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.
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.
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.
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.
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.
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.