Office of Nutrition Services
350 Capitol Street • Room 519 • Charleston, WV 25301-3715
phone: 304-558-0030 • fax: 304-558-1541

Medical Professionals' FAQ

Hemoglobin Testing

Infant Formula

Whole Milk


Hemoglobin Testing

How often does the West Virginia WIC Program perform hematological testing?

WIC performs hematological testing to obtain a hemoglobin value during the initial certification visit for each WIC applicant.

  • Pregnant women are tested once during their certification.
  • Breastfeeding women are tested during their certification as a breastfeeding.
  • Postpartum women are tested once during their certification as postpartum.
  • Infants are not tested before 9 months of age.  If the first test is normal, the infant will not be tested again until 6 months later.
  • Children are tested once a year.

Any participant with a hemoglobin value that is not within normal limits will be tested again by WIC within 90 days, unless the health care provider sends WIC a value that is taken within those 60 days and shows an improved value.

Any participant with a hemoglobin value that West Virginia WIC considers to be high risk will be sent immediately to the health care provider.

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What hemoglobin values are considered by WIC to be abnormal and/or high risk?

  Abnormal High Risk
Pregnant Women
(1st Trimester)
< 11.0 < 10.0
Pregnant
(2nd Trimester)
< 10.5 < 10.0
Pregnant Women
(3rd Trimester)
< 11.0 < 10.0
Infants < 11.0 < 9.5
Children
12-60 months of age
< 11.0 < 10.0

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How can a physician receive a patient's hemoglobin value?

A physician may receive a patient's hemoglobin value from WIC in several ways.

  • WIC will send abnormal hemoglobin values to the physician when the value is considered to be high risk by WIC or when the value remains abnormal after 90 days during the follow-up visit.
  • The physician may send a release form signed by the participant or parent/guardian to WIC to provide the hemoglobin value.
  • The physician may use the hemoglobin value on the West Virginia WIC Program Record of Measurements card that is given to the participant or parent/guardian during the WIC clinic visit.

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Can WIC use a physician's hemoglobin value?

WIC can use a hemoglobin value taken by the health care provider when the value and date are provided by the physician's office.

The hemoglobin value must be no older than 60 days before the WIC certification visit or  90 days of the follow-up visit for an abnormal value.

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Infant Formula

Why does the West Virginia WIC Program only provide iron fortified infant formula for WIC participants?

The West Virginia WIC Program supports the American Academy of Pediatrics (AAP) policy that exclusive breastfeeding is the ideal nutrition and sufficient to support optimal growth and development for full-term infants during the first 6 months after birth and should be continued with the addition of age-appropriate introduction of solid foods and juices, at least through the first 12 months, and thereafter for as long as mutually desired (AAP, Work Group on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 1997; 100: 1035-1039).

In the absence of human milk, iron-fortified infant formula is an appropriate substitute for feeding the full-term infant during the first year of life. Low-iron formulas exist because iron is perceived by some to cause constipation and other feeding problems. Well-controlled studies have consistently failed to show any increased risk of feeding intolerance with the use of iron-fortified formulas (Pediatric Nutrition Handbook, 4th edition, 1998).

The West Virginia WIC Program will issue low-iron formula only when one of the following medical conditions occur which adversely affect metabolism and/or deposition of iron (i.e., iron-overload):

  • Repeated blood transfusions for treatment of underlying hematological disorder
  • Thalassemia Major (Cooley's Anemia)
  • Neonatal Hemochromatosis (Neonatal Iron Storage Disease)
  • Atransferinemia (Iron Transport Deficiency Anemia)

Please contact the Nutrition Education Coordinator for the West Virginia WIC Program at 304-558-0030 when one of the above conditions exist. Blood work documentation indicating the disorder/disease must be received prior to issuance of low-iron formula by the West Virginia WIC Program.

Please contact the Nutrition Education Coordinator for the West Virginia WIC Program at 304-558-0030 with any questions.

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Why does the West Virginia WIC Program encourage use of certain infant formula?

The West Virginia Department of Health and Human Resources, Bureau for Public Health, Office of Nutrition Services/WIC Program has entered into an agreement with Abbott Ross  Nutrition. Abbott Ross Nutrition provides Similac Advance Early Shield, Similac Sensitive, Similac Sensitive RS, and Isomil as the sole source milk-based and soy-based formulas for WIC participants.

The agreement is a federally mandated cost containment system. It provides a savings of approximately $8.36 million per year to the West Virginia WIC Program. This savings allows the West Virginia WIC Program to continue to serve an additional 15,000 WIC participants, in addition to the caseload served by the federal WIC grant.

In accordance with federal regulations, WIC-eligible formulas are mainly issued in a concentrated liquid or powdered forms. The issuance of a ready-to-feed formula is limited to exceptions when there is an unsanitary or restricted water supply, there is poor refrigeration, the infant caretaker may have difficulty in correctly diluting a concentrated liquid or powdered product, or the product is available in only a ready-to-feed form.

All other standard milk-based or soy-based infant formulas require the completion of the West Virginia WIC Prescription Formula Documentation Form (WIC-53) by a physician, certified nurse practitioner with prescriptive authority, or physician assistant with prescriptive authority prior to issuance of formula drafts.

Please contact the Nutrition Education Coordinator for the West Virginia WIC Program at 304-558-0030 with any questions.

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How can a special formula be prescribed for a West Virginia WIC participant?

A WIC participant who is prescribed formula other than Similac Advance Early Shield, Similac Sensitive, Similac Sensitive RS, or Isomil must have a completed WV WIC Prescription Formula Documentation Form (WIC-53) prior to issuance of drafts for the special formula. The form may be obtained from the local WIC clinic. The form must be completed by a physician or health care provider with prescriptive authority. It must include the participant's name, diagnosis, formula prescribed, and original signature/date. A signature stamp will not be accepted.

The form may either be returned to the participant to give to WIC staff, or mailed directly to the WIC clinic. The form may be faxed to the WIC clinic, with the original sent by mail, when the participant must receive issuance of drafts for the formula quickly.

Any special formula can be issued in either concentrate or powder form, provided it is manufactured in that form.  The issuance of a ready-to-feed formula is limited to exceptions when there is an unsanitary or restricted water supply, there is poor refrigeration, the infant caretaker may have difficulty in correctly diluting a concentrated liquid or powdered product, or the product is available in only a ready-to-feed form.

Please contact the Nutrition Coordinator for the West Virginia WIC Program at 304-558-0030 with any questions.

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Whole Milk

Why does the West Virginia WIC Program not allow cow's milk for WIC participants until one year of age?

The West Virginia WIC Program does not allow cow's milk before the age of one. The Committee on Nutrition of the American Academy of Pediatrics (AAP) recommends the consumption of breast milk or iron-fortified infant formula, along with age-appropriate solid foods and juices, during the first twelve months of life. The AAP recommends that whole cow's milk and low-iron formulas not be used during the first year of life (AAP, The Use of Whole Cow's Milk in Infancy, Pediatrics, 1992, 89:1105-1109).

Please contact the Nutrition Education Coordinator for the West Virginia WIC Program at 304-558-0030 with any questions.

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Why does the West Virginia WIC Program not allow reduced fat milk for WIC participants until two years of age?

The West Virginia WIC Program food packages for children age 12 to 23 months only offer whole milk. Per recommendations of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents (National Cholesterol Education Program/NIH), The American Academy of Pediatrics Committee on Nutrition, and The American Heart Association Nutrition Committee, fat and cholesterol should not be restricted during the first two years of life (AAP, Pediatric Nutrition Handbook, 1993, page 44; NIH, Report of the Expert panel on Blood Cholesterol Levels in Children and Adolescents, 1991, page 1).

Please contact the Nutrition Education Coordinator for the West Virginia WIC Program at 304-558-0030 with any questions.

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