Effective Date: September 1, 2017 Revised from: October 1, 2015

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1 Page 1 of 5 Effective Date: September 1, 2017 Revised from: October 1, 2015 Policy: Food packages for women shall be customized to meet the client s nutritional/medical needs, food preferences, food intolerances and living circumstances. When tailoring consider cooking and shopping limitations. For example, food packages for homeless clients may include milk issued as quarts and small packages of juice. The reason for tailoring the food package must be documented in the client s KWIC record. The food package shall be customized to prescribe a WIC eligible nutritional (medical food) if medically indicated. (See Policy: FCI: Woman Food Packages - Special Formula) Reference: CFR Procedure: 1. The base food packages for pregnant women are: Basket Cereal Breakfast Cereal 36 oz 36 oz Skim, 0%, ½%, or 1% Milk 5 ½ gallons 6 gallons Dairy 2% milk 5 ½ gallons (CPA determines need due to maternal weight loss during pregnancy.) 6 gallons (CPA determines need due to maternal weight loss during pregnancy.) Eggs Eggs 1 dozen 2 dozen Fish Tuna or Salmon N/A 30 oz FP 7 Cheese Cheese N/A 1 pound FVB Fresh Fruit & Vegetables $11.00 $11.00 Juice Concentrated Juice 3-11 ½ to 12 oz containers 3-11 ½ to 12 oz containers Canned Beans 4-16 oz cans 4-16 oz cans Legumes Peanut Butter oz jar oz jar

2 Page 2 of 5 Whole Grains Whole Grains 16 ounces 16 ounces 2. Tailor the base food package, as necessary, to prescribe situation appropriate food package. 3. Base food packages are tailored by selecting the desired food item from each food category basket. 4. The baskets and contents for possible substitution are: Cereal Basket Breakfast Cereal 36 ounces 36 ounces Excl Breastfeeding Mostly BF/PG Pregnant with a single fetus Dairy Basket Skim, 0%,½% or 1% Milk* 22 quarts 24 quarts 2% Milk* Fat Free or Lowfat (half gallon)** Lactose Free Milk Reduced Fat Lactose Free Milk (half gallon)** (2%) Fat Free or Lowfat Lactose Free Milk (quart)** 22 quarts (CPA determines need for due to maternal weight loss during pregnancy.) Substitute half gallon for 2 quarts Mostly BF/PG 24 quarts (CPA determines need for due to maternal weight loss during pregnancy.) Substitute half gallon for 2 quarts (CPA determines need for due to maternal weight loss during pregnancy.) Substitute quart for quart

3 Page 3 of 5 Reduced Fat Lactose Free Milk (quart)** (2%) Soy Milk Substitute quart for quart (CPA determines need for due to maternal weight loss during pregnancy.) Substitute half gallon for 2 quarts (substitute on a quart for quart basis up to the total maximum allowance of milk.) Nonfat or Low-Fat Evaporated Nonfat Dry Cheese Low-Fat or Non-Fat Yogurt Substitute a 12 oz can for 0.75 quarts of fluid milk (substitute for dangling quart) Substitute 1 quart reconstituted for 1 quart fluid milk Substitute 1 pound for 3 quarts up to 1 pound Substitute 32 ounces (1 quart) for 1 quart milk. Only 1 quart yogurt per food package is allowed. Tofu Substitute 1 16 ounce container for 1 quart fluid milk. *Quarts of milk roll up to a base food package of gallons. Milk may be tailored to ½ gallons or quarts for shopping convenience or living circumstances. For example a client may ride the bus to shop, walk to the store or have limited refrigeration. ** Lactose free milk is available in either ½ gallons or quarts, be sure to select the container size available where the client/caregiver shops. A combination of cheese, yogurt or tofu may be substituted for no more than 4 quarts of milk for women with Food Package V and no more than a total of 6 quarts of milk for women with Food Package VII. Egg Basket Eggs 1 dozen 2 dozen Canned Beans*** Substitute oz cans for 1 dozen Peanut Butter*** Substitute a oz jar for 1 dozen ***Only allowed if KWIC record documents cooking and storage limitations.

4 Page 4 of 5 Chunk, Light Tuna or Pink Salmon Fish Basket N/A 30 ounces FP 7 Cheese Basket (FP 7 only) Cheese N/A 1 pound Fresh fruits or vegetables benefit FVB Basket $11.00 $11.00 Concentrated Juice (11 ½ to 12 oz container) Ready to Drink Juice (8- pack of 6.75 ounce boxes)*** Juice Basket 144 fluid ounces reconstituted Substitute fluid ounce for fluid ounce reconstituted ***Only allowed if KWIC record documents cooking and storage limitations.

5 Page 5 of 5 Legume Basket Mostly BF/PG Canned Beans ounce cans ounce cans Dried beans, peas or lentils Substitute 1 pound for ounce cans Peanut Butter Substitute ounce jar for ounce cans Whole Wheat Bread/Rolls/Buns, Whole Wheat Tortillas, Soft Corn Tortillas, Brown Rice, Oatmeal or Whole Wheat Pasta Whole Grains Basket 16 ounces 16 ounces Mostly BF/PG Pregnant with multiple fetuses or Pregnant with linked breastfeeding infant

Effective Date: September 1, 2017 Revised from: October 1, 2015

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