Approved Formulas in the New York State WIC Program
Formulary
Effective August 2023
Contract Infant Formulas | Size and Formulation | Approved for |
---|---|---|
Enfamil Infant | 12.5 oz. powder | I / C |
Enfamil Infant | 13 oz. concentrate | I / C |
Enfamil Infant and Enfamil NeuroPro Infant | 32 oz. ready-to-use | I / C |
Enfamil A.R. | 12.9 oz. powder | I / C |
Enfamil Gentlease | 12.4 oz. powder | I / C |
Enfamil Reguline | 12.4 oz. powder | I / C |
Similac Soy Isomil | 12.4 oz. powder, 13 oz. concentrate, 32 oz. ready-to-use |
I / C |
Hypoallergenic Formulas | Size and Formulation | Approved for |
---|---|---|
Alfamino Infant | 14.1 oz. powder | I / C |
EleCare for Infants | 14.1 oz. powder | I / C |
EleCare Jr. | 14.1 oz. powder | C only |
Extensive HA | 14.1 oz. powder | I / C |
Nutramigen | 13 oz. concentrate, 32 oz. ready-to-use | I / C |
Nutramigen with Probiotic LGG | 12.6 oz. powder | I / C |
Neocate Infant with DHA and ARA and Neocate Syneo Infant | 14.1 oz. powder | I / C |
Neocate Jr. | 14.1 oz. powder | C only |
PurAmino Infant | 14.1 oz. powder | I / C |
Similac Alimentum | 12.1 oz. powder, 32 oz. ready-to-use | I / C |
Formulas for Premature Infants | Size and Formulation | Approved for |
Enfamil NeuroPro EnfaCare | 13.6 oz. powder | I only |
Similac Neosure | 13.1 oz. powder, 32 oz. ready-to-use | I only |
Specialized Formulas | Size and Formulation | Approved for |
Pregestimil | 16 oz. powder, 6 pack (2 oz.) ready-to-use |
I / C |
Enfaport | 6 pack (6 oz.) ready-to-use | I only |
Similac PM 60/40 | 14.1 oz. powder | I / C |
Pareve Infant Formula | Size and Formulation | Approved for |
---|---|---|
Gerber Good Start Soy (PAREVE for religious exemptions only) |
20 oz. powder | I / C |
Calorie and Nutrient Dense Products | Size and Formulation | Approved for |
---|---|---|
Boost | 6 pack (8 oz.) ready-to-use | W only |
Boost High Protein | 6 pack (8 oz.) ready-to-use | W only |
Boost Kid Essentials | 8 oz. ready-to-use | C only |
Ensure | 6 pack (8 oz.) ready-to-use | W only |
Ensure Plus | 6 pack (8 oz.) ready-to-use | W only |
PediaSure | 6 pack (8 oz.) ready-to-use | C only |
PediaSure with Fiber | 4 pack (7.4 oz.) ready-to-use | C only |
PediaSure Enteral | 8 oz. ready-to-use | C only |
PediaSure Enteral with Fiber | 8 oz. ready-to-use | C only |
Modular Products | Size and Formulation | Approved for |
MCT oil (Nestle) | 32 oz. ready-to-use | I / C / W |
Phenex-1 | 14.1 oz. powder | I / C |
Phenex-2 | 14.1 oz. powder | C / W |
- Medical documentation is required for:
- Infants 6 months or older with greater amounts of contract formula in lieu of infant foods
- Infants and children with exempt formula
- Children with contract formula
- Children and women with infant foods
- Children and women with WIC-eligible nutritionals
- Medical documentation includes an appropriate qualifying medical condition for the formula, quantity (ounces/day), length of use, and food restrictions. The Medical Documentation Form is available at: https://www.health.ny.gov/forms/doh-4456.pdf
- Premature formulas may be provided to premature infants up to their corrected age of 12 months.
- All flavors are approved for NYS WIC eligible formula products.
- The need for Ready-To-Use formula will be addressed by the WIC Program
- I = infant less than 1 year; C = child less than 5 years; W = woman