Appendix A2 Relevant WIC Policy and Guidance Documents

Appendix A2
Relevant WIC Policy and Guidance Documents

Appendix A2. Relevant WIC Policy and Guidance Documents includes the
following:
1. Value Enhance Nutrition Assessment (VENA) in WIC. (2006). Executive
Summary, p. 3-5. Full text available at:
https://wicworks.fns.usda.gov/sites/default/files/media/document/VENA_Guidanc
e.pdf
2. “Special Supplemental Nutrition Program for Women, Infants and Children
(WIC): Revisions in the WIC Food Packages; Final Rule.” Federal Register
79:42 (March 4, 2014) p. 12274-12300.

Value Enhance Nutrition Assessment (VENA) in WIC. (2006). Executive Summary,
p. 3-5. Full text available at:
https://wicworks.fns.usda.gov/sites/default/files/media/document/VENA_Guidance.pdf

VALUE ENHANCED NUTRITION ASSESSMENT IN WIC

The First Step In
Quality Nutrition Services

U.S. Department of Agriculture
Food and Nutrition Service

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12274

Federal Register / Vol. 79, No. 42 / Tuesday, March 4, 2014 / Rules and Regulations
FOR FURTHER INFORMATION CONTACT:

DEPARTMENT OF AGRICULTURE

Anne Bartholomew, Chief, Nutrition
Services Branch, Supplemental Food
Programs Division, Food and Nutrition
Service, USDA, 3101 Park Center Drive,
Room 522, Alexandria, Virginia 22302,
(703) 305–2746 OR
ANNE.BARTHOLOMEW@
FNS.USDA.GOV.

Food and Nutrition Service
7 CFR Part 246
[FNS–2006–0037]
RIN 0584–AD77

Special Supplemental Nutrition
Program for Women, Infants and
Children (WIC): Revisions in the WIC
Food Packages

SUPPLEMENTARY INFORMATION:

Food and Nutrition Service
(FNS), USDA.
ACTION: Final rule.
AGENCY:

This final rule considers
public comments submitted in response
to the interim rule revising the WIC food
packages published on December 6,
2007. The interim rule implemented the
first comprehensive revisions to the
WIC food packages since 1980. The
interim rule revised regulations
governing the WIC food packages to
align them more closely with updated
nutrition science and the infant feeding
practice guidelines of the American
Academy of Pediatrics, promote and
support more effectively the
establishment of successful long-term
breastfeeding, provide WIC participants
with a wider variety of food, and
provide WIC State agencies with greater
flexibility in prescribing food packages
to accommodate participants with
cultural food preferences. This rule
makes adjustments that improve clarity
of the provisions set forth in the interim
rule.
DATES: Effective Date: This rule is
effective May 5, 2014.
Implementation Dates:
• State agencies must implement the
provision in Table 2 at 7 CFR
246.10(e)(10) increasing the cash-value
voucher for children to $8 per month no
later than June 2, 2014.
• The provision found at 7 CFR
246.12(f)(4) requiring split tender for
cash-value vouchers shall be
implemented no earlier than October 1,
2014 and no later than April 1, 2015.
• Footnote 11 of Table 2 at 7 CFR
246.10(e)(10) shall be implemented on
the later of October 1, 2014, or the date
on which the State agency exercises
their option to issue authorized soybased beverage or tofu to children who
receive Food Package IV.
• The provisions in Footnote 10 of
Table 2 at 7 CFR 246.10(e)(10) and
Footnote 12 of Table 3 at 7 CFR
246.10(e)(11) authorizing yogurt for
children and women in Food Packages
III–VII may be implemented no earlier
than April 1, 2015.

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SUMMARY:

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I. Overview
This final rule addresses public
comments submitted in response to the
interim rule revising the WIC food
packages published on December 6,
2007 (72 FR 68966), and makes
adjustments that improve clarity of the
provisions set forth in the interim rule.
II. Background
An interim rule revising the WIC food
packages was published in the Federal
Register on December 6, 2007 (72 FR
68966). The interim rule implemented
the first comprehensive revisions to the
WIC food packages since 1980 and
largely reflected recommendations made
by the National Academies’ Institute of
Medicine (IOM) in its Report ‘‘WIC
Food Packages: Time for a Change’’
(‘‘Report’’).1 The interim rule aligned
the food packages more closely with
updated nutrition science, promoted
and supported more effectively the
establishment of successful long-term
breastfeeding, provided WIC
participants with a wider variety of
food, and provided WIC State agencies
with greater flexibility in prescribing
food packages to accommodate
participants with cultural food
preferences. WIC State agencies were
required to implement the changes by
October 1, 2009.
III. General Summary of Comments
Received on the Interim Rule To Revise
the WIC Food Packages
The interim rule revising the WIC
food packages provided an extensive
public comment period to obtain
comments on the impact of the changes
experienced during implementation of
the new food packages. The interim rule
comment period ended February 1,
2010.
A total of 7,764 comment letters were
received on the interim rule; of those,
111 were form letters. A total of 6,664
of the letters were from program
participants, and included comments
submitted in Spanish, Chinese, and
other languages, in addition to English.
1 Institute of Medicine, National Academy of
Sciences. ‘‘WIC Food Packages: Time for a Change,’’
2005. Available at Internet site: http://
www.fns.usda.gov/wic-food-packages-time-change.

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The remaining comment letters were
submitted from a variety of sources,
including WIC State and local agencies
and Indian Tribal Organizations, the
National WIC Association (NWA),
professional organizations and
associations, advocacy groups,
healthcare professionals (including
universities), members of Congress, the
food industry, vendors, farmers, and
private citizens.
In general, commenters expressed
broad support for the changes and
reported relatively smooth
implementation of the new WIC food
packages. Commenters also voiced
concerns about various aspects of the
interim rule and made
recommendations for clarifying or
improving specific provisions of the
interim rule. Overall, participants
expressed overwhelming support for the
revised WIC food packages, especially
the addition of whole grains and fruits
and vegetables. However, many
participants who were enrolled in WIC
during the transition from the previous
food packages to the revised food
packages expressed displeasure with
changes to fat-reduced milks and less
cheese.
FNS considered all timely comments
without regard to whether they were
provided by a single commenter or
repeated by many. Importance was
given to the substance or content of the
comment, rather than the number of
times a comment was submitted.
WIC State agencies are to be
commended for the staff and vendor
training that led to successful
implementation of the new WIC food
packages, as well as nutrition education
provided to participants on the benefits
of the new foods in the WIC food
packages. Successful implementation of
the new WIC food packages was further
enhanced by the efforts of WIC’s
partners in the advocacy, retail, and
medical communities.
IV. Discussion of the Final Rule
Provisions
The following is a discussion of the
major provisions set forth in this final
rule, a brief summary of the comments
received on the interim rule that
addressed these issues, and FNS’
rationale for either modifying or
retaining provisions in this final rule.
Provisions not addressed in the
preamble to this final rule did not
receive significant or substantial public
comments and remain unchanged.
The preamble to this final rule
articulates the basis and purpose behind
significant changes from the December
6, 2007 interim rule. The reasons
supporting provisions of the interim

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Federal Register / Vol. 79, No. 42 / Tuesday, March 4, 2014 / Rules and Regulations
regulations were carefully examined in
light of the comments received to
determine the continued applicability of
the justifications. Unless otherwise
stated, or unless inconsistent with this
final rule or this preamble, the
rationales contained in the preamble to
the proposed and interim regulations
should be regarded as the basis for this
final rule. Therefore, a thorough
understanding of the rationales for the
interim regulations may require
reference to the preamble of the August
7, 2006 proposed rule (71 FR 44784) and
the December 6, 2007 interim rule (72
FR 68966).

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A. Definitions
The following definitions have been
added or modified in the final rule.
Farmers’ market. As described in a
subsequent section of this preamble,
this final rule adds the definition of
‘‘farmers’ markets’’ at 7 CFR 246.2.
Full nutrition benefit. As described in
a subsequent section of this preamble,
this final rule adds the definition of
‘‘full nutrition benefit’’ at 7 CFR 246.2.
WIC-eligible medical foods. Based on
review and discussion with the Food
and Drug Administration (FDA), this
final rule changes the name of the food
category ‘‘WIC-eligible medical food’’ to
‘‘WIC-eligible nutritionals,’’ but does
not substantively change this food
category. This nomenclature
modification better describes the group
of special WIC-eligible nutritional
products the WIC Program provides to
participants with qualifying conditions,
and alleviates confusion associated with
the use of the term ‘‘medical food,’’
which is defined by regulations
governing FDA and differs from the WIC
use of this term. The FNS definition for
‘‘WIC-eligible medical food’’ and the
FDA definition for ‘‘medical food’’ are
both comprehensive and detailed.
Although the definition of ‘‘WIC-eligible
medical food’’ closely aligns with the
FDA definition for ‘‘medical food,’’
there are slight differences, such that
some, but not all ‘‘WIC-eligible medical
foods’’ meet FDA’s definition of
‘‘medical food.’’ In an effort to alleviate
confusion, and distinguish between the
two product categories and definitions,
FNS is modifying the name of the food
category from ‘‘WIC-eligible medical
food’’ to ‘‘WIC-eligible nutritionals.’’
Other than the name change, the
definition for this food category put
forth in the interim rule remains
unchanged in this final rule.

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B. General Provisions That Affect All
WIC Food Packages
1. Nutrition Tailoring
Prior to the interim rule, FNS policy
allowed both categorical and individual
nutrition tailoring of WIC food
packages. Categorical nutrition tailoring
is the process of modifying the WIC
food packages for participant groups or
subgroups with similar supplemental
nutrition needs, based on scientific
nutrition rationale, public health
concerns, cultural eating patterns, and
State established policies. The interim
rule prohibits categorical nutrition
tailoring, but continues to allow
individual nutrition tailoring based on
the Competent Professional Authority’s
(CPA) assessment of a participant’s
supplemental nutrition needs.
A total of 33 commenters (of these, 8
were form letters) opposed the provision
that prohibits categorical tailoring,
stating that State agencies need the
flexibility to propose modifications to
food packages that respond to rapid
changes in food industry, science,
dietary recommendations,
demographics, and other factors.
Commenters asked that State agencies
be able to request approval for
categorical tailoring to meet nutritional
needs and preferences.
As stated in the preamble to the
interim rule, the IOM conducted a full,
independent and rigorous scientific
review of the nutritional needs of WIC
participants prior to recommending the
quantities and types of WIC foods to
address those needs in its Report. In
addition, Section 232 of Public Law
111–296 amended Section 17(f)(11)(C)
of the Child Nutrition Act of 1966, as
amended (42 U.S.C. 1786), by requiring
the Secretary to conduct, as often as
necessary, but not less than every 10
years, a scientific review of
supplemental foods available under the
program and to amend the foods, as
needed, to reflect nutrition science,
public health concerns, and cultural
eating patterns. As such, future reviews
of the WIC food packages by FNS will
be conducted as needed and used to
determine the need for modification of
current WIC food packages. FNS
believes that this is the appropriate
process for changes to the WIC food
packages and that State agencies will
best be able to meet the nutritional
needs of each WIC participant through
nutrition assessment and individual
tailoring of the food package. Therefore,
the provision to disallow State agency
proposals to categorically tailor WIC
food packages is retained in this final
rule at 7 CFR 246.10(c).

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12275

2. Cultural Food Package Proposals
The interim rule allows State agencies
to submit to FNS a plan for substitution
of food(s) to allow for different cultural
eating patterns. The interim rule
includes criteria for submitting plans for
substitutions and the criteria FNS will
use to evaluate such plans. A total of 26
commenters (8 form letters) asked FNS
to change the criterion that ‘‘any
proposed substitute food must be
nutritionally equivalent or superior to
the food it is intended to replace’’ to be
less restrictive and easier to satisfy.
The increased variety and choice in
the supplemental foods in the interim
rule, as recommended by the IOM,
provide State agencies expanded
flexibility in prescribing culturally
appropriate packages for diverse groups.
Further, the interim rule allows State
agencies flexibility to meet
unanticipated cultural needs of
participants by submitting plans for
substitutions. The criteria are not meant
to preclude justifiable cultural
substitution proposals submitted by
WIC State agencies, but are intended to
ensure that WIC food substitutions
maintain the nutritional integrity of the
WIC foods they replace. FNS will
continue to make determinations on
proposed plans for cultural
substitutions based on existing
evaluation criteria as appropriate.
Therefore, the criteria for submitting
State agency plans for substitutions for
different cultural eating patterns and the
criteria FNS will use to evaluate such
plans are retained at 7 CFR 246.10(i).
The interim rule increased the variety
and number of substitutions available
for several WIC foods. This final rule
further increases the number of
substitutions and options available, i.e.,
yogurt, canned jack mackerel, and
whole wheat macaroni (pasta) products.
These additions are within the context
of the IOM recommendations. FNS
believes that these changes already
provide substantial flexibility for
prescribing food packages and that
further modifications of the current WIC
food packages are best determined
through future scientific reviews of the
WIC food packages. FNS will, therefore,
not accept WIC State agency plans for
substitutions of WIC foods for reasons
other than to accommodate cultural
eating patterns as provided for in 7 CFR
246.10(i).
3. Medical Documentation and
Supervision Requirements
a. Milk and Milk Alternatives
Under the interim rule, medical
documentation by a health care
professional licensed to write medical

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prescriptions is required for the
issuance of certain milk alternatives for
children and women. A total of 180
comment letters (53 of these form
letters) opposed this requirement,
primarily the documentation for
children to receive soy-based beverage.
Commenters stated that the provision is
unnecessary, costly and burdensome for
participants and physicians, creates
barriers to services, and undermines
FNS’ efforts to provide foods that meet
the cultural needs of participants. The
NWA and the American Dietetic
Association (now known as the
Academy of Nutrition and Dietetics)
stressed that WIC dietitians and
nutritionists are trained health
professionals capable of doing a
complete nutrition assessment, selecting
WIC foods, and providing appropriate
education to participants and caregivers,
in consultation with the health care
provider when warranted.
Based on the experiences cited by
WIC State and local agencies related to
medical documentation throughout
implementation of the new food
packages, FNS will no longer require a
health care professional licensed to
write medical prescriptions to provide
documentation for children to receive
soy-based beverage and tofu as milk
substitutes. Also, FNS will no longer
require documentation from a health
care professional licensed to write
medical prescriptions for women to
receive tofu in excess of the maximum
substitution allowance. Instead,
consistent with IOM recommendations
for documentation from a ‘‘WIC
recognized medical authority,’’ FNS will
allow the CPA to determine and
document the need for tofu and soybased beverage as substitutes for milk
for children, as established by State
agency policy. Such determination must
be based on individual nutritional
assessment, as required under the
interim rule and retained in this final
rule at 7 CFR 246.10(b)(2)(ii)(C), and
consultation with the participant’s
health care provider, as appropriate.
Such determination can be made for
situations that include, but are not
limited to, milk allergy, lactose
intolerance, and vegan diets. As
previously discussed, the interim rule
revised regulations governing the WIC
food packages to, among other things,
accommodate participants with cultural
food preferences. Since cultural
practices may affect nutrient intake,
FNS will allow soy for cultural practices
that prevent participants from including
in their diets cow’s milk and lactose-free
or lactose-reduced fortified dairy

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products in amounts that meet their
nutritional needs.
FNS will allow the CPA, as
established by State agency policy, to
determine the need for tofu in quantities
that exceed the maximum substitution
rates. Such determination can be made
for situations that include, but are not
limited to, milk allergy, lactose
intolerance, and vegan diets.
FNS believes that allowing the CPA to
make determinations for milk
substitutes is consistent with IOM
recommendations for documentation
from a ‘‘WIC recognized medical
authority.’’ Although FNS is no longer
requiring documentation from a health
care professional licensed to write
medical prescriptions, it is incumbent
upon WIC State agencies to ensure that
participants and caregivers receive
education that stresses the importance
of milk over milk substitutes, and that
appropriate policies and procedures are
in place for appropriate issuance of milk
substitutes. Parents and caregivers
should be made aware that children’s
diets may be nutritionally inadequate
when milk is replaced by other foods,
and provided appropriate nutrition
education. The value of milk for WIC
participants, particularly in the
development of bone mass for children,
should be emphasized. Lactose-free or
lactose-reduced fortified dairy products
should be offered before non-dairy milk
alternatives to those participants with
lactose intolerance that cannot drink
milk. Also, if milk is replaced by milk
alternatives that are not vitamin D
fortified, vitamin D intakes may be
inadequate. Thus, replacements for milk
are to be approached with caution even
if they are rich in calcium.
Therefore, Table 2 of 7 CFR
246.10(e)(10) of this final rule requires
that issuance of tofu and soy-based
beverage as substitutes for milk for
children be based on an individual
nutritional assessment by the CPA, in
consultation with the participant’s
health care provider as appropriate.
Table 2 of 7 CFR 246.10(e)(10) allows
the CPA, as established by State agency
policy, to determine the need for
women to receive tofu in excess of the
maximum substitution allowance.
b. Technical Requirements for Medical
Documentation
Under the interim rule, technical
requirements for medical
documentation were established. A total
of 51 comments opposed the provision
requiring health care providers to
prescribe the supplemental foods and
quantities appropriate for a participant’s
qualifying condition in Food Package III
(for participants with qualifying

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conditions). Commenters believe that
medical documentation, especially for
authorization of supplemental foods in
Food Package III, is burdensome to State
agencies, participants and the medical
community. Commenters stated that this
provision has little value since the foods
could otherwise be purchased by the
participants at grocery stores.
Commenters also stated that the WIC
nutritionist or registered dietitian is
capable of determining appropriate
amounts and types of supplemental
foods to issue to participants based on
a nutrition assessment of the
participant.
Due to the nature of the health
conditions of participants who are
issued supplemental foods in Food
Package III, close medical supervision is
essential for each participant’s dietary
management. FNS considers it
appropriate that the responsibility for
this close medical supervision remain
with the participant’s health care
provider. Medical documentation
requirements for specific supplemental
foods that do not usually require a
prescription were established to ensure
that the participant’s healthcare
professional has determined that the
supplemental foods are not medically
contraindicated by the participant’s
condition. Therefore, FNS retains the
technical requirements for medical
documentation for supplemental foods
in Food Package III as written in the
interim rule. However, FNS recognizes
that WIC registered dietitians and/or
qualified nutritionists play an important
role in the continuum of care of
medically fragile WIC participants.
Therefore, FNS would support State
agency policy that allows health care
providers to refer to the WIC registered
dietitian and/or qualified nutritionist for
identifying appropriate supplemental
foods (excluding WIC formula) and their
prescribed amounts, as well as the
length of time the supplemental foods
are required by the participant. This
arrangement would be supported only
in situations where the health care
provider has indicated on the medical
documentation form that the provider
acknowledges referral to the WIC
registered dietitian and/or qualified
nutritionist for such determinations.
This gives the health care provider
medical oversight while allowing the
WIC registered dietitian and/or qualified
nutritionist to determine the appropriate
issuance of WIC foods to participants
with qualifying conditions in Food
Package III.
4. Sodium Content of WIC Foods
In its Report, the IOM found that
intakes of sodium were excessive in the

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diets of WIC participants. The IOM
reported that more than 90 percent of
WIC children 2 through 4 years and of
pregnant, lactating, and nonbreastfeeding postpartum women had
usual sodium intakes above the
Tolerable Upper Intake Level (UL). More
than 60 percent of WIC children age 1
year had usual sodium intakes above the
UL. As such, the IOM recommended,
and the interim rule reflected,
reductions in the overall sodium level of
WIC food packages. The majority of WIC
foods under the interim rule may not
contain added salt (sodium).
However, options for some WIC foods,
i.e., cheese, vegetable juice, canned
vegetables, canned beans, peanut butter,
and canned fish include both regular
and lower sodium varieties. In an effort
to support participants in reducing
sodium intake, FNS provided technical
assistance to State agencies encouraging
them to offer only lower sodium
varieties of these foods when these
options exist.
FNS encourages WIC State agencies
that offer canned vegetables to allow
only lower sodium canned vegetables
and lower-sodium versions of other
WIC-eligible foods, i.e., breads, as they
become more widely available in the
marketplace. FNS encourages food
manufacturers to reduce excess sodium
in processed foods and to make a wider
variety of these foods available to help
WIC achieve its goal to safeguard the
health of children and women.
5. Organic Foods
The interim rule authorizes organic
forms of foods that meet minimum
nutrition requirements described in
Table 4 of 7 CFR 246.10(e)(12).
However, WIC State agencies are
responsible for determining the specific
brands and types of foods to authorize
on their State WIC food lists. Some State
agencies allow organic foods on their
foods lists, but this will vary by State.
The decision may be influenced by a
number of factors such as cost, product
distribution within a State, and WIC
participant acceptance.
FNS received 52 comments asking
that State agencies be required to offer
organic foods in the WIC food packages.
Many of these comments were from one
State where the WIC State agency had
recently removed organic milk from its
list of authorized WIC foods. This final
rule continues to provide State agencies
the option to offer organic forms of WICeligible foods through the regular WIC
food instrument, e.g., milk, eggs, peanut
butter, and encourages State agencies to
make available authorized foods that are
acceptable and will be consumed by
participants, including organic varieties.

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This final rule clarifies in Table 4 of 7
CFR 246.10(e)(12) that State agencies are
required to allow organic forms of fruits
and vegetables purchased with the cashvalue voucher.
C. Supplemental Foods and Food
Packages
Note: The order of some of the topics in
this section is modified from the interim rule
for the purposes of discussion.

1. Fruits and Vegetables in Food
Packages III Through VII
a. Dollar Amount of Cash-Value
Voucher
In order to maintain cost neutrality,
the interim rule published December
2007 (72 FR 68966) only provided fully
breastfeeding women with the IOM
recommended amount of $10.00 per
month fruit and vegetable cash-value
vouchers; all other women participants
were provided $8.00 per month, and
children were provided $6.00. An
amendment to the interim rule was
published in the Federal Register on
December 31, 2009 (74 FR 69243) to
provide all WIC women participants
with $10.00 per month fruit and
vegetable cash-value vouchers,
consistent with IOM’s
recommendations.
A total of 448 commenters (76 form
letters) asked FNS to increase the fruit
and vegetable cash-value voucher to the
IOM recommended level from $6 to $8
for children. The Department has
responded to commenters’ requests
under this final rule by increasing the
cash-value voucher for children to $8
per month. This increase will allow
State agencies to further efforts to
increase fruit and vegetable
consumption by children.
A total of 162 commenters (36 form
letters) asked FNS to further increase
the fruit and vegetable voucher for fully
breastfeeding women from $10 to $12 to
provide incentive for women to choose
to fully breastfeed, and to meet the
intent of the IOM to provide an
enhancement to the food packages for
fully breastfeeding women. While FNS
understands the benefit of increasing
the value of the food package for fully
breastfeeding women, it is not possible
under this rulemaking to go beyond the
dollar value for the cash-value voucher
for the fully breastfeeding package due
to cost. Therefore, the cash-value
voucher remains at $10 for all women,
including fully breastfeeding women, in
this final rule. The base year for
calculation of the value of the fruit and
vegetable voucher and the base value to
be used are updated in 7 CFR
246.16(j)(2).

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b. Clarification of Authorized Fruits and
Vegetables
To improve the consumption of fresh
fruits and vegetables and to appeal to
participants of different cultural
backgrounds, the interim rule
authorized a wide variety of choices
within the authorized fruit and
vegetable options. The interim rule
reflects the IOM recommendation to
provide a cash-value fruit and vegetable
benefit to participants with few
restrictions. The following is a
discussion of clarifications and
revisions to the interim rule pertaining
to authorized fruits and vegetables.
Technical corrections in this final rule
clarify that both fresh fruits and fresh
vegetables must be authorized by State
agencies. This final rule further clarifies
that 21 CFR 101.95 defines the term
‘‘fresh’’ when referring to eligible fresh
fruits and vegetables.
Technical corrections in this final rule
clarify that the cash-value voucher may
be redeemed for any eligible fruit and
vegetable (refer to Table 4 of 7 CFR
246.10(e)(12) and its footnotes). Except
as authorized by this final rule, State
agencies may not selectively choose
which fruits and vegetables are available
to participants. For example, if a State
agency chooses to offer dried fruits, it
must authorize all WIC-eligible dried
fruits, i.e., those without added sugars,
fats, oils, or sodium, and may not allow
only a single variety of dried fruits. This
final rule clarifies that State agencies
may, however, invoke their
administrative option at 7 CFR
246.10(b)(1)(i) to establish criteria in
addition to the minimum Federal
requirements in Table 4 of 7 CFR
246.10(e)(12), which could include
restricting packaging (such as plastic
containers) and package sizes (such as
single serving) of processed fruits and
vegetables available for purchase with
the cash-value voucher. In addition,
State agencies may identify specific
types of certain processed WIC-eligible
fruits and vegetables (e.g., salsas, tomato
sauces, stewed and diced tomatoes) on
their food lists if they believe there is
cause for significant vendor and
participant confusion in identifying
specific items within those categories
that are WIC-eligible.
A technical correction has been made
in Table 4 of 7 CFR 246.10(e)(12) to
clarify that the following products are
not allowed: Dried white potatoes,
mixed vegetables containing white
potatoes, noodles, nuts or sauce packets,
and decorative flowers and blossoms.
Canned tomato sauce and tomato paste
without added sugar, fats, oils are
authorized. Salsa and spaghetti sauce

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without added sugar, fats, and oils are
also authorized.
This final rule clarifies that the fruit
or vegetable must be listed as the first
ingredient in WIC-eligible processed
fruits and vegetables. In addition, it
clarifies that frozen fruits may not
contain added fats, oils, salt (i.e.,
sodium) or added sugars.
For the reasons described in section
IV.B.4 of this preamble, Table 4 of 7
CFR 246.10(e)(12) will be revised to
allow State agencies the option to offer
only lower sodium canned vegetables
for purchase with the cash-value
voucher.

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c. White Potatoes
The interim rule excludes the
purchase of white potatoes with the
cash-value voucher. A total of 266 (of
these, 213 were form letters) opposed
the restriction of white potatoes.
Commenters stated that white potatoes
should be included in the WIC food
packages because they are versatile,
economical, contain key nutrients, and
are preferred by participants. Thirty-two
commenters (20 form letters) stated that
the exclusion of white potatoes is
difficult to administer.
The restriction of white potatoes, as
recommended by the IOM, is based on
data indicating that consumption of
starchy vegetables meets or exceeds
recommended amounts, and food intake
data showing that white potatoes are the
most widely used vegetable. Including
white potatoes in the WIC food packages
would not contribute towards meeting
the nutritional needs of the WIC
population and would not support the
goal of expanding the types and
varieties of fruits and vegetables
available to program participants, as
recommended by the IOM. Therefore,
the provision to exclude white potatoes
from the WIC food packages is retained
in this final rule. The Department
recognizes that white potatoes can be a
healthful part of one’s diet. However,
WIC food packages are carefully
designed to address the supplemental
nutritional needs of a specific
population. Although white potatoes are
not offered in the WIC food package,
nutrition education provided to WIC
participants will continue to include
white potatoes as a healthy source of
nutrients and an important part of a
healthful diet.
d. Dried Fruit and Dried Vegetables for
Children
As recommended by the IOM, the
interim rule disallows dried fruits and
vegetables to be purchased with the
cash-value voucher for children because
of the risk of choking. FNS received a

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small number of comments asking that
dried fruits be allowed for children,
citing a lack of evidence that they pose
choking hazards for all children.
Recommendations made by IOM for the
Child and Adult Care Food Program
allow dried fruits for children as long as
they do not pose a choking hazard.2
Therefore, at the State agency’s option,
this final rule authorizes dried fruits
and dried vegetables to be purchased
with the cash-value voucher for
children. Nutrition education regarding
choking hazards, developmental
readiness, proper food preparation, and
oral health care should be provided to
caregivers of young children.
e. Standards of Identity for Canned
Fruits and Canned Vegetables
Two technical corrections have been
in made in Table 4 of 7 CFR
246.10(e)(12) related to the standards of
identity for canned fruits and canned
vegetables. This final rule corrects the
specifications for WIC-eligible canned
fruits to reflect that only those WICeligible canned fruits that have a
standard of identity, as listed at 21 CFR
Part 145, must conform to the FDA
standard of identity. Similarly, this final
rule corrects the specifications for WICeligible canned vegetables to reflect that
only those WIC-eligible canned
vegetables that have a standard of
identity, as listed at 21 CFR Part 155,
must conform to the FDA standard of
identity. The provision that WIC-eligible
canned vegetables contain no added
sugars, fats, and oils remains
unchanged. This final rule clarifies that
home-canned and home-preserved fruits
and vegetables are not authorized.
f. Implementation of Fruit and Vegetable
Options
(1) Paying the difference with the
cash-value voucher. The interim rule
authorized State agencies the option to
allow participants to pay the difference
if the fruit and vegetable purchase
exceeds the value of the cash-value
voucher, a transaction known as ‘‘split
tender.’’ A total of 116 commenters (59
form letters) asked FNS to require all
State agencies to allow split tender
transactions to ensure that participants
are able to maximize use of their cashvalue voucher. Because it may be
difficult for participants to accurately
estimate the exact purchase price of the
fruit and vegetable selections,
particularly when fresh, canned, dried,
2 Institute of Medicine, National Academy of
Sciences. ‘‘Child and Adult Care Food Program:
Aligning Dietary Guidance for All,’’ 2010. Available
at Internet site: http://www.fns.usda.gov/child-andadult-care-food-program-aligning-dietary-guidanceall.

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or frozen items are combined in one
purchase or when items are purchased
in bulk, FNS agrees that all participants
should be allowed to pay the difference
when the purchase of allowable fruits
and vegetables exceeds the value of the
fruit/vegetable cash-value voucher.
Therefore, this final rule adds a
provision at 7 CFR 246.12(f)(4) to
require State agencies to allow split
tender transactions with the cash-value
voucher.
(2) Minimum vendor stocking
requirements. A technical oversight in
the interim rule has been corrected at 7
CFR 246.12(g)(3)(i) by clarifying that
authorized vendors must stock at least
two different fruits and two different
vegetables.
(3) Authorizing farmers’ markets. The
interim rule gave State agencies the
option to allow farmers at farmers’
markets to accept cash-value vouchers.
FNS received 29 comments (mostly
form letters) recommending that
farmers’ market organizations, rather
than the individual farmer, be
authorized to accept cash-value
vouchers, as is permitted under the WIC
Farmers’ Market Nutrition Program
(FMNP). Sixty-nine commenters (mostly
form letters) additionally recommended
that the WIC Program regulations be
more closely aligned with the FMNP.
Commenters stated that consistency
between the two programs would make
FMNP participation easier both for WIC
participants and authorized farmers.
Many of the comments suggested that
State agencies be allowed to authorize
farmers’ markets in addition to the
current provision (7 CFR 246.12(v)) that
allows State agencies the flexibility to
authorize farmers at farmers’ markets or
roadside stands. FNS finds merit in
such a provision; this also would
provide more consistency between WIC
and FMNP.
Seventy-eight comments went on to
suggest that the authorization of
farmers’ markets should be a Federal
requirement, rather than a State agency
option. FNS believes that State agencies
are in the best position to determine
what works for their individual benefit
delivery systems, taking into
consideration such factors as participant
access, the availability of farmers, and
the administrative burdens of
monitoring and authorization.
Therefore, the final rule amends 7 CFR
246.12 to allow WIC State agencies to
authorize farmers or farmers’ markets to
accept WIC cash-value vouchers, but
such authorization will remain as a
State agency option. As a result of the
addition of farmers’ markets,
conforming amendments have been

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made in 7 CFR 246.2, 246.4, 246.18, and
246.23.
A number of comments were received
recommending that the Federal WIC
regulations be modified to be consistent
with the fruits and vegetables eligible
for purchase under the FMNP. FNS
makes every effort to ensure that both
programs are aligned in most areas, to
the extent possible. However, each
program has different statutory
objectives. Thus, FNS is convinced that
it is critical for each program to
maintain its separate identity. As stated
previously, FNS found merit in allowing
farmers’ markets to redeem WIC cashvalue vouchers, an example of aligning
both programs. FNS finds no need to
make any further operational changes in
this area through this final rule. A
technical amendment is added to 7 CFR
246.4(a)(14) to correct a cross-reference
to 7 CFR 246.12 that addresses the State
agency options regarding vendor
sanctions.
2. Mature Legumes (Dry Beans, Peas and
Lentils) and Peanut Butter
a. Clarification of Allowable Mature
Legumes
Technical corrections have been made
to the list of authorized mature legumes
in Table 4 of 7 CFR 246.10(e)(12).
Refried beans, without added sugars,
fats, oils, vegetables or meat, have been
added to the examples of allowable
legumes in Table 4 of 7 CFR
246.10(e)(12). The specification in Table
4 also clarifies that mature legumes
issued via the WIC food instrument may
not contain added vegetables or fruits.

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b. Issuance of Mature Legumes (Dry
Beans and Peas)
The interim rule includes mature dry
beans, peas, or lentils in dry-packaged
or canned forms as a WIC food category.
Items in this food category are issued
via the regular WIC food instrument.
FNS provided technical assistance to
State agencies on the interim rule
clarifying that beans and peas that do
not qualify under this category may be
purchased only with the cash-value
voucher. A total of 23 commenters (8 of
which were form letters) asked FNS to
allow all mature varieties and forms of
dry beans and peas to be purchased
with both the cash-value voucher and
the WIC food instrument to eliminate
confusion on the part of participants
and vendors.
The nutritional profile of mature dry
legumes is different than that for
immature varieties and FNS believes it
is important to maintain this
distinction. Mature legumes are
excellent sources of plant protein, and

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also provide other nutrients such as iron
and zinc. Mature dry beans and peas are
similar to meats, poultry, and fish in
their contribution of these nutrients. In
WIC, they are offered as a separate food
category from the fruit and vegetable
category. Therefore, mature legumes in
dry-packaged and canned forms,
without added vegetables, fruits, meat,
sugars, fats, or oils, are the only dry
beans and peas authorized to be issued
via the WIC food instrument.
c. Disallowed Ingredients in Peanut
Butter
A technical oversight has been
corrected in Table 4 of 7 CFR
246.10(e)(12) to disallow peanut butter
with added marshmallows, honey, jelly,
chocolate/or similar ingredients.
3. Fruit and Vegetable Juice
Technical corrections have been made
in Table 4 of 7 CFR 246.10(e)(12) related
to the standard of identities for canned
fruit and vegetable juices. This final rule
corrects the specifications for WICeligible canned fruit juice and vegetable
juice to reflect that only those WICeligible juices that have a standard of
identity, as listed at 21 CFR Part 146
and 21 CFR Part 156, must conform to
these FDA standards of identity.
4. Milk and Milk Alternatives
a. Whole milk for participants greater
than 2 years of age. Under the interim
rule, and as recommended by the IOM,
whole milk is not authorized for
children greater than 2 years of age and
women in Food Packages IV–VII. Under
the interim rule, whole milk may be
issued to medically fragile children
older than 2 years of age and women
only in Food Package III for participants
with qualifying conditions. A total of
216 commenters, primarily local agency
WIC staff, asked FNS to allow the CPA
to prescribe whole milk for participants
in any food package if necessary for
participants who have medical or
nutritional reasons for requiring
additional calories.
FNS believes that WIC staff can assist
participants in Food Packages IV–VII in
meeting their nutritional needs through
fat-reduced milks and other foods.
Whole milk adds unnecessary saturated
fat and cholesterol to the diets of
participants. Nutrition education and
individual tailoring of the food package
within authorized parameters remain
the most effective tools for WIC staff to
use to help participants make
appropriate choices based on their
specific needs. Therefore, the provision
to authorize whole milk for children
greater than 2 years of age and women
only in Food Package III is retained in

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this final rule in Table 3 of 7 CFR
246.10(e)(11).
b. Fat-Reduced Milks for Children 12
Months to 2 Years of Age in Food
Package III and IV
Under the interim rule, children 12
months to 2 years of age may only be
issued whole milk. A total of 332
commenters (34 form letters) want
flexibility in this provision, citing
American Academy of Pediatrics (AAP)
policy,3 recommending fat-reduced
milks for children over the age of 1 for
whom overweight or obesity is a
concern.
In light of current AAP policy, FNS
will allow, at State agency option, fatreduced milks to be issued to 1-year-old
children (12 months to 2 years of age)
for whom overweight or obesity is a
concern. Under Food Package IV, FNS
will allow the CPA to make a
determination for the need for fatreduced milks for young children based
on an individual nutritional assessment
and consultation with the child’s health
care provider if necessary, as
established by State agency policy. FNS
will provide technical assistance for
issuing fat-reduced milks to children 12
months to 2 years of age in Food
Package IV. Due to the medically fragile
qualifying conditions of children 12
months to 2 years of age, FNS will
continue to require medical
documentation for issuance of WICeligible formula and foods, including
fat-reduced milks, under Food Package
III.
c. Fat Content of Milk for Children Over
2 Years of Age and Women
Under the interim rule, children ≥ 24
months of age and women may be
issued a variety of milk types (i.e.,
nonfat, lowfat (1%) and reduced fat
(2%) milk). Seven commenters
recommended the issuance of only
nonfat or lowfat (1%) milk to children
≥ 24 months of age and women to be
consistent with the Dietary Guidelines
for Americans. FNS notes that State
agencies already have policies to ensure
that CPAs issue the appropriate milk to
participants based on the assessed
nutritional needs of individual
participants. Since 1995 the Dietary
Guidelines for Americans have
recommended consumption of nonfat
and lowfat milk and milk products. In
technical assistance provided to State
agencies on the interim rule, FNS
supported and encouraged State
agencies to issue only nonfat and lowfat
3 American Academy of Pediatrics. Policy
Statement Lipid Screening and Cardiovascular
Health in Childhood, Pediatrics Vol. 122 No. 1 July
2008, pp. 198–208.

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milk to children and women unless
otherwise indicated by nutrition
assessment. As such, FNS finds merit in
adding a provision that nonfat and
lowfat (1%) milks are the standard
issuance for children ≥ 24 months of age
and women in Food Packages IV–VII.
Reduced fat (2%) milk is authorized
only for participants with certain
conditions, including but not limited to,
underweight and maternal weight loss
during pregnancy. The need for reduced
fat (2%) milk for children ≥ 24 months
of age (Food Package IV) and women
(Food Packages V, VI, VII) will be
determined as part of the careful
nutrition assessment completed by the
CPA, as established by State agency
policy.

authorized milk substitutes to fulfill the
maximum allowance. Because milk in
quart sizes has become more widely
available as States have implemented
the interim rule, and this final rule
allows the option of providing a quart
of yogurt for children and women (as
described in a subsequent section of this
preamble), and allows issuance of a 12
ounce can of evaporated milk to
substitute for the ‘‘dangling quart,’’ State
agency concerns about difficulty
providing the full milk benefit to
participants who substitute cheese for
milk should be alleviated. State agencies
also have the option to prescribe half
gallon containers of milk every other
month for participants in lieu of the
‘‘dangling quart.’’

d. Fortification of Whole Milk
This final rule clarifies the minimum
nutrient requirements for all milks
listed in Table 4 of 7 CFR 246.10(e)(12).
The table restates the milk
specifications to make it clearer that
vitamin A fortification is not required
for whole milk.

f. Cheese in Excess of Maximum
Substitution Rates
Under the interim rule, cheese may be
substituted for milk. The IOM set a
substitution rate for cheese for milk, but
put a cap on the amount that can be
substituted to control total and saturated
fat content of the food packages. Under
the interim rule, FNS allowed, with
medical documentation, additional
amounts of cheese to be issued beyond
the substitution rate to provide State
agencies with flexibility to
accommodate participants with lactose
intolerance. This accommodation was
made because, at the time, milk
alternatives for participants with lactose
intolerance were more limited. Few soybased beverages that met FNS’
nutritional standards were available,
and the interim rule did not authorize
yogurt, which had been recommended
by IOM as a milk substitute. Since that
time, more soy-based beverages that
meet the nutritional standards
established by FNS are available in the
marketplace, and this final rule
authorizes yogurt for children and
women. As a result, State agencies have
increased flexibility, in addition to
offering lower lactose milks, to
accommodate lactose intolerance with
substitutes other than cheese, as
recommended by the IOM. Therefore,
this final rule will no longer allow
cheese to be issued beyond established
substitution rates, even with medical
documentation, which is consistent
with the recommendation of the IOM.

e. Provision of Maximum Monthly
Allowance of Milk
Under the interim rule, the maximum
monthly allowance of milk must be
provided to participants, as the WIC
benefit to participants is the full
authorized amount. The interim rule
allows a substitution rate of 1 pound of
cheese for 3 quarts of milk, leaving a
quart of milk or milk substitute that
must be provided to participants issued
this option to fulfill the maximum
allowance in the food package.
A total of 17 commenters (6 of these
form letters) asked FNS to drop the
‘‘dangling quart’’ or allow State agencies
to round the quantity of milk up when
substituting cheese for milk because of
limited availability and higher costs of
milk in quart size containers. A total of
20 commenters (6 of these form letters)
asked FNS to allow State agencies to
issue 12 ounce cans of evaporated milk,
which are the largest size available in
the marketplace and which reconstitute
to 24 fluid ounces, as the ‘‘dangling
quart.’’
The IOM cited milk as an important
source of calcium and vitamin D for
WIC participants, and this food category
should not be shortchanged. Therefore,
the ‘‘dangling quart’’ may not be
ignored. This final rule will continue to
require that State agencies provide the
maximum allowance of milk to
participants if cheese is substituted for
milk in order for participants to obtain
their full milk benefit.
State agencies continue to have the
option to make available other

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g. Yogurt
The IOM recommended adding yogurt
to the WIC food packages as a partial
milk substitute for children and women.
However, under the interim rule, FNS
determined that the addition of yogurt
to the WIC food packages was cost
prohibitive. The interim rule solicited
comments from State agencies about the

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extent to which WIC participants would
benefit from the addition of yogurt, and
whether that addition could be achieved
in a cost-effective manner.
A total of 304 comment letters (63 of
these form letters) encouraged FNS to
allow yogurt as a milk substitute,
emphasizing that yogurt provides
priority nutrients and is convenient,
popular, and culturally acceptable to
WIC participants. Commenters also
cited a pilot study, conducted by the
California WIC Program in conjunction
with the National Dairy Council, which
demonstrated the feasibility of
providing yogurt in WIC food packages.4
The pilot study results cited participant
acceptance and ease of implementation.
FNS agrees that yogurt is a desirable
milk alternative for participants who
might not otherwise drink sufficient
amounts of fluid milk due to lactose
intolerance or other reasons. Therefore,
this final rule authorizes yogurt as a
substitute for milk for children and
women in Food Packages III–VII, at the
State agency’s option.
(1) Maximum Monthly Allowance of
Yogurt
At State agency option, 1 quart of
yogurt may be substituted for 1 quart of
milk for women and children in Food
Packages III–VII. No more than 1 quart
of yogurt is authorized per participant.
(2) Authorized Yogurts
As recommended by the IOM, yogurt
must conform to the standard of identity
for yogurt as listed in Table 4 of 7 CFR
246.10(e)(12) and may be plain or
flavored with ≤ 40 grams of total sugar
per 1 cup of yogurt. Only lowfat and
nonfat yogurts are authorized for
children over 2 years of age and women.
Whole fat yogurt is authorized only for
children less than two years of age. State
agencies have the option to determine
the container sizes of yogurt to
authorize on their food lists.
h. Tofu
Under the interim rule, calcium-set
tofu prepared only with calcium salts,
(e.g., calcium sulfate), and without
added fats, sugars, oils, or sodium, is
authorized. A technical correction has
been made in this final rule to clarify
that tofu must be calcium-set, i.e.,
contain calcium salts, but may also
contain other coagulants, i.e.,
magnesium chloride. This additional
flexibility allows State agencies to meet
the needs of WIC’s culturally diverse
participants. Tofu with only calcium
4 Fung, EB, et al. Randomized, controlled trial to
examine the impact of providing yogurt to women
enrolled in WIC. J Nutr Educ Behav. 2010 May–
Jun;42(3 Suppl):S22–9.

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sulfate may not be readily available in
the marketplace. Major tofu
manufactures with national distribution
make tofu with calcium sulfate alone or
in addition to magnesium chloride as a
coagulant. Magnesium chloride is not a
flavoring or preservative, and should
not be confused with sodium chloride,
which is not permitted. The calcium
content of various types of tofu, even
those set only with calcium salts, varies.
In choosing the brands and types of
calcium-set tofu to include on food lists,
State agencies should read the nutrition
labels and choose tofu with the highest
amount of calcium.
5. Breastfeeding Provisions
Under the interim rule, food packages
for infants and women are designed to
strengthen WIC’s breastfeeding
promotion and support efforts and
provide additional incentives to assist
mothers in making the decisions to
initiate and continue to breastfeed. The
provisions disallow routine issuance of
infant formula to partially breastfeeding
infants in the first month after birth to
help mothers establish milk production
and the breastfeeding relationship.
Overall, commenters expressed support
for the breastfeeding provisions, with 7
State agencies stating they have already
seen increases in breastfeeding rates
attributable to the interim rule
provisions. State agencies stressed that
adequate training of WIC staff and the
provision of appropriate counseling and
support to mothers is critical to the
success of the new food packages for the
breastfeeding mothers and their infants.

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a. Exclusive Breastfeeding
This final rule clarifies the intent of
the WIC Program that all women be
supported to exclusively breastfeed
their infants and to choose the fully
breastfeeding food package without
infant formula at 7 CFR 246.10(e).
Breastfeeding women who do not
exclusively breastfeed are to be
supported to continue breastfeeding to
the maximum extent possible through
minimum supplementation with infant
formula.
b. Clarification of Partially Breastfeeding
Terminology
Commenters asked FNS to address
terminology used to describe the
mother-infant pair who ‘‘partially’’
breastfeed (both breastfeed and formula
feed). Confusion exists because partially
breastfeeding is used to describe a
combination of any amounts of
breastfeeding and formula feeding.
However, under the interim rule, for the
purposes of food package issuance, the
partially breastfeeding food package is

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defined by a maximum quantity of
formula that assumes the mother is
substantially breastfeeding her infant.
Confusion also exists because WIC’s
definition of a breastfeeding woman is
the practice of feeding a mother’s breast
milk to her infant on the average of at
least once a day. This definition
determines the categorical eligibility of
a participant as a breastfeeding woman,
and did not change under the interim
rule revising the WIC food packages. All
women who meet this definition are
counted as breastfeeding women for
participation purposes, regardless of the
food package they are issued or the
amount of formula their infants receive.
Under the interim rule, three infant
feeding variations are defined for the
purposes of assigning food quantities
and types in Food Packages I and II for
infants: (1) Fully formula feeding, (2)
fully breastfeeding (the infant does not
receive formula from the WIC Program),
and (3) partially breastfeeding (the
infant is breastfed but also receives
some infant formula from WIC up to the
maximum allowance described for
partially breastfed infants in Table 1 of
7 CFR 246.10(e)(9)). Breastfeeding
assessment and the mother’s plans for
breastfeeding serve as the basis for
determining food package issuance.
Breastfed infants who are assessed to
need more formula than is allowed
under the food package for partially
breastfed infants are assigned to the
fully formula feeding package.
FNS agrees that terminology used to
describe food packages for the motherinfant pair that both breastfeed and
formula feed, regardless of amount from
either source, needs clarification.
Therefore, this final rule attempts to
minimize confusion about food package
issuance by parenthetically adding the
descriptor ‘‘mostly’’ breastfeeding to the
partially breastfeeding food package
designation established under the
interim rule.
c. Issuance of Formula to Breastfed
Infants
There has been some confusion about
the issuance of one can of powder infant
formula in the first month to breastfed
infants. For breastfeeding women who
do not receive the fully breastfeeding
package, WIC staff are expected to
individually tailor the amount of infant
formula based on the assessed needs of
the breastfeeding infant and provide the
minimal amount of formula that meets
but does not exceed the infant’s
nutritional needs. This is consistent
with long-standing FNS policy that
dates back to the 1980s. State agencies
should develop policies for handling
breastfeeding mothers’ formula requests

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that encourage substantial and
continued breastfeeding. This is true
whether the infant receives the fully
formula feeding package (although the
infant may be minimally breastfeeding)
or the partially (mostly) breastfeeding
food package. The full nutrition benefit
should not be used as the standard for
issuance unless the mother is not
breastfeeding the infant at all.
The interim rule strengthened the
WIC food packages to better enhance
breastfeeding promotion and support.
Food packages for partially (mostly)
breastfed infants and women were
created that provide additional foods for
mothers as incentives, to better meet
nutritional needs, and to provide less
infant formula to partially breastfed
infants than to infants who receive the
fully formula fed package.
The food packages for partially
(mostly) breastfed mothers and infants
are designed to provide for the
supplemental nutrition needs of the
breastfeeding pair, provide minimal
formula supplementation to help
mothers maintain milk production, and
provide incentives for continued
breastfeeding by way of a larger variety
and quantity of food than the full
formula/postpartum packages. FNS
emphasizes that the benefits of the
partially breastfed food packages are lost
if the breastfeeding mother-infant pair is
issued the full formula/postpartum
packages. Appropriate support and
counseling should be provided to
mothers to minimize the number of
breastfeeding infants receiving the full
formula packages.
This final rule clarifies at 7 CFR
246.10(b)(2)(ii)(C) that food package
quantities are to be issued based on
assessment of each participant’s
individual breastfeeding and nutritional
needs.
d. Issuance of Formula to Breastfed
Infants in the First Month After Birth
This final rule clarifies that the
issuance of any formula to breastfed
infants in the first month after birth is
a State agency option. If a State agency
chooses this option, it may issue one
can of powder infant formula in the
container size that provides closest to
104 reconstituted fluid ounces to
partially breastfed infants on a case-bycase basis. Breastfed infants who are
provided this option are considered
partially (mostly) breastfed. Breastfed
infants should not receive more than the
one can option in order to maintain the
mother’s milk production. State
agencies should not create food
packages that standardize issuance of
formula to partially (mostly) breastfed
infants in the first month after birth.

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e. Food Package VII for Fully
Breastfeeding Women
Under the interim rule, Food Package
VII is issued to three categories of WIC
participants—fully breastfeeding
women whose infants do not receive
formula from the WIC Program; women
pregnant with two or more fetuses, and
women fully or partially (mostly)
breastfeeding multiple infants. This
final rule clarifies that Food Package VII
is issued to partially (mostly)
breastfeeding mothers who are
breastfeeding multiples from the same
pregnancy.
A total of 12 commenters (4 form
letters) asked that partially breastfeeding
women who are also pregnant be
allowed to receive the more enhanced
Food Package VII. FNS agrees with
commenters that pregnant women who
are also partially (mostly) breastfeeding
singleton infants would benefit from the
increased quantity and variety of foods
in this food package. Therefore, this
final rule authorizes pregnant women
who are also partially (mostly)
breastfeeding to receive Food Package
VII.
Under the interim rule, women fully
breastfeeding multiples receive 1.5
times the maximum allowance of foods
authorized in Food Package VII to meet
their nutritional needs. A total of 36
commenters (8 form letters) asked FNS
to revise the food package quantities for
women fully breastfeeding multiples to
reflect a consistent amount each month
and to specify amounts in quantities
available in marketplace. In technical
assistance provided to State agencies on
the interim rule, FNS provided
flexibility to allow States to choose how
they will issue these quantities. Some
States have elected to issue foods in this
food package in amounts averaged over
a 2-month timeframe to eliminate
concern about providing quantities
available in the marketplace. Others
issue double the ‘‘regular’’ fully
breastfeeding package one month and
then issue the ‘‘regular’’ fully
breastfeeding package the next month.
FNS will allow State agencies to retain
the flexibility to determine how best to
issue food packages quantities for
women fully breastfeeding multiples
and therefore will not change the
provision to specify a set amount that
must be provided each month.
f. Human Milk Fortifier (HMF)
Fifteen commenters (4 form letters)
asked that partially (mostly)
breastfeeding women whose infants
receive human milk fortifier (HMF) be
considered fully breastfeeding.

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Issuance of HMF as a WIC formula is
allowed with medical documentation
under the interim rule, as it was under
previous WIC policy. A woman whose
infant receives HMF is considered
partially breastfeeding because her
infant is receiving formula from WIC.
HMF provides additional protein,
minerals, and vitamins that, when
added to breastmilk in the first
postpartum month for premature
infants, results in nutrient, mineral, and
vitamin concentrations similar to those
of the formulas developed for feeding
preterm infants. HMF is given in the
hospital, but most often is discontinued
prior to discharge. There is a limit on
how long HMF is necessary and the
need and length of time an infant
should remain on HMF should be
determined and monitored by the health
care provider.
Since HMF is to be used for only a
very short time, the woman can be
transitioned back to the fully
breastfeeding package as soon as the
infant is no longer receiving HMF from
WIC. The final rule will retain the
provision that Food Package VII is
issued only to women whose infants do
not receive formula from WIC, including
HMF.
6. Whole Wheat Bread and Whole Grain
Options
a. Authorized Breads
Under the interim rule, whole wheat
breads, rolls and buns that meet the
FDA standard of identity for whole
wheat bread (21 CFR 136.180) are
authorized. Some commenters asked
FNS to allow baked products that do not
meet the standard of identity for whole
wheat bread, e.g., English muffins and
bagels, if these products otherwise meet
the whole wheat requirements. FNS has
considered this request, but has
determined that identifying the WICeligibility of whole wheat bread
products that do not meet the standard
of identity would be complex given the
number of products in the marketplace.
Therefore, the requirement that whole
wheat breads meet the standard of
identity for whole wheat bread is
retained in this final rule in Table 4 of
7 CFR 246.10(e)(12).
b. Package Sizes of Whole Wheat/Whole
Grain Bread
The interim rule established a
maximum monthly allowance of two
pounds of whole wheat bread or other
whole grain options for children in
Food Packages III and IV; and one
pound of whole wheat bread or other
whole grain options for women in Food
Packages III, V and VII. Commenters

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asked that FNS authorize bread in the
more commonly available 20 ounce
package size.
Although the availability of bread in
package sizes to meet the WIC
maximum monthly amount of bread
authorized in WIC food packages was of
initial concern as State agencies
planned to implement the new food
packages and supply in the marketplace
may have been limited, bread
manufacturers have increasingly
produced WIC-eligible breads in 16
ounce package sizes to respond to the
changes in the WIC Program. As such,
all State agencies have breads in
appropriate size packages on their WIC
food lists. A greater number of WICeligible breads in 16 ounce package
sizes continue to be introduced by
manufacturers, which will further
increase the bread options available to
participants. Therefore, FNS believes
that this situation has been addressed
and the maximum allowance for whole
wheat and whole grain bread is
unchanged in this final rule.
c. Expansion of Whole Grain Options
Under the interim rule, whole grains
(brown rice, bulgur, oats, and whole
grain barley), as well as tortillas, are
authorized as substitutions for whole
wheat and whole grain bread. A total of
310 commenters (22 of these form
letters) asked FNS to consider
expanding the list of whole grain foods
available to participants. Suggestions
included whole grain pasta, whole
wheat English Muffins, and whole
wheat bagels.
To make available additional whole
grain foods to participants, this final
rule will add whole wheat pasta to the
list of whole wheat/whole grain bread
alternatives. Whole wheat macaroni
(pasta) products that meet the FDA
standard of identity (21 CFR 139.138)
and have no added sugars, fats, oils, or
salt (i.e., sodium) are WIC-eligible.
Other shapes and sizes that otherwise
meet the FDA standard of identity for
whole wheat macaroni (pasta) products
are also authorized (e.g. whole wheat
rotini, whole wheat penne).
d. Technical Corrections
In technical assistance provided to
State agencies on the interim rule, FNS
clarified that State agencies must offer
whole wheat and/or whole grain bread.
State agencies have the option to also
authorize the other whole grain options
listed in Table 4 of 7 CFR 246.10(e)(12).
This final rule clarifies this provision.
Also, consistent with technical
assistance provided to State agencies on
the interim rule, FNS clarifies in Table
4 of 7 CFR 246.10(e)(12) of this final

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rule that corn tortillas made from
ground masa flour (corn flour) using
traditional processing methods are WICeligible. FNS recognizes that a small
loss of corn kernel occurs during the
traditional processing of tortillas, and
therefore, such tortillas are not
considered whole grain. FNS
encourages State agencies to authorize
corn tortillas that have whole corn listed
as their primary ingredient. However, if
the market availability of such corn
tortillas is limited, FNS will allow State
agencies to authorize corn tortillas made
from ground masa flour using
traditional processing methods, due to
the high participant acceptance of corn
tortillas, especially among Hispanic
cultures. A technical clarification has
been made in Table 4 of 7 CFR
246.10(e)(12) to the minimum
requirements and specifications for
whole wheat tortillas to address the
types of flour authorized. This final rule
continues to require that whole grain
breads and cereals meet FDA labeling
requirements for making a health claim
as a ‘‘whole grain food with moderate
fat content.’’ However, for simplicity
and clarity, the final rule removes the
specifics of the labeling requirements
from Table 4 of 7 CFR 246.10(e)(12) and
instead refers readers and manufacturers
directly to the FDA health claim
notification for further reference at
http://www.fda.gov/food/
ingredientspackaginglabeling/
labelingnutrition/ucm073634.htm.
A technical clarification has been
made in Table 4 of 7 CFR 246.10(e)(12)
to the minimum requirements and
specification for whole wheat bread to
address consistency with the standard
of identity for whole wheat bread. For
additional clarity and to aid State
agencies and participants in identifying
WIC-eligible whole grain bread
products, a statement has been added to
the requirements noting whole grain
breads must conform to the FDA
standard of identity for bread, buns and
rolls.
7. Breakfast Cereals
Under the interim rule, at least one
half of all breakfast cereals on each State
agency’s authorized food list must meet
the whole grain requirements as
specified in Table 4 at 7 CFR
246.10(e)(12). This provision allows
certain corn and rice-based cereals to be
offered to participants who may have
allergies to whole grain cereals. FNS is
retaining this provision in this final
rule, but encourages State agencies to
issue whole grain cereals to participants
to the maximum extent possible,
reserving non-whole grain options for
those participants with allergies or other

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medical reasons where whole grains are
contraindicated. Participants should
receive nutrition education on the
benefits of whole grain in the diets to
reduce the risk of coronary heart disease
and type-2 diabetes, help with body
weight maintenance, and increase
intake of dietary fiber.
A technical correction has been made
in this final rule in Table 4 of 7 CFR
246.10(e)(12) to clarify that there is no
FDA standard of identity listed for
breakfast cereals.
8. Infant Foods in Food Packages II and
III
a. Fresh Bananas as Substitute for Jarred
Infant Foods
Under the interim rule, State agencies
have the option to offer fresh bananas as
a substitute for up to 16 ounces of infant
food fruit at a rate of one pound of
bananas per eight ounces of infant food
fruit via the regular WIC food
instrument. To ensure participants
receive the full food package benefit of
this provision, and to simplify the
transaction for vendors as well as
participants, FNS will also allow State
agencies the option to substitute fresh
bananas at a rate of one banana per four
ounces of jarred infant food fruit, up to
a maximum of 16 ounces, in Food
Packages II and III for infants 6 to 12
months of age. This is consistent with
recommendations of the IOM.
b. Cash-Value Voucher in Lieu of
Commercial Jarred Infant Foods
Under the interim rule, jarred infant
foods (fruits, vegetables, and meat) are
provided in Food Packages II and III for
infants 6 months through 11 months of
age. Although this provision overall has
been well received, concerns initially
made by commenters on the proposed
rule persist regarding this provision. A
total of 508 commenters on the interim
rule asked FNS to include a State option
to provide a cash-value voucher to older
infants receiving Food Packages II and
III in lieu of commercial jarred infant
food fruits and vegetables. Commenters
stated that foods for older infants should
be developmentally appropriate as
infants transition to toddler foods, and
noted the lack of availability of jarred
infant foods in appropriate textures for
the older infant. Commenters also stated
that the amount of jarred infant foods in
the WIC food packages is excessive for
some older infants who are progressing
in their feeding skills and transitioning
from infant foods to table foods
consumed during family meals.
FNS remains committed to IOM’s
recommendation that commercial jarred
infant foods be provided in the WIC

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food packages to ensure that infants
receive and consume fruits and
vegetables in developmentally
appropriate textures and in a variety of
flavors. The IOM also intended that
commercial jarred infant foods be
provided to ensure that these items are
consumed by infants and not other
participants or family members. Food
safety and nutrient content were also
considerations. FNS recognizes these
considerations and continues to provide
commercial jarred infant foods in this
final rule.
FNS acknowledges the preference for
alternative options for infants and
agrees that the lack of developmentally
appropriate infant foods available in the
marketplace may make it difficult for
State agencies to provide a range of
textures appropriate for infants at
different stages of development. This
void in the market is particularly noted
among infant food products for older
infants, and may compromise the
appropriate progression of an infant’s
feeding skills. The FNS Infant Nutrition
and Feeding Guide 5 indicates that at
around nine months of age, most infants
are developmentally ready to consume
foods of increased texture and
consistency. Such consistency should
progress from pureed to ground to forkmashed and eventually to diced.
Therefore, in light of these
considerations, under this final rule,
FNS will allow infants 9 months
through 11 months of age to receive a
cash-value voucher for the purchase of
fresh fruits and vegetables in lieu of a
portion of the infant food fruits and
vegetables provided in Food Packages II
and III. For partially breastfed infants
and fully formula fed infants,
participants may opt to receive a $4
cash-value voucher plus 64 ounces of
infant food fruits and vegetables; fully
breastfed infants may receive an $8
cash-value voucher plus 128 ounces of
infant food fruit and vegetables. The
decision to issue cash-value vouchers in
lieu of infant food fruits and vegetables
is a State agency option. If a State
agency chooses this option, it may not
categorically issue cash-value vouchers
to all infants of this age group. Instead,
the cash-value voucher is to be provided
to the participant only after a thorough
assessment by the CPA, as established
by State agency policy, and is optional
for the participant, i.e., the mother may
choose to receive either the maximum
allowance of jarred foods or the
combination of jarred foods and a fruit
5 Food and Nutrition Service 2009. Infant
Nutrition and Feeding: A Guide for Use in the WIC
and CSF Programs. Available at Internet site:
http://www.nal.usda.gov/wicworks/Topics/FG/
CompleteIFG.pdf.

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and vegetable cash-value voucher for
her infant. State agencies must ensure
that appropriate nutrition education is
provided to the caregiver addressing
safe food preparation, storage
techniques, and feeding practices to
make certain participants are meeting
their nutritional needs in a safe and
effective manner.
States continue to have the option to
offer, via the regular WIC food
instrument, fresh bananas as a substitute
for infant food fruit in Food Packages II
and III for infants six to twelve months
of age as described in section IV.C.8.a of
this preamble.
This final rule clarifies that a fruit or
vegetable must be listed as the primary
(first) ingredient in WIC-eligible jarred
infant foods. Further, this final rule
clarifies that combinations of single
ingredients of fruits and/or vegetables
(e.g., peas and carrots, apples and
squash) are allowed in Food Package II
and III for infants 6 to 12 months of age.
c. White Potatoes in Jarred Infant Foods
White potatoes are excluded from
purchase with the cash-value voucher in
the WIC food packages. However, this
final rule clarifies that jarred infant
foods that meet the minimum
requirements and specifications for an
infant food product and include white
potatoes as an ingredient, but not the
primary ingredient, are allowed in Food
Packages II and III for infants 6 to 12
months of age.

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d. Infant Cereal
Under the interim rule, infant cereal
is provided in Food Packages II and III
for infants 6 months to 12 months of
age. A total of 223 commenters (16 form
letters) asked FNS to allow State
agencies the option to offer ‘‘adult’’
breakfast cereals, as appropriate, to
older infants to encourage
developmental feeding skills and
support the transition from infant foods
to appropriate table and finger foods.
Commenters stated that participants
report not purchasing infant cereal
because older infants prefer cereals they
can eat with their fingers.
The IOM recommended the provision
of iron-fortified infant cereal for infants
6 to 12 months of age as a quality source
of iron and zinc, nutrients needed by
infants for optimal growth and
development. Providing infant cereal for
infants 6 months through 11 months of
age is consistent with pediatric nutrition
guidelines. The FNS Infant Nutrition
and Feeding Guide 6 states that ready-to6 Food and Nutrition Service 2009. Infant
Nutrition and Feeding: A Guide for Use in the WIC
and CSF Programs. Available at Internet site:

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eat, iron-fortified cereals designed for
adults or older children are not
recommended for infants because they:
(1) often contain mixed grains; (2) tend
to contain more sodium and sugar than
infant cereals; and (3) typically contain
less iron per infant-sized serving. Food
safety is also of concern with the
provision of adult cereals to infants as
these products could cause choking if
the infant is not developmentally ready
to consume foods of this texture. For
these reasons, the provision of ironfortified infant cereal for infants 6
months of age through 12 months of age
in Food Packages II and III remains
unchanged in this final rule.
9. Canned Fish
The IOM recommended that a variety
of canned fish that do not pose a
mercury hazard be offered in Food
Package VII. In addition to canned light
tuna, canned salmon, and canned
sardines, the interim rule authorized
canned mackerel in Food Package VII
for fully breastfeeding women.
However, the two species of mackerel
specified in the interim rule—N.
Atlantic and Chub (Pacific)—are not
readily available in canned form in the
United States. FNS received 21
comments asking that canned Jack
mackerel also be authorized in Food
Package VII, citing its lower levels of
mercury and acceptance by WIC
participants.
To allow more variety and choice
among canned fish options, this final
rule authorizes Jack mackerel as a
canned fish option in Food Package VII.
King mackerel is not authorized in any
form. FNS encourages State agencies to
offer all authorized canned fish options,
i.e., tuna, salmon, sardines, and Jack
mackerel, to ensure variety and choice
for participants. This final rule also
clarifies that canned fish with added
sauces and flavorings, e.g., tomato
sauce, mustard, lemon, are authorized at
the State agency’s option.
10. Food Package III for Children and
Women With Qualifying Conditions
a. Infant Foods In Lieu of the CashValue Voucher
Under the interim rule, children and
women with qualifying conditions who
require the use of a WIC formula (i.e.,
infant formula, exempt infant formula or
WIC-eligible nutritional (formerly WICeligible medical food)) receive Food
Package III. Among the supplemental
foods provided to participants in this
food package is a cash-value voucher to
purchase fruits and vegetables. A total
http://www.nal.usda.gov/wicworks/Topics/FG/
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of 33 commenters requested the
substitution of commercial jarred infant
food fruit and vegetables in lieu of the
cash-value voucher for participants over
the age of one who have a qualifying
medical condition, such as prematurity,
developmental delays, and dysphasia
(swallowing disorders). Commenters
pointed out that these individuals
would benefit from the use of this
ready-to-feed form of pureed fruits and
vegetables over the purchase of fresh
fruits and vegetables.
Food Package III is reserved for
medically fragile participants who have
specific dietary needs that are dictated
by their medical condition. FNS is
committed to providing these
individuals with WIC Formula (i.e.,
infant formula, exempt infant formula
and WIC-eligible nutritionals) and
supplemental foods that best meet their
special dietary needs. Thus, FNS finds
merit in the argument that some
participants with certain qualifying
conditions may require a pureed form of
fruits and vegetables to meet their
nutritional needs, and would benefit
from the convenience of purchasing
jarred infant food fruits and vegetables.
As such, this final rule allows State
agencies the flexibility to provide
children and women in Food Package III
the option of receiving commercial
jarred infant food fruits and vegetables
in lieu of the cash-value voucher. The
quantity of commercial jarred infant
food fruits and vegetables is based on
the substitution ratio of 128 ounces of
infant food fruits and vegetables for the
$8 cash-value voucher for children and
160 ounces of infant food fruits and
vegetables for the $10 cash-value
voucher for women. The need for
commercial jarred infant food fruits and
vegetables in lieu of the cash-value
voucher will be determined by medical
documentation that meets the criteria
established in 7 CFR 246.10(d). Some
participants may prefer to purchase
fruits and vegetables via the cash-value
voucher and process/puree the fruits
and vegetables themselves; this remains
an option and is encouraged for those
who would benefit from this method of
modifying the consistency and texture
of foods to improve nutritional intake.
Some commenters asked FNS to allow
children in Food Package IV the option
to receive commercial jarred infant
foods in lieu of the cash-value voucher.
However, FNS believes it appropriate
that caregivers of children who do not
have qualifying conditions making them
eligible for Food Package III, and who
need modifications in food consistency,
receive nutrition education on choosing
and preparing foods that meet the
child’s needs, e.g., pureeing fruits and

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vegetables and/or choosing those with
soft texture/consistency.
b. Allowance of Infant Formula in Food
Package III for Infants
Food package III is reserved for
participants who have one or more
qualifying conditions that require an
exempt infant formula or WIC-eligible
nutritional (formerly WIC-eligible
medical food) to supplement their
nutrition needs, as determined by the
participant’s health care professional.
Infants who have a qualifying condition
and are successfully managed with an
infant formula are issued Food Package
I or II, as deemed appropriate for their
age and feeding method.
Under the interim rule, infants who
require a combination of infant formula
and a WIC-eligible nutritional or exempt
infant formula are not able to receive
both products through a WIC food
package. In addition, these infants at 6
months of age may not be
developmentally ready to consume solid
foods due to their medical condition
and would benefit from an increased
amount of formula in place of infant
foods at that timeframe. FNS received
74 comments requesting that infants
who are not developmentally ready to
consume solid foods be allowed
increased infant formula amounts in
lieu of infant foods in Food Package II.
FNS agrees that there are a small
percentage of infants who have a
qualifying condition, such as
prematurity, whose nutritional needs
may be successfully managed with
infant formula alone or a combination of
infant formula and WIC-eligible
nutritionals. These infants are
considered medically fragile and would
benefit from the close medical
supervision provided under Food
Package III. These infants may not be
ready to consume infant foods at 6
months of age, as would otherwise
generally healthy term infants, and they
may benefit from receiving additional
formula in lieu of infant foods at that
time. Therefore, this final rule expands
the type of formula authorized to infants
with qualifying conditions in Food
Package III to include infant formula.
The issuance of infant formula in Food
Package III would be strictly reserved
for those infants who are medically
fragile. Infants who do not have a
qualifying condition and are otherwise
generally healthy infants will continue
to receive Food Packages I and II, as
appropriate. In Food Package III, infants
greater than 6 months of age may
receive additional infant formula,
exempt infant formula or WIC-eligible
nutritionals (formerly WIC-eligible
medical food) in lieu of infant foods at

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the same maximum monthly allowance
as infants ages 4 through 5 months of
age of the same feeding option. As with
exempt infant formula and WIC-eligible
nutritionals, infants receiving infant
formula in Food Package III will need
medical documentation that meets the
criteria established in 7 CFR 246.10(d).
11. Liquid Concentrate Infant Formula
Amounts and Full Nutrition Benefit
Table 1 in 7 CFR 246.10(e)(9) of the
interim rule established the full
nutrition benefit and the maximum
monthly allowances of each physical
form of infant formula, for each food
package category and infant feeding
variation. The interim rule also
described the full nutrition benefit as
the reconstituted fluid ounce amounts
for liquid concentrate infant formula
(based on a 13 ounce can) which formed
the basis of substitution rates for other
physical forms of infant formula (i.e.,
powder and ready-to-feed infant
formula). Providing the full nutrition
benefit amounts ensure that participants
receive a comparable nutritional benefit
no matter which physical form of infant
formula they receive.
For decades, infant formula
manufacturers consistently provided
liquid concentrate and ready-to-feed
infant formula in container sizes or
packaging that evenly divide into the
maximum monthly allowance, while
powder infant formulas traditionally
vary in package size across
manufacturers. FNS has become aware
of a shift in the marketplace, such that
liquid concentrate and ready-to-feed
infant formula container sizes (i.e., 13
and 32-fluid ounces) are no longer
standard for all major infant formula
manufacturers. Because the maximum
monthly allowance amounts of liquid
infant formula under the interim rule
are evenly divisible by a 13 ounce
standard for liquid concentrate
(reconstituted) and a 32 ounce standard
of ready-to-feed infant formula, there is
little flexibility to accommodate changes
in the package size while still providing
the full nutrition benefit and not
exceeding the maximum monthly
allowance amount.
This final rule provides the technical
correction of revised maximum monthly
allowance amounts for liquid
concentrate and ready-to-feed infant
formula. The revision of maximum
monthly allowance amounts for liquid
infant formula (i.e., liquid concentrate
and ready-to-feed) is consistent with the
legislative authority granted to the
Secretary of Agriculture in Section 733
of Public Law 111–80 and reiterated in
Section 712 of Public Law 112–55, the
Consolidated and Further Continuing

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Appropriations Act, 2012 that
authorizes State Agencies to exceed the
current maximum amount of liquid
infant formula to ensure the full
nutrition benefit be provided to
participants. This will maintain
competition in the infant formula
market and address recent changes in
package size availability of liquid
concentrate and ready-to-feed infant
formula.
Liquid concentrate infant formula will
now have a separate maximum monthly
allowance amount different from the
full nutrition benefit to accommodate
market changes in packaging. This
provision does not change the full
nutrition benefit amounts as established
in the interim rule. The full nutrition
benefit will now be defined as the
minimum amount of reconstituted
liquid concentrate infant formula as
specified in Table 1 of 7 CFR
246.10(e)(9) of this rule for each food
package category and infant feeding
option (e.g., Food Package IA fully
formula fed, IA–FF).
Infant formula issuance, whether
using monthly issuance or rounding
methodology, should be based on
providing the amount of infant formula
that most closely provides the full
nutrition benefit to all infant
participants as deemed appropriate
based on breastfeeding assessment and
infant food package and feeding
method. At a minimum, State agencies
must provide the full nutrition benefit
to all non-breastfed infants. For
breastfed infants, even those receiving
the fully formula fed package, infant
formula amounts should be tailored
based on the assessed needs of the
breastfed infant and provide the
minimal amounts of formula that meets
but does not exceed the infant’s
nutritional needs. This final rule adds
the definition of full nutrition benefit at
7 CFR 246.2.
12. Infant Formula Requirements
Technical Correction
A technical correction has been made
to infant formula requirements in 7 CFR
246. 246.10(e)(1)(iii) to clarify the
qualifying conditions for the types of
supplemental foods (i.e., noncontract
brand infant formula and any contract
brand infant formula that does not meet
the requirements in Table 4 of 7 CFR
246.10(e)(12)) that may be issued in this
food package only with medical
documentation.

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Procedural Matters
Executive Order 12866 and Executive
Order 13563
Executive Orders 12866 and 13563
direct agencies to assess all costs and
benefits of available regulatory
alternatives and, if regulation is
necessary, to select regulatory
approaches that maximize net benefits
(including potential economic,
environmental, public health and safety
effects, distributive impacts, and
equity). Executive Order 13563
emphasizes the importance of
quantifying both costs and benefits, of
reducing costs, of harmonizing rules,
and of promoting flexibility.
This final rule has been designated a
‘‘significant regulatory action,’’ under
section 3(f) of Executive Order 12866.
Accordingly, the rule has been reviewed
by the Office of Management and
Budget.
Regulatory Impact Analysis Summary
As required for all rules that have
been designated as Significant by the
Office of Management and Budget, a
Regulatory Impact Analysis (RIA) was
developed for this final rule. The RIA
for this rule was published as part of
docket number FNS–2006–0037 on
www.regulations.gov. A summary of the
analysis follows:
Need for Action. This final rule
considers public comments submitted

in response to the interim rule revising
the WIC food packages published in
December 2007 (72 FR 68966). The
interim rule implemented the first
comprehensive revisions to the WIC
food packages since 1980. The interim
rule revised regulations governing the
WIC food packages to align them more
closely with updated nutrition science
and the infant feeding practice
guidelines of the American Academy of
Pediatrics, promote and support more
effectively the establishment of
successful long-term breastfeeding,
provide WIC participants with a wider
variety of food, and provide WIC State
agencies with greater flexibility in
prescribing food packages to
accommodate participants with cultural
food preferences.
This final rule addresses public
comments received on the interim rule
and makes adjustments that improve
clarity of the provisions set forth in the
interim rule.
Benefits. The revised food packages
were developed to better reflect current
nutrition science and dietary
recommendations, promote and support
more effectively the establishment of
successful long-term breastfeeding,
provide WIC participants with a wider
variety of food than do current food
packages, and provide WIC State
agencies with greater flexibility in
prescribing food packages to
accommodate participants with cultural
Estimate

food preferences. The final rule makes
additional administrative and food
package changes that will allow local
WIC agencies to better meet the
nutritional needs and dietary
preferences of program participants.
Costs. FNS estimates that the cost of
all mandatory and optional provisions
in this final rule will total $1.17 billion
over 5 years assuming State
implementation beginning May 1, 2014
(for all provisions except the split
tender and soy-based beverage for
children provisions, which have
effective dates of October 1, 2014) and
yogurt for women and children with an
effective date of April 1, 2015. If the
optional provisions are adopted by
fewer than all State agencies, then the
cost of the rule will be lower. The cost
of the mandatory provisions across all
State agencies, plus the cost of the
optional provisions by State agencies
that serve half of WIC participants, is
estimated to be $999 million over 5
years.
Accounting statement. The following
accounting statement gives the
estimated discounted, annualized costs
of the rule assuming full State agency
implementation of the rule’s mandatory
and optional provisions. The figures are
computed from the nominal 5-year
estimates developed in the full RIA. The
accounting statement contains figures
computed with 7 percent and 3 percent
discount rates.
Discount rate
(percent)

Year dollar

Period covered

Benefits
Qualitative: The final rule modifies several provisions of the interim rule based on comments from State and local agencies, interest groups, participants, and others. These modifications better fulfill the intent of the interim rule and the IOM recommendations that are the basis for the
WIC food package changes. The rule would increase the quantity of fruits and vegetables contained in the food packages for children to the
level recommended by the IOM. The rule also gives States and local agencies more flexibility to meet the medical needs and cultural preferences of WIC participants. Recent research on WIC participants indicates that changes in the WIC food package have resulted in increases
in consumption of healthful foods recommended by IOM (see RIA text). The effect of the rule, therefore is a benefit to participants and not
simply a transfer of Federal funds replacing costs that WIC participants would have incurred in the absence of this rule. Because we do not
quantify the value of the benefits in the impact analysis, and therefore cannot separate them from the estimated Federal transfer to WIC participants, we show our entire dollar impact under transfers. No longer requiring medical documentation for children to receive soy-based beverage and tofu as milk substitutes will save participants some time, although we believe the overall impact on that their time will be minimal
and the savings will be nominal. There may also be a benefit in that some WIC participants may not have been taking the soy-based beverage and tofu substitution because getting medical documentation was presenting a barrier. Providing a mechanism to access soy-based
beverage and tofu by working with a WIC Competent Professional Authority will help to remove that barrier and may result in nutrition benefits for this group of participants.

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Transfers
Annualized Monetized ................................................................................

$225.2

2014

7

($millions/year) ...........................................................................................

230.5

2014

3

FY2014–2018

Quantified: The rule contains a mix of mandatory provisions and State options. For purposes of this impact analysis we estimate the value of
both the mandatory and optional provisions assuming full implementation by all WIC State Agencies. The figures shown here are estimates of
the value of full implementation of mandatory and optional provisions assuming no offsetting savings. The figures shown here which are limited to the food benefit, are transfers from the Federal government to WIC participants.
Costs

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Federal Register / Vol. 79, No. 42 / Tuesday, March 4, 2014 / Rules and Regulations
Estimate

Year dollar

Discount rate
(percent)

12287
Period covered

Qualitative: Local and State WIC agencies will incur some administrative costs, other than reporting and recordkeeping, to implement the final
rule. However, we are unable to quantify the potential increases in administrative burden due to the final provisions. These include the costs
of training WIC clinic and administrative staff and the periodic review and updating of WIC-approved food lists. The State option to authorize
farmers’ markets to accept WIC cash-value vouchers may introduce administrative costs, however in general, we anticipate that State Agencies and local WIC providers will be able to absorb the burden associated with implementing this rule with current NSA funds. State and local
agencies have substantial flexibility in how they spend their NSA funds and may need to reprioritize or postpone some initiatives to undertake
the implementation activities, as well as adapt to certain ongoing administrative requirements associated with the final rule. FNS will continue
to provide technical assistance to State and local agencies to assist them in implementing the new provisions of the final rule.

Regulatory Flexibility Act
This final rule has been reviewed
with regard to the requirements of the
Regulatory Flexibility Act (RFA) of
1980, (5 U.S.C. 601–612). Pursuant to
that review, FNS Administrator Audrey
Rowe certified that this rule would not
have a significant impact on a
substantial number of small entities.
State and local agencies and WIC
participants will be most affected by the
rule and WIC authorized vendors and
the food industry may be indirectly
affected.
Although not required by the RFA,
FNS prepared a Regulatory Flexibility
Analysis describing the impact of this
interim rule on small entities that
reflects comments that were received on
the Regulatory Flexibility Analysis that
was included in the WIC Food Package
interim rule published at 72 FR 68982,
December 6, 2007.

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Need for and Objectives of the Final
Rule
The interim rule, published in the
Federal Register on December 6, 2007
(72 FR 68966), revised the WIC food
packages. The revisions align the WIC
food packages with the Dietary
Guidelines for Americans and infant
feeding practice guidelines of the
American Academy of Pediatrics. The
interim rule revisions largely reflect
recommendations made by the Institute
of Medicine (IOM) of the National
Academies in its report, ‘‘WIC Food
Packages: Time for a Change,’’ with
certain cost containment and
administrative modifications found
necessary by the Department to ensure
cost neutrality. The interim rule allowed
FNS to obtain feedback on the major
changes as recommended by IOM, as
well as the implementation of
procedures, while allowing
implementation to move forward. State
agencies, including Indian Tribal
Organizations, were required to
implement the changes by October 1,
2009, and new food packages are now
being provided to WIC participants in
all States. The interim rule comment
period ended February 1, 2010. Public

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comments received on the interim rule
are reflected in the final rule.
The interim rule required substantial
changes by State and local agencies.
Overall, implementation proceeded
smoothly and all States have
successfully implemented the changes.
This final rule makes a much more
limited number of modifications than
those contained in the interim rule and
requires less significant changes in
response to the public comments
received. Therefore, the expected effects
are minimal for FNS and other Federal
Agencies. FNS will continue to provide
technical assistance to State and local
agencies to assist them in fully
implementing the changes. This rule
will require State and local agencies to
make further modifications to their
procedures that are far less substantial
than the changes required under the
Interim rule. Foreign countries will not
be affected.
Description and Estimate of Number of
Small Entities to Which the Final Rule
Would Apply
This final rule applies to WIC State
agencies with respect to their selection
of foods to be included on their food
lists. As a result, vendors will be
indirectly affected. The rule may have
an indirect economic affect on certain
small businesses because they may have
to carry a larger variety of certain foods
to be eligible for authorization as a WIC
vendor. Currently, approximately
46,000 stores are authorized to accept
WIC food instruments, some of which
are small businesses. With the high
degree of State flexibility allowable
under this final rule, small vendors will
be impacted differently in each State
depending upon how that State chooses
to meet the new requirements. Since
neither FNS nor the State agencies
regulate food producers under the WIC
Program, it is not known how many
small entities within that industry may
be indirectly affected by the final rule.
A 2011 evaluation conducted by
Altarum Institute 7 sought to understand
7 Altarum Institute 2011. Impact of the Revised
WIC Food Package on Small WIC Vendors: Insight
from a Four State Evaluation.

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the impact that the WIC food package
changes had on small stores. The study
demonstrated that most small WIC
stores were able to maintain their
authorization with the WIC Program
during the period the food package
changes were implemented. Small
stores appear to have added healthy
foods to their inventory in response to
the WIC food package changes. The
report concludes that adequate vendor
preparation likely factored into the
overall success of implementation, and
cites the need for ongoing engagement
of these and other WIC stakeholders.
Description of Projected Reporting,
Recordkeeping, and Other Compliance
Requirements
Modifications included in the final
rule to eliminate certain medical
documentation requirements imposed
by the interim rule will decrease the
Information Collection Burden
associated with this rule.
Steps Taken To Minimize Significant
Economic Impact on Small Entities, and
Significant Alternatives Considered
FNS considered significant
alternatives in developing the interim
rule including those that may reduce the
indirect impact on small business.
These considerations included (among
others) the establishment of differing
compliance or reporting requirements or
timetables that take into account the
resources available to small entities; the
clarification, consolidation, or
simplification of compliance and
reporting requirements under the rule
for small entities; the use of
performance, rather than design,
standards; and an exemption from
coverage of the rule, or any part thereof,
for small entities.
In general, the alternatives of
exempting small entities from the
requirements in the interim rule or
altering the requirements for small
entities were rejected. The WIC food
packages provide supplemental foods
designed to address the nutritional
needs of low-income pregnant,
breastfeeding, non-breastfeeding
postpartum women, infants and

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children up to age 5 who are at
nutritional risk. Exempting small
entities from providing the specific
foods intended to address the
nutritional needs of participants or
altering the requirements for small
entities would undermine the purpose
of the WIC Program and endanger the
health status of participants. Therefore,
this final rule retains those
requirements.
FNS did, however, modify the new
food provisions in an effort to mitigate
the impact on small entities. As in the
past, State agencies must establish
minimum requirements for the variety
and quantity of foods that a vendor must
stock in order to receive WIC Program
authorization. The interim rule added
new food items, such as fruits and
vegetables and whole grain breads,
which may require some WIC vendors,
particularly smaller stores, to expand
the types and quantities of food items
stocked in order to maintain their WIC
authorization. In addition, vendors also
have to make available more than one
food type from each WIC food category,
except for the categories of peanut
butter and eggs, which may be a change
for some vendors. To mitigate the
impact of the fruit and vegetable
requirement, the interim rule allowed
canned, frozen and dried fruits and
vegetables to be substituted for fresh
produce. These provisions are all
retained in this final rule.
The interim rule authorized State
agencies the option to allow participants
to pay the difference if the fruit and
vegetable purchase exceeds the value of
the cash-value voucher, a transaction
known as ‘‘split tender.’’ In response to
public comments received on the
interim rule, this final rule requires
State agencies to allow split tender
transactions with the cash-value
voucher.
Unfunded Mandates Reform Act
Title II of the Unfunded Mandates
Reform Act of 1995 (UMRA), Public
Law 104–4, establishes requirements for
Federal agencies to assess the effects of
their regulatory actions on State, local
and tribal governments and the private
sector. Under section 202 of the UMRA,
the Department generally must prepare
a written statement, including a cost
benefit analysis, for proposed and final
rules with ‘‘Federal mandates’’ that may
result in expenditures by State, local or
tribal governments, in the aggregate, or
the private sector, of $100 million or
more in any one year. When such a
statement is needed for a rule, Section
205 of the UMRA generally requires the
Department to identify and consider a
reasonable number of regulatory

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alternatives and adopt the most cost
effective or least burdensome alternative
that achieves the objectives of the rule.
This final rule contains no Federal
mandates (under the regulatory
provisions of Title II of the UMRA) for
State, local and tribal governments or
the private sector of $100 million or
more in any one year. Thus, the rule is
not subject to the requirements of
sections 202 and 205 of the UMRA.
Executive Order 12372
The WIC Program is listed in the
Catalog of Federal Domestic Assistance
Programs under 10.557. For the reasons
set forth in the final rule in 7 CFR part
3015, subpart V, and related Notice (48
FR 29115, June 24, 1983), this program
is included in the scope of Executive
Order 12372 which requires
intergovernmental consultation with
State and local officials.
Federalism Summary Impact Statement
Executive Order 13132 requires
Federal agencies to consider the impact
of their regulatory actions on State and
local governments. Where such actions
have federalism implications, agencies
are directed to provide a statement for
inclusion in the preamble to the
regulations describing the agency’s
considerations in terms of the three
categories called for under Section
(6)(b)(2)(B) of Executive Order 13121.
Prior Consultation With State Officials
Since publication of the interim rule
revising the WIC food packages, FNS
has obtained input from WIC State and
local agency staff about the provisions
and implementation of the changes.
Examples of the different forums and
methods FNS has used to solicit WIC
State and local agency staff input on the
WIC food packages include the
following:
• Hosting annual meetings of the
National Advisory Council on Maternal,
Infant and Fetal Nutrition that includes
WIC staff as members of the Council; the
Council develops recommendations for
FNS on how to improve operations of
WIC, including aspects related to the
authorized foods and food packages;
• Consulting and collaborating with
the National WIC Association (NWA) on
a wide variety of WIC issues, including
those related to the WIC food packages.
NWA is a non-profit organization that
was founded in 1983 by State and local
agencies that administer the WIC
Program. NWA’s paid membership
includes 72 of the 90 WIC State
agencies, 813 local agencies, 7 State
WIC Associations, and 27 sustaining
members (i.e., for-profit and non-profit
businesses or organizations).

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Functioning as a coalition of WIC
agencies, NWA is dedicated to
maximizing WIC resources through
effective management practices. NWA
also serves in a leadership role for WIC
agencies by developing position papers
on issues of concern to the WIC
community; and
• Regular meetings and consultation
with State health officials and other
WIC stakeholders, including the
medical community, advocacy groups,
and retailers.
Nature of Concerns and the Need To
Issue This Rule
This final rule considers public
comments submitted in response to the
interim rule revising the WIC food
packages published in December 2007
(72 FR 68966). The interim rule
implemented the first comprehensive
revisions to the WIC food packages
since 1980. This final rule addresses
public comments received on the
interim rule and makes adjustments that
improve clarity of the provisions set
forth in the interim rule.
Extent to Which We Meet Those
Concerns
FNS has considered the impact of
final rule on State and local agencies.
FNS believes that the rule is responsive
to the expressed concerns and requests
of commenters representing State and
local concerns.
Executive Order 12988
This final rule has been reviewed
under Executive Order 12988, Civil
Justice Reform. This final rule is not
intended to have preemptive effect with
respect to any State or local laws,
regulations or policies which conflict
with its provisions or which would
otherwise impede its full and timely
implementation. This rule is not
intended to have retroactive effect
unless so specified in the DATES
section of the final rule. Prior to any
judicial challenge to the provisions of
the final rule, all applicable
administrative procedures must be
exhausted.
Civil Rights Impact Analysis
The intent of this final rulemaking is
not to limit participation or to have an
adverse effect on current participants.
FNS does not expect any protected
populations to be adversely affected by
the implementation of the requirements
in this rule. State agencies must ensure
participant access to supplemental
foods. The foods available to WIC
participants as a result of this final rule
are intended to broaden the appeal of
the WIC food packages for all groups

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and encourage participation in WIC.
This final rule revises certain provisions
to better address the needs of
participants with certain medical
conditions, and provides State agencies
increased flexibility in prescribing
culturally appropriate packages for
diverse groups. FNS does not anticipate
this rulemaking will result in any
adverse civil rights impacts.
Executive Order 13175
Executive Order 13175 requires
Federal agencies to consult and
coordinate with tribes on a governmentto-government basis on policies that
have tribal implications, including
regulations, legislative comments or
proposed legislation, and other policy
statements or actions that have
substantial direct effects on one or more
Indian tribes, on the relationship
between the Federal Government and
Indian tribes, or on the distribution of
power and responsibilities between the
Federal Government and Indian tribes.
In late 2010 and early 2011, USDA
engaged in a series of consultative
sessions to obtain input by Tribal
officials or their designees concerning
the impact of this rule on the tribe or
Indian Tribal governments, or whether
this rule may preempt Tribal law. USDA
did not receive any input during these
sessions that this rule preempts any
Tribal law. Input received relative to
this rule included overall satisfaction
with the new WIC foods, especially the
fruits and vegetables and whole grains,
and changes related to supporting
breastfeeding mothers. Some tribes
reported that WIC participants who
were enrolled in WIC during the
transition from the previous food
packages to the revised food packages
expressed displeasure with issuance of
lower fat milks and less cheese. The
input from Indian tribes during these
sessions was consistent with the general
comments received for the interim rule,
and have been addressed in this final
rule. Reports from these consultations
will be made part of the USDA annual
reporting on Tribal Consultation and
Collaboration. USDA will respond in a
timely and meaningful manner to all
Tribal government requests for
consultation concerning this rule and
will provide additional venues, such as
webinars and teleconferences, to
periodically host collaborative
conversations with Tribal officials or
their designees concerning ways to
improve this rule in Indian country.
Paperwork Reduction Act of 1995
The Paperwork Reduction Act of 1995
(44 U.S.C. Chap. 35; see 5 CFR 1320)
requires that the Office of Management

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and Budget (OMB) approve all
collections of information by a Federal
agency before they can be implemented.
Respondents are not required to respond
to any collection of information unless
it displays a current valid OMB control
number. This final rule changes the
information collection burden
previously approved under OMB 0584–
0545. Implementation of the data
collection requirements resulting from
this final rule is contingent upon OMB
approval under the Paperwork
Reduction Act of 1995.
The proposed food package rule was
published in the Federal Register [71
FR 44784] with a 60-day notice on
August 7, 2006, which provided the
public an opportunity to submit
comments on the information collection
burden resulting from the proposed
rule. FNS received no public comments
in response to this solicitation. On
November 1, 2006, OMB filed comment
in accordance with 5 CFR 1320.11(c),
requiring FNS to review public
comments in response to the proposed
rule and address any such comments in
the preamble of the final rule.
The interim food package rule was
published in the Federal Register [72
FR 68966] on December 6, 2007, and
included an estimated annual
information collection burden of 14,919
burden hours, which was approved as
OMB Number 0584–0545. These
information collection burden hours
were merged into the information
collection, WIC Program Reporting and
Recordkeeping Requirements, OMB
Number 0584–0043, changing the total
approved burden hours for OMB
Number 0584–0043 from 3,595,075 to
3,609,994. Information collection OMB
Number 0584–0545 was then
discontinued. Information collection
OMB Number 0584–0043 was renewed
as of December 27, 2012, changing the
total approved burden hours from
3,609,994 to 4,024,697.
In this final rule, FNS will no longer
require a health care professional
licensed to write medical prescriptions
to provide documentation for children
to receive soy-based beverage and tofu
as milk substitutes. Also, FNS will no
longer require documentation from a
health care professional licensed to
write medical prescriptions for women
to receive tofu in excess of the
maximum substitution allowance. As a
result of this final rulemaking, the
overall information collection burden
associated with OMB Number 0584–
0043 is estimated to have decreased by
4,200 burden hours annually due to
program changes in this rulemaking.
The total estimated burden hours for

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12289

OMB Number 0584–0043 will decrease
from 4,024,697 to 4,020,497.
The breakdown of the changes is
described below:
OMB Number 0584–0043;
WIC Program Reporting and
Recordkeeping Requirements;
expiration date December 31, 2015.
Type of Request: Revision of a
currently approved collection.
Abstract: Federal regulations at 7 CFR
246.10(d)(1)(vi) and (viii) require
medical documentation for the issuance
of soy-based beverage and tofu for
children, and tofu above the maximum
substitution amount for women. Federal
regulations at 7 CFR 246.10(d)(1)(v)
require medical documentation for the
issuance of supplemental foods to
participants who receive Food Package
III (for participants with qualifying
conditions).
Under the interim rule, medical
documentation by a health care
professional licensed to write medical
prescriptions is required for the
issuance of certain milk alternatives for
children and women. A total of 180
comment letters (53 of these form
letters) opposed this requirement,
primarily the documentation for
children to receive soy-based beverage.
Commenters stated that the provision is
unnecessary, costly and burdensome for
participants and physicians, creates
barriers to services, and undermines
FNS’ efforts to provide foods that meet
the cultural needs of participants. The
NWA and the American Dietetic
Association (now known as the
Academy of Nutrition and Dietetics)
stressed that WIC dietitians and
nutritionists are health professionals
trained and capable of doing a complete
nutrition assessment, selecting WIC
foods, and providing appropriate
education to participants and caregivers,
in consultation with the health care
provider when warranted.
Based on the experiences cited by
WIC State and local agencies related to
medical documentation throughout
implementation of the new food
packages, FNS will no longer require a
health care professional licensed to
write medical prescriptions to provide
documentation for children to receive
soy-based beverage and tofu as milk
substitutes. Also, FNS will no longer
require documentation from a health
care professional licensed to write
medical prescriptions for women to
receive tofu in excess of the maximum
substitution allowance.
Estimate of Burden
This final rule amends the
supplemental foods that require medical
documentation as described in 7 CFR

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246.10(d)(1) However, medical
documentation continues to be required
for issuance of supplemental foods in
Food Package III. After revising to
reflect the changes made by this final
rule, the total annual reporting and
recordkeeping burden estimated for
medical documentation is decreased by
4,200 hours.
FNS estimates that approximately 1
percent of participants (89,606) will be
issued supplemental foods under Food
Package III. FNS estimates that it will
take three minutes (0.05 hours) for the
documentation required to issue the
authorized foods, thus resulting in an
estimated reporting burden for
participants of 8,961 hours (89,606 total
participants × 0.05 person hours × 2
certification periods per year). This
results in a decrease in the approved
reporting burden under OMB 0584–
0043 for participants providing medical
documentation for supplemental foods
from 13,160 burden hours to 8,961
burden hours (a decrease of 4,200
burden hours).
FNS will submit an Information
Collection Request clearance package to
OMB based on the provisions of this
final rule. These amended information
collection requirements will not become
effective until approved by OMB. When
OMB has approved these information
collection requirements, FNS will
publish separate action in the Federal
Register announcing OMB approval.
E-Government Act Compliance
The Food and Nutrition Service is
committed to complying with the EGovernment Act, 2002, to promote the
use of the Internet and other
information technologies to provide
increased opportunities for citizen
access to Government information and
services, and for other purposes.
List of Subjects in 7 CFR Part 246

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Administrative practice and
procedure, Civil rights, Food assistance
programs, Grant programs-health, Grant
programs-social programs, Indians,
Infants and children, Maternal and child
health, Nutrition, Penalties, Reporting
and recordkeeping requirements,
Women.
■ For reasons set forth in the preamble,
7 CFR Part 246 is amended as follows:
PART 246—SPECIAL SUPPLEMENTAL
NUTRTION PROGRAM FOR WOMEN,
INFANTS AND CHILDREN
1. The authority citation for 7 CFR
part 246 continues to read as follows:

■

Authority: 42 U.S.C. 1786.
■

2. In § 246.2:

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a. Add a definition for ‘‘Farmers’
market’’ in alphabetical order;
■ b. Add a definition for ‘‘Full nutrition
benefit’’ in alphabetical order;
■ c. Remove the definition heading
‘‘WIC-eligible medical foods’’ and add
in its place ‘‘WIC-eligible nutritionals
for participants with qualifying
conditions (hereafter referred to as
‘‘WIC-eligible nutritionals)’’; and
■ d. Remove the term ‘‘WIC-eligible
medical foods’’ and add in its place the
term ‘‘WIC-eligible nutritionals’’
wherever it appears.
■ The revisions and additions read as
follows:
■

§ 246.2

Definitions.

*

*
*
*
*
Farmers’ market means an association
of local farmers who assemble at a
defined location for the purpose of
selling their produce directly to
consumers.
*
*
*
*
*
Full nutrition benefit means the
minimum amount of reconstituted fluid
ounces of liquid concentrate infant
formula as specified in Table 1 of
§ 246.10(e)(9) for each food package
category and infant feeding variation
(e.g., Food Package IA fully formula fed,
IA–FF).
*
*
*
*
*
■ 3. In § 246.4:
■ a. Amend paragraph (a)(11)(iii) by
removing ‘‘§ 246.10(b)(1)’’ and adding in
its place ‘‘§ 246.10(b)(2)(i)’’.
■ b. Revise paragraph (a)(14)(iii);
■ c. Redesignate paragraphs (a)(14)(v)
through (xvii) as paragraphs (vi) through
(xviii) and add a new paragraph
(a)(14)(v);
■ d. Amend newly designated
paragraph (a)(14)(vi) by removing
‘‘§ 246.12(k)(1)(i)’’ and adding in its
place ‘‘§ 246.12(l)(1)(i)’’;
■ e. Revise newly designated paragraph
(a)(14)(xii); and
■ f. Amend paragraph (a)(18) by
removing the words ‘‘and food vendors’’
and adding in their place the phrase ‘‘,
food vendors, farmers and farmers’
markets’’.
The revisions and additions read as
follows:
§ 246.4

State plan.

(a) * * *
(14) * * *
(iii) A sample vendor, farmer and/or
farmers’ market, if applicable,
agreement. The sample vendor
agreement must include the sanction
schedule, the process for notification of
violations in accordance with
§ 246.12(l)(3), and the State agency’s
policies and procedures on incentive
items in accordance with

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§ 246.12(g)(3)(iv), which may be
incorporated as attachments or, if the
sanction schedule, the process for
notification of violations, or policies on
incentive items are in the State agency’s
regulations, through citations to the
regulations. State agencies that intend to
delegate signing of vendor, farmer and/
or farmers’ market agreements to local
agencies must describe the State agency
supervision and instruction that will be
provided to ensure the uniformity and
quality of local agency activities;
*
*
*
*
*
(v) Farmer monitoring. The system for
monitoring farmers and/or farmers’
markets within its jurisdiction, if
applicable, for compliance with
program requirements;
*
*
*
*
*
(xii) Vendor, farmer and/or farmers’
market training. The procedures the
State agency will use to train vendors
(in accordance with § 246.12(i)), farmers
and/or farmers’ markets (in accordance
with § 246.12(v)). State agencies that
intend to delegate any aspect of training
to a local agency, contractor, vendor or
farmer representative must describe the
supervision and instructions that will be
provided by the State agency to ensure
the uniformity and quality of vendor,
farmer and/or farmers’ market training;
*
*
*
*
*
■ 4. In § 246.10:
■ a. Remove the term ‘‘WIC-eligible
medical food’’ and add in its place the
term ‘‘WIC-eligible nutritional’’
wherever it appears; and remove the
term ‘‘WIC-eligible medical foods’’ and
replace it with ‘‘WIC-eligible
nutritionals’’ wherever it appears;
■ b. Revise paragraph (b)(1)(i);
■ c. Amend paragraph (b)(2)(ii)(C) by
removing the words ‘‘age and’’ before
‘‘nutritional’’ and adding the words
‘‘and breastfeeding’’ after ‘‘nutritional’’;
■ d. Amend paragraph (d)(1)(ii) by
removing the phrase ‘‘a child’’ and
adding in its place the phrase ‘‘an
infant, child,’’;
■ e. Remove paragraphs (d)(1)(vi)
through (d)(1)(viii);
■ f. Redesignate paragraph (d)(1)(ix) as
(d)(1)(vi);
■ g. Revise the heading of paragraph
(d)(2);
■ h. Amend paragraph (d)(2)(ii) by
adding a space between ‘‘formula’’ and
‘‘and’’;
■ i. Revise paragraph (d)(3)(i);
■ j. Revise paragraph (d)(4)(ii)(D);
■ k. Revise paragraphs (e) introductory
text through (e)(1)(iii);
■ l. Revise paragraph (e)(1)(v);
■ m. Revise paragraph (e)(2)(ii);
■ n. Revise paragraph (e)(2)(iv);
■ o. Revise paragraph (e)(3)(v);

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Federal Register / Vol. 79, No. 42 / Tuesday, March 4, 2014 / Rules and Regulations
p. Revise paragraphs (e)(4)(ii) through
(e)(7)(ii); and
■ q. Revise paragraphs (e)(9) through
(e)(12).
The revisions and additions read as
follows:
■

§ 246.10

Supplemental foods.

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*

*
*
*
*
(b) * * *
(1) * * *
(i) Establish criteria in addition to the
minimum Federal requirements in Table
4 of paragraph (e)(12) of this section for
the supplemental foods in their States,
except that the State agency may not
selectively choose which eligible fruits
and vegetables are available to
participants. These State agency criteria
could address, but not be limited to,
other nutritional standards, competitive
cost, State-wide availability, and
participant appeal. For eligible fruits
and vegetables, State agencies may
restrict packaging, e.g., plastic
containers, and package sizes, such as
single serving, of processed fruits and
vegetables available for purchase with
the cash-value voucher. In addition,
State agencies may identify certain
processed WIC-eligible fruits and
vegetables on food lists where the
potential exists for vendor or participant
confusion in determining authorized
WIC-eligible items.
*
*
*
*
*
(d) * * *
(2) Medical documentation for other
supplemental foods. * * *
(3) * * *
(i) Made a medical determination that
the participant has a qualifying
condition as described in paragraphs
(e)(1) through (e)(7) of this section that
dictates the use of the supplemental
foods, as described in paragraph (d)(1)
of this section; and
*
*
*
*
*
(4) * * *
(ii) * * *
(D) The qualifying condition(s) for
issuance of the authorized supplemental
food(s) requiring medical
documentation, as described in
paragraphs (e)(1) through (e)(7) of this
section; and
*
*
*
*
*
(e) Food packages. There are seven
food packages available under the
Program that may be provided to
participants. The authorized
supplemental foods must be prescribed
from food packages according to the
category and nutritional needs of the
participants. Breastfeeding assessment
and the mother’s plans for breastfeeding
serve as the basis for determining food
package issuance for all breastfeeding

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women. The intent of the WIC Program
is that all breastfeeding women be
supported to exclusively breastfeed
their infants and to choose the fully
breastfeeding food package without
infant formula. Breastfeeding mothers
whose infants receive formula from WIC
are to be supported to breastfeed to the
maximum extent possible with minimal
supplementation with infant formula.
Formula amounts issued to breastfed
infants are to be tailored to meet but not
exceed the infant’s nutritional needs.
The seven food packages are as follows:
(1) Food Package I—Infants birth
through 5 months.—(i) Participant
category served. This food package is
designed for issuance to infant
participants from birth through age 5
months who do not have a condition
qualifying them to receive Food Package
III. The following infant feeding
variations are defined for the purposes
of assigning food quantities and types in
Food Packages I: Fully breastfeeding
(the infant doesn’t receive formula from
the WIC Program); partially (mostly)
breastfeeding (the infant is breastfed but
also receives infant formula from WIC
up to the maximum allowance
described for partially (mostly) breastfed
infants in Table 1 of paragraph (e)(9) of
this section; and fully formula fed (the
infant is not breastfed or is breastfed
minimally (the infant receives infant
formula from WIC in quantities that
exceed those allowed for partially
(mostly) breastfed infants).
(ii) Infant feeding age categories.—(A)
Birth to one month. Two infant food
packages are available during the first
month after birth—fully breastfeeding
and fully formula-feeding. State
agencies also have the option to make
available a third food package
containing not more than one can of
powder infant formula in the container
size that provides closest to 104
reconstituted fluid ounces to breastfed
infants on a case-by-case basis. The
infant receiving this food package is
considered partially breastfeeding. State
agencies choosing to make available a
partially breastfeeding package in the
first month may not standardize
issuance of this food package. Infant
formula may not be routinely provided
during the first month after birth to
breastfed infants in order to support the
successful establishment of
breastfeeding.
(B) One through 5 months. Three
infant food packages are available from
1 months through 5 months—fully
breastfeeding, partially (mostly)
breastfeeding, or fully formula-fed.
(iii) Infant formula requirements. This
food package provides iron-fortified
infant formula that is not an exempt

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12291

infant formula and that meets the
requirements in Table 4 of paragraph
(e)(12) of this section. The issuance of
any contract brand or noncontract brand
infant formula that contains less than 10
milligrams of iron per liter (at least 1.5
milligrams iron per 100 kilocalories) at
standard dilution is prohibited. Except
as specified in paragraph (d) of this
section, local agencies must issue as the
first choice of issuance the primary
contract infant formula, as defined in
§ 246.2, with all other infant formulas
issued as an alternative to the primary
contract infant formula. Noncontract
brand infant formula and any contract
brand infant formula that does not meet
the requirements in Table 4 of
paragraph (e)(12) of this section may be
issued in this food package only with
medical documentation of the
qualifying condition. A health care
professional licensed by the State to
write prescriptions must make a
medical determination and provide
medical documentation that indicates
the need for the infant formula. For
situations that do not require the use of
an exempt infant formula, such
determinations include, but are not
limited to, documented formula
intolerance, food allergy or
inappropriate growth pattern. Medical
documentation must meet the
requirements described in paragraph (d)
of this section.
*
*
*
*
*
(v) Authorized category of
supplemental foods. Infant formula is
the only category of supplemental foods
authorized in this food package. Exempt
infant formulas and WIC-eligible
nutritionals are authorized only in Food
Package III. The maximum monthly
allowances, allowed options and
substitution rates of supplemental foods
for infants in Food Packages I are stated
in Table 1 of paragraph (e)(9) of this
section.
(2) * * *
(ii) Infant food packages. Three food
packages for infants 6 through 11
months are available — fully
breastfeeding, partially (mostly)
breastfeeding, or fully formula fed.
*
*
*
*
*
(iv) Authorized categories of
supplemental foods. Infant formula,
infant cereal, and infant foods are the
categories of supplemental foods
authorized in this food package. The
maximum monthly allowances, allowed
options and substitution rates of
supplemental foods for infants in Food
Packages II are stated in Table 1 of
paragraph (e)(9) of this section.
*
*
*
*
*
(3) * * *

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Federal Register / Vol. 79, No. 42 / Tuesday, March 4, 2014 / Rules and Regulations

(v) Authorized categories of
supplemental foods. The supplemental
foods authorized in this food package
require medical documentation for
issuance and include WIC formula
(infant formula, exempt infant formula,
and WIC-eligible nutritionals), infant
cereal, infant foods, milk, cheese, eggs,
canned fish, fresh fruits and vegetables,
breakfast cereal, whole wheat/whole
grain bread, juice, legumes and/or
peanut butter. The maximum monthly
allowances, allowed options and
substitution rates of supplemental foods
for infants in Food Package III are stated
in Table 1 of paragraph (e)(9) of this
section. The maximum monthly
allowances, allowed options, and
substitution rates of supplemental foods
for children and women in Food
Package III are stated in Table 3 of
paragraph (e)(11) of this section.
*
*
*
*
*
(4) * * *
(ii) Authorized categories of
supplemental foods. Milk, breakfast
cereal, juice, fresh fruits and vegetables,
whole wheat/whole grain bread, eggs,
and legumes or peanut butter are the
categories of supplemental foods
authorized in this food package. The
maximum monthly allowances, allowed
options and substitution rates of
supplemental foods for children in Food
Package IV are stated in Table 2 of
paragraph (e)(10) of this section.
(5) Food Package V—Pregnant and
partially (mostly) breastfeeding
women.—(i) Participant category served.
This food package is designed for
issuance to women participants with
singleton pregnancies who do not have
a condition qualifying them to receive
Food Package III. This food package is
also designed for issuance to partially
(mostly) breastfeeding women
participants, up to 1 year postpartum,
who do not have a condition qualifying

them to receive Food Package III and
whose partially (mostly) breastfed
infants receive formula from the WIC
program in amounts that do not exceed
the maximum allowances described in
Table 1 of paragraph (e)(9) of this
section. Women participants partially
(mostly) breastfeeding more than one
infant from the same pregnancy,
pregnant women fully or partially
breastfeeding singleton infants, and
women participants pregnant with two
or more fetuses, are eligible to receive
Food Package VII as described in
paragraph (e)(7) of this section.
(ii) Authorized categories of
supplemental foods. Milk, breakfast
cereal, juice, fresh fruits and vegetables,
whole wheat/whole grain bread, eggs,
legumes and peanut butter are the
categories of supplemental foods
authorized in this food package. The
maximum monthly allowances, allowed
options and substitution rates of
supplemental foods for women in Food
Package V are stated in Table 2 of
paragraph (e)(10) of this section.
(6) Food Package VI—Postpartum
women.—(i) Participant category served.
This food package is designed for
issuance to women up to 6 months
postpartum who are not breastfeeding
their infants, and to breastfeeding
women up to 6 months postpartum
whose participating infant receives
more than the maximum amount of
formula allowed for partially (mostly)
breastfed infants as described in Table
1 of paragraph (e)(9) of this section, and
who do not have a condition qualifying
them to receive Food Package III.
(ii) Authorized categories of
supplemental foods. Milk, breakfast
cereal, juice, fresh fruits and vegetables,
eggs, and legumes or peanut butter are
the categories of supplemental foods
authorized in this food package. The
maximum monthly allowances, allowed

options and substitution rates of
supplemental foods for women in Food
Package VI are stated in Table 2 of
paragraph (e)(10) of this section.
(7) Food Package VII—Fully
breastfeeding.—(i) Participant category
served. This food package is designed
for issuance to breastfeeding women up
to 1 year postpartum whose infants do
not receive infant formula from WIC
(these breastfeeding women are
assumed to be exclusively breastfeeding
their infants), and who do not have a
condition qualifying them to receive
Food Package III. This food package is
also designed for issuance to women
participants pregnant with two or more
fetuses, women participants partially
(mostly) breastfeeding multiple infants
from the same pregnancy, and pregnant
women who are also partially (mostly)
breastfeeding singleton infants, and who
do not have a condition qualifying them
to receive Food Package III. Women
participants fully breastfeeding multiple
infants from the same pregnancy receive
1.5 times the supplemental foods
provided in Food Package VII.
(ii) Authorized categories of
supplemental foods. Milk, cheese,
breakfast cereal, juice, fresh fruits and
vegetables, whole wheat/whole grain
bread, eggs, legumes, peanut butter, and
canned fish are the categories of
supplemental foods authorized in this
food package. The maximum monthly
allowances, allowed options and
substitution rates of supplemental foods
for women in Food Package VII are
stated in Table 2 of paragraph (e)(10) of
this section.
*
*
*
*
*
(9) Full nutrition benefit and
maximum monthly allowances, options
and substitution rates of supplemental
foods for infants in Food Packages I, II
and III are stated in Table 1 as follows:

TABLE 1—FULL NUTRITION BENEFIT (FNB) AND MAXIMUM MONTHLY ALLOWANCES (MMA) OF SUPPLEMENTAL FOODS FOR
INFANTS IN FOOD PACKAGES I, II AND III
Fully formula fed (FF)

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Foods 1

WIC Formula

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45678

Partially (mostly) breastfed (BF/FF)

Food Packages
I–FF &
III–FF
A: 0 through 3
months
B: 4 through 5
months

Food Packages
II–FF &
III–FF
6 through 11
months

A: FNB=806 fl oz,
MMA=823 fl oz,
reconstituted liquid concentrate or
832 fl. oz. RTF or
870 fl oz reconstituted powder.

FNB=624 fl oz,
MMA=630 fl oz,
reconstituted liquid concentrate.
or 643 fl. oz RTF or
696 fl oz reconstituted powder.

19:10 Mar 03, 2014

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Food Packages
I–BF/FF & III BF/FF
(A: 0 to 1 month 2 3)
B: 1 through 3
months
C: 4 through 5
months
A: 104 fl oz reconstituted powder.
B: FNB=364 fl oz,
MMA=388 fl oz,
reconstituted liquid concentrate or
384 fl oz RTF or
435 fl oz reconstituted powder.

Fmt 4701

Sfmt 4700

Food Packages
II–BF/FF & III
BF/FF
6 through 11
months
FNB=312 fl oz,
MMA=315 fl oz,
reconstituted liquid concentrate or
338 fl oz RTF or
384 fl oz reconstituted powder.

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04MRR2

Fully breastfed (BF)
Food
Package
I–BF
0 through 5
months

Food
Package
II–BF
6 through 11
months

Federal Register / Vol. 79, No. 42 / Tuesday, March 4, 2014 / Rules and Regulations

12293

TABLE 1—FULL NUTRITION BENEFIT (FNB) AND MAXIMUM MONTHLY ALLOWANCES (MMA) OF SUPPLEMENTAL FOODS FOR
INFANTS IN FOOD PACKAGES I, II AND III—Continued
Fully formula fed (FF)
Food Packages
I–FF &
III–FF
A: 0 through 3
months
B: 4 through 5
months

Foods 1

Partially (mostly) breastfed (BF/FF)
Food Packages
I–BF/FF & III BF/FF
(A: 0 to 1 month 2 3)
B: 1 through 3
months
C: 4 through 5
months

Food Packages
II–FF &
III–FF
6 through 11
months

Fully breastfed (BF)

Food Packages
II–BF/FF & III
BF/FF
6 through 11
months

Food
Package
I–BF
0 through 5
months

Food
Package
II–BF
6 through 11
months

24 oz ......................
128 oz ....................

......................
......................

24 oz.
256 oz.

................................

......................

77.5 oz.

B: FNB=884 fl oz,
MMA=896 fl oz,
reconstituted liquid concentrate or
913 fl oz RTF or
960 fl oz reconstituted powder.

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Infant Cereal 9 11 .......
Infant food fruits and
vegetables
9 10 11 12 13.
Infant food meat 9 ....

................................
................................

24 oz ......................
128 oz ....................

C: FNB=442 fl oz,
MMA=460 fl oz,
reconstituted liquid concentrate or
474 fl oz RTF or
522 fl oz reconstituted powder.
................................
................................

................................

................................

................................

Table 1 footnotes: (Abbreviations in order of appearance in table): FF = fully formula fed; BF/FF = partially (mostly) breastfed; BF = fully
breastfed; RTF = Ready-to-feed; N/A = the supplemental food is not authorized in the corresponding food package.
1 Table 4 of paragraph (e)(12) of this section describes the minimum requirements and specifications for the supplemental foods. The competent professional authority (CPA) is authorized to determine nutritional risk and prescribe supplemental foods as established by State agency
policy in Food Packages I and II. In Food Package III, the CPA, as established by State agency policy, is authorized to determine nutritional risk
and prescribe supplemental foods per medical documentation.
2 State agencies have the option to issue not more than one can of powder infant formula in the container size that provides closest to 104 reconstituted fluid ounces to breastfed infants on a case-by-case basis.
3 Liquid concentrate and ready-to-feed (RTF) may be substituted at rates that provide comparable nutritive value.
4 WIC formula means infant formula, exempt infant formula, or WIC-eligible nutritionals. Infant formula may be issued for infants in Food Packages I, II and III. Medical documentation is required for issuance of infant formula, exempt infant formula, WIC-eligible nutritionals, and other supplemental foods in Food Package III. Only infant formula may be issued for infants in Food Packages I and II.
5 The full nutrition benefit is defined as the minimum amount of reconstituted fluid ounces of liquid concentrate infant formula as specified for
each infant food package category and feeding variation (e.g., Food Package IA-fully formula fed).
6 The maximum monthly allowance is specified in reconstituted fluid ounces for liquid concentrate, RTF liquid, and powder forms of infant formula and exempt infant formula. Reconstituted fluid ounce is the form prepared for consumption as directed on the container.
7 State agencies must provide at least the full nutrition benefit authorized to non-breastfed infants up to the maximum monthly allowance for
the physical form of the product specified for each food package category. State agencies must issue whole containers that are all the same size
of the same physical form. Infant formula amounts for breastfed infants, even those in the fully formula fed category should be individually tailored to the amounts that meet their nutritional needs.
8 State agencies may round up and disperse whole containers of infant formula over the food package timeframe to allow participants to receive the full nutrition benefit. State agencies must use the methodology described in accordance with paragraph (h)(1) of this section.
9 State agencies may round up and disperse whole containers of infant foods (infant cereal, fruits and vegetables, and meat) over the Food
Package timeframe. State agencies must use the methodology described in accordance with paragraph (h)(2) of this section.
10 At State agency option, for infants 6–12 months of age, fresh banana may replace up to 16 ounces of infant food fruit at a rate of 1 pound of
bananas per 8 ounces of infant food fruit. State agencies may also substitute fresh bananas at a rate of 1 banana per 4 ounces of jarred infant
food fruit, up to a maximum of 16 ounces.
11 In lieu of infant foods (cereal, fruit and vegetables), infants greater than 6 months of age in Food Package III may receive infant formula, exempt infant formula or WIC-eligible nutritionals at the same maximum monthly allowance as infants ages 4 through 5 months of age of the same
feeding option.
12 At State agency option, infants 9 months through 11 months in Food Packages II and III may receive a cash-value voucher to purchase
fresh (only) fruits and vegetables in lieu of a portion of the infant food fruits and vegetables. Partially (mostly) breastfed infants and fully formula
fed infants may receive a $4 cash-value voucher plus 64 ounces of infant food fruits and vegetables; fully breastfeeding infants may receive a $8
cash-value voucher plus 128 ounces of infant food fruit and vegetables.
13 State agencies may not categorically issue cash-value vouchers for infants 9 months through 11 months. The cash-value voucher is to be
provided to the participant only after an individual nutrition assessment, as established by State agency policy, and is optional for the participant,
i.e., the mother may choose to receive either the maximum allowance of jarred foods or a combination of jarred foods and a fruit and vegetable
cash-value voucher for her infant. State agencies must ensure that appropriate nutrition education is provided to the caregiver addressing safe
food preparation, storage techniques, and feeding practices to make certain participants are meeting their nutritional needs in a safe and effective manner.

(10) Maximum monthly allowances of
supplemental foods in Food Packages
IV through VII. The maximum monthly

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TABLE 2—MAXIMUM MONTHLY ALLOWANCES OF SUPPLEMENTAL FOODS FOR CHILDREN AND WOMEN IN FOOD PACKAGES
IV, V, VI AND VII
Children
Foods 1

Juice, single strength 6 .............
Milk, fluid ...................................
Breakfast cereal 13 ....................
Cheese .....................................
Eggs ..........................................
Fresh fruits and vegetables 14 15

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Whole wheat or whole grain
bread 16.
Fish (canned) ............................
Legumes, dry 17 and/or Peanut
butter.

Women

Food Package IV: 1
through 4 years

Food Package V: Pregnant and Partially
(Mostly) Breastfeeding
(up to 1 year
postpartum) 2

Food Package VI:
Postpartum (up to 6
months postpartum) 3

128 fl oz ..........................
16 qt 7 8 9 10 11 ...................
36 oz ...............................
N/A ..................................
1 dozen ...........................
$8.00 in cash-value
vouchers.
2 lb ..................................

144 fl oz ..........................
22 qt 7 8 9 10 12 ...................
36 oz ...............................
N/A ..................................
1 dozen ...........................
$10.00 in cash-value
vouchers.
1 lb ..................................

96 fl oz ............................
16 qt 7 8 9 10 12 ...................
36 oz ...............................
N/A ..................................
1 dozen ...........................
$10.00 in cash-value
vouchers.
N/A ..................................

144 fl oz.
24 qt 7 8 9 10 12.
36 oz.
1 lb.
2 dozen.
$10.00 in cash-value
vouchers.
1 lb.

N/A ..................................
1 lb or 18 oz ....................

N/A ..................................
1 lb and 18 oz .................

N/A ..................................
1 lb or 18 oz ....................

30 oz.
1 lb and 18 oz.

Food Package VII: Fully
Breastfeeding (up to 1
year post-partum) 4 5

Table 2 Footnotes: N/A = the supplemental food is not authorized in the corresponding food package.
1 Table 4 of paragraph (e)(12) of this section describes the minimum requirements and specifications for the supplemental foods. The competent professional authority (CPA) is authorized to determine nutritional risk and prescribe supplemental foods as established by State agency
policy.
2 Food Package V is issued to two categories of WIC participants: Women participants with singleton pregnancies; breastfeeding women
whose partially (mostly) breastfed infants receive formula from the WIC Program in amounts that do not exceed the maximum formula allowances, as appropriate for the age of the infant as described in Table 1 of paragraph (e)(9) of this section.
3 Food Package VI is issued to two categories of WIC participants: Non-breastfeeding postpartum women and breastfeeding postpartum
women whose infants receive more than the maximum infant formula allowances, as appropriate for the age of the infant as described in Table 1
of paragraph (e)(9) of this section.
4 Food Package VII is issued to four categories of WIC participants: Fully breastfeeding women whose infants do not receive formula from the
WIC Program; women pregnant with two or more fetuses; women partially (mostly) breastfeeding multiple infants from the same pregnancy; and
pregnant women who are also fully or partially (mostly) breastfeeding singleton infants.
5 Women fully breastfeeding multiple infants from the same pregnancy are prescribed 1.5 times the maximum allowances.
6 Combinations of single-strength and concentrated juices may be issued provided that the total volume does not exceed the maximum monthly allowance for single-strength juice.
7 Whole milk is the standard milk for issuance to 1-year-old children (12 through 23 months). At State agency option, fat-reduced milks may be
issued to 1-year-old children for whom overweight or obesity is a concern. The need for fat-reduced milks for 1-year-old children must be based
on an individual nutritional assessment and consultation with the child’s health care provider if necessary, as established by State agency policy.
Lowfat (1%) or nonfat milks are the standard milk for issuance to children ≥ 24 months of age and women. Reduced fat (2%) milk is authorized
only for participants with certain conditions, including but not limited to, underweight and maternal weight loss during pregnancy. The need for reduced fat (2%) milk for children ≥ 24 months of age (Food Package IV) and women (Food Packages V–VII) must be based on an individual nutritional assessment as established by State agency policy.
8 Evaporated milk may be substituted at the rate of 16 fluid ounces of evaporated milk per 32 fluid ounces of fluid milk or a 1:2 fluid ounce substitution ratio. Dry milk may be substituted at an equal reconstituted rate to fluid milk.
9 For children and women, cheese may be substituted for milk at the rate of 1 pound of cheese per 3 quarts of milk. For children and women in
Food Packages IV–VI, no more than 1 pound of cheese may be substituted. For fully breastfeeding women in Food Package VII, no more than 2
pounds of cheese may be substituted for milk. State agencies do not have the option to issue additional amounts of cheese beyond these maximums even with medical documentation. (No more than a total of 4 quarts of milk may be substituted for a combination of cheese, yogurt or tofu
for children and women in Food Packages IV–VI. No more than a total of 6 quarts of milk may be substituted for a combination of cheese, yogurt
or tofu for women in Food Package VII.)
10 For children and women, yogurt may be substituted for fluid milk at the rate of 1 quart of yogurt per 1 quart of milk; a maximum of 1 quart of
milk can be substituted. Additional amounts of yogurt are not authorized. Whole yogurt is the standard yogurt for issuance to 1-year-old children
(12 through 23 months). At State agency option, lowfat or nonfat yogurt may be issued to 1-year-old children for whom overweight and obesity is
a concern. The need for lowfat or nonfat yogurt for 1-year-old children must be based on an individual nutritional assessment and consultation
with the child’s health care provider if necessary, as established by State agency policy. Lowfat or nonfat yogurts are the only types of yogurt authorized for children ≥ 24 months of age and women. (No more than a total of 4 quarts of milk may be substituted for a combination of cheese,
yogurt or tofu for children and women in Food Packages IV–VI. No more than a total of 6 quarts of milk may be substituted for a combination of
cheese, yogurt or tofu for women in Food Package VII.)
11 For children, issuance of tofu and soy-based beverage as substitutes for milk must be based on an individual nutritional assessment and
consultation with the participant’s health care provider if necessary, as established by State agency policy. Such determination can be made for
situations that include, but are not limited to, milk allergy, lactose intolerance, and vegan diets. Soy-based beverage may be substituted for milk
for children on a quart for quart basis up to the total maximum allowance of milk. Tofu may be substituted for milk for children at the rate of 1
pound of tofu per 1 quart of milk. (No more than a total of 4 quarts of milk may be substituted for a combination of cheese, yogurt or tofu for children in Food Package IV.) Additional amounts of tofu may be substituted, up to the maximum allowance for fluid milk for lactose intolerance or
other reasons, as established by State agency policy.
12 For women, soy-based beverage may be substituted for milk on a quart for quart basis up to the total maximum allowance of milk. Tofu may
be substituted for milk at the rate of 1 pound of tofu per 1 quart of milk. (No more than a total of 4 quarts of milk may be substituted for a combination of cheese, yogurt or tofu for women in Food Packages V and VI. No more than a total of 6 quarts of milk may be substituted for a combination of cheese, yogurt or tofu for women in Food Package VII.). Additional amounts of tofu may be substituted, up to the maximum allowances for fluid milk, for lactose intolerance or other reasons, as established by State agency policy.
13 At least one-half of the total number of breakfast cereals on the State agency’s authorized food list must have whole grain as the primary ingredient and meet labeling requirements for making a health claim as a ‘‘whole grain food with moderate fat content’’ as defined in Table 4 of
paragraph (e)(12) of this section.

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14 Both fresh fruits and fresh vegetables must be authorized by State agencies. Processed fruits and vegetables, i.e., canned (shelf-stable), frozen, and/or dried fruits and vegetables may also be authorized to offer a wider variety and choice for participants. State agencies may choose to
authorize one or more of the following processed fruits and vegetables: canned fruit, canned vegetables, frozen fruit, frozen vegetables, dried
fruit, and/or dried vegetables. The cash-value voucher may be redeemed for any eligible fruit and vegetable (refer to Table 4 of paragraph
(e)(12) of this section and its footnotes). Except as authorized in paragraph (b)(1)(i) of this section, State agencies may not selectively choose
which fruits and vegetables are available to participants. For example, if a State agency chooses to offer dried fruits, it must authorize all WIC-eligible dried fruits.
15 The monthly value of the fruit/vegetable cash-value vouchers will be adjusted annually for inflation as described in § 246.16(j).
16 Whole wheat and/or whole grain bread must be authorized. State agencies have the option to also authorize brown rice, bulgur, oatmeal,
whole-grain barley, whole wheat macaroni products, or soft corn or whole wheat tortillas on an equal weight basis.
17 Canned legumes may be substituted for dry legumes at the rate of 64 oz. (e.g., four 16-oz cans) of canned beans for 1 pound dry beans. In
Food Packages V and VII, both beans and peanut butter must be provided. However, when individually tailoring Food Packages V or VII for nutritional reasons (e.g., food allergy, underweight, participant preference), State agencies have the option to authorize the following substitutions: 1
pound dry and 64 oz. canned beans/peas (and no peanut butter); or 2 pounds dry or 128 oz. canned beans/peas (and no peanut butter); or 36
oz. peanut butter (and no beans).

(11) Maximum monthly allowances of
supplemental foods for children and
women with qualifying conditions in

Food Package III. The maximum
monthly allowances, options and
substitution rates of supplemental foods

for participants with qualifying
conditions in Food Package III are stated
in Table 3 as follows:

TABLE 3—MAXIMUM MONTHLY ALLOWANCES (MMA) OF SUPPLEMENTAL FOODS FOR CHILDREN AND WOMEN WITH
QUALIFYING CONDITIONS IN FOOD PACKAGE III
Children
Foods 1
1 through 4 years
Juice, single strength 6 ........
WIC Formula 7 8 ...................
Milk ......................................
Breakfast cereal 15 16 ...........
Cheese ................................
Eggs ....................................
Fruits and vegetables 17 18 19

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Whole wheat or whole grain
bread 20.
Fish (canned) ......................
Legumes, dry 21 and/or Peanut butter.

Women

Pregnant and partially
breastfeeding (up to 1 year
postpartum) 2

Postpartum (up to 6 months
postpartum) 3

Fully breastfeeding, (up to 1
year post-partum) 4 5

128 fl oz .....................
455 fl oz liquid concentrate.
16 qt 9 10 11 12 13 ...........
36 oz ..........................
N/A .............................
1 dozen ......................
$8.00 in cash-value
vouchers.
2 lb .............................

144 fl oz ..............................
455 fl oz liquid concentrate

96 fl oz ................................
455 fl oz liquid concentrate

144 fl oz.
455 fl oz liquid concentrate.

22 qt 9 10 11 12 14 ....................
36 oz ...................................
N/A ......................................
1 dozen ...............................
$10.00 in cash-value vouchers.
1 lb ......................................

16 qt 9 10 11 12 14 ....................
36 oz ...................................
N/A ......................................
1 dozen ...............................
$10.00 in cash-value vouchers.
N/A ......................................

24 qt 9 10 11 12 14.
36 oz.
1 lb.
2 dozen.
$10.00 in cash-value vouchers.
1 lb.

N/A .............................
1 lb .............................
Or ...............................
18 oz ..........................

N/A ......................................
1 lb ......................................
And ......................................
18 oz ...................................

N/A ......................................
1 lb ......................................
Or ........................................
18 oz ...................................

30 oz.
1 lb.
And.
18 oz.

Table 3 Footnotes: N/A=the supplemental food is not authorized in the corresponding food package.
1 Table 4 of paragraph (e)(12) of this section describes the minimum requirements and specifications for the supplemental foods. The competent professional authority (CPA), as established by State agency policy, is authorized to determine nutritional risk and prescribe supplemental
foods per medical documentation.
2 This food package is issued to two categories of WIC participants: Women participants with singleton pregnancies and breastfeeding women
whose partially (mostly) breastfed infants receive formula from the WIC Program in amounts that do not exceed the maximum formula allowances as appropriate for the age of the infant as described in Table 1 of paragraph (e)(9) of this section.
3 This food package is issued to two categories of WIC participants: Non-breastfeeding postpartum women and breastfeeding postpartum
women whose breastfed infants receive more than the maximum infant formula allowances as appropriate for the age of the infant as described
in Table 1 of paragraph (e)(9) of this section.
4 This food package is issued to four categories of WIC participants: Fully breastfeeding women whose infants do not receive formula from the
WIC Program; women pregnant with two or more fetuses; women partially (mostly) breastfeeding multiple infants from the same pregnancy, and
pregnant women who are also partially (mostly) breastfeeding singleton infants.
5 Women fully breastfeeding multiple infants from the same pregnancy are prescribed 1.5 times the maximum allowances.
6 Combinations of single-strength and concentrated juices may be issued provided that the total volume does not exceed the maximum monthly allowance for single-strength juice.
7 WIC formula means infant formula, exempt infant formula, or WIC-eligible nutritionals.
8 Powder and ready-to-feed may be substituted at rates that provide comparable nutritive value.
9 Whole milk is the standard milk for issuance to 1-year-old children (12 through 23 months). Fat-reduced milks may be issued to 1-year old
children as determined appropriate by the health care provider per medical documentation. Lowfat (1%) or nonfat milks are the standard milks for
issuance for children ≥ 24 months of age and women. Whole milk or reduced fat (2%) milk may be substituted for lowfat (1%) or nonfat milk for
children ≥ 24 months of age and women as determined appropriate by the health care provider per medical documentation.
10 Evaporated milk may be substituted at the rate of 16 fluid ounces of evaporated milk per 32 fluid ounces of fluid milk or a 1:2 fluid ounce
substitution ratio. Dry milk may be substituted at an equal reconstituted rate to fluid milk.
11 For children and women, cheese may be substituted for milk at the rate of 1 pound of cheese per 3 quarts of milk. For children and women
in the pregnant, partially breastfeeding and postpartum food packages, no more than 1 pound of cheese may be substituted. For women in the
fully breastfeeding food package, no more than 2 pounds of cheese may be substituted for milk. State agencies do not have the option to issue
additional amounts of cheese beyond these maximums even with medical documentation. (No more than a total of 4 quarts of milk may be substituted for a combination of cheese, yogurt or tofu for children and women in the pregnant, partially breastfeeding and postpartum food packages. No more than a total of 6 quarts of milk may be substituted for a combination of cheese, yogurt or tofu for women in the fully breastfeeding
food package.)

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12 For children and women, yogurt may be substituted for fluid milk at the rate of 1 quart of yogurt per 1 quart of milk; a maximum of 1 quart of
milk can be substituted. Additional amounts of yogurt are not authorized. Whole yogurt is the standard yogurt for issuance to 1-year-old children
(12 through 23 months). Lowfat or nonfat yogurt may be issued to 1-year-old children (12 months to 23 months) as determined appropriate by
the health care provider per medical documentation. Lowfat or nonfat yogurts are the standard yogurt for issuance to children ≥ 24 months of
age and women. Whole yogurt may be substituted for lowfat or nonfat yogurt for children ≥ 24 months of age and women as determined appropriate by the health care provider per medical documentation. (No more than a total of 4 quarts of milk may be substituted for a combination of
cheese, yogurt or tofu for children and women in the pregnant, partially breastfeeding and postpartum food packages. No more than a total of 6
quarts of milk may be substituted for a combination of cheese, yogurt or tofu for women in the fully breastfeeding food package.)
13 For children, soy-based beverage and tofu may be substituted for milk as determined appropriate by the health care provider per medical
documentation. Soy-based beverage may be substituted for milk on a quart for quart basis up to the total maximum allowance of milk. Tofu may
be substituted for milk for children at the rate of 1 pound of tofu per 1 quart of milk. (No more than a total of 4 quarts of milk may be substituted
for a combination of cheese, yogurt or tofu for children.) Additional amounts of tofu may be substituted, up to the maximum allowance for fluid
milk for children, as determined appropriate by the health care provider per medical documentation.
14 For women, soy-based beverage may be substituted for milk on a quart for quart basis up to the total maximum monthly allowance of milk.
Tofu may be substituted for milk at the rate of 1 pound of tofu per 1 quart of milk. (No more than a total of 4 quarts of milk may be substituted for
a combination of cheese, yogurt or tofu for women in the pregnant, partially breastfeeding and postpartum food packages. No more than a total
of 6 quarts of milk may be substituted for a combination of cheese, yogurt or tofu for women in the fully breastfeeding food package.) Additional
amounts of tofu may be substituted, up to the maximum allowances for fluid milk, as determined appropriate by the health care provider per
medical documentation.
15 32 dry ounces of infant cereal may be substituted for 36 ounces of breakfast cereal as determined appropriate by the health care provider
per medical documentation.
16 At least one half of the total number of breakfast cereals on the State agency’s authorized food list must have whole grain as the primary ingredient and meet labeling requirements for making a health claim as a ‘‘whole grain food with moderate fat content’’ as defined in Table 4 of
paragraph (e)(12) of this section.
17 Both fresh fruits and fresh vegetables must be authorized by State agencies. Processed fruits and vegetables, i.e., canned (shelf-stable), frozen, and/or dried fruits and vegetables may also be authorized to offer a wider variety and choice for participants. State agencies may choose to
authorize one or more of the following processed fruits and vegetables: canned fruit, canned vegetables, frozen fruit, frozen vegetables, dried
fruit, and/or dried vegetables. The cash-value voucher may be redeemed for any eligible fruit and vegetable (refer to Table 4 of paragraph
(e)(12) of this section and its footnotes). Except as authorized in paragraph (b)(1)(i) of this section, State agencies may not selectively choose
which fruits and vegetables are available to participants. For example, if a State agency chooses to offer dried fruits, it must authorize all WIC-eligible dried fruits.
18 Children and women whose special dietary needs require the use of pureed foods may receive commercial jarred infant food fruits and
vegetables in lieu of the cash-value voucher. Children may receive 128 oz of commercial jarred infant food fruits and vegetables and women
may receive 160 oz of commercial jarred infant food fruits and vegetables in lieu of the cash-value voucher. Infant food fruits and vegetables
may be substituted for the cash-value voucher as determined appropriate by the health care provider per medical documentation.
19 The monthly value of the fruit/vegetable cash-value vouchers will be adjusted annually for inflation as described in § 246.16(j).
20 Whole wheat and/or whole grain bread must be authorized. State agencies have the option to also authorize brown rice, bulgur, oatmeal,
whole-grain barley, whole wheat macaroni products, or soft corn or whole wheat tortillas on an equal weight basis.
21 Canned legumes may be substituted for dry legumes at the rate of 64 oz. (e.g., four 16-oz cans) of canned beans for 1 pound dry beans. In
Food Packages V and VII, both beans and peanut butter must be provided. However, when individually tailoring Food Packages V or VII for nutritional reasons (e.g., food allergy, underweight, participant preference), State agencies have the option to authorize the following substitutions: 1
pound dry and 64 oz. canned beans/peas (and no peanut butter); or 2 pounds dry or 128 oz. canned beans/peas (and no peanut butter); or 36
oz. peanut butter (and no beans).

(12) Minimum requirements and
specifications for supplemental foods.

Table 4 describes the minimum
requirements and specifications for

supplemental foods in all food
packages:

TABLE 4—MINIMUM REQUIREMENTS AND SPECIFICATIONS FOR SUPPLEMENTAL FOODS
Categories/foods
WIC FORMULA:
Infant formula ................

Exempt infant formula ...

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WIC-eligible
nutritionals.1.

Minimum requirements and specifications

All authorized infant formulas must:
(1) Meet the definition for an infant formula in section 201(z) of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 321(z)) and meet the requirements for an infant formula under section 412 of the Federal Food, Drug
and Cosmetic Act, as amended (21 U.S.C. 350a) and the regulations at 21 CFR parts 106 and 107;
(2) Be designed for enteral digestion via an oral or tube feeding;
(3) Provide at least 10 mg iron per liter (at least 1.5 mg iron/100 kilocalories) at standard dilution;
(4) Provide at least 67 kilocalories per 100 milliliters (approximately 20 kilocalories per fluid ounce) at standard dilution.
(5) Not require the addition of any ingredients other than water prior to being served in a liquid state.
All authorized exempt infant formula must:
(1) Meet the definition and requirements for an exempt infant formula under section 412(h) of the Federal Food,
Drug, and Cosmetic Act as amended (21 U.S.C. 350a(h)) and the regulations at 21 CFR parts 106 and 107;
and
(2) Be designed for enteral digestion via an oral or tube feeding.
Certain enteral products that are specifically formulated to provide nutritional support for individuals with a qualifying condition, when the use of conventional foods is precluded, restricted, or inadequate. Such WIC-eligible
nutritionals must serve the purpose of a food, meal or diet (may be nutritionally complete or incomplete) and
provide a source of calories and one or more nutrients; be designed for enteral digestion via an oral or tube
feeding; and may not be a conventional food, drug, flavoring, or enzyme.

MILK AND MILK ALTERNATIVES:

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TABLE 4—MINIMUM REQUIREMENTS AND SPECIFICATIONS FOR SUPPLEMENTAL FOODS—Continued
Categories/foods
Cow’s milk 2 ......................

Goat’s milk ...........................

Cheese .................................

Yogurt (cow’s milk) ...............

Tofu ......................................

Soy-based beverage ............

JUICE ...................................

EGGS ...................................

BREAKFAST CEREAL
(READY-TO-EAT AND INSTANT AND REGULAR
HOT CEREALS).

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FRUITS AND VEGETABLES
(FRESH AND PROCESSED) 4 5 6 8 9.

WHOLE WHEAT BREAD,
WHOLE GRAIN BREAD,
AND WHOLE GRAIN OPTIONS:
Bread .............................

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Minimum requirements and specifications
Must conform to FDA standard of identity for whole, reduced fat, lowfat, or nonfat milks (21 CFR 131.110). Must
be pasteurized. May be flavored or unflavored. May be fluid, shelf-stable, evaporated (21 CFR 131.130), or dry.
Dry whole milk must conform to FDA standard of identity (21 CFR 131.147). Nonfat dry milk must conform to
FDA standard of identity (21 CFR 131.127).
Cultured milks must conform to FDA standard of identity for cultured milk, e.g. cultured buttermilk, kefir cultured
milk, acidophilus cultured milk (21 CFR 131.112).
Acidified milk must conform to FDA standard of identity for acidified milk, e.g., acidified kefir milk, acidified acidophilus milk or acidified buttermilk (21 CFR 131.111).
All reduced fat, lowfat, and nonfat cow’s milk types and varieties must contain at least 400 IU of vitamin D per
quart (100 IU per cup) and 2000 IU of vitamin A per quart (500 IU per cup).
Must be pasteurized. May be flavored or unflavored. May be fluid, shelf-stable, evaporated or dry (i.e., powdered).
All reduced fat, lowfat, and nonfat goat’s milk must contain at least 400 IU of vitamin D per quart (100 IU per cup)
and 2000 IU of vitamin A per quart (500 IU per cup).
Domestic cheese made from 100 percent pasteurized milk. Must conform to FDA standard of identity (21 CFR
part 133); Monterey Jack, Colby, natural Cheddar, Swiss, Brick, Muenster, Provolone, part-skim or whole Mozzarella, pasteurized process American, or blends of any of these cheeses are authorized.
Cheeses that are labeled low, free, reduced, less or light in sodium, fat or cholesterol are WIC eligible.
Yogurt must be pasteurized and conform to FDA standard of identity for whole fat (21 CFR 131.200), lowfat (21
CFR 131.203), or nonfat (21 CFR 131.206); plain or flavored with ≤40 g of total sugars per 1 cup yogurt. Yogurts that are fortified with vitamin A and D and other nutrients may be allowed at the State agency’s option.
Yogurts sold with accompanying mix-in ingredients such as granola, candy pieces, honey, nuts and similar ingredients are not authorized. Drinkable yogurts are not authorized.
Calcium-set tofu prepared with calcium salts (e.g., calcium sulfate). May not contain added fats, sugars, oils, or
sodium. Tofu must be calcium-set, i.e., contain calcium salts, but may also contain other coagulants, i.e., magnesium chloride.
Must be fortified to meet the following nutrient levels: 276 mg calcium per cup, 8 g protein per cup, 500 IU vitamin A per cup, 100 IU vitamin D per cup, 24 mg magnesium per cup, 222 mg phosphorus per cup, 349 mg potassium per cup, 0.44 mg riboflavin per cup, and 1.1 mcg vitamin B12 per cup, in accordance with fortification
guidelines issued by FDA. May be flavored or unflavored.
Must be pasteurized 100% unsweetened fruit juice. Must contain at least 30 mg of vitamin C per 100 mL of juice.
Must conform to FDA standard of identity as appropriate (21 CFR part 146) or vegetable juice must conform to
FDA standard of identity as appropriate (21 CFR part 156). With the exception of 100% citrus juices, State
agencies must verify the vitamin C content of all State-approved juices. Juices that are fortified with other nutrients may be allowed at the State agency’s option. Juice may be fresh, from concentrate, frozen, canned, or
shelf-stable. Blends of authorized juices are allowed.
Vegetable juice may be regular or lower in sodium.
Fresh shell domestic hens’ eggs or dried eggs mix (must conform to FDA standard of identity in 21 CFR 160.105)
or pasteurized liquid whole eggs (must conform to FDA standard of identity in 21 CFR 160.115).
Hard boiled eggs, where readily available for purchase in small quantities, may be provided for homeless participants.
Must contain a minimum of 28 mg iron per 100 g dry cereal.
Must contain ≤21.2 g sucrose and other sugars per 100 g dry cereal (≤6 g per dry oz).
At least half of the cereals authorized on a State agency’s food list must have whole grain as the primary ingredient by weight AND meet labeling requirements for making a health claim as a ‘‘whole grain food with moderate fat content’’.3
Any variety of fresh (as defined by 21 CFR 101.95) whole or cut fruit without added sugars.
Any variety of fresh (as defined by 21 CFR 101.95) whole or cut vegetable, except white potatoes, without added
sugars, fats, or oils (orange yams and sweet potatoes are allowed).
Any variety of canned fruits (must conform to FDA standard of identity as appropriate (21 CFR part 145)); including applesauce, juice pack or water pack without added sugars, fats, oils, or salt (i.e., sodium). The fruit must
be listed as the first ingredient.
Any variety of frozen fruits without added sugars, fats, oils, or salt (i.e., sodium).
Any variety of canned or frozen vegetables, except white potatoes (orange yams and sweet potatoes are allowed); without added sugars, fats, or oils. Vegetable must be listed as the first ingredient. May be regular or
lower in sodium. Must conform to FDA standard of identity as appropriate (21 CFR part 155).
Any type of dried fruits or dried vegetable, except white potatoes (orange yams and sweet potatoes are allowed);
without added sugars, fats, oils, or salt (i.e., sodium).
Any type of immature beans, peas, or lentils, fresh or in canned 5 forms.
Any type of frozen beans (immature or mature). Beans purchased with the CVV may contain added vegetables
and fruits, but may not contain added sugars, fats, oils, or meat as purchased. Canned beans, peas, or lentils
may be regular or lower in sodium content.
State agencies must allow organic forms of WIC-eligible fruits and vegetables.

Whole wheat bread must conform to FDA standard of identity (21 CFR 136.180). (Includes whole wheat buns
and rolls.) ‘‘Whole wheat flour’’ and/or ‘‘bromated whole wheat flour’’ must be the only flours listed in the ingredient list.

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TABLE 4—MINIMUM REQUIREMENTS AND SPECIFICATIONS FOR SUPPLEMENTAL FOODS—Continued

Categories/foods

Whole Grain Options ....

FISH (CANNED) 5 ................

MATURE LEGUMES (DRY
BEANS AND PEAS) 7.

PEANUT BUTTER ...............

INFANT FOODS:
Infant Cereal .................
Infant Fruits ...................
Infant Vegetables ..........

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Infant Meat ....................

Minimum requirements and specifications
OR
Whole grain bread must conform to FDA standard of identity (21 CFR 136.110) (includes whole grain buns and
rolls).
AND
Whole grain must be the primary ingredient by weight in all whole grain bread products.
AND
Must meet FDA labeling requirements for making a health claim as a ‘‘whole grain food with moderate fat content’’.3
Brown rice, bulgur, oats, and whole-grain barley without added sugars, fats, oils, or salt (i.e., sodium). May be instant-, quick-, or regular-cooking.
Soft corn or whole wheat tortillas. Soft corn tortillas made from ground masa flour (corn flour) using traditional
processing methods are WIC-eligible, e.g., whole corn, corn (masa), whole ground corn, corn masa flour, masa
harina, and white corn flour. For whole wheat tortillas, ‘‘whole wheat flour’’ must be the only flour listed in the
ingredient list.
Whole wheat macaroni products. Must conform to FDA standard of identity (21 CFR 139.138) and have no added
sugars, fats, oils, or salt (i.e., sodium). ‘‘Whole wheat flour’’ and/or ‘‘whole durum wheat flour’’ must be the only
flours listed in the ingredient list. Other shapes and sizes that otherwise meet the FDA standard of identity for
whole wheat macaroni (pasta) products (139.138), and have no added sugars, fats, oils, or salt (i.e., sodium),
are also authorized (e.g., whole wheat rotini, and whole wheat penne).
Canned only:
Light tuna (must conform to FDA standard of identity (21 CFR 161.190));
Salmon (Pacific salmon must conform to FDA standard of identity (21 CFR 161.170));
Sardines; and
Mackerel (N. Atlantic Scomber scombrus; Chub Pacific Scomber japonicas; Jack Mackerel 10
May be packed in water or oil. Pack may include bones or skin. Added sauces and flavorings, e.g., tomato
sauce, mustard, lemon, are authorized at the State agency’s option. May be regular or lower in sodium content.
Any type of mature dry beans, peas, or lentils in dry-packaged or canned 5 forms. Examples include but are not
limited to black beans, black-eyed peas, garbanzo beans (chickpeas), great northern beans, white beans (navy
and pea beans), kidney beans, mature lima (‘‘butter beans’’), fava and mung beans, pinto beans, soybeans/
edamame, split peas, lentils, and refried beans. All categories exclude soups. May not contain added sugars,
fats, oils, vegetables, fruits or meat as purchased. Canned legumes may be regular or lower in sodium content.11
Baked beans may only be provided for participants with limited cooking facilities.11
Peanut butter and reduced fat peanut butter (must conform to FDA Standard of Identity (21 CFR 164.150));
creamy or chunky, regular or reduced fat, salted or unsalted forms are allowed. Peanut butters with added
marshmallows, honey, jelly, chocolate or similar ingredients are not authorized.
Infant cereal must contain a minimum of 45 mg of iron per 100 g of dry cereal.12
Any variety of single ingredient commercial infant food fruit without added sugars, starches, or salt (i.e., sodium).
Texture may range from strained through diced. The fruit must be listed as the first ingredient.13
Any variety of single ingredient commercial infant food vegetables without added sugars, starches, or salt (i.e.,
sodium). Texture may range from strained through diced. The vegetable must be listed as the first ingredient.14
Any variety of commercial infant food meat or poultry, as a single major ingredient, with added broth or gravy.
Added sugars or salt (i.e. sodium) are not allowed. Texture may range from pureed through diced.15

Table 4 Footnotes: FDA = Food and Drug Administration of the U.S. Department of Health and Human Services.
1 The following are not considered a WIC-eligible nutritional: Formulas used solely for the purpose of enhancing nutrient intake, managing body
weight, addressing picky eaters or used for a condition other than a qualifying condition (e.g., vitamin pills, weight control products, etc.); medicines or drugs, as defined by the Food, Drug and Cosmetic Act (21 U.S.C. 350a) as amended; enzymes, herbs, or botanicals; oral rehydration
fluids or electrolyte solutions; flavoring or thickening agents; and feeding utensils or devices (e.g., feeding tubes, bags, pumps) designed to administer a WIC-eligible formula.
2 All authorized milks must conform to FDA standards of identity for milks as defined by 21 CFR part 131 and meet WIC’s requirements for vitamin fortification as specified in Table 4 of paragraph (e)(12) of this section. Additional authorized milks include, but are not limited to: calciumfortified, lactose-reduced and lactose-free, organic and UHT pasteurized milks. Other milks are permitted at the State agency’s discretion provided that the State agency determines that the milk meets the minimum requirements for authorized milk.
3 FDA Health Claim Notification for Whole Grain Foods with Moderate Fat Content at http://www.fda.gov/food/ingredientspackaginglabeling/
labelingnutrition/ucm073634.htm
4 Processed refers to frozen, canned,5 or dried.
5 ‘‘Canned’’ refers to processed food items in cans or other shelf-stable containers, e.g., jars, pouches.
6 The following are not authorized: herbs and spices; creamed vegetables or vegetables with added sauces; mixed vegetables containing noodles, nuts or sauce packets, vegetable-grain (pasta or rice) mixtures; fruit-nut mixtures; breaded vegetables; fruits and vegetables for purchase
on salad bars; peanuts or other nuts; ornamental and decorative fruits and vegetables such as chili peppers on a string; garlic on a string;
gourds; painted pumpkins; fruit baskets and party vegetable trays; decorative blossoms and flowers, and foods containing fruits such as blueberry muffins and other baked goods. Home-canned and home-preserved fruits and vegetables are not authorized.
7 Mature legumes in dry-packed or canned forms may be purchased with the WIC food instrument only. Immature varieties of fresh or canned
beans and frozen beans of any type (immature or mature) may be purchased with the cash-value voucher only. Juices are provided as separate
food WIC categories and are not authorized under the fruit and vegetable category.
8 Excludes white potatoes, mixed vegetables containing white potatoes, dried white potatoes; catsup or other condiments; pickled vegetables;
olives; soups; juices; and fruit leathers and fruit roll-ups. Canned tomato sauce, tomato paste, salsa and spaghetti sauce without added sugar,
fats, or oils are authorized.
9 State agencies have the option to allow only lower sodium canned vegetables for purchase with the cash-value voucher.
10 FDA defines jack mackerel as any of the following six species: Trachurus declivis, trachurus japonicas, trachurur symmetricus, trachurus
murphyi, trachurus novaezelandiae, and trachurus lathami in The Seafood List at http://www.fda.gov/Food/GuidanceRegulation/
GuidanceDocumentsRegulatoryInformation/Seafood/ucm113260.htm. King mackerel is not authorized.

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11 The following are not authorized in the mature legume category: soups; immature varieties of legumes, such as those used in canned green
peas, green beans, snap beans, yellow beans, and wax beans; baked beans with meat, e.g., beans and franks; and beans containing added
sugars (with the exception of baked beans), fats, oils, meats, fruits or vegetables.
12 Infant cereals containing infant formula, milk, fruit, or other non-cereal ingredients are not allowed.
13 Mixtures with cereal or infant food desserts (e.g., peach cobbler) are not authorized; however, combinations of single ingredients (e.g.,
apple-banana) and combinations of single ingredients of fruits and/or vegetables (e.g., apples and squash) are allowed.
14 Combinations of single ingredients (e.g., peas and carrots) and combinations of single ingredients of fruits and/or vegetables (e.g., apples
and squash) are allowed. Mixed vegetables with white potato as an ingredient (e.g., mixed vegetables) are authorized. Infant foods containing
white potatoes as the primary ingredient are not authorized.
15 No infant food combinations (e.g., meat and vegetables) or dinners (e.g., spaghetti and meatballs) are allowed.

5. In § 246.12:
a. Remove the phrase ‘‘WIC-eligible
medical foods’’ and add in its place
‘‘WIC-eligible nutritionals’’ wherever it
appears;
■ b. Amend paragraph (a)(1) by
removing the words ‘‘and farmers’’ after
‘‘vendors’’ in the second sentence and
adding in their place the phrase ‘‘,
farmers and farmers’ markets,’’;
■ c. Amend paragraphs (f)(2)(ii) and
(f)(2)(iv) by removing the word
‘‘vouchermay’’ and adding in its place
the words ‘‘voucher may’’ whenever it
appears in these paragraphs;
■ d. Add a new paragraph (f)(4);
■ e. Amend paragraph (g)(3)(i) by
removing the words ‘‘varieties of’’ in
both places that it appears in the second
sentence and adding in their place the
word ‘‘different’’;
■ f. Amend paragraph (h)(3)(i) by
removing the word ‘‘vouchersonly’’ and
adding in its place the words ‘‘vouchers
only’’;
■ g. Amend paragraph (h)(3)(vii) by
adding the words ‘‘, or cash-value
vouchers’’ after the word ‘‘instruments’’;
■ h. Revise the heading and the first two
sentences of paragraph (h)(3)(viii);
■ i. Amend paragraph (h)(3)(x) by
removing the last sentence of the
paragraph;
■ j. Redesignate paragraphs (h)(3)(xi)
through (h)(3)(xxv) as paragraphs
(h)(3)(xii) through (h)(3)(xxvi) and add a
new paragraph (h)(3)(xi);
■ k. Amend paragraph (l)(1)(ii)(A) by
adding the words ‘‘, or cash-value
vouchers,’’ after the word
‘‘instruments’’;
■ l. Revise paragraph (o);
■ m. Amend paragraphs (r)(3) and (t) by
adding the phrase ‘‘, farmers’ markets,’’
after the word ‘‘farmer’’;
■ n. Amend paragraph (u)(5) by adding
the words ‘‘, farmers, farmers’ markets,’’
after the word ‘‘contractors’’;
■ o. Revise the heading and
introductory text of paragraph (v);
■ p. Amend paragraph (v)(1) by adding
the words ‘‘or farmers’ market’’ after the
word ‘‘farmer’’;
■ q. Revise paragraph (v)(1)(iv);
■ r. Amend paragraphs (v)(2) through
(v)(6) by adding the words ‘‘or farmers’
market’’ after the word ‘‘farmer’’
wherever it occurs;
■ s. Revise paragraph (v)(3);

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■
■

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t. Redesignate paragraphs (v)(4)
through (v)(6) as paragraphs (v)(5)
through (v)(7), and add a new paragraph
(v)(4); and
■ u. Add a new paragraph (v)(8).
The revisions and additions read as
follows:
■

§ 246.12

Food delivery systems.

*

*
*
*
*
(f) * * *
(4) Split tender transactions. The
State agency must implement
procedures that allow the participant,
authorized representative or proxy to
pay the difference when a fruit and
vegetable purchase exceeds the value of
the cash-value vouchers.
*
*
*
*
*
(h) * * *
(3) * * *
(viii) Food instrument and cash-value
voucher redemption. The vendor must
submit food instruments and cash-value
vouchers for redemption in accordance
with the redemption procedures
described in the vendor agreement. The
vendor may redeem a food instrument
or cash-value voucher only within the
specified time period. * * *
(xi) Split tender for cash-value
vouchers. The vendor must allow the
participant, authorized representative or
proxy to pay the difference when a fruit
and vegetable purchase exceeds the
value of the cash-value vouchers (also
known as a split tender transaction).
*
*
*
*
*
(o) Participant parent/caretaker,
proxy, vendor, farmer, farmers’ market,
and home food delivery contractor
complaints. The State agency must have
procedures to document the handling of
complaints by participants, parents or
caretakers of infant or child
participants, proxies, vendors, farmers,
farmers’ markets, home food delivery
contractors, and direct distribution
contractors. Complaints of civil rights
discrimination must be handled in
accordance with § 246.8(b).
*
*
*
*
*
(v) Farmers and farmers’ markets. The
State agency may authorize farmers,
farmers’ markets, and/or roadside stands
to accept the cash-value voucher for
eligible fruits and vegetables. The State
agency must enter into written

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agreements with all authorized farmers
and/or farmers’ markets. The agreement
must be signed by a representative who
has legal authority to obligate the farmer
or farmers’ market and a representative
of the State agency. The agreement must
be for a period not to exceed 3 years.
Only farmers or farmers’ markets
authorized by the State agency may
redeem the fruit and vegetable cashvalue voucher. The State agency must
require farmers or farmers’ markets to
reapply at the expiration of their
agreements and must provide farmers or
farmers markets with not less than 15
days advance written notice of the
expiration of the agreement.
*
*
*
*
*
(1) * * *
(iv) Redeem the cash-value voucher in
accordance with a procedure
established by the State agency. Such
procedure must include a requirement
for the farmer or farmers’ market to
allow the participant, authorized
representative or proxy to pay the
difference when the purchase of fruits
and vegetables exceeds the value of the
cash-value vouchers (also known as a
split tender transaction);
*
*
*
*
*
(3) Neither the State agency nor the
farmer or farmers’ market has an
obligation to renew the agreement. The
State agency, the farmer, or farmers’
market may terminate the agreement for
cause after providing advance written
notification.
(4) Farmer agreements for State
agencies that do not authorize farmers.
Those State agencies which authorize
farmers’ markets but not individual
farmers shall require authorized
farmers’ markets to enter into a written
agreement with each farmer within the
market that is authorized to accept cashvalue vouchers. The State agency shall
set forth the required terms for the
written agreement as defined in
§ 246.12(v)(1) and (v)(2), and provide a
sample agreement for use by the
farmers’ market.
*
*
*
*
*
(8) Monitoring farmers and farmers’
markets.—(i) The State agency must
design and implement a system for
monitoring its authorized farmers and
farmers’ markets for compliance with

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program requirements. The State agency
must document, at a minimum, the
following information for all monitoring
visits: name(s) of the farmer, farmers
market, or roadside stand; name(s) and
signature(s) of the reviewer(s); date of
review; and nature of problem(s)
detected.
(ii) Compliance buys. For compliance
buys, the State agency must also
document:
(A) The date of the buy;
(B) A description of the farmer (and
farmers’ market, as appropriate)
involved in each transaction;
(C) The types and quantities of items
purchased, current retail prices or prices
charged other customers, and price
charged for each item purchased, if
available. Price information may be
obtained prior to, during, or subsequent
to the compliance buy; and
(D) The final disposition of all items
as destroyed, donated, provided to other
authorities, or kept as evidence.
■ 6. In § 246.16, revise paragraph (j)(2)
to read as follows:
§ 246.16

Distribution of funds.

*
*
*
*
(j) * * *
(2) Base value of the fruit and
vegetable voucher. The base year for
calculation of the value of the fruit and
vegetable voucher is fiscal year 2008.
The base value to be used equals:
(i) $8 for children; and
(ii) $10 for women.
*
*
*
*
*
■ 7. In § 246.18:
■ a. Revise paragraph (a)(4);
■ b. Amend paragraphs (b), (d), (e), and
(f) by adding the phrase ‘‘or farmers’
market’’ after the word ‘‘farmer’’
whenever it appears;
■ c. Revise the first sentence in
paragraph (b)(9);
■ d. Amend paragraph (c) introductory
text by adding the phrase ‘‘, farmer, or
farmers’ market’’ after the word
‘‘vendor’’ in the last sentence; and

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e. Revise paragraph (c)(2);
The revisions and additions read as
follows:

■

§ 246.18 Administrative review of State
agency actions.

(a) * * *
(4) Farmer or farmers’ market
appeals.—(i) Adverse actions. The State
agency shall provide a hearing
procedure whereby farmers or farmers’
markets adversely affected by certain
actions of the State agency may appeal
those actions. A farmer or farmers’
market may appeal an action of the State
agency denying its application to
participate, imposing a sanction, or
disqualifying it from participation in the
program. Expiration of an agreement is
not subject to appeal.
(ii) Effective date of adverse actions
against farmers or farmers’ markets. The
State agency must make denials of
authorization and disqualifications
effective on the date of receipt of the
notice of adverse action. The State
agency must make all other adverse
actions effective no earlier than 15 days
after the date of the notice of the adverse
action and no later than 90 days after
the date of the notice of adverse action
or, in the case of an adverse action that
is subject to administrative review, no
later than the date the farmer receives
the review decision. The State agency
must make all other adverse actions
effective no earlier than 15 days after
the date of the notice of adverse action
and no later than 90 days after the date
of the notice of adverse action or, in the
case of an adverse action that is subject
to an administrative review, no later
than the date the farmer or farmers’
market receives the review decision.
(b) * * *
(9) Written notification of the review
decision, including the basis for the
decision, within 90 days from the date
of receipt of the request for an
administrative review from a vendor,
farmer, or farmer’s market, and within

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60 days from the date of receipt of a
local agency’s request for an
administrative review. * * *
(c) * * *
(2) A decision-maker who is someone
other than the person who rendered the
initial decision on the action and whose
determination is based solely on
whether the State agency has correctly
applied Federal and State statutes,
regulations, policies, and procedures
governing the Program, according to the
information provided to the vendor,
farmer, or farmers’ market concerning
the cause(s) for the adverse action and
the response from the vendor, farmer, or
farmers’ market.
*
*
*
*
*
■ 8. In § 246.23:
■ a. Amend paragraph (a)(1) by
removing the words ‘‘or food
instruments’’ and by adding in its place
the phrase ‘‘food instruments, or cashvalue vouchers’’; and
■ b. Revise paragraph (a)(2).
The revisions read as follows:
§ 246.23

Claims and penalties.

(a) * * *
(2) If FNS determines that any part of
the Program funds received by a State
agency; or supplemental foods, either
purchased or donated commodities; or
food instruments or cash-value
vouchers, were lost as a result of thefts,
embezzlements, or unexplained causes,
the State agency shall, on demand by
FNS, pay to FNS a sum equal to the
amount of the money or the value of the
supplemental foods, food instruments,
or cash-value vouchers so lost.
*
*
*
*
*
Dated: February 20, 2014.
Janey Thornton,
Acting Under Secretary, Food, Nutrition, and
Consumer Services.
[FR Doc. 2014–04105 Filed 2–28–14; 8:45 am]
BILLING CODE 3410–30–P

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