Contract Formulas Approved by the New York State WIC Program Effective April 2020 • Medical documentation is required for: • exempt formula, WIC-Eligible Nutritionals, and/or • greater amounts of contract formula for infants 6 months or older unable to tolerate solid infant foods • Medical documentation includes an appropriate qualifying medical condition/medical reason for the formula, quantity (ounces/day), length of use, and food restrictions • All flavors are approved for NYS WIC eligible formula products The need for Ready-To-Use formula will be addressed by the WIC Program. 12.9 oz powder Enfamil A.R. 12.4 oz powder Enfamil Gentlease 13 oz concentrate Enfamil Infant 8.1 oz concentrate Gerber Good Start Soy 12.5 oz powder Enfamil Infant 32 oz ready-to-use Enfamil Infant 12.9 oz powder Gerber Good Start Soy 4 pack (8.45 oz) ready-to-use Gerber Good Start Soy Approved for infants and children Infants = less than 1 year Children = less than 5 years 32 oz ready-to-use Enfamil NeuroPro Infant
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Contract Formulas Approved by the New York State WIC ... · Contract Formulas Approved by the New York State WIC Program Effective April 2020 • Medical documentation is required
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Contract Formulas Approved by the New York State WIC Program
• greater amounts of contract formula for infants 6 months or older unable to tolerate solid infant foods
• Medical documentation includes an appropriate qualifying medical condition/medical reason for the formula, quantity (ounces/day), length of use, and food restrictions
• All flavors are approved for NYS WIC eligible formula products
The need for Ready-To-Use formula will be addressed by the WIC Program.
12.9 oz powder
Enfamil A.R.
12.4 oz powder
Enfamil Gentlease
13 oz concentrate
Enfamil Infant
8.1 oz concentrate
Gerber Good Start Soy
12.5 oz powder
Enfamil Infant
32 oz ready-to-use
Enfamil Infant
12.9 oz powder
Gerber Good Start Soy
4 pack (8.45 oz) ready-to-use
Gerber Good Start Soy
Approved for
infants and children
Infants = less than 1 year
Children = less than 5 years
32 oz ready-to-use
Enfamil NeuroPro Infant
Approved Exempt Formulas / WIC Nutritionals for Infants, Children & Women
Effective April 2020
Hypoallergenic Formulas
14.1 oz powder
EleCare for Infants & EleCare Jr.
13 oz concentrate & 32 oz ready-to-use
Nutramigen
12.6 oz powder
Nutramigen with Enflora LGG
14.1 oz powder
Neocate Infant with DHA and ARA
14.1 oz powder
Neocate Jr.
Formulas for Premature Infants - available only in pharmacies
12.8 oz powder
Enfamil NeuroPro EnfaCare
13.1 oz powder, 32 oz ready-to-use
Similac Neosure
Specialized Formulas - available only in pharmacies
• greater amounts of contract formula for infants 6 months or older unable to tolerate solid infant foods
• Medical documentation includes an appropriate qualifying medical condition/medical reason for the formula, quantity (ounces/day), length of use, and food restrictions
• All flavors are approved for NYS WIC eligible formula products
The need for Ready-To-Use formula will be addressed by the WIC Program.