Wisconsin WIC Program

Formula, Medical Food and Other Prescription-Required Product Information

Formulas, medical foods and other products are provided to individuals in the following categories.

• Infants  
  Birth through 12 months of age

• Children  
  1 through 4 years of age

• Pregnant Women  
  Up to 6 weeks postpartum

• Postpartum Women  
  Breastfeeding:  up to 12 months after delivery; 
  non-breastfeeding: up to 6 months after delivery

The Wisconsin WIC Program actively promotes and supports breastfeeding as the norm for infant feeding. Breastmilk provides superior nutrition and immunological benefits, and fosters close parent/child relationships. When a mother decides to breastfeed partially, or not to breastfeed, WIC provides formula. WIC also provides several specialized formulas and medical foods when required for the treatment of a medical condition.

Standard Contract Formulas for Infants

For routine formula feeding, the Wisconsin WIC Program provides only the following Nestlé^® Good Start^® baby formulas. No standard Similac or Enfamil formulas will be given.

• Gentle Plus
  Milk-based

• Soy Plus
  Soy-based, milk-free, lactose-free

Also available:

• Protect Plus
  Milk-based, with probiotic cultures

Products Requiring Prescriptions (Revised 10/09)

The Wisconsin WIC Program provides the products listed below when prescribed by a physician, physician assistant, or advanced practice nurse prescriber for treatment of allowable medical conditions. Examples of allowable medical conditions are included below. 

For more information on the products listed (e.g., indications for use, contraindications, maximum quantities per month, and average amounts per day), consult the page for health care providers.

• Standard contract infant formulas (listed above)
  For children on/after their first birthday for prematurity or developmental delays.

• Enfamil Enfacare LIPIL
  For infants and children for prematurity.

• Similac Neosure DHA & ARA 
  For infants and children for prematurity.

• Enfamil Nutramigen LIPIL with Enflora LGG
  For infants and children with protein intolerance or severe or multiple allergies.

• Similac Alimentum DHA and ARA
  For infants and children with protein intolerance, severe food allergies, fat malabsorption due to cystic fibrosis, or short bowel syndrome.

• Enfamil AR LIPIL
  For infants and children with Gastroesophageal Reflux.

• Enfamil Pregestimil LIPIL 
  For infants and children with fat malabsorption due to cystic fibrosis, short bowel syndrome, biliary atresia, severe protein calorie malnutrition, or galactosemia.

• Elecare Unflavored 
  For infants and children with severe food allergies, short bowel syndrome, or gastrointestinal impairment.

• Elecare Vanilla 
  For children with severe food allergies, short-bowel syndrome, eosinophilic disorders, or GI tract impairment.

• Neocate Infant Unflavored 
  For infants and children with severe food allergy to cow’s milk and soy milk, or multiple food protein intolerances; short bowel syndrome, esophagitis, or Gastroesophageal Reflux.

• PediaSure (various flavors) and PediaSure with Fiber 
  For children with medical conditions that limit food intake or increase nutrient requirements, such as cancer.

• Ensure: Regular, with Fiber, High Calcium, High Protein, Plus 
  For women with medical conditions that limit food intake or increase nutrient requirements, such as cancer.

• Boost: Regular, Plus, High Protein 
  For women with medical conditions that limit food intake or increase nutrient requirements, such as cancer.

• Whole Milk 
  For children 2-4 years old and women with medical conditions that limit food intake or increase nutrient requirements, such as cancer, or conditions that increase requirements for fat versus carbohydrates.

Examples of NOT ALLOWED CONDITIONS include intolerance symptoms such as spitting up, constipation, diarrhea, or rashes; and managing body weight without an underlying medical condition. No other products besides those listed above are provided.

For specialized products not listed above, talk to your doctor about coverage by Medicaid/BadgerCare Plus, your private insurance, or the manufacturer. 

The Regional Centers for Children with Special Health Care Needs can help families and providers with information and referral for case management and technical assistance to meet the needs of children with special health care needs.

If you have any questions about products and services provided by WIC, talk to your WIC Registered Dietitian or Nutritionist. 

Last Revised:  June 14, 2011