If one of WIC's standard contract formulas is not appropriate for your patient, there may be a medical condition warranting a therapeutic formula. Please review procedures for prescribing therapeutic formula here.

Similac® Alimentum® Powder 

Milk based. Hypoallergenic formula for cow and/or soy protein allergies. Proteins are broken down into tiny pieces for easier digestion.

Indications/Used for

• Cow milk protein allergy
• Soy protein allergy
• Protein sensitivity, colic, severe diarrhea, and rashes

Calories per ounce: 20 cals./ oz.

See Manufacturer Information

Nutramigen® with Enflora™ LGG® Powder

Milk based. Hypoallergenic formula for cow milk protein allergy and conditions with malabsorption. Proteins broken down for easier digestion.

Indications/Used for

• Cow milk protein allergy
• Soy protein allergy
• GERD
• Malabsorption

Calories per ounce: 20 cals./ oz.

See Manufacturer Information

Enfamil® NeuroPro EnfaCare® Powder

Milk based. Increased vitamins and minerals. Increased calories for growth. Milk Fat Globule Membrane (MFGM) and DHA to support brain development.

Indications/Used for

• Premature infants born ≤ 37 weeks gestation

Calories per ounce: 22 cals./ oz.

See Manufacturer Information

Nutramigen® Concentrate

Milk based. Hypoallergenic formula for cow milk protein allergy. Proteins broken down for easier digestion.

Indications/Used for

• Cow milk protein allergy
• Colic

Calories per ounce: 20 cals./ oz.

See Manufacturer Information

Similac NeoSure® Powder

Milk based. Increased protein, energy, vitamins, and minerals compared to term infant formulas. Extra calories for growth.

Indications/Used for

• Premature infants born ≤ 37 weeks gestation

Calories per ounce: 22 cals./ oz.

See Manufacturer Information

PediaSure Grow & Gain Shake (Vanilla)

Provides additional calories for children with food restrictions. Additional dietary support for children with lactose and gluten intolerance.

Indications/Used for

• For children 1 year and older.

Calories per ounce: 30 cals./ oz.

See Manufacturer Information

WIC infants not exclusively breastfed or receiving breastmilk may be issued the following infant formula. A prescription is not required for these formulas.

Enfamil® Infant

Milk based. Iron-fortified for full-term infants.

Indications/Used for

• Full term healthy infants

 

Calories per ounce: 20 cals./ oz.

See Manufacturer Information

Enfamil® ProSobee®

Soy plant protein based, milk-free, lactose-free.

Indications/Used for

• Lactose intolerance
• Fussiness and gas as a result of sensitivity to milk-based formula
• Vegan dietary practices

 

Calories per ounce: 20 cals./ oz.

See Manufacturer Information

Enfamil® Gentlease®

Reduced lactose. Milk protein blend similar to breast milk that has been partially broken down.

Indications/Used for

• Fussiness and gas
• Colic
• Transition formula from breast milk feedings

 

Calories per ounce: 20 cals./ oz.

See Manufacturer Information

Enfamil A.R.™

Milk based with added rice starch. Increases viscosity in the bottle 10x that of routine formula. Rice starch forms a bolus in stomach to reduce amount of free liquid.

Indications/Used for

• Excessive spitting up
• GERD

 

Calories per ounce: 20 cals./ oz.

See Manufacturer Information

Enfamil® Reguline®

Cow milk based with prebiotics and partially broken down proteins.

Indications/Used for

• Constipation
• Difficult stools

 

Calories per ounce: 20 cals./ oz.

See Manufacturer Information