Division of Community Nutrition
Subject: Non-Approved Formulas / Products Policy: FDS 03.4 Reference: N / A Effective: August 12, 2013 Supersedes: March 1, 2011
Page 1 of 2 I. Policy:
The Virginia WIC Program does not authorize specific formulas and medical foods listed below.
II. Procedure:
A. Cow’s milk, goat’s milk and evaporated milk are not considered infant formulas and are not authorized for any infant less than 12 months of age.
B. The following products are NOT APPROVED and shall not be covered under any circumstances in the Virginia WIC Program.
1) Infant Formula a. Enfamil 1. Enfamil LIPIL 2. Enfamil PREMIUM with Triple Health Guard 3. Enfamil AR LIPIL 4. Enfamil Restfull Lipil 5. Enfagrow Premium Next Step 6. Enfagrow Soy Next Step 7. Enfamil Prosobee Lipil 8. Enfamil Gentlease Lipil
b. Abbott 1. Similac Go & Grow Milk-Based Formula 2. Similac Isomil DF 3. Similac Go & Grow Soy-Based 4. Similac Sensitive RS 5. Similac Organic
c. Gerber 1. Good Start Gentle PLUS 2. Good Start Protect PLUS 3. Good Start Soy PLUS 4. Good Start Gentle PLUS 2 5. Good Start Protect PLUS 2 6. Good Start Soy PLUS 2
Division of Community Nutrition
Subject: Non-Approved Formulas / Products Policy: FDS 03.4 Reference: N / A Effective: August 12, 2013 Supersedes: March 1, 2011
Page 2 of 2 d. Generic Brand infant formulas
2) Other Products a. Medicines or drugs; b. Electrolyte or rehydration fluids; c. Flavoring agents for formulas or foods; d. Vitamin / mineral preparations; e. Parenteral nutrition products; f. Formulas or products used for the sole purpose of weight management or enhancing nutrient intake without documented underlying medical condition (Pediasure or Pediasure with Fiber); g. Or rice milk (e.g., Rice Dream or Vitamite)