The WIC program is required to have a contract with a specific formula company to help keep costs down. There are separate contracts for milk-based and soy-based formulas. We renew these contracts every five years. The award for the contract from October 2022 – September 2027 for milk-based formula is Mead Johnson, the makers of Enfamil.

The milk-based formulas offered under the new contract include:

• Enfamil Infant
• Enfamil Gentlease
• Enfamil A.R.
• Enfamil Reguline

The soy-based formula will continue to be with Abbott, the makers of Similac.

As planned for March 1, your patients who are currently selecting standard alternative brands from different manufacturers will be required to transition to one of the contract products. These are Enfamil Infant, Enfamil Gentlease, Enfamil A.R., Enfamil Reguline and Similac Soy Isomil.   

WIC will not be able to accept medical requests for other brand-equivalents.  For example, if your patient requires a gentle formulation, WIC will provide Enfamil Gentlease and cannot accept a prescription for Similac Total Comfort or Good Start Soothe. 

The end of the alternative brand flexibilities does not affect therapeutic formulas, such as premature transitional, hypoallergenic or elemental formulas. These may still be requested through the Medical Request for Therapeutic Formulas.  

Texas WIC has a printable handout available to help support your patient’s formula change.

Most babies can change from one brand of formula to another without much problem. In the first few days on a new formula, some babies will have a slight change in the color of their stool or may drink a little less than normal. This is normal and should get better in a few days. 

If the new formula is not tolerated, the WIC program can exchange any unopened, unused cans of formula for a different WIC contract standard formula within the same month that it was purchased. Starting March 1, your patients receiving standard infant formulas will only be able to redeem the contract brands. WIC will no longer provide alternative brand formulas, such as milk-based equivalents from Similac, Good Start, store labels or imported brands. WIC will not be able to accept medical requests for other brand-equivalents. 

Specialty formulas, like hypoallergenic formulas, will still be available with  a completed Medical Request for Therapeutic Formula Form.

The new contract term will be from October 1, 2022 – September 30, 2027.

Instructions listed on the individual can should always be followed when preparing formula. Texas WIC educates clients using the CDC recommendations for safe formula preparation. A helpful article for your patients on safe formula preparation is here: How to Mix Infant Formula | Texas WIC

Instructions listed on the individual can should always be followed when preparing formula.

Tips for preparing imported infant formula (English)

Tips for preparing imported infant formula (Spanish)

Yes, regardless the brand, the monthly formula quantities are the same. These are determined based on federally set program limits and vary based on an infant’s age and breastfeeding frequency. 

Families should check their formula products at similacrecall.com to determine if they were impacted. Recalled infant formula can be returned to the grocery vendor for an exchange. If your patient is unable to make an exchange at the store, they should contact their WIC office for assistance. 

Medical formulas can be returned to WIC to change to a different formula with a new prescription within the same month they purchased the formula.

WIC has temporarily added more options so that WIC participants can find a formula at the store to meet their baby’s needs without updating the WIC card.

For a list of alternative brands that families can get with WIC, visit texashhs.org/wicfoodupdates. This page has the most up-to-date information on alternative formulas as more brands are being added. 

The WIC program has sent text messages to clients receiving these formulas advising them to talk with their healthcare provider about the best alternative. You will need to provide your patient with a new prescription or verbally confirm the new formula choice with the WIC program. Due to potential supply shortages, please be prepared to provide your WIC clinic with an additional alternative formula for your patient if the first choice is unavailable. 

WIC clinics in your area may call your office on behalf of clients to ask for this information.

Prescription forms can be found here: Texas WIC Medical Request for Formula/Food

You must fill out these boxes at a minimum: 

• 1: Patient name
• 3: Formula name and quantity needed
• 4: Length of issuance
• 5: Qualifying condition
• 7: Name, Signature and Contact information of Healthcare Provider. 

If you do not fill out these boxes, the prescription is considered incomplete and cannot be accepted by the WIC clinic.

For exempt formulas, health care providers must authorize the specific brand and formulation through the Medical Request Form before it can be issued by the WIC program. Health care providers can provide verbal authorization to change to an alternative brand of formula to WIC staff over the phone, or the provider can complete a new Medical Request Form listing the acceptable alternatives for a patient. Without healthcare provider authorization, the WIC clinic is unable to make changes to the formula package.

Similac Alimentum Powder Alternatives 

• Extensive HA: 20kcal/oz, hypoallergenic, extensively hydrolyzed whey protein
• Nutramigen: 20 kcal/oz hypoallergenic, casein hydrolysate (due to shortage, please indicate if generic option is ok)
• Pregestimil DHA/ARA: hypoallergenic casein hydrolysate

EleCare Powder Alternatives

• Alfamino Infant: 20kcal/oz, hypoallergenic, 100% free amino acids
• Neocate DHA/ARA: 20kcal/oz, hypoallergenic, 100% free amino acids
• Neocate Syneo 20kcal/oz, hypoallergenic, 100% free amino acids, contains prebiotics and probiotics.
• PurAmino: 20kcal/oz, hypoallergenic, 100% free amino acids

EleCare Jr. Powder Alternatives

• Alfamino Jr. 30kcal/oz, hypoallergenic, 100% free amino acids
• Equacare Jr. 30kcal/oz, hypoallergenic, 100% free amino acids
• Essential Care Jr. 30kcal/oz, hypoallergenic, 100% free amino acids, contains low FODMAP prebiotics
• Neocate Jr. 30kcal/oz, hypoallergenic, 100% free amino acids
• Puramino Jr. 30kcal/oz, hypoallergenic, 100% free amino acids

Similac PM 60/40

Possible alternatives include:

• Human milk*
• Standard infant formula, used with phosphate binders
• Renastart (currently only available from WIC for children over age 1)

*Donor human milk has a similar composition of phosphorus and is covered with a prescription by Texas Medicaid. Information about coverage of donor human milk is outlined in the Texas Medicaid Provider Procedures Manual, Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook, Section 2.2.13.

If your patient needs breastfeeding support, please refer them to the free 24/7 Texas Lactation Support Hotline at 855-550-6667 to speak with a lactation consultant. In-person and virtual breastfeeding assistance is available at one of our five lactation support centers, available to all moms regardless of WIC enrollment. Refer moms to this webpage: We’re Here to Help | Texas WIC.

All formulas available through Texas WIC with a prescription can be found on the Texas WIC Formulary. This document also contains helpful nutrition information and qualifying conditions for each formula.

Abbott sent out information to health care providers about extended supply disruptions for metabolic and some specialty formulas. You can find updated information from the FDA Investigation of Cronobacter Infections for parents and caregivers of infants receiving medical specialty infant formulas.

Specialty formulas and formulas designed for inborn errors of metabolism were also produced at the Sturgis, Michigan plant, where the recall originated. However, metabolic formulas were not included in the recall because the FDA determined that “the risk of not having these products available could significantly worsen underlying medical conditions. For many of these patients, the risk of life-threatening adverse events from restricted access to these critically needed products is likely greater than the risk from consuming products that have been produced at the facility.” 

The FDA indicates that parents and caregivers who use these formulas should be aware that there may be some risk of Cronobacter contamination.  

Potentially impacted metabolic formulas are:

Texas WIC offers a variety of alternative metabolic formulas that can be found on the Texas WIC Formulary. Please contact your patients that receive these formulas to discuss options and provide an updated Texas WIC Medical Request for Metabolic Formula/Food. WIC clients will need to return to their WIC clinic to update their monthly benefits to an alternative formula. 

Please send an email to [email protected]