Formula Resource Manual

MN WIC FORMULA RESOURCE MANUAL Product Name

Packaging

Nutrient Source

Note: *Please refer to the "Formula Amounts Guide"for allowed quantities. Manufacturers frequently alter the ingredients in their formula products, which may affect the nutrient content. For the most current and accurate information, refer to the product label and/or contact the manufacturer. Minnesota WIC accepts no liability for content errors in this document or for the misuse of formula products.

This institution is an equal opportunity provider. 1

Note: As of 2/1/2019 this manual is undergoing revision.

MN WIC FORMULA RESOURCE MANUAL

Product Name

Packaging

Acerflex (Nutricia)

USE: Isoleucine-, leucine-, valine-free medical formula used in the dietary management of maple syrup urine disease (MSUD) in children over 1 year of age.

16 oz. (454 g) Resealable cans

Pineapple flavor

Must be consumed in conjunction with natural protein, fluid and other nutrients in quantities prescribed by a physician or dietitian to meet protein and general nutrition requirements. Fat, carbohydrate and low protein sources may be used to supply needed calories and to fulfill essential fatty acid requirements.

Per 100 g powder: 395 kcals, 20 g protein equivalent, 17 g fat, 40.5 g CHO

CAUTION: Use only under medical supervision. Not intended as a sole source of nutrition. Not for parenteral use.

Store unopened can at room temperature. Do not store at extreme temperatures. Once opened, reseal can and store in a cool, dry place (not in refrigerator) and use within one month.

Nutrient Source

Protein (20% kcals) - Amino acids (without isoleucine, leucine and valine)

Fat (39% kcals) - Canola oil, hybrid safflower oil, fractionated coconut oil

Carbohydrate (41% kcal) - Corn syrup solids, sucrose

Note: *Please refer to the "Formula Amounts Guide"for allowed quantities. Manufacturers frequently alter the ingredients in their formula products, which may affect the nutrient content. For the most current and accurate information, refer to the product label and/or contact the manufacturer. Minnesota WIC accepts no liability for content errors in this document or for the misuse of formula products.

This institution is an equal opportunity provider. 2

Note: As of 2/1/2019 this manual is undergoing revision.

MN WIC FORMULA RESOURCE MANUAL Product Name

Alfamino Infant (Nestle)

USE: Elemental 1) Severe malabsorption 2) GI impairment 3) Food allergies, e.g., allergy to cow's milk, soy, and/or intact protein *Note: A protein hydrolysate (Extensive HA, Nutramigen, Alimentum, or Pregestimil) is recommended before issuing unless medically contraindicated. 4) Medical condition requiring an elemental formula such as: short bowel syndrome, necrotizing enterocolitis, eosinophilic esophagitis, etc.

20cal/oz when mixed 1 scoop to 1 oz water; hypoallergenic amino acid based elemental. 43% of fat is MCT oil; Similar to Elecare DHA/ARA, Neocate DHA/ARA and PurAmino. Available in PWD.

Packaging

Nutrient Source

14.1 oz (400 g) cans

Infants: 9

Children / Women: 10

6 cans / case

1 Tbsp. = 8 g. powder

CAUTION: For use only under medical supervision. Not intended as the sole source of nutrition. Must be supplemented with protein to meet methionine requirements.

Note: *Please refer to the "Formula Amounts Guide"for allowed quantities. Manufacturers frequently alter the ingredients in their formula products, which may affect the nutrient content. For the most current and accurate information, refer to the product label and/or contact the manufacturer. Minnesota WIC accepts no liability for content errors in this document or for the misuse of formula products.

This institution is an equal opportunity provider. 3

Note: As of 2/1/2019 this manual is undergoing revision.

MN WIC FORMULA RESOURCE MANUAL Product Name

Alfamino Junior (Nestle)

USE: Elemental 1) Severe malabsorption 2) GI impairment 3) Severe food allergies, multiple protein intolerance 4) Medical condition requiring an elemental formula such as: short bowel syndrome, necrotizing enterocolitis, eosinophilic esophagitis, etc. Can only be issued to women and children.

30 cal/oz, hypoallergenic amino acid based elemental. 63% of fat is MCT oil; Similar to Elecare Jr, Neocate Jr .

Packaging

Nutrient Source

Baby's Only Organic Infant Formulas (Nature's Only) Naturesone

BCAD 1 (Mead Johnson)

USE: Leucine-, isoleucine- and valine- free medical food powder for infants and toddlers with Maple Syrup Urine Disease (MSUD) or other inborn errors of branched chain amino acid metabolism.

1 lb. (454 g) powder cans 6 cans / case

Per 100 g powder: 500 kcals, 16.2 g protein equivalent, 26 g fat, 51g CHO

CAUTION: For use only under medical supervision. Appropriate amounts of isoleucine, leucine and valine must be supplied by other foods. Careful monitoring of the diet is needed.

Protein (13% kcals) - Amino acids

Fat (47% kcals) - Palm olein, soy oil, coconut oil, high oleic sunflower oil

Carbohydrate (40 % kcals) - Corn syrup solids, sucrose, modified corn starch, maltodextrin

Note: *Please refer to the "Formula Amounts Guide"for allowed quantities. Manufacturers frequently alter the ingredients in their formula products, which may affect the nutrient content. For the most current and accurate information, refer to the product label and/or contact the manufacturer. Minnesota WIC accepts no liability for content errors in this document or for the misuse of formula products.

This institution is an equal opportunity provider. 4

Note: As of 2/1/2019 this manual is undergoing revision.

MN WIC FORMULA RESOURCE MANUAL Product Name

BCAD 2 (Mead Johnson)

USE: Leucine-, isoleucine- and valine- free medical food for children and adults with Maple Syrup Urine Disease (MSUD) or other inborn errors of branched chain amino acid metabolism.

Per 100 g powder: 410 kcals, 24 g protein equivalent, 8.5 g fat, 57 g CHO

CAUTION: For use only under medical supervision. Appropriate amounts of isoleucine, leucine and valine must be supplied by other foods. Careful monitoring of the diet is needed. Nutritionally inadequate.

Packaging

1 lb. (454 g ) powder cans 6 cans / case

Can be modified with flavor enhancers

Nutrient Source

Protein (24% kcals) - Amino acids

Fat (19% kcals) - Soy oil

Carbohydrate (57 % kcals) - Corn syrup solids, sucrose, modified corn starch

Benecalorie (Nestle)

1.5 oz. cups, 24 / case

USE: Modular intended to be added to food or beverage. Low-volume calorie and protein supplement. Indications for use include: Protein calorie malnutrition, elevated caloric needs, inadequate food intake, fluid restricted diets, pulmonary disease, burns, HIV/AIDS, anorexia, eating disorders, and cancer. Lactose-, gluten-, and cholesterol-free, low residue, kosher.

Per 1.5 oz. container: 330 kcals, 7 g Protein, 0 g Carbohydrate, 33 g Fat.

Protein (9 % kcals) - Calcium Caseinate

Fat (91 % kcals) - High oleic sunflower oil, mono & diglycerides

Carbohydrate (0% kcals) - None

CAUTION: Use under medical supervision. Not to be used as sole source of nutrition. Shake vigorously prior to opening.

Benefiber (Nestle)

USE: Soluble dietary fiber that can be added to a wide variety of foods and beverages, and tube feedings. Used for bowel management programs. It does not impact the flavor, color, texture, or aroma of the products to which it is added.

Per 1 Tbsp: 3 g dietary fiber, 16 kcals, 4 g CHO, 0 g fat, 15 mg sodium, 15 mg potassium. Gluten-free, kosher. Recommendations: start by the addition of 1 Tbsp. into the diet and increase by 1 Tbsp. every third day until the desired level of fiber is reached.

CAUTION: Use under medical supervision. Maximum intake not to exceed 6 ? Tbsp. or 20 g of product per day. Gradual inclusion into the diet and adequate intake of fluids is recommended.

7.2 oz. (205 g) powder resealable canister 4 / case

Protein (0% kcals) - None

Fat (0% kcals) - None

Yield: 51 servings per canister. 1 Tbsp. = 4 g. Recommended mixing: 1 Tbsp. of product to 24 fl oz. of water for tube feedings.

Carbohydrate (100% kcals) - Partially hydrolyzed guar gum

Note: *Please refer to the "Formula Amounts Guide"for allowed quantities. Manufacturers frequently alter the ingredients in their formula products, which may affect the nutrient content. For the most current and accurate information, refer to the product label and/or contact the manufacturer. Minnesota WIC accepts no liability for content errors in this document or for the misuse of formula products.

This institution is an equal opportunity provider. 5

Note: As of 2/1/2019 this manual is undergoing revision.

MN WIC FORMULA RESOURCE MANUAL Product Name

Beneprotein (Nestle) (formerly Resource Beneprotein)

THIS PRODUCT IS ONLY APPROPRIATE FOR USE IN INDIVIDUALS GREATER THAN 3 YEARS OLD.

USE: 100 % high quality whey protein designed to be mixed with foods and beverages. For persons with protein calorie malnutrition, high protein diets, elevated protein requirements for renal (dialysis) or wound management). Can be administered through a feeding tube as a flush.

Packaging

Nutrient Source

8 oz. powder cans

Protein (100% kcals)

6 cans / case

- Whey protein isolate

-

Yield: 134 oz. per can. Fat (0% kcals)

- None

(milk)

Carbohydrate (0% kcals)

Per 1 scoop (7 g): 25 kcals, 0 g CHO, 6 g Protein

CAUTION: Not for parenteral use. Not for persons with galactosemia.

Boost (Nestle)

USE: Nutrition supplement.

30 kcals/oz. Per 8 oz.: 240 kcals, 10 g Protein, 41 g Carbohydrate, 4 g Fat Similar to Ensure.

CAUTION: Use only under medical supervision. Refrigerate after opening. Not recommended for tube feeding due to high osmolality. Boost Kid Essentials or PediaSure are better options for children under 10 years of age.

8 oz. RTU Available at retail stores in 6-packs.

Flavors: Chocolate, Strawberry, Vanilla

Protein (20% kcals) - Milk protein concentrate

Fat (16% kcals) - Canola oil, high oleic sunflower oil, corn oil

Carbohydrate (67% kcals) - Corn syrup solids, sucrose

Boost Glucose Control (Nestle)

USE: Complete liquid formula with fiber specifically formulated for persons with Type I and Type II diabetes. Lactose-free, gluten-free. Suitable as an oral supplement, snack, or mini-meal.

Per 237 mL: 250 kcals (1.06 kcals/ mL), 14 g protein, 20 g CHO, 12 g fat

8 fl. oz. (237 mL) ready-to-use brik pak 27 / case

Flavors: Vanilla, Chocolate, Strawberry.

Vanilla flavor: Protein (23% kcals) - Sodium and calcium caseinates, soy protein isolate

Fat (44% kcals) - High oleic sunflower oil, soy oil

CAUTION: Use only under medical supervision.

Carbohydrate (33% kcals) - Hydrolyzed corn starch

Note: *Please refer to the "Formula Amounts Guide"for allowed quantities. Manufacturers frequently alter the ingredients in their formula products, which may affect the nutrient content. For the most current and accurate information, refer to the product label and/or contact the manufacturer. Minnesota WIC accepts no liability for content errors in this document or for the misuse of formula products.

This institution is an equal opportunity provider. 6

Note: As of 2/1/2019 this manual is undergoing revision.

MN WIC FORMULA RESOURCE MANUAL Product Name

Boost High Protein (Nestle)

USE: Nutritionally complete, lactose-free, low-osmolality, liquid supplement.

30 kcals/oz. Per 8 oz.: 240 kcals (30 kcal/oz.), 15 g protein, 6 g fat, 33 g CHO

Similar to Ensure High Protein.

CAUTION: For use only under medical supervision.

Packaging

8 fl. oz. ready-to-use carton

27 cartons/ case

Flavors: Vanilla

Nutrient Source

Protein (24% kcals) - Sodium and calcium caseinates, soy protein isolates

Fat (22% kcals) - Canola oil, high oleic sunflower oil, corn oil

Carbohydrate (54% kcals) - Sucrose, corn syrup

Boost Kid Essentials 1.0 Cal (Nestle)

USE: Nutritionally complete, pediatric oral liquid supplement with probiotics for children ages 1-13. Indicated for inadequate oral intake, increased energy needs, malnutrition, and weight maintenance. Lactose free, gluten-free, low residue, kosher.

8 oz. ready-to-use 27 cartons/case

Flavors: Chocolate, Strawberry, Vanilla.

Protein (12% kcals) Fat (34%% kcals) Carbohydrate (54% kcals)

30 kcals/oz. Per 8 oz.: 240 kcals, 7g Protein, 32 g Carbohydrate, 9 g Fat

CAUTION: Use only under medical supervision. Refrigerate after opening.

Boost Kid Essentials 1.5 Cal (Nestle)

USE: Nutritionally complete, pediatric oral liquid supplement with probiotics for children ages 1-13. Indicated for inadequate oral intake, elevated caloric needs, volume intolerance, shortened feeding schedules, and malnutrition. For tube feeding or oral use. Lactose free, gluten-free, low residue, kosher

30 kcals/oz. Per 8 oz.: 360 kcals,10 g Protein, 39 g Carbohydrate, 18 g Fat

8 oz. ready-to-use cartons

27 cartons/case

Flavors: Chocolate, Strawberry, Vanilla.

Protein (11% kcals) Fat (45% kcals) Carbohydrate (44% kcals)

CAUTION: Use only under medical supervision. Refrigerate after opening.

Note: *Please refer to the "Formula Amounts Guide"for allowed quantities. Manufacturers frequently alter the ingredients in their formula products, which may affect the nutrient content. For the most current and accurate information, refer to the product label and/or contact the manufacturer. Minnesota WIC accepts no liability for content errors in this document or for the misuse of formula products.

This institution is an equal opportunity provider. 7

Note: As of 2/1/2019 this manual is undergoing revision.

MN WIC FORMULA RESOURCE MANUAL

Product Name

Packaging

Boost Kid Essentials 1.5 Cal with Fiber (Nestle)

USE: Nutritionally complete, pediatric oral liquid supplement with probiotics for children ages 1-13. Indicated for inadequate oral intake, elevated caloric needs, volume intolerance, shortened feeding schedules, and bowel function. For tube feeding or oral use. Lactose free, gluten-free, low residue, kosher

8 oz. ready-to-use cartons

27 cartons/case

Vanilla flavor

30 kcals/oz. Per 8 oz.: 360 kcals,10 g Protein, 39 g Carbohydrate, 18 g Fat

CAUTION: Use only under medical supervision. Refrigerate after opening.

Boost Plus (Nestle)

USE: High-calorie, low-residue, lactose-free oral supplement. For inadequate oral intake, protein-calorie malnutrition, and fluid restriction who cannot consume adequate calories from solid foods.

45 kcals/oz. Per 8 oz.: 360 kcals, 14 g protein, 14 g fat, 45 g CHO.

. 8 oz. RTU Available at retail stores in 6-packs.

Flavors: Chocolate, Strawberry, Vanilla

CAUTION: For use only under medical supervision. Not for individuals with galactosemia.

Boost Pudding (Nestle) USE: Nutritional supplement in pudding form for persons with chewing or swallowing problems.

5 oz. serving provides: 240 kcals, 7 g protein, 9 g fat, 33 g CHO.

5 oz. cans 48 cans / case

Flavors: Vanilla, Chocolate.

Similar to Ensure Pudding and Resource Pudding.

Nutrient Source

Protein (11% kcals) Fat (45% kcals) Carbohydrate (44% kcals)

Protein (15% kcals) - Calcium and sodium caseinate Fat (22 % kcals) - Corn oil Carbohydrate (15% kcals) - Corn syrup solids, sucrose

Protein (11% kcals) - Nonfat milk Fat (34% kcals) - Partially hydrogenated soy oil Carbohydrate (55% kcals) - Sucrose, modified food starch, lactose

Note: *Please refer to the "Formula Amounts Guide"for allowed quantities. Manufacturers frequently alter the ingredients in their formula products, which may affect the nutrient content. For the most current and accurate information, refer to the product label and/or contact the manufacturer. Minnesota WIC accepts no liability for content errors in this document or for the misuse of formula products.

This institution is an equal opportunity provider. 8

Note: As of 2/1/2019 this manual is undergoing revision.

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