PDF Georgia WIC Approved Formulas and Nutritionals

Georgia WIC Approved Formulas and Nutritionals

Gerber Good Start Gentle Gerber Good Start Soy Gerber Good Start Soothe

Contract Infant Formula

Nestl? Nutrition/Gerber Nestl? Nutrition/Gerber Nestl? Nutrition/Gerber

Non-Contract Formulas/Nutritionals Requiring Medical Documentation:

Formula Acerflex Add-Ins Alfamino Infant Alfamino Junior

A-Soy

Benecalorie

Beneprotein

Boost

Boost Breeze Boost Glucose Control Boost Kid Essentials 1.0 Boost Kid Essentials 1.5 Boost Kid Essentials 1.5 w / fiber Boost Nutritional Pudding

Boost Plus

Bright Beginning Soy

Manufacturer Nutricia Nutricia Nestl? Nutrition Nestl? Nutrition PBM Products Nestl? Nutrition Nestl? Nutrition Nestl? Nutrition Nestl? Nutrition

Nestl? Nutrition

Nestl? Nutrition

Nestl? Nutrition

Nestl? Nutrition

Nestl? Nutrition

Nestl? Nutrition

PBM Products

Formula

Calcilo XD

Carnation Breakfast Essentials

Compleat

Compleat Pediatric Compleat Pediatric Reduced Calorie Complete Amino Acid Mix Complex MSUD Amino Acid Bars

Cyclinex 1

Cyclinex 2

Duocal EleCare (for Infants)

EleCare Jr

Enfamil A.R.

Enfamil EnfaCare

Manufacturer Abbott Nutrition

Nestl? Nutrition

Nestl? Nutrition Nestl? Nutrition

Nestl? Nutrition

Nutricia North America

Applied Nutrition Corporation

Abbott Nutrition Abbott Nutrition Nutricia Abbott Nutrition Abbott Nutrition Mead Johnson Mead Johnson

Formula Enfamil Human Milk Fortifier Acidified Liquid Enfamil Premature 20 with iron

Manufacturer

Mead Johnson

Mead Johnson

Enfamil Premature 24 with iron

Mead Johnson

Enfamil Premature 30 with iron

Mead Johnson

Enfaport

Mead Johnson

Ensure Clear

Abbott Nutrition

Ensure High Abbott

Protein

Nutrition

Ensure

Abbott

Original

Nutrition

Ensure Plus

Abbott Nutrition

Ensure

Abbott

Pudding

Nutrition

EO28 Splash

Nutricia

Fiber Source Nestl?

HN

Nutrition

Gerber

Nestl?

Extensive Nutrition/

HA

Gerber

Revised April 2017

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Georgia WIC Approved Formulas and Nutritionals

Formula

Manufacturer

Gerber Good

Start

Nestl?

Premature Nutrition

24

Glucerna

Abbott Nutrition

Glutarex-1

Abbott Nutrition

Glutarex-2

Abbott Nutrition

Hominex-1

Abbott Nutrition

Hominex-2

Abbott Nutrition

Introlite

Abbott Nutrition

IsoSource Nestl?

1.5

Nutrition

IsoSource Nestl?

HN

Nutrition

I-Valex-1

Abbott Nutrition

I-Valex-2

Abbott Nutrition

Jevity

Abbott Nutrition

KetoCal 3:1 Nutricia

KetoCal 4:1 Nutricia

Ketonex-1

Abbott Nutrition

Ketonex-2

Abbott Nutrition

KetoVie

Cambrooke Therapeutics

KetoVolve

Solace Nutrition

L-Emental

Hormel Health Labs

L-Emental Hormel

Hepatic

Health Labs

L-Emental Hormel

Pediatric

Health Labs

Lipistart

Vitaflow

Formula

Manufacturer

Lo*Pro

Med-Diet Labs

Lophlex LQ Nutricia

MCT Oil

Nestl? Nutrition

MCT Procal Vitaflow

Methionaid Nutricia

Microlipid

Nestl? Nutrition

Monogen Nutricia

MSUD Analog

Nutricia

MSUD Maxamaid

Nutricia

MSUD Maxamum

Nutricia

MSUD-1

Nutricia

MSUD-2

Nutricia

Neocate

Infant DHA & Nutricia

ARA

Neocate Junior

Nutricia

Neocate

Junior with Nutricia

Prebiotics

Neocate Nutra

Nutricia

Neocate Splash

Nutricia

Neocate Syneo Infant

Nutricia

Nepro with Abbott

Carb Steady Nutrition

Nitro-Pro

Hormel Health Labs

NovaSource Nestle

Renal

Nutrition

Nutramigen

Mead Johnson

Nutramigen with Enflora LGG Toddler

Mead Johnson

Formula Nutramigen with Enflora LGG

Nutren 1.0

Nutren 1.0 with Fiber

Nutren 1.5

Nutren 2.0

Glytrol

Nutren Junior Nutren Junior Fiber Nutren Pulmonary Replete with Fiber

NutriHep

Osmolite 1.0

Osmolite 1.2

PediaSure

PediaSure 1.5 Cal PediaSure 1.5 Cal with fiber PediaSure Enteral PediaSure Enteral w/Fiber and scFOS PediaSure Peptide 1.0 Cal

Manufacturer

Mead Johnson

Nestle Nutrition Nestl? Nutrition Nestl? Nutrition Nestl? Nutrition Nestl? Nutrition Nestl? Nutrition Nestl? Nutrition Nestl? Nutrition Nestl? Nutrition Nestl? Nutrition Abbott Nutrition Abbott Nutrition Abbott Nutrition Abbott Nutrition

Abbott Nutrition

Abbott Nutrition

Abbott Nutrition

Abbott Nutrition

Revised April 2017

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Georgia WIC Approved Formulas and Nutritionals

Formula PediaSure Peptide 1.5 Cal PediaSure w/Fiber

Pepdite Junior

Peptamen

Peptamen 1.5 Peptamen AF Peptamen Jr. HP Peptamen Junior Peptamen Junior 1.5 Peptamen Junior Fiber Peptamen Junior with Prebio

Perative

Periflex Advance Periflex Early Years Periflex Infant Periflex LQ (previously Xphe Maxamum)

Phenex-1

Phenex-2

Manufacturer

Abbott Nutrition

Abbott Nutrition Nutricia North America Nestle Nutrition Nestl? Nutrition Nestl? Nutrition Nestl? Nutrition Nestl? Nutrition Nestl? Nutrition Nestl? Nutrition

Nestl? Nutrition

Abbott Nutrition

Nutricia

Nutricia North America Nutricia North America

Nutricia North America

Abbott Nutrition Abbott Nutrition

Formula

PhenylAde 40Drink Mix

PhenylAde 60Drink Mix

PhenylAde Amino Acid Bars PhenylAde Amino Acid Blend

PhenylAde Drink Mixes

PhenylAde Essential Drink PhenylAde MTE Amino Acid Blend Phenyl-Free 2 Phenyl-Free 2HP Phlexy ? 10 Bar Phlexy ? 10 Capsules Phlexy ? 10 Drink Mix PKU Periflex Junior Plus PKUExpress

PKU-Gel

Polycal

Portagen

Pregestimil

Manufacturer Applied Nutrition Corporation Applied Nutrition Corporation Applied Nutrition Corporation Applied Nutrition Corporation Applied Nutrition Corporation Applied Nutrition Corporation Applied Nutrition Corporation Mead Johnson Mead Johnson

Nutricia

Nutricia

Nutricia

Nutricia North America Vitaflo Limited Vitaflo Limited Nutricia Mead Johnson Mead Johnson

Formula

Manufacturer

Pregestimil Mead

24

Johnson

Product

Mead

3232 A

Johnson

ProMod Liquid Protein

Abbott Nutrition

Promote

Abbott Nutrition

Promote with Abbott

Fiber

Nutrition

Pro-Peptide

Hormel Health Labs

Pro-Peptide Hormel

for Kids

Health Labs

Pro-Peptide Hormel

VHN

Health Labs

Pro-Phree

Abbott Nutrition

Propimex-1

Abbott Nutrition

Propimex-2

Abbott Nutrition

Nutricia

Protifar

North

America

ProViMin

Abbott Nutrition

Pulmocare

Abbott Nutrition

PurAmino

Mead Johnson

PurAmino Mead

Toddler

Johnson

RCF

Abbott Nutrition

RE/GEN

Nutra/ Balance

Renalcal

Nestl? Nutrition

RenaStart Vitaflo

Resource Nestl?

2.0

Nutrition

Revised April 2017

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Georgia WIC Approved Formulas and Nutritionals

Formula

Manufacturer

Scandical

Calorie

Aptalis

Booster

Scandishake Aptalis

Scandishake Lactose Free

Aptalis

Scandishake Sugar Free

Aptalis

Similac

Abbott

Alimentum Nutrition

Similac Expert Care Alimentum

Abbott Nutrition

Similac

Abbott

NeoSure

Nutrition

Similac Expert Care NeoSure

Abbott Nutrition

Similac Human Milk Fortifier

Abbott Nutrition

Similac PM Abbott

60/40

Nutrition

Similac Special Care with Iron 20

Abbott Nutrition

Similac Special Care with Iron 24

Abbott Nutrition

Similac Special Care with Iron 30

Abbott Nutrition

SolCarb Solace

Suplena with Carb Steady

Tolerex

Abbott Nutrition Nestl? Nutrition

TwoCal HN

Abbott Nutrition

Tyrex-1 Tyrex-2

Abbott Nutrition Abbott Nutrition

Formula UCD Anamix Junior UCD-2 Vivonex Pediatric

Vivonex Plus

Vivonex RTF

Vivonex T.E.N. XLeu Maxamaid XLeu Maxamum XLys, XTrp Maxamaid XLys, XTrp Maxamum XMet Maxamaid XMet Maxamum XMTVI Maxamaid XMTVI Maxamum XPhe , XTyr Maxamaid XPhe Maxamaid XPTM Analog

Manufacturer Nutricia Nutricia Nestl? Nutrition Nestl? Nutrition Nestl? Nutrition Nestl? Nutrition Nutricia

Nutricia

Nutricia

Nutricia

Nutricia

Nutricia

Nutricia

Nutricia

Nutricia

Nutricia

Nutricia

Revised April 2017

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Georgia WIC Approved Formulas and Nutritionals

Ready-to-feed formula may be indicated in limited documented cases, such as: o Unsanitary or restricted water supply o Inadequate refrigeration o Caregiver has a documented condition which inhibits the proper dilution of concentrated or powder formula. o For participants in Food Package III with a qualifying medical condition and who are receiving exempt infant formulas or nutritionals (a) if the ready-to-feed form better accommodates the participant's medical condition or (b) if the ready-tofeed form improves the participant's compliance in consuming the prescribed formula.

If a health care provider with prescriptive authority orders a product that is not on this list, contact the Nutrition Unit to determine whether the product may be authorized for distribution through Georgia WIC.

Special formulas may be acquired through the Nutrition Unit. See Georgia WIC Procedures Manual, Food Package Section for appropriate procedure and forms.

This institution is an equal opportunity provider. Revised April 2017

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