Approved Formulas in the New York State WIC Program
Formulary
Effective March 2023
| Contract Infant Formulas | Size and Formulation | Temporarily available as a substitute at the point of purchase |
Approved for |
|---|---|---|---|
| Enfamil Infant | 12.5 oz. powder | Enfamil Infant 21.1 oz. powder, Enfamil Infant 29.4 oz. powder, Enfamil NeuroPro Infant 20.7 oz. powder, Enfamil NeuroPro Infant 28.3 oz. powder, Enfamil NeuroPro Infant 31.4 oz. powder, Enfamil NeuroPro Infant 36.4 oz. powder, Parents Choice Infant 12.5 oz. powder, Parents Choice Infant 22.2 oz. powder, Parents Choice Infant 36 oz. powder, Well Beginnings Infant 22.2 oz. powder, Well Beginnings Infant 34 oz. or 35 oz. powder, CVS Health Infant 34 oz. powder, Up & Up Infant 22.2 oz. powder Up & Up Infant 35 oz. powder, Always My Baby Infant 22.2 oz. powder, Signature Care Infant 22.2 oz. powder, Signature Care Infant 34 oz. or 35 oz. powder, Tippy Toes Infant 22.2 oz powder, Tippy Toes Infant 34 oz. powder, |
I / C |
| Enfamil Infant | 13 oz. concentrate | I / C | |
| Enfamil Infant and Enfamil NeuroPro Infant | 32 oz. ready-to-use | Enfamil NeuroPro Infant 6 pack (8 oz.) ready-to-use | I / C |
| Enfamil A.R. | 12.9 oz. powder | Enfamil A.R. 19.5 oz. powder, Enfamil A.R. 27.4 oz. powder, Enfamil A.R. 30.4 oz. powder, Parents Choice A.R. 21.5 oz. powder, Parents Choice A.R. 32.2 oz. powder, Up & Up A.R. 32.2 oz. powder |
I / C |
| Enfamil Gentlease | 12.4 oz. powder | Enfamil Gentlease 19.9 oz. powder, Enfamil Gentlease 27.7 oz. powder, Enfamil NeuroPro Gentlease 19.5 oz. powder, Enfamil NeuroPro Gentlease 27.4 oz. powder, Enfamil NeuroPro Gentlease 30.4 oz. powder, Enfamil NeuroPro Gentlease 35.2 oz. powder, Parents Choice Gentle 12 oz. powder, Parents Choice Gentle 21.5 oz. powder, Parents Choice Gentle 34 oz. powder, Well Beginnings Gentle 21.5 oz. powder, CVS Health Gentle 21.5 oz. powder, CVS Health Gentle 33.2 oz. powder, Up & Up Gentle 21.5 oz. powder, Up & Up Gentle 33.2 oz. powder, Always My Baby Gentle 21.5 oz. powder, Signature Care Gentle 21.5 oz. powder, Tippy Toes Gentle 21.5 oz. powder, Tippy Toes Gentle 33.2 oz. powder, Tippy Toes Gentle 34 oz. powder, |
I / C |
| Enfamil Reguline | 12.4 oz. powder | Enfamil Reguline 19.5 oz. powder | I / C |
| Similac Soy Isomil | 12.4 oz. powder | Similac Soy Isomil 30.8 oz. powder | I / C |
| Similac Soy Isomil | 13 oz. concentrate, 32 oz. ready-to-use | I / C |
| Hypoallergenic Formulas | Size and Formulation | Temporarily available as a substitute at the point of purchase |
Approved for |
|---|---|---|---|
| Alfamino Infant | 14.1 oz. powder | I / C | |
| EleCare for Infants | 14.1 oz. powder | I / C | |
| EleCare Jr. | 14.1 oz. powder | C only | |
| Gerber Good Start Extensive HA | 14.1 oz. powder | I / C | |
| Nutramigen | 13 oz. concentrate, 32 oz. ready-to-use | I / C | |
| Nutramigen with Probiotic LGG | 12.6 oz. powder | Nutramigen with Probiotic LGG 19.8 oz. powder, Nutramigen with Probiotic LGG 27.8 oz. powder |
I / C |
| Neocate Infant with DHA and ARA | 14.1 oz. powder | Neocate Syneo Infant 14.1 oz. powder | I / C |
| Neocate Jr. | 14.1 oz. powder | C only | |
| PurAmino Infant | 14.1 oz. powder | I / C | |
| Similac Alimentum | 12.1 oz. powder, 32 oz. ready-to-use | I / C | |
| Formulas for Premature Infants | Size and Formulation | Temporarily available as a substitute at the point of purchase |
Approved for |
| Enfamil NeuroPro EnfaCare | 13.6 oz. powder | Enfamil NeuroPro EnfaCare 23 oz. powder | I only |
| Similac Neosure | 13.1 oz. powder, 32 oz. ready-to-use | I only | |
| Specialized Formulas | Size and Formulation | Temporarily available as a substitute at the point of purchase |
Approved for |
| Pregestimil | 16 oz. powder, 6 pack (2 oz.) ready-to-use available 6/17/2022 |
I / C | |
| Enfaport | 6 pack (6 oz.) ready-to-use | I only | |
| Similac PM 60/40 | 14.1 oz. powder | I / C |
| Pareve Infant Formula | Size and Formulation | Approved for |
|---|---|---|
| Gerber Good Start Soy | 12.9 oz. powder | I / C |
| Calorie and Nutrient Dense Products | Size and Formulation | Approved for |
|---|---|---|
| Boost | 6 pack (8 oz.) ready-to-use | W only |
| Boost High Protein | 6 pack (8 oz.) ready-to-use | W only |
| Boost Kid Essentials | 8 oz. ready-to-use | C only |
| Bright Beginnings Soy Drink | 6 pack (8 oz.) ready-to-use | C only |
| Ensure | 6 pack (8 oz.) ready-to-use | W only |
| Ensure Plus | 6 pack (8 oz.) ready-to-use | W only |
| PediaSure | 6 pack (8 oz.) ready-to-use | C only |
| PediaSure with Fiber | 6 pack (8 oz.) ready-to-use | C only |
| PediaSure Enteral | 8 oz. ready-to-use | C only |
| PediaSure Enteral with Fiber | 8 oz. ready-to-use | C only |
| Modular Products | Size and Formulation | Approved for |
| MCT oil (Nestle) | 32 oz. ready-to-use | I / C / W |
| Phenex-1 | 14.1 oz. powder | I / C |
| Phenex-2 | 14.1 oz. powder | C / W |
- Medical documentation is required for:
- Infants 6 months or older with greater amounts of contract formula in lieu of infant foods
- Infants and children with exempt formula
- Children with contract formula
- Children and women with infant foods
- Children and women with WIC-eligible nutritionals
- Medical documentation includes an appropriate qualifying medical condition for the formula, quantity (ounces/day), length of use, and food restrictions. The Medical Documentation Form is available at: https://www.health.ny.gov/forms/doh-4456.pdf
- Premature formulas may be provided to premature infants up to their corrected age of 12 months.
- All flavors are approved for NYS WIC eligible formula products.
- The need for Ready-To-Use formula will be addressed by the WIC Program
- I = infant less than 1 year; C = child less than 5 years; W = woman
