Sec. 10.54.01.11. Nutritional Risk Factors

A. For purposes of the WIC Program, to be considered at nutritional risk:

(1) A woman shall exhibit one of the nutritional risk factors listed in Chart A, as shown in §C of this regulation; and

(2) An infant or child shall exhibit one of the nutritional risk factors listed in Chart B, as shown in §D of this regulation.

B. Explanation of Charts. The nutritional risk factors fall into one of six priority levels, which are identified by a single digit number, with “1” indicating Priority I, “2” indicating Priority II, “3” indicating Priority III, “4” indicating Priority IV, “5” indicating Priority V, and “6” indicating Priority VI, as set forth in Regulation .09 of this chapter.

C. Chart A.

Nutrition Risk Criteria (Women)	Pregnant	Breastfeeding	Postpartum
Underweight, prepregnancy	1	N/A	N/A
Underweight, postpartum	N/A	1	3
Overweight, prepregnancy	1	N/A	N/A
Overweight, postpartum	N/A	1	3
Low maternal weight gain	1	N/A	N/A
Maternal weight loss	1	N/A	N/A
High maternal weight gain	1	1	6
Low hemoglobin/hematocrit	1	1	3
Elevated blood lead	1	1	3
Hyperemesis gravidarum	1	N/A	N/A
Gestational diabetes	1	N/A	N/A
History of gestational diabetes	1	1	3
History of preterm delivery	1	1	3
History of low birth weight	1	1	3
History of spontaneous abortion, fetal, or neonatal loss	1	1	3
Pregnancy at a young age	1	1	3
Closely spaced pregnancies	1	1	3
High parity and young age	1	1	3
Late to prenatal care	1	N/A	N/A
Multifetal gestation	1	1	3
Fetal growth restriction	1	N/A	N/A
History of birth of a large-for-gestational-age infant	1	1	3
Medical condition, nutrition related	1	1	3
Maternal smoking	1	1	N/A
Alcohol and substance use	1	1	3
Dental problems	1	1	6
Failure to meet dietary guidelines	4	4	6
Vegan diet	4	4	6
Highly restrictive diet	4	4	6
Excessive caffeine	N/A	4	N/A
Pica	4	4	6
Inadequate diet-requires that 2 or more food groups be determined to be inadequate, based upon the food frequency questionnaire or 24-hour dietary recall.	4	4	6
Dietary supplements-inappropriate or excessive intake	4	4	6
Inadequate vitamin or mineral supplementation	4	4	6
Possibility of regression of nutritional status	4	4	6
Transfer	N/A	N/A	N/A
Breastfeeding mother of infant at nutritional risk	N/A	1, 2, or 4	N/A
Breastfeeding complications	N/A	1	N/A
Homelessness	4	4	6
Migrancy	4	4	6
Limited ability to make feeding decisions	4	4	6

D. Chart B.

Nutrition Risk Criteria (Infants and Children)	Infant	Child
Underweight, infant, child	1	3
Overweight, infant, child	1	3
Short stature, infant, child	1	3
Failure to thrive	1	3
Inadequate growth, infant, child	1	3
Low birth weight	1	3
Prematurity	1	N/A
Small for gestational age	1	N/A
Large for gestational age	1	N/A
Low hemoglobin or hematocrit	1	3
Elevated blood lead	1	3
Medical condition, nutrition-related	1	3
Dental problems	1	3
Fetal alcohol syndrome	1	3
Neonatal abstinence syndrome	1	3
Failure to meet dietary guidelines	N/A	5
Vegan diet	N/A	5
Highly restrictive diet	4	5
Inappropriate infant feeding	4	N/A
Solid foods introduced early	4	N/A
Fed cow's milk first 12 months	4	N/A
No dependable iron source	4	N/A
Improper formula dilution	4	N/A
Fed foods low in nutrients	4	N/A
Lack of sanitation, formula or breast milk	4	N/A
Infrequent breastfeeding if sole source of nutrition	4	N/A
Inappropriate use of bottle	4	5
Pica	N/A	5
Inadequate diet - requires that 2 or more food groups be determined to be inadequate, based on food frequency questionnaire or 24-hour dietary recall	N/A	5
Dietary supplements-inappropriate or excessive intake	4	5
Inadequate vitamin or mineral supplementation	4	5
Inappropriate child feeding	N/A	5
Possibility of regression of nutritional status	4	5
Transfer	N/A	N/A
Breastfeeding complications, infant	1	N/A
Mother in WIC or eligible while pregnant	2	N/A
Breastfeeding infant of woman at nutritional risk	1 or 4	N/A
Homelessness	4	5
Migrancy	4	5
Limited ability to make feeding decisions	4	5
Foster care	4	5
Complementary feeding process for an infant or child <2	4	5