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Nutrition Assessment During a Formula Shortage

The WIC nutrition assessment is an especially important WIC service during the current infant formula supply shortage. VENA Guidance and its participant-centered, health outcome-based approach can help WIC staff identify potential nutrition risks, barriers, and solutions for infants who rely on formula, whether it be their only source of nutrition (i.e., fully formula-fed) or a part of it (i.e., they consume a combination of infant formula and breast milk, also referred to as combination feeding), including referrals.

 

Image of 6 Approaches to VENA

Below are some assessment considerations, tools and resources that may help WIC staff as they work with parents and caretakers of babies who rely on infant formula.

Assessment Considerations

  • What are the infant’s actual needs for formula?
  • What are the current and potential impacts on the infant’s nutritional intake, nutritional needs, and feeding?
  • What is the caregiver’s ability to mix formula appropriately and follow feeding recommendation from baby’s health care provider?
  • What steps in the caregiver’s formula and preparation, storage, and cleaning process lend themselves to potential foodborne illness?
  • What steps in the breastfeeding participant’s expression, storage, and thawing/use of breastmilk lend themselves to food safety concerns?
  • What is the caregiver's feeding plan (i.e., human milk and formula, complementary foods)?

Identifying and Addressing WIC Nutrition Risks, Needs, and Barriers: Potential Springboard and Probing Questions and Resources

Questions related to safely preparing, handling, and storing formula and expressed breastmilk (Nutrition risk Inappropriate Nutrition Practices for Infants)

Resources 

(note, this is not an exhaustive list)

  • Where are you getting your formula?

USDA's Infant Formula page featuring key messages, tips for finding infant formula, and safe and appropriate feeding alternatives

HHS’s Information for Families During the Formula Shortage, including finding safe substitutes (available in Spanish, Vietnamese, Creole, and Navajo)

FDA's Resources for Parents and Caregivers on Imported Infant Formula, including information on recognizing labels of imported formula products that may be available in some areas

FAQs from FDA that include how to avoid buying counterfeit formulas

  • How do you prepare your formula?
  • From where did you get the instructions?
  • How do you store your formula? (unopened and open containers as well as prepared formula

Powdered Infant Formula Preparation and Storage

Infant Feeding: Tips for Food Safety, a job aid from the WLOL course, Feeding Infants: Nourishing Attitudes and Techniques

Tips for preparing imported infant formula on FDA’s Infant Formula Supply page

Infant Formula Safety Dos and Don'ts

CDC’s Information for Families During the Infant Formula Shortage page, with the handout Feeding Your Baby During the Infant Formula Shortage that includes guidance for imported infant formula

HHS's Information for Families During the Formula Shortage, including information about watering down formula, making formula at home, and using cow’s milk (available in Spanish, Vietnamese, Creole, and Navajo)

  • Where do you usually prepare your baby’s formula?
Powdered Infant Formula Preparation and Storage
  • How do you express, store, thaw, and use breastmilk?

Pumping and Hand Expression Resources

Human Milk Storage Guidelines

 

Questions related to consuming adequate breast milk and/or infant formula to meet energy and nutrient requirements (Nutrition risk Inappropriate Nutrition Practices for Infants)Resources
  • What cues does your baby give you that tells you your baby is satisfied after each feeding?
  • How often does your baby give these cues after a feeding?

Infant Developmental Skills/Hunger and Satiety Cues, a job aid from the WLOL course, Feeding Infants: Nourishing Attitudes and Techniques

WIC Breastfeeding Check-In Tool that includes Breastfeeding Reassurance Tips covering hunger and fullness cues

  • Tell me about your concerns about or problems with breastfeeding.
WIC Breastfeeding Check-In Tool that includes Breastfeeding Reassurance Tips, and a WIC Infant Formula Tailoring Calculator to help prescribe only the amount an infant needs
  • What concerns do you have about your baby’s weight and growth?

WIC Growth Charts

WIC Infant Formula Tailoring Calculator

Breastfeeding Reassurance Tips covering growth patterns and spurts as well as cluster feeding

  • What concerns you most about feedings?

Infant Developmental Skills/Hunger and Satiety Cues, a job aid from the WLOL course, Feeding Infants: Nourishing Attitudes and Techniques

WIC Breastfeeding Check-In Tool that includes Breastfeeding Reassurance Tips

WIC Growth Charts

Additional Resources

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