Important Update for Healthcare Providers on Infant Formula Alternatives

Dear Healthcare Provider:

The Ohio Department of Health supports the infant feeding recommendations made by the American Academy of Pediatrics, Committee on Nutrition.

While the Ohio Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) encourages and supports breastmilk as the optimal food for babies, we know that there are families of infants who cannot or choose not to breastfeed exclusively. For those families, supplemental iron-fortified formula is available through the Ohio WIC Program.

Due to the recent Abbott infant formula recall and related formula shortages, the State WIC office is temporarily allowing several flexibilities, including more formula options (brands and container sizes) for standard milk and soy-based infant formulas. Additionally, the Ohio WIC Program is temporarily allowing the issuance of store brand hypoallergenic infant formulas.

To help facilitate and streamline the prescription process, there is now a box to mark “or store brand equivalent” on the Ohio WIC Prescribed Formula and Food and Request Form. These store brand equivalent formulas are only available for Similac Alimentum and Nutramigen with Enflora LGG powder and meet the American Academy of Pediatrics’ criteria for hypoallergenicity1. To allow greater flexibility for WIC participants, you may check both boxes. The State WIC team is also temporarily allowing multiple formulas to be selected on a single Ohio WIC Prescribed Formula and Food Request Form. Healthcare providers should select the top two to three formulas that meet the participant’s nutritional needs indicating first, second, and third recommended formulas, as appropriate. WIC health professionals will work collaboratively with WIC participants to determine which option will be issued to the WIC Nutrition Card. Ohio WIC’s Prescribed Formula and Food Request Form has been revised appropriately. Please ensure that you are using the most current version of this form with the effective date June 2022.

As a reminder, special formulas issued by WIC must be prescribed for their specific nutrient content related to treatment of a medical condition. Prescription requests for special formulas must still contain all of the following information:

• Participant’s name and date of birth.
• Amount of formula to be provided per day (must be a specific, measurable volume).
• Intended length of use of the formula (not to exceed six months).
• Documented medical diagnosis (must relate to the special formula requested).
• Name of formula.
• Any contraindications for other supplemental foods that WIC provides.
• Signature, credentials, and telephone number of the prescribing healthcare provider.
• Date prescribed.

WIC cannot approve a special formula request if the formula:

• Prescription does not include the minimum information outlined in this letter.
• Does not meet WIC requirements for issuance.
• Is prescribed solely for weight management or nonspecific “intolerance.”

WIC health professionals will work with healthcare providers to obtain any missing data and provide expedient service for WIC participants. The health professionals in the WIC clinics make decisions related to the issuance of formulas and foods based on WIC policy and an individualized nutrition assessment.

The State WIC team is dedicated to providing as many infant formula options as possible until the formula shortage subsides. If you have any questions, please contact your local WIC office.

Thank you for your continued support of your patients who participate in the Ohio WIC program.

Sincerely,

Sean Keller, Interim Director
Ohio WIC Program