title: Changing WIC changes what children eat.
abstract: OBJECTIVE
  This study assessed the impact of revisions to the USDA Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food packages on nutritional behavior and obesity in children 0- to 4-years-old participating in the New York State (NYS) WIC program. In January 2009, NYS was the first to implement these revisions, which added fruits, vegetables, and whole grains and replaced whole milk with low(1%)-/nonfat milk for children 2- to 4-year-old.
  
  
  METHODS
  In this cross-sectional study, >3.5 million administrative records in the NYS WIC Statewide Information System (WICSIS) were analyzed at 6-month intervals from July to December 2008 (pre-implementation) through July to December 2011. Behavioral data in WICSIS were obtained from parent interview by WIC staff at mandatory certification and recertification visits.
  
  
  RESULTS
  Comparing July to December in 2008 and 2011, increases were observed in breastfeeding initiation (72.2-77.5%); delaying introduction of solid foods until after 4 months of age (90.1-93.8%); daily fruit (87.0-91.6%), vegetable (78.1-80.8%), and whole grain consumption (59.0-64.4%) by children aged 1-4 years; and switches from whole milk to low-/nonfat milk by children aged 2-4 years (66.4-69.4%). In 1-year-old children, the proportion ≥95th percentile weight-for-recumbent length decreased from 15.1 to 14.2%; the proportion of children 2- to 4-year-old with body mass index (BMI) ≥95th percentile decreased from 14.6 to 14.2%.
  
  
  CONCLUSIONS
  These findings demonstrate that positive changes in dietary intake and reductions in obesity followed implementation of the USDA-mandated cost-neutral revisions to the WIC food package for the hundreds of thousands of young children participating in the NYS WIC program.
authors.affiliation: Public Health Solutions, New York, NY, USA. machiasson@healthsolutions.org
authors.forename: M A
authors.initials: MA
authors.lastname: Chiasson
authors.forename: S E
authors.initials: SE
authors.lastname: Findley
authors.forename: J P
authors.initials: JP
authors.lastname: Sekhobo
authors.forename: R
authors.initials: R
authors.lastname: Scheinmann
authors.forename: L S
authors.initials: LS
authors.lastname: Edmunds
authors.forename: A S
authors.initials: AS
authors.lastname: Faly
authors.forename: N J
authors.initials: NJ
authors.lastname: McLeod
mesh_terms: D000818:Animals; D001942:Breast Feeding; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D002523:Edible Grain; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D063105:Food Assistance / Q000592:standards*; D005638:Fruit; D006801:Humans; D007223:Infant; D008019:Life Style; D008297:Male; D008892:Milk / Q000737:chemistry; D009518:New York; D009749:Nutrition Surveys; D009765:Obesity / Q000517:prevention & control; D014675:Vegetables