Cheryl Alto, MS, RD Julie Aalbers, RD

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Medical Formula Update August 29, 2011

Cheryl Alto, MS,

Julie Aalbers,

We want to hear from you.Please type in your questionsThank you for joining us today-

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While we are waiting..

FormulaTWIST Resources for youProvidence HME

Todays webinar: updates, information and resourcesUpdates go into effect September 1stNew formula will not always be available Sept. 1st, grocery stores will sell out of old product before bringing in new product. 4Formula changes and updates

Similac lid colors now match labels, not family line of products

WIC vouchers reflect what is on the label: e.g. Similac Expert Care Neosure

TWIST search keeps it simple: Neosure6Similac Sensitive for Spit Up powder is available once againSimilac Sensitive for Spit UpReturning to market after manufacturer shortage

Food modules will be available to assign September 1st

Smaller stores, rural areas may be slower to receive stock

Food module code in TWIST is changing: SMS-RS SSS

7Elecare for InfantsOldNew: Available in Unflavored onlyName and graphic changeElecare unflavored becomes Elecare for InfantsFood module code in TWIST: ELE ELI

8Elecare JrName, graphic change and addition of unflavoredElecare flavored becomes Elecare JrFood module code in TWIST: ELE-F ELJ

OldNew: Elecare Jr, Unflavored or Vanilla9PediaSure Peptide 1.0

New addition to Oregon WIC formularyFormerly known as Vital JrComparable to Peptamen Jr Contains 3 gram fiberFood code module in TWIST: PEP-1.0

Vanilla, Strawberry or UnflavoredNEW!Comparable product: Peptamen Junior 1.0 and 1.5 (meaning the calorie per ml)When to use: When needing very broken down proteins- GI malabsorption, Cal/service (237 vs 250 with Peptamen Jr)1.5 offers the same absorptive qualities with 50% more calories in the same volume.Lactose free, gluten free, kosher

10PediaSure Peptide 1.5

Food code module in TWIST: PEP-1.58 oz (237 ml)/bottle1.0 providing 237 Kcal per serving1.5 providing 355 Kcal per serving24 bottles/caseVanilla onlyNEW!11

Peptides? Elemental? Hydrolyzed?Source of graphic: Abbott websiteElecare for infants, Neocate infant, Nutramigen AAAlimentum, Nutramigen, PregestimilCommon examples of formulas for infantsCommon examples of formulas for childrenPeptamen Jr, Pediasure PeptideElecare Jr, Neocate Junior, EO28 Splash Similac Advance Pediasure, Nutren Jr, Boost Kid Essentials 12Gerber Good Start GentleOld 12 oz can sizeNew12.7 oz can size

Name, label and container size changesPlus goes away.In most stores now.


Gerber Good Start GentleName & Package Changes

12.7 oz can, powder

Yields 90 oz.12.1 oz box, concentrate

Yields 24.2 oz4-pack 8.45 oz boxesready-to-feed

Yields 33.8 ozClients receiving Good Start: powder1 conc2 RTFFor Powder 1 can less for IB and IN categories. 14Summary of Gerber Good Start Changes

Good Start Gentle PlusGerber Good Start GentleFormula Module Search NameGood Start oldGerber Good Start - newFormula Module CodeGOSGGSVoucher DescriptionPowderCan 12.7 oz Good Start Gentle or 12 oz Gentle Plus powderCan 12.7 oz Gerber Good Start Gentle powderVoucher Description ConcentrateCan 13 oz Good Start Gentle or Gentle Plus concentrateBox 12.1 oz Gerber Good Start Gentle concentrateVoucher Description RTFCan 32 oz Good Start Gentle or Gentle Plus ready-to-feedFour-pack 8.45 oz boxes Gerber Good Start Gentle RTFThe change in container sizes results in changes to the number of cans/containers allowed. TWIST will calculate the correct number of containers for you.


Deciding which Gerber Good Start formula to choose Assign formula modules based on what is available at the participants store Both old and new formula modules will be in TWIST Void and replace vouchers to match whats in the store

To see who is on Good Start in your agency run the Participant Use of Food Code report in the Food Instrument Module in TWIST. Run for old and new food codes. 16Formula that WIC does NOT provide:Gerber Good Start Protect

Contains probiotics, live cultures Recent reports of health care providers recommending probiotics in the form of drops, formula or even foods 2010 AAP position: insufficient research to recommend routine use in formula Suitable alternative would be Gerber Good Start GentleGerber Good Start ProtectProbiotic is a live and active culture, Bifodobacterium Lactis.AAP stance: Probiotics should not be given to children who are seriously or chronically ill until the safety of administration has been established.Source:;126/6/1217.pdfAccessed 8/26/1117A new product that you may be hearing aboutJust like all other Mead Johnson standard infant formulas, Oregon WIC, by contract, cannot provideA suitable alternative would be Similac Advance

Formula that WIC does NOT provide: Enfamil Premium Newborn

Enfamil Premium NewbornWhat questions have you formulated?

Updates and ChangesFormula code changes in TWISTFormula NameOld Food CodeNew Food CodeElecare for InfantsELEELIElecare JrELE-FELJGerber Good StartGOSGGSNeocate InfantNECNEINeocate JuniorNEC-JRNEJPediaSure Peptide 1.0NonePEP-1.0PediaSure Peptide 1.5None PEP-1.5Peptamen Jr 1.0PEP-1.0PEJ-1.0Peptamen Jr 1.5PEP-1.5PEJ-1.5Similac Soy IsomilISASSISimilac Sensitive for Fussiness & GasSMSSSFSimilac Sensitive for Spit UpSMS-RSSSS21

Food package screenOld ISA codeSame screen as it will look on Sept 1 with new SSI code.Even past codes change.22

Formula search screen Search - Old Elecare Flavored Name

Search New Elecare Jr. Name23To assign an infant formula for a child 24 months or older (C2-C5) you will need to call your assigned Nutrition ConsultantThere may be another formula that is more age appropriate to meet the nutrient and calorie needs of the childStart a discussion with families: work to develop a transition plan before child is 18 months of age

TWIST Tweaks

Providence HME order forms Check address for accuracy-each month If address has changed, indicate in special instructions section

Resources available to youTalking points and in-service guide

Formula Reference Guide 1st Revision

Food Package Module Revision

Revised September 1, 2011Medical Formula Job Aid


31Thank you for joining us today!Todays materials will be available on the Oregon WIC website at: