Friday, July 17, 2015

WIC Program Deserves Support

Program Provides Essential Nutrition to 1 Million Texas Infants, Children, and Mothers

By Steven Abrams, MD
Austin Pediatrician

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) has had unprecedented success in enhancing the nutritional status of pregnant women and young children in the United States since Congress authorized it in 1972. Sometimes perceived as a free infant formula program, it is much more. It is a comprehensive program that supports good nutrition during pregnancy, provides breastfeeding support for mothers, and provides nutritional planning for at-risk children in the first five years of life.

The government has until Sept. 30, 2015, to reauthorize the WIC program, providing funding through the Texas Department of State Health Services.

Texas is home to more than 1 million WIC recipients, about three-fourths of whom are infants and children. Among infant recipients, almost half receive some breast milk, critical to short- and long-term health.

It is critical that the WIC program be continued without being weakened. Deciding who receives WIC and what benefits are given is the job of scientific and governmental experts. It and other food assistance programs must be free of nonscientific input.

People who participate in Medicaid are automatically income eligible for WIC, but they must also meet other program requirements, such as being pregnant or having nutritional need.

This link between the two programs makes WIC available to families with relatively little administrative paperwork. Linking WIC to Medicaid is rational because the health care costs of inadequate early nutrition ultimately would be paid by Medicaid.

This approach has led to a fairly constant rate of WIC participation by families who are at risk. It also has allowed for contracting with suppliers, such as infant formula companies, to be done in a way that offers tremendous discounts for the government while meeting the needs of children. An April 27 Wall Street Journal article, “Makers of Baby Formula Press Their Case on WIC Program,” states that taking away this link would decrease the effectiveness of the program and would unnecessarily complicate the management of WIC.

It has been clearly demonstrated that the “1,000 days” from conception through about 2 years of age is absolutely critical to lifelong health and good outcomes. Good nutrition during that time sets a trajectory of good development and a decreased risk of later cardiovascular problems.

This early investment in nutrition is a moral imperative. For example, lactation counseling leads to increased rates of breastfeeding and decreases infections and other short- and long-term health problems in children.

WIC is a supplemental program; it does not meet 100 percent of its participants’ needs. It is flexible in providing for healthy and appropriate nutrition for all participants, especially mothers.

The food selections in WIC are limited, and it is inaccurate to believe recipients are using the benefits inappropriately. What is accurate: Infant formula is expensive, and families will dilute infant formula when they cannot pay for it. One study suggested formula dilution occurs in more than 10 percent of families who provide formula to their infants.

Take away WIC from at-risk families, and the rate of malnourished infants and their mothers will increase substantially.

Steven Abrams, MD, is professor of pediatrics and chair of the Department of Pediatrics at Dell Medical School at The University of Texas. He served as a member of the Committee on Nutrition of the American Academy of Pediatrics from 2009-15 and as a member of the Dietary Guidelines Advisory Committee in 2015.

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