. References American Academy of Pediatrics, Committee on Nutrition. “Use of Soy Protein- Based Formulas in Infant Feeding” PEDIATRICS Vol. 121 No. 5 May 2008, pp. 1062-1068.

Policy 730 – Bid Formula: Use and Description

Page 8 of 10

American Academy of Pediatrics, Committee on Nutrition. “Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Timing of Introduction of Complementary Foods, and Hydrolyzed Formulas.” PEDIATRICS Vol. 121 No. 1 January 2008, pp. 183-191. American Academy of Pediatrics, Committee on Nutrition. “Lactose Intolerance in Infants, Children, and Adolescents” PEDIATRICS Vol. 118 No. 3 September 2006, pp. 1279-1286. American Academy of Pediatrics, Committee on Nutrition. “Iron Fortification of Infant Formulas” PEDIATRICS Vol. 104 No. 1 July 1999, pp. 119-123. Tatum Hattner, J. “Human Milk and Pediatric Formula Update ” Nutrition Focus for Children with Special Health Care Needs. May/June 2011. Vol 26, No.3. “Human Milk and Formulas.” Nutrition Practice Care Guidelines for Preterm Infants in the Community. Oregon Pediatric Nutrition Practice Group. 2013 revision. Oregon WIC Training: Breastfeeding Module. Oregon Health Authority. 2013. Oregon WIC Training: Infant Formula Module. Oregon Health Authority. 2014 Policy History Policy History Table Date Revised, Reviewed, or Released 11/07/2012 Released 10/13/2016 Released

Policy 730 – Bid Formula: Use and Description

Page 9 of 10

Date Revised, Reviewed, or Released 01/04/2019 Released 04/01/2026 Minor Revision The date at the top of the policy is the date of the most recent release. Policies become effective on the release date. Policy changes become compliance findings 6 months from the release date. Major Revision: Policies with content changes that impact local agency functions. Please review all policies with major revisions. The Food and Nutrition Service (FNS) reviewed and approved these changes. Minor Revision: Changes in policy that have small impacts on local agency functions. Minor edits, grammatical updates, clarifications, and/or formatting changes have occurred in these policies. Reviewed: The policy was checked for accuracy. Minor formatting changes may have been made. Date of Origin: Date policy was initially released. If you need this in large print or an alternate format, please call 971-673- 0040. This institution is an equal opportunity provider.

Policy 730 – Bid Formula: Use and Description

Page 10 of 10

Appendix A Bid Infant Formula: Contact Summary Oregon WIC Program (01/2019) Type of Contact Contact Information: Abbott Laboratories Company Name

Abbott Nutrition, Abbott Laboratories Columbus, OH http://www.abbottnutrition.com For general product and formula nutrient information 1-800-227-5767 Hours: Monday through Friday, 8:30 a.m. to 5 p.m. EST Product finder Go to website to find location of a store that carries a particular Abbott product: http://abbottnutrition.com/StoreLocator.aspx