Division of Community Nutrition
Subject: Contract Infant Formula Policy: FDS 03.1 Reference: CFR §246.10 Effective: August 12, 2013 Supersedes: September 15, 2012
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I. Policy:
The local agency shall provide a contract formula (Abbott Similac Advance, Abbott Similac Sensitive or Abbott Similac Soy Isomil) unless a special formula is prescribed by a health care professional. Iron-fortified formula is provided for infants up to 12 months of age.
II. Procedure(s):
A. Powder or Concentrate Contract Formula
1) Abbott Similac Advance (13-fl oz concentrate or 12.4 oz. powder) shall routinely be provided
2) Abbott Similac Soy Isomil (13-fl oz. concentrate or 12.4 oz. powder) or Abbott Similac Sensitive (13-fl oz. concentrate or 12.6 oz. powder) shall be provided when a participant is intolerant to or has a medical condition which prohibits the use of Abbott Similac Advance
a. Abbott Similac Soy Isomil, Abbott Similac Sensitive and Abbott Similac Advance EarlyShield are kosher products and appropriate for individuals following religious dietary practices
b. Abbott Similac Soy Isomil and Abbott Similac Sensitive do not require the completion of a WIC-395
B. Ready-to-Feed Contract Infant Formula
1) Ready to feed formula shall be authorized when the CPA determines one or more of the following:
a. Unsanitary or restricted water supply.
b. Parent / legal guardian or caretaker has difficulty in correctly diluting concentrated or powdered formula.
c. RTF formula better accommodates the participant’s condition (special formula only)
d. RTF formula improves the participant’s compliance in consuming the prescribed formula (special formula only)
2) Upon determination that a participant is eligible to receive a ready-to-feed formula, the CPA shall complete and submit a Request for Ready to Feed Formula, WIC-407.
Division of Community Nutrition
Subject: Contract Infant Formula Policy: FDS 03.1 Reference: CFR §246.10 Effective: August 12, 2013 Supersedes: September 15, 2012
Page 2 of 2
a. File a copy of the WIC-407 in the participant’s record.
b. A request for ready-to-feed formula shall be renewed at each WIC certification.
c. This process does not apply to formulas that are only available in the ready-to-feed form.
C. Infants who transfer from another state shall use the contract formula unless the health care professional requests a special formula.