West Virginia WIC Policy & Procedure 4.04 Effective Date: 2/17/2026 4.04

Infant Food Package Birth through 11 Months

POLICY:

Food Package I is designed for issuance to infant participants from birth through age 5 months who do not have a condition qualifying them for Food Package III. Food Package I includes four infant food packages available from 0 to five (5) months of age 1) fully breastfeeding, 2) mostly breastfeeding, 3) minimally breastfeeding, or 4) fully formula feeding.

Food Package II is designed for issuance to infant participants from 6 through 11 months of age who do not have a condition qualifying them to receive Food Package III. Food Package II includes four infant food packages available from 6 months of age through 11 months - 1) fully breastfeeding, 2) mostly breastfeeding, 3) minimally breastfeeding or 4) fully formula fed.

Food Package III is designed for any infant from birth through 11 months with a documented qualifying condition that requires the use of WIC formula because the use of conventional foods is precluded, restricted, or inadequate to address their special nutritional needs. Allowable documentation is by either a WIC-53 Prescription Formula Form or other medical documentation (see Policy 4.09 Food Package III - Women, Infants and Children with Qualifying Medical Conditions).

Note: infant formula requirements specified in this policy include standard contract infant formulas (see Policy 4.02 Standard Contract Formula).

Note: Formula is considered out-of-date on the first day of the month labeled as the expiration date. PROCEDURE: A. Fully Breastfeeding Infants

1. Fully breastfeeding infants receive no infant formula from the WIC Program in order to successfully establish breastfeeding.

2. Fully breastfeeding infants birth through 5 months are not provided any infant formula or supplemental foods via Food Package I.

3. Fully breastfeeding infants 6 through 11 months are provided a monthly allowance of supplemental foods via Food Package II.

a. The monthly allowance of supplemental foods for exclusively breastfeeding infants 6 through 11 months will be up to but not exceeding the following amounts:

i. 16 oz. infant cereal; and ii. 128 oz. total infant fruits and/or vegetables or substitution of 64 oz. + ½ Cash Value Benefit (CVB) or full CVB (without infant fruits and vegetables); and iii. 40 oz. infant meat

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West Virginia WIC Policy & Procedure 4.04 Effective Date: 2/17/2026 4.04

Infant Food Package Birth through 11 Months

B. Mostly Breastfeeding Infant 1. Mostly breastfeeding infants receive up to but not exceeding half Monthly Maximum Amount (MMA) of the prescribed type and form of infant formula.

a. Mostly breastfeeding infants cannot receive more than two formula increases through the certification period to continue a breastfeeding status.

2. Mostly breastfeeding infants age 0 through 5 months receive formula from the WIC Program in an amount up to but not to exceed approximately half the amount of infant formula allowed for a fully formula fed infant.

a. Mostly breastfeeding infants 0 through 3 months can receive up to the maximum monthly allowance of:

i. 435 fl oz. reconstituted powder formula; or ii. 388 fl oz. reconstituted liquid concentrate formula; or iii. 384 fl oz. RTF formula

b. Mostly breastfeeding infants 4 through 5 months can receive up to the maximum monthly allowance of:

i. 522 fl oz. reconstituted powder formula; or ii. 460 fl oz. reconstituted liquid concentrate formula; or iii. 474 fl oz. RTF formula

3. Mostly breastfeeding infants 6 through 11 months are provided with a monthly allowance of supplemental foods.

a. Mostly breastfeeding infants 6 through 11 months can receive up to the maximum monthly allowance of:

i. 384 fl oz. reconstituted powder formula or 315 fl oz. reconstituted liquid concentrate formula or 338 fl oz. RTF formula; and ii. 8 oz. infant cereal; and iii. 128 oz. total infant food fruits and/or vegetables or substitution of 64 oz + ½ Cash Value Benefit (CVB) or full CVB (without infant fruits and vegetables)

C. Minimally Breastfeeding Infants

1. Minimally breastfeeding infants 0 through 5 months receive formula from the WIC Program in an amount more than half the MMA up to the full MMA of the prescribed type and form of infant formula.

a. Minimally breastfeeding infants 0 through 3 months can receive the maximum monthly allowance of:

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West Virginia WIC Policy & Procedure 4.04 Effective Date: 2/17/2026 4.04

Infant Food Package Birth through 11 Months

i. 436-869 fl oz. reconstituted powder formula; or ii. 389-822 fl oz. reconstituted liquid concentrate formula; or iii. 385-831 fl oz. RTF formula

b. Minimally breastfeeding infants 4 through 5 months can receive the maximum monthly allowance of: iv. 523-959 fl oz. reconstituted powder formula; or v. 461-895 fl oz. reconstituted liquid concentrate formula; or vi. 475-912 fl oz. RTF formula

2. Minimally breastfeeding infants 6 through 11 months are provided with a monthly allowance of supplemental foods.

a. Minimally breastfeeding infants 6 through 11 months can receive the maximum monthly allowance of:

i. 385-695 fl oz. reconstituted powder formula or 316-629 fl oz. reconstituted liquid concentrate formula or 339-642 fl oz. RTF formula; and ii. 8 oz. infant cereal; and iii. 128 oz. total infant food fruits and/or vegetables or substitution of 64 oz. + ½ Cash Value Benefit (CVB) or full CVB (without infant fruits and vegetables)

D. Mother-Infant Dyad Matching

1. When a breastfeeding parent requests a change to formula, the infant will receive a complete nutrition assessment. This assessment may be completed by a Breastfeeding Peer Counselor, Breastfeeding Liaison, CPA based upon availability and staffing within the agency. The assessment will include but is not limited to: a. How frequently the infant is breastfeeding; b. How long the infant is breastfeeding at each feeding; and/or c. Mom’s feelings about breastfeeding Note: see https://wicbreastfeeding.fns.usda.gov/breastfeeding-check

2. The mother/infant dyad must match. The infant food package must be changed and saved first. If prescription changes are deemed necessary by the CPA following a full nutrition assessment, the CPA will create a new food package.

3. When food benefits have been issued for a current month and the CPA determines that the infant needs an increase in formula, the CPA will create a new food package with the increased formula amount and perform an Exchange/Increase transaction in the Crossroads system. Future benefits must be voided and reissued. Crossroads will only allow an increase twice during the infant’s first year.

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West Virginia WIC Policy & Procedure 4.04 Effective Date: 2/17/2026 4.04

Infant Food Package Birth through 11 Months

E. Temporary Formula Supplementation

1. If a mother/infant dyad is receiving the fully breastfeeding package, and must temporarily supplement with formula, the food packages will be temporarily changed to a mostly/minimally breastfeeding package depending on the amount of formula needed.

2. If a breast pump needs to be loaned, see Policy 5.21 Use of Breast Pumps to ensure the loan criteria has been met.

3. The temporary formula change in Crossroads lasts until the mother/infant dyad is reassessed and/or a new Prescription Formula Form (WIC-53) is provided.

F. Fully Formula Fed Infant 1. Fully formula feeding infants 0, through 5 months receive the full MMA of the prescribed type and form of infant formula. The tailored fully formula feeding infant package may not exceed the maximum monthly allowances.

a. Fully formula feeding infants birth through 3 months can receive the maximum monthly allowance of:

i. 870 fl oz. reconstituted powder formula; or ii. 823 fl oz. reconstituted liquid concentrate formula; or iii. 832 fl oz. RTF formula

b. Fully formula feeding infants 4 through 5 months can receive the maximum monthly allowance of:

i. 960 fl oz. reconstituted powder; or ii. 896 fl oz. reconstituted liquid concentrate formula; or iii. 913 fl oz. RTF formula

2. Fully formula feeding infants 6 through 11 months are provided with a monthly allowance of supplemental foods.

a. Fully formula feeding infants 6 through 11 months can receive the maximum monthly allowance of:

i. 696 fl oz. reconstituted powder formula or 630 fl oz. reconstituted liquid concentrate formula or 643 fl oz. RTF formula; and ii. 8 oz. infant cereal; and iii. 128 oz. total infant food fruits and/or vegetables or substitution of 64 oz. + ½ Cash Value Benefit (CVB) or full CVB (without infant fruits and vegetables)

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West Virginia WIC Policy & Procedure 4.04 Effective Date: 2/17/2026 4.04

Infant Food Package Birth through 11 Months

G. Prescribing Food Packages

1. Only a CPA is authorized to prescribe supplemental foods in quantities that meet the MMA and are appropriate for the participant, taking into consideration the participant’s age and nutritional needs. 2. Infants birth through five (5) months who are prescribed an exempt infant formula that is documented on a Prescription Formula Form (WIC-53) completed by a healthcare provider, will receive the prescribed amount, only up to the MMA of fully formula feeding infants (see Policy 4.09 Food Package III – Women, Infants and Children with Qualifying Medical Conditions).

a. The mother’s food package will be assigned based on the formula amount issued to the infant.

REFERENCES:

1. WIC Regulations 7 CFR 246.10 Supplemental Foods 2. USDA Breastfeeding Policy and Guidance, July 2016, Chapter 3, “Issuing Food Packages to the Breastfeeding Dyad” 3. USDA Breastfeeding Policy and Guidance, July 2016, Appendix C, “Food Package Issuance Protocols” 4. USDA Nutrition Services Standards, Chapter 13, Food Package Prescriptions 5. USDA Special Supplemental Nutrition Program for Women, Infants and Children, Food Package Policy and Guidance, Chapter 2, Food Package Design 6. USDA Special Supplemental Nutrition Program for Women, Infants and Children, Food Package Policy and Guidance Chapter 3, Determining Eligibility of WIC Foods 7. USDA Special Supplemental Nutrition Program for Women, Infants and Children, Food Package Policy and Guidance Chapter 4, Nutrition Tailoring of WIC Food Packages 8. USDA Special Supplemental Nutrition Program for Women, Infants and Children, Food Package Policy and Guidance Chapter 6, WIC Formula 9. WIC Policy Memorandum 2020-1 Donation of Unused, Returned Infant Formula

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