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Pediatric Formulas - Frequently Asked Questions
MN WIC Program
- Can Pediasure be provided for "poor weight gain" or "texture issues"? (07/15/09)
- If Pediasure was provided for a low weight participant and the participant is now maintaining adequate weight with the Pediasure (but no longer meets the criteria), can the participant continue to receive Pediasure? (07/15/09)
- Can Pediasure be provided for a "picky eater"? (07/15/09)
- If a participant is receiving Pediasure, can they really get all the regular WIC foods, including milk? Isn't that too much liquid (milk plus formula)? (07/15/09)
Can Pediasure be provided for "poor weight gain" or "texture issues"? (07/15/09)
Medical formula may only be issued when a qualifying condition (i.e., medical diagnosis) is present. It may not be provided to manage weight without an underlying medical condition. Qualifying Conditions (for any medical formulas) include:
- Premature birth
- Low birth weight
- Failure to thrive
- Metabolic disorders
- Gastroinstestinal disorders
- Mal-absorption syndromes
- Immune system disorders
- Life threatening disorders, disease and medical conditions that impair ingestion, digestion, absorption or utilization of nutrients that could adversely affect the participant's nutrition status.
Poor weight gain is not a "medical diagnosis". Medical formula, such as Pediasure, should not be provided for "growth concerns" unless there is a documented underlying diagnosed medical condition which is causing poor weight gain (e.g., failure to thrive, cystic fibrosis).
"Texture issues" are also not a "medical diagnosis". CPAs should evaluate the situation (what is the medical diagnosis) and work with the Health Care Provider to assure the most appropriate food package is provided.
If Pediasure was provided for a low weight participant and the participant is now maintaining adequate weight with the Pediasure (but no longer meets the criteria), can the participant continue to receive Pediasure? (07/15/09)
If there is not an underlying condition/medical diagnosis, Pediasure may not be provided.
Can Pediasure be provided for a "picky eater"? (07/15/09)
No. CPAs may not provide Pediasure in this case. When a parent/caregiver requests a pediatric formula (or drink mix) because the child is a "picky eater", or "just to be on the safe side", the CPA should explore the child’s "picky eating" through an assessment of the family’s feeding practices and the child’s intake. For example:
- review child's growth (using the growth chart) and, if appropriate, assure parents the child is growing adequately;
- assess food availability in the household;
- assess family meal patterns: are there regular meals?; does the child eat alone?; does child/family watch TV during meals?
- assess snacking: are snacks scheduled?; is snacking excessive?
- assess child's intake: does the child consume excessive amounts of milk? Or juice, Koolaid, or other sweet beverages?
- assess bottle use: is child taking a bottle?
- assess for problems in the family.
Following the assessment, the CPA can focus counseling on the specific factors possibly contributing to the problem and assist the caregiver in establishing healthier eating patterns. If appropriate, the CPA can suggest other foods for increasing the child’s caloric intake.
Providing pediatric formula in such cases doesn’t address the underlying issues, and may reinforce poor eating habits. For example, a "picky eater" who drinks several cans/day of a pediatric drink will likely have little appetite or interest in regular foods. Furthermore, it may contribute to excessive caloric intake and lead to childhood overweight.
If a participant is receiving Pediasure, can they really get all the regular WIC foods, including milk? Isn't that too much liquid (milk plus formula)? (07/15/09)
Technically, yes, a participant is eligible for medical formula and supplemental foods if medical documentation indicates that it is appropriate to issue both. CPAs should tailor the food package to provide only the types and amounts of medical formula and supplemental foods most appropriate for the participant based on Health Care Provider’s documentation and CPA assessment.
If the medical formula is prescribed because the participant has allergies or protein intolerance and cannot drink milk, then milk should not be provided. The maximum amount of medical formula would rarely be warranted in this situation. Children need about 16 oz. of milk per day. For most powder formulas, approximately 6 cans would provide this amount.
