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Contract Formulas Approved by the New York State WIC Program
Effective April 2020
• Medical documentation is required for:
• exempt formula, WIC-Eligible Nutritionals, and/or
• greater amounts of contract formula for infants 6 months or older unable to tolerate solid infant foods
• Medical documentation includes an appropriate qualifying medical condition/medical reason for the formula, quantity (ounces/day), length of use, and food restrictions
• All flavors are approved for NYS WIC eligible formula products
The need for Ready-To-Use formula will be addressed by the WIC Program.
12.9 oz powder
Enfamil A.R.
12.4 oz powder
Enfamil Gentlease
13 oz concentrate
Enfamil Infant
8.1 oz concentrate
Gerber Good Start Soy
12.5 oz powder
Enfamil Infant
32 oz ready-to-use
Enfamil Infant
12.9 oz powder
Gerber Good Start Soy
4 pack (8.45 oz) ready-to-use
Gerber Good Start Soy
Approved for
infants and children
Infants = less than 1 year
Children = less than 5 years
32 oz ready-to-use
Enfamil NeuroPro Infant
Approved Exempt Formulas / WIC Nutritionals for Infants, Children & Women
Effective April 2020
Hypoallergenic Formulas
14.1 oz powder
EleCare for Infants & EleCare Jr.
13 oz concentrate & 32 oz ready-to-use
Nutramigen
12.6 oz powder
Nutramigen with Enflora LGG
14.1 oz powder
Neocate Infant with DHA and ARA
14.1 oz powder
Neocate Jr.
Formulas for Premature Infants - available only in pharmacies
12.8 oz powder
Enfamil NeuroPro EnfaCare
13.1 oz powder, 32 oz ready-to-use
Similac Neosure
Specialized Formulas - available only in pharmacies
16 oz powder
Pregestimil
6 pack (6 oz) ready-to-use
Enfaport
14.1 oz powder
Similac PM 60/40
Approved for infants, children
and women
Infant = less than 1 year
Child = less than 5 years
Infant Child
Infant & Child Infant & Child Infant & Child
Infant & Child Child Infant & Child
Infant Infant
Infant & Child Infant Infant & Child
12.1 oz powder & 32 oz ready-to-use
Similac Alimentum
Calorie and Nutrient Dense Products
6 pack (8 oz) ready-to-use
Boost/Boost High Protein
8 oz ready-to-use
Boost Kid Essentials
6 pack (8 oz) ready-to-use
Bright Beginnings Soy Drink
6 pack (8 oz) ready-to-use
Ensure & Ensure Plus
6 pack (8 oz) ready-to-use
Pediasure/Pediasure with Fiber
8 oz ready-to-use
Pediasure Enteral & Enternal Fiber
Modular Products - available only in pharmacies
32 oz ready-to-use
MCT Oil (Nestle)
14.1 oz powder
Phenex-1 & Phenex-2
• Medical documentation is required for:
• exempt formula, WIC-Eligible Nutritionals, and/or
• greater amounts of contract formula for infants 6 months or older unable to tolerate solid infant foods
• Medical documentation includes an appropriate qualifying medical condition/medical reason for the formula, quantity (ounces/day), length of use, and food restrictions
• All flavors are approved for NYS WIC eligible formula products
The need for Ready-To-Use formula will be addressed by the WIC Program.
Woman Child
Child Woman
Child Child
Infant, Child & Woman Infant & Child Child & Woman
