Women, Infant and Children Supplemental Nutrition Program, or WIC

When a pregnant or breastfeeding mother has limited access to health care, is low-income, or is nutritionally lacking, there is the potential to place an unborn fetus or young child at-risk for prematurity, low-birth weight, and failure to thrive. These are risk factors for Cerebral Palsy and other birth defects. That’s where government programs that provide short-term assistance for the basics, like the Women, Infant and Children, commonly known referred to as WIC, can help a mother provide her baby with a healthy start to life.

WIC provides a healthy start to individuals that are nutritionally at-risk

Women, Infants and Children, the government program commonly known as WIC, provides supplemental foods and formula, nutrition assessments and education, healthcare and social services, and breastfeeding support to low-income women who are either pregnant, postpartum and breastfeeding, or nutritionally at-risk. The program also serves young infants who are on formula or children who are deemed nutritionally at-risk. The purpose of the program is to reduce the number of infants and children born prematurely, at low birth weight, or inadequate growth standards. It does so by providing nutrition assessments, income assessments, and healthcare services to low-income mothers who are nutritionally vulnerable. Social services promote and prevent alcohol, drug and tobacco use while pregnant or breastfeeding.

WIC’s nutrition program, the Special Supplemental Nutrition Program, is a Federal program that is overseen by the U.S. Department of Agriculture’s Food and Nutrition Services agency, or FNS. SSNP is completely separate and not to be confused with the Supplemental Nutrition Assistance Program, or SNAP, which is a domestic hunger safety plan also administered by the U.S. Department of Agriculture’s Food and Nutrition Service.

One of the main differences between the WIC and SNAP programs is that WIC is focused exclusively on the health of pregnant mothers, breastfeeding mothers, the unborn child, newborns and young children under the age of 5, although fathers can receive WIC benefits under specific circumstances. The items available for purchase under WIC are very restrictive, limited to the nutrients required of the target served, for instance prenatal diets for pregnant mothers, nutrients required for breastfeeding mothers, or special diets required due to health conditions.

SNAP, which use to be called the food stamp program, is a cash assistance program aimed to help low-income individuals – not just pregnant, postpartum or young children – afford food. More items are available to purchase under the SNAP program.

For that reason, there are considerable limits and controls in place that dictate what a recipient can buy, and not buy, through their WIC benefits.

How many people are served by WIC?

According to a report published January 2013 by the Office of Research and Analysis, 14.55 million individuals were eligible for WIC. Children between the age of 1 and 4 accounted for more than 60 percent of those eligible in 2010. Coverage of WIC-eligible infants accounted for the highest coverage rate, 85 percent, while WIC-eligible children accounted for the lowest coverage rate of 52 percent.

In 2010, WIC served 62.6 percent of the WIC-eligible population, keeping in line with the 56 to 63 percent range served for more than a decade. Western states accounted for the highest coverage rates at 63 to 73 percent, while Mountain Plain states required the lowest coverage rates between 50 to 54 percent.

For coverage rates for all participants listed by State, visit WIC Coverage Rates by State.

Since its inception in 1974 when 88,000 individuals participated in WIC, the program has grown significantly. In 2011, for example, 8.9 million individuals participated monthly in the WIC program. Of those:

• 4.7 million, or 52.8 percent, are children
• 2.1 million, or 23.5 percent, are infants
• 2.1 million, or 23.5 percent, are women

The following charts the progression of WIC participation through the years:

• 1974, 88,000
• 1980, 1.9 million
• 1990, 4.5 million
• 2000, 7.2 million
• 2010, 9.2 million
• 2011, 8.9 million

What is WIC?

WIC is a Federal program that provides a short-term nutrition plan to help women who are pregnant, or who have children ages five and under, maintain their physical health during and after pregnancy and during the infant’s first five years. The program, which is available in all 50 states, is also intended to help young children get the right start in life by providing a pre-determined amount of nutritionally-sound food to both mother and child each month.

WIC’s focus is on healthy eating among vulnerable or at-risk groups of women and young children; a family cannot participate in the program once a child turns five years old. However, if needed, the government does have other programs that may assist school-aged children with nutrition concerns.

Since its inception as a pilot program in 1968 and it establishment as a permanent program on October 7, 1975, studies indicate WIC assists in improving the overall health of economically-vulnerable expectant and postpartum mothers and their young, developing children. Additionally, WIC has reduced the infant mortality rate in the United States by focusing on reduction of premature and low birth rate children. The program is also credited with improving childhood immunization rates, and promoting awareness of the dangers of consuming alcohol, using drugs, and smoking tobacco during pregnancy and around young children.

WIC differs from other social programs in that it is not an entitlement. It’s a federal grant program provided by Food and Nutrition Services, or FNS, to providers; Congress authorizes the grant amount annually. It is a Federal government program and provides funds to 90 WIC state agencies within 50 states, 34 Indian Tribal Organizations, American Samoa, District of Columbia, Guam, Northern Mariana Islands, Puerto Rico and the Virgin Islands. It is available through 1,836 local agencies and 9,000 clinics.

Nationwide, about 45,000 retailers accept WIC benefits, and several other agencies provide WIC educational and medical services. Some places that provide WIC services include:

• Social service agencies
• Hospitals
• Clinics
• County or municipal health departments
• Schools

Who is eligible for WIC benefits?

Qualifying for WIC benefits is a straightforward process that is based on several factors and tier-level requirements. Applicants must meet eligibility requirements in four areas: categorical, residential, income and nutrition.

Categorical requirements

The following category requirements specify personal situations that fit WIC guidelines for eligibility:

• If the woman is pregnant, benefits can be provided during pregnancy and up to six months after birth, or end of pregnancy
• If the woman is postpartum, benefits can be provided up to six months after the birth of the infant
• If the woman is breastfeeding, benefits can be provided up to infant’s first birthday
• Nutritionally at-risk infants, benefits can be provided up to the first birthday
• Nutritionally at-risk young children, benefits can be provided up to the child’s fifth birthday
• Fathers, benefit can be provided in specific circumstances if legal guardian of a child under the age of five

Nutrition risk requirement

Potential participants must be deemed nutritionally at-risk, either through a medical condition or a dietary condition.

A woman’s risk is assessed using information about her overall health, her physical condition, or if there have been issues with her current or past pregnancies. Factors that might indicate at-risk health for women include:

• anemia
• dental problems, including tooth decay, periodontal disease, tooth loss or ineffectively replaced teeth that impair ability to ingest food properly
• gingivitis
• elevated blood lead levels
• low blood sugar
• a pre-existing condition, such as nutrient deficiency diseases, gastro-intestinal disorders, diabetes mellitus, thyroid disorders, hypertension and prehypertension, renal disease, cancer, central nervous system disorders, genetic and congenital disorders, inborn errors of metabolism, infectious diseases, food allergies, celiac disease, hypoglycemia, drug-nutrient interactions, eating disorders, depression, pre-diabetes, and developmental/sensory/motor disabilities that interfere with the ability to eat
• irregular weight
• gestational diabetes
• history high-risk pregnancies, such as pre-eclampsia, large for gestational age infant, nutrition related congenital defects or birth defects
• history of poor pregnancy outcomes, such as spontaneous abortion, fetal loss or neonatal loss
• pregnancy at a young age
• closely spaced pregnancies
• lack of adequate prenatal care
• multi-fetal gestation
• fetal growth restriction
• pregnant women currently breastfeeding
• severe conditions that affect nutritional status, including juvenile rheumatoid arthritis, lupus erythematosus, cardiorespiratory disease, heart disease, cystic fibrosis, or persistent asthma that requires daily medication
• smokers
• alcohol misuse
• illegal drug use

Factors that might indicate at-risk nutritional health for infants and children include:

• birth defects
• congenital defects
• fetal alcohol syndrome
• low birth weight
• short stature
• oral-motor dysfunction
• prematurity
• inappropriate growth patterns
• inappropriate weight gain patterns
• mother that maternal smoking
• maternal alcohol or illegal drug use during pregnancy or near conception

In addition, women, infant and children are assessed for dietary risk criteria that include:

• failure to meet Dietary Guidelines for Americans, including choosing healthy foods, age-appropriate physical activities, and positive lifestyle behaviors
• inappropriate nutrition and feeding practices for infants
• inappropriate nutrition and feeding practices for children
• inappropriate nutrition and feeding practices for women

These individuals must be assessed as nutritionally at-risk or dietary at-risk as determined through a risk assessment – free to program applicants and performed by an approved physician, nutritionist or a nurse. The risk is evaluated and prioritized by a number of factors including:

• Clinically-proven to be anemic, underweight, or overweight. Or, if pregnant, have a history of pregnancy complications or poor pregnancy outcomes; and
• Determined to have inappropriate nutrition/feeding practices or fail to meet the Dietary Guidelines for Americans.

These guidelines are revised every five years by the Department of Agriculture, or USDA, and the U.S. Department of Health and Human Services, or HHS. To download this guide, visit Dietary Guidelines.

Residential requirement

Although there is no time requirement applied to residency, applicants must provide proof of residency in the county where they apply for benefits, or the residency requirements established for their Indian Tribal Organization. In general, applicants should apply to the local WIC clinic that serves the area in which they reside.

Income requirement

As a general rule, to be eligible for WIC, applicants must have income at or below established income levels or standards. Applicants are automatically determined income-eligible if they are receiving benefits from the following programs:

• Medicaid
• Supplemental Nutrition Assistance Program
• Temporary Assistance for Needy Families, formerly referred to as Aid to Families with Dependent Children, or AFDC
• Supplementary Nutrition Assistance Program, or SNAP; formerly referred to as the food stamp program

Some State agencies qualify applicants that participate in other State-administered programs not listed above, as well. In some circumstances, applicants can qualify if certain family members are eligible to receive Medicaid or TANF.

If the applicant is not currently enrolled in one of these programs, the agency will qualify the applicant based on income eligibility. To qualify for WIC, an applicant’s gross income must fall at or below 185 percent of the U.S. Poverty Income Guidelines. Adjusted income eligibility guidelines were published on March 29, 2013 and went into effect on July 1, 2013. They can be found at WIC Income Eligibility Guidelines.

Guidelines are updated yearly. In general, 48 contiguous states, District of Columbia, Guam and designated territories follow the main chart. Alaska and Hawaii have separate charts with higher maximum levels.

The charts issue maximum income guidelines that are followed by most States. However, States do have the option of setting lower income limit standards when administering their program. For example, for an expectant single mother, that amount must be lower than $21,257 annually. For a mother with one child, the maximum income level is $28,694. In Alaska and Hawaii the maximum level is higher.

To access income eligibility guidelines, visit at WIC Income Eligibility Guidelines 2013-2014.

WIC Prescreening Tool

The U.S. Department of Agriculture’s Food and Nutrition Service, or FNS, offers an online prescreening tool which ascertains whether the applicants fit the categorical, residential and income eligibility for WIC benefits based on the response to a series of questions. The WIC Prescreening Tool will inform applicants that they “may be eligible” or “may not be eligible” for WIC benefits. If determined eligible, the online prescreening applicants are provided State-specific contact information, a print-out of their responses, a list of certification documents required for the appointment, and contact information to schedule a certification appointment with their local WIC agency. The WIC Prescreening Tool can be accessed by copying and pasting the following into your URL, http://wic.fns.usda.gov/wps/pages/start.jsf.

Not all who are eligible will receive WIC benefits

WIC does not have enough funds to serve all eligible individuals, so they have created a system of priorities for approving WIC benefits. Local WIC agencies fill vacancies as they exist. When they reach maximum caseload, vacancies are filled in the following priority:

Those nutritionally at-risk due to a nutrition-related medical condition including:

• Pregnant woman, breastfeeding woman, and infants
• Infants, 0 to 6 months, whose mothers have a medical problem and are eligible to participate
• Children, under the age of 5

Those nutritionally at-risk due to an inadequate dietary pattern including:

• Pregnant woman, breastfeeding woman, and infants
• Children, under the age of 5

Others can be considered nutritionally at-risk due to:

• Non-breastfeeding, postpartum woman with nutrition risk
• Individuals that are homeless or migrants and deemed at-risk
• Current participants who, without WIC, could continue to have medical and/or dietary concerns

Since WIC encourages mothers to breastfeed, pregnant women and new WIC mothers receive a higher level of priority for program certification, a greater quantity and variety of foods than mothers who do not breastfeed, and a longer certification period than non-breastfeeding mothers. For frequently asked WIC questions, WIC Fact Sheet.

For more information on the priority list, visit WIC Eligibility Priority System.

How to apply

Applying for WIC assistance is relatively easy. The first step an applicant should take is to contact their state health authority or community health department. Most states have implemented an online application process. However, applicants will be asked to meet with a caseworker in most cases, and will be asked to undergo a health and nutrition assessment.

During this visit, applicants should have on-hand:

• A copy of her birth certificate, and her child’s
• A driver’s license
• Medicaid paperwork
• Medical information
• Employment or unemployment compensation information
• Child support information
• IRS forms
• A utility bill or pay stub that shows her address
• proof of enrollment, if applicable, with Medicaid, Temporary Assistance for Needy Families, or Supplemental Nutrition Assistance Program.

An applicant will need to undergo a physical assessment by a qualified physician, a nurse or a medical professional to determine whether thresholds are met. A woman must have one of the physical conditions on WIC’s list of nutrition risk criteria to qualify for benefits.

What can a person purchase using WIC benefits?

Currently, WIC is undergoing a transformation in terms of how benefits are provided to recipients. By 2020, the agency is required to provide benefits using an electronic benefit transfer card, or EBT card system. Today, in many states, recipients use a paper voucher that outlines what items, and how many of each, can be purchased. Some states are still distributing WIC foods in warehouse settings or delivering foods to participant homes.

A cashier at a retailer that accepts WIC vouchers will account for all of the items on the voucher; and all of the items need not be purchased in a single visit.

What items an applicant is approved for will depend on his or her situation, medical condition and nutrition risk. If a woman is pregnant, approved items will reflect those she requires to eat healthy during her pregnancy. If she is postpartum and breastfeeding, requirements include the nutrients essential for the baby. If she has a health condition, requirements are specific to her nutrient needs. The change on a voucher, or on an EBT card, will take place when a recipient re-qualifies every six months.

Although states have the right to modify what is purchased using WIC benefits, the specifications that are in place regarding purchase is remarkably consistent.

The foods that can be purchased using a WIC voucher or EBT card may include:

• Baby food
• Canned fish
• Canned vegetables or fruit
• Cheese
• Dried beans, peas, or lentils
• Eggs
• Fresh fruits
• Fresh vegetables
• Infant cereal
• Infant formula
• Iron-fortified infant formula (for non-breastfed infants)
• Iron-fortified or whole-grain adult cereal
• Low-fat milk
• Oatmeal
• Peanut butter
• Soy-based beverages
• Tofu
• Vitamin C-rich fruit or vegetable juice, or sugar-free juice (bottled or concentrate)
• Whole milk (children under 12 months)
• Whole wheat or whole-grain bread, rolls

Note, these foods are supplied here as a reference. Because the list is continually updated, please refer to the official WIC site, or a current list from your local agency.

Although most items can be purchased at grocers that accept WIC benefits, fresh vegetables can be purchased at many local farmers’ markets under the WIC Farmers’ Market Nutrition Program, or FMNP. The FNMP was created to encourage recipients to purchase fresh, locally-grown produce.

WIC places further restrictions on the number of any given items that can be purchased; for instance, the program only allows for the purchase of 16- to 18-ounce jars of peanut butter. Some states will provide a list of brands that meet nutritional requirements. The number of items allowed is based on the size and makeup of a family and their individual nutritional needs.

Refer to your State’s WIC website for WIC approved retailers, state-contracted formula providers, and restrictions.

What services are provided to WIC recipients?

A part of WIC’s mission – in addition to providing mothers and children with nutritious food – is to offer health services. WIC agencies participate in a number of health/education programs that are aimed at helping a mother develop a healthy diet, and healthy habits, for herself and her child.

Some of the services available through WIC may include:

• Health assessments
• Nutritional instruction
• Health referrals
• Psychological support
• Social services for alcohol misuse, illegal drug use, or tobacco use
• Breastfeeding information and instruction

Because one of the hallmarks of WIC is to encourage postpartum women to breastfeed, WIC agencies provide a variety of breast pumps to mothers. These pumps include manual pumps or a multi-user hospital grade pump, as well as a pump kit. The type of pump provided to a mother will be determined after an assessment by a health professional. One-to-one support of peer counselors and breastfeeding experts is available in an initial session and later to promote the continuation of breastfeeding.

What are the limits of WIC?

WIC is considered a short-term program. Because WIC is not a traditional entitlement program, there are limits placed on an applicant’s ability to receive assistance through the program. Because WIC is a federal grant, the program will never be able to serve everyone that applies for aid, even during a robust economy.

Once a state’s WIC resources are exhausted, a priority wait list is implemented that can, depending an applicant’s circumstances, delay approval of his or her application.

Because a child with Cerebral Palsy is considered to have a serious medical issue, it is likely, but not guaranteed, that his or her parent will be approved for benefits. The best move a parent can make to maximize the chance of receiving aid is to apply early, and have all the information – particularly clinically-based evidence – on-hand when meeting with a caseworker.

Another limit on the WIC program is that benefits, once approved, are not portable. That means if an applicant chooses to move out of the state where they were approved for benefits, even if the reason is a sound one, he or she will have to re-apply in the new state where they reside, and the process of approval will begin again.

WIC recipients should produce proof – their EBT card – that verifies their participation in the WIC program to the new agency in another state in an effort to expedite further consideration.