Women Infants and Children Program
Women, Infants and Children program exempt formulas are provided based on HCP determination, regardless of the state’s contract for routine products. HCPs can complete the state’s medical documentation form for exempt formulas to ensure their Women Infants and Children Program infants receive the infant formula they recommend.
Select your state to download forms:
“Nutramigen® LGG®† is Women Infant and Children Program approved in all 50 states”
Tennessee Medical Documentation Form
Nutramigen LGG Medical Documentation Form
Nutramigen Toddler Medical Documentation Form
PurAmino Medical Documentation Form
PurAmino Toddler Medical Documentation Form
Tennessee Approved Mead Johnson Products Information
Women Infants and Children Program Monthly Allotments
The Special Supplemental Nutrition Program for Women
Infants and Children program is the USDA’s supplemental nutrition program. It provides foods, infant formula, nutrition education and referrals to health and other social services to participants at no charge. States are required to have an infant formula rebate contract in place. By federal requirement, the contract brand of infant formulas used in a state is determined through a sealed bid process. The state programs’ contracts cover routine milk and soy infant formulas. The program also provides additional infant formula products which are not covered under the state’s contract and therefore are not rebated. These additional formulas include those the FDA defines as exempt formulas, such as extensive hydrolysates, premature formulas and some other specialty formulas.
†LGG® is a registered trademark of Chr. Hansen A/S.
Patient Savings Programs
Explore various Mead Johnson programs created to help parents save on baby