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Washington County �WIC Program�Growing Healthy Futures

OHSU Resident Presentation

Tara Olson, MPA, RDN

October 8^th, 2020

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OUR VISION

Every Oregon family achieves optimal nutrition and lifelong health.

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Saving the Children: A Story of WIC

https://www.youtube.com/watch?v=Ot7FGXdTrY4

Oregon WIC - Growing Healthy Futures

https://www.youtube.com/watch?v=idpllw5Ouck&feature=youtu.be

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Washington County WIC Locations

Beaverton
12550 SW Second St
Hillsboro
254 N. First Ave
Tigard
New location: 11555 SW Durham Rd Suite E8

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Eligibility

Live in Oregon

Who?

Have

DO NOT need proof of citizenship (WIC isn’t a public charge program)

Pregnant, postpartum, or BF women, infants, children under age 5
Women who miscarried within the last 6 months
Dads, grandparents, foster parents, and guardians may apply for their children

Have a nutritional need and meet WIC income guidelines

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WIC Income Guidelines

(Effective as of June 1, 2020)

Automatically qualify with:

SNAP

TANF

OHP

Household size	Monthly	Weekly
1	$1,968	$454
2	$2,658	$614
3	$3,349	$773
4	$4,040	$933
5	$4,730	$1,092
6	$5,421	$1,251

Poverty Level - 185%

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2019 Data for Washington County WIC

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WIC visits�Health screenings include:

Measuring for height and weight
Assessing iron levels
Completing a health assessment – screening for immunizations, medical conditions, etc.
Referring to dietitian or other community resources
Offering breastfeeding support and nutrition-focused counseling

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WIC Benefits

eWIC Card

NO MORE VOUCHERS! Food packages are now on the card, making things easier.

WIC Shopper App

Find eligible foods and check WIC benefit balance.

Breastfeeding Support

Breastfeeding help and breast pumps for moms who need them

Benefits

To buy healthy foods

WIC Farm Direct Nutrition Program

(FDNP)

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WIC foods

Vegan diets –Tofu and a variety of beans are available for vegetarians or vegans.
Dairy – Dairy alternative options include soy, lactose-free, acidophilus or goat milk alternatives.
Juice – WIC follows the AAP recommendations of 4 oz or less of juice for children
Organics – Organic fruits, veggies and baby food

This picture on the top left represents a typical WIC food package. Average value per participant is around $50. (A pregnant mom with a child would get approximately $150 worth of food per month)

WIC Food package choices include:

Fruits & Veggies; can be organic; fresh or frozen
Whole Grains; adding new options like whole grain pasta and tortillas
Milk; low-fat age 2 and older
Cheese (single-serving string cheese mozzarella was recently added)
Eggs
Peanut Butter and/or beans; adding canned beans in addition to dried
Cereal (In 2019 Oregon removed certain cereals to eliminate any artificial dyes)
Juice (As noted above, the amount per month averages out to be 4 ounces per day, in line with AAP recommendations)
Fish (canned)
Infant Foods (In 2019: Oregon first in the nation to remove infant rice cereal from our food package due to concerns with levels of arsenic in infant rice cereal)
Baby food (offering more organic options)
Tofu and yogurt (added more options in 2019)

Items on our food list are evaluated by:

Nutrient profile analysis
Participant preferences
Price
Availability

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NUTRITION FOCUSED COUNSELING IS THE CORNERSTONE OF WIC

WIC values quality nutrition education which is what sets our program aside from other supplemental food programs.

WIC sees our participants every 3 to 6 months for nutrition education. Potentially up to 21 contacts between birth and 5 years of age. This education takes many different forms. We offer:

personalized nutrition-focused consultation that assess health and diet and addresses responsive feeding,
a variety of group classes (share typical classes) and
20 different online nutrition-related course options for our busier families. (Online nutrition education options for WIC families include: Life course nutrition, Breastfeeding, Baby and me classes, Infant feeding cues and baby behaviors, Picky eating behaviors, Shopping for, storing and preparing fresh fruits and veggies, Physical activity)

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Registered Dietitian Nutritionists

Available at every WIC office
Follow-up with high risk participants, including participants with food allergies, in foster care, with special health care needs, women with gestational diabetes, premature infants, etc.
Monitor children on special medical formulas and help determine WIC approved formulas and foods
WIC dietitians are available to support patients with greater medical complexity.

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WIC supports breastfeeding women in the following ways

All WIC staff are trained to provide basic breastfeeding education and support
WIC peer counselors provide mother to mother support helping women overcome common breastfeeding challenges
WIC protects breastfeeding by not routinely issuing formula to breastfeeding infants in the first 30 days.

WIC staff training breastfeeding - All counseling staff are required to have a minimum competency in breastfeeding covering:

Value of long-term, exclusive breastfeeding
Planning for the hospital
Skin to skin
Establishing milk supply
Baby behavior and infant sleep patterns

List of classes that a WIC certifier takes

Helping with a breastfeeding and what to expect in the hospital
The First hour, Skin-to-skin, Value of exclusivity
Early postpartum breastfeeding -Establishing milk production
Maintaining breastfeeding through the first year
Baby behavior, Growth spurts, Adequate milk, Sleep, Stooling, Milk volume, Teething, Returning to work or school
Overcoming Challenges -Focus on physiological issues, from most to least commonly occurring, Low milk production, Engorgement, Sore nipples, Mastitis, plugged ducts, Overactive letdown

The reason WIC does not provide formula in the first 30 days - A major goal of WIC is to improve the health of mothers, infants and children; therefore, WIC families are encouraged to breastfeed infants unless medically contraindicated. The first days and weeks after delivery are a critical time for mothers and infants to establish breastfeeding. Formula supplements interfere with milk production and make learning to breastfeed difficult.

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WIC provides professional lactation support:�International Board Certified Lactation Consultants (IBCLC)

Expertise in clinical management of complex lactation problems
500-1000 clinical practice hours, 90 hours BF-specific education & passing international exam
20 IBCLCs that work throughout Oregon in WIC

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WIC and breast pumps

Multi-user breast pump loans for WIC mothers with medical needs (premature birth, multiple birth, etc.)
Personal pumps for WIC mothers temporarily separated from their babies for work or school (20 hours/week or more)
Manual pumps for WIC mothers with short-term separations (less than 20 hours/week)

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WIC and formula

USDA requires that WIC provide infant formula when mothers are unable or choose not to breastfeed

WIC is federally mandated to use a competitive bid process for standard infant formula as a means of cost containment

Current contract is with Abbott Nutrition for milk-based and soy-based formulas:

Similac Advance

Similac Soy Isomil

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Infant Formulas WIC offers

Without Medical Documentation Form

Similac Advance
Similac Soy Isomil
Similac Sensitive for Fussiness and Gas (Nov 2020)
Similac Total Comfort (Nov 2020)

With Medical Documentation Form:

Similac for Spit-Up
Similac Alimentum
Similac Neosure
Enfamil Nutramigen
Enfamil Enfacare

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Toddler Formulas WIC offers

With Medical Documentation Form:

Pediasure
Boost Kids Essentials 1.0, 1.5
Elecare Jr.
Neocate Jr.
Neocate Splash
Bright Beginnings Soy

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Whole Milk for Children over 2 years old

Child must be on a formula in order to receive whole milk on WIC food package
Medical Documentation Form is required for both the formula and whole milk

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WIC Medical Documentation Form

Use when a participant has a need/diagnosis for a medical formula
Limited to formulas allowed by Oregon WIC; formulary is listed on backside
Located on the Oregon WIC website as a fillable form

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Collaborative Partnerships

Maternal Child and Reproductive Health Program (Nurse Family Partnership, Cacoon, and other home visiting programs)
Community Action resource advocates (utility financial assistance, Head Start enrollment, Early Connections, home visiting, etc.)
Oregon Child Development Coalition (OCDC)
Project Access Now OHP assistors
Neighborhood Health Center child dental screenings
Hillsboro, Beaverton and Tigard Libraries story times

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Changes to WIC �during COVID-19

In-person appointments transitioned to phone appointments
No longer taking measurements or screening for iron status
Able to mail eWIC cards and breast pumps to participants
Mailed Farm Direct Nutrition Program (FDNP) checks directly
WIC food list expanded

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How can we work together?

Connect with IBCLCs or peer counselors for breastfeeding resources
Have critical dialogs with WIC dietitians about infant formula or medically fragile patients
Encourage staff to refer OHP patients that are pregnant, infants or children (up to age five) to WIC.

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Referrals to WIC

Use our new online interest form

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Let’s be in touch!

Tara_Olson@co.Washington.or.us or 503-846-8610