MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source

Note: *Please refer to the “Formula Amounts Guide”for allowed quantities. Manufacturers frequently alter the ingredients in their formula products, which may affect the nutrient content. For the most current and accurate information, refer to the product label and/or contact the manufacturer. Minnesota WIC accepts no liability for content errors in this document or for the misuse of formula products.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Acerflex (Nutricia) 16 oz. (454 g) Protein (20% kcals) Resealable cans - Amino acids (without isoleucine, leucine USE: Isoleucine-, leucine-, valine-free medical formula used in the dietary management of and valine) maple syrup urine disease (MSUD) in children over 1 year of age. Pineapple flavor Fat (39% kcals) Must be consumed in conjunction with natural protein, fluid and other nutrients in quantities - Canola oil, hybrid safflower oil, prescribed by a physician or dietitian to meet protein and general nutrition requirements. fractionated coconut oil Fat, carbohydrate and low protein sources may be used to supply needed calories and to fulfill essential fatty acid requirements. Carbohydrate (41% kcal) - Corn syrup solids, sucrose Per 100 g powder: 395 kcals, 20 g protein equivalent, 17 g fat, 40.5 g CHO

CAUTION: Use only under medical supervision. Not intended as a sole source of nutrition. Not for parenteral use.

Store unopened can at room temperature. Do not store at extreme temperatures. Once

opened, reseal can and store in a cool, dry place (not in refrigerator) and use within one month.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Alfamino Infant (Nestle) 14.1 oz (400 g) cans Infants: 9 USE: Elemental Children / Women: 10 1) Severe malabsorption 6 cans / case 2) GI impairment 3) Food allergies, e.g., allergy to cow's milk, soy, and/or intact protein *Note: A protein hydrolysate (Extensive HA, Nutramigen, Alimentum, or Pregestimil) is recommended 1 Tbsp. = 8 g. powder before issuing unless medically contraindicated. 4) Medical condition requiring an elemental formula such as: short bowel syndrome, necrotizing enterocolitis, eosinophilic esophagitis, etc.

20cal/oz when mixed 1 scoop to 1 oz water; hypoallergenic amino acid based elemental. 43% of fat is MCT oil; Similar to Elecare DHA/ARA, Neocate DHA/ARA and PurAmino. Available in PWD.

CAUTION: For use only under medical supervision. Not intended as the sole source of nutrition. Must be supplemented with protein to meet methionine requirements.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Alfamino Junior (Nestle)

USE: Elemental 1) Severe malabsorption 2) GI impairment 3) Severe food allergies, multiple protein intolerance 4) Medical condition requiring an elemental formula such as: short bowel syndrome, necrotizing enterocolitis, eosinophilic esophagitis, etc. Can only be issued to women and children.

30 cal/oz, hypoallergenic amino acid based elemental. 63% of fat is MCT oil; Similar to Elecare Jr, Neocate Jr .

Baby’s Only Organic Infant Formulas (Nature’s Only) Naturesone

BCAD 1 (Mead Johnson) 1 lb. (454 g) powder Protein (13% kcals) cans - Amino acids USE: Leucine-, isoleucine- and valine- free medical food powder for infants and toddlers 6 cans / case with Maple Syrup Urine Disease (MSUD) or other inborn errors of branched chain amino Fat (47% kcals) acid metabolism. - Palm olein, soy oil, coconut oil, high oleic sunflower oil Per 100 g powder: 500 kcals, 16.2 g protein equivalent, 26 g fat, 51g CHO Carbohydrate (40 % kcals) CAUTION: For use only under medical supervision. Appropriate amounts of isoleucine, - Corn syrup solids, sucrose, modified corn leucine and valine must be supplied by other foods. Careful monitoring of the diet is starch, maltodextrin needed.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source BCAD 2 (Mead Johnson) 1 lb. (454 g ) powder Protein (24% kcals) cans - Amino acids USE: Leucine-, isoleucine- and valine- free medical food for children and adults with 6 cans / case Maple Syrup Urine Disease (MSUD) or other inborn errors of branched chain amino acid Fat (19% kcals) metabolism. Can be modified with - Soy oil flavor enhancers Per 100 g powder: 410 kcals, 24 g protein equivalent, 8.5 g fat, 57 g CHO Carbohydrate (57 % kcals) - Corn syrup solids, sucrose, modified corn CAUTION: For use only under medical supervision. Appropriate amounts of isoleucine, starch leucine and valine must be supplied by other foods. Careful monitoring of the diet is needed. Nutritionally inadequate.

Benecalorie (Nestle) 1.5 oz. cups, 24 / case Protein (9 % kcals) - Calcium Caseinate USE: Modular intended to be added to food or beverage. Low-volume calorie and protein supplement. Indications for use include: Protein calorie malnutrition, elevated caloric Fat (91 % kcals) needs, inadequate food intake, fluid restricted diets, pulmonary disease, burns, HIV/AIDS, - High oleic sunflower oil, mono & anorexia, eating disorders, and cancer. diglycerides Lactose-, gluten-, and cholesterol-free, low residue, kosher. Carbohydrate (0% kcals) Per 1.5 oz. container: 330 kcals, 7 g Protein, 0 g Carbohydrate, 33 g Fat. - None

CAUTION: Use under medical supervision. Not to be used as sole source of nutrition. Shake vigorously prior to opening.

Benefiber (Nestle) 7.2 oz. (205 g) powder Protein (0% kcals) resealable canister - None USE: Soluble dietary fiber that can be added to a wide variety of foods and beverages, 4 / case and tube feedings. Used for bowel management programs. It does not impact the flavor, Fat (0% kcals) color, texture, or aroma of the products to which it is added. - None

Per 1 Tbsp: 3 g dietary fiber, 16 kcals, 4 g CHO, 0 g fat, 15 mg sodium, 15 mg potassium. Yield: 51 servings per Carbohydrate (100% kcals) Gluten-free, kosher. Recommendations: start by the addition of 1 Tbsp. into the diet and canister. 1 Tbsp. = 4 g. - Partially hydrolyzed guar gum increase by 1 Tbsp. every third day until the desired level of fiber is reached. Recommended mixing: 1 Tbsp. of product to 2- CAUTION: Use under medical supervision. Maximum intake not to exceed 6 ½ Tbsp. or 4 fl oz. of water for tube 20 g of product per day. Gradual inclusion into the diet and adequate intake of fluids is feedings. recommended.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Beneprotein (Nestle) 8 oz. powder cans Protein (100% kcals) (formerly Resource Beneprotein) 6 cans / case - Whey protein isolate (milk) - THIS PRODUCT IS ONLY APPROPRIATE FOR USE IN INDIVIDUALS GREATER THAN 3 Yield: 134 oz. per can. Fat (0% kcals) YEARS OLD. - None

USE: 100 % high quality whey protein designed to be mixed with foods and beverages. Carbohydrate (0% kcals) For persons with protein calorie malnutrition, high protein diets, elevated protein requirements for renal (dialysis) or wound management). Can be administered through a feeding tube as a flush.

Per 1 scoop (7 g): 25 kcals, 0 g CHO, 6 g Protein

CAUTION: Not for parenteral use. Not for persons with galactosemia.

Boost (Nestle) 8 oz. RTU Protein (20% kcals) Available at retail - Milk protein concentrate USE: Nutrition supplement. stores in 6-packs. Fat (16% kcals) 30 kcals/oz. Per 8 oz.: 240 kcals, 10 g Protein, 41 g Carbohydrate, 4 g Fat - Canola oil, high oleic sunflower oil, corn oil Similar to Ensure. Flavors: Chocolate, Strawberry, Vanilla Carbohydrate (67% kcals) CAUTION: Use only under medical supervision. Refrigerate after opening. Not - Corn syrup solids, sucrose recommended for tube feeding due to high osmolality. Boost Kid Essentials or PediaSure are better options for children under 10 years of age.

Boost Glucose Control (Nestle) 8 fl. oz. (237 mL) Vanilla flavor: ready-to-use brik pak Protein (23% kcals) USE: Complete liquid formula with fiber specifically formulated for persons with Type I and 27 / case - Sodium and calcium caseinates, soy Type II diabetes. Lactose-free, gluten-free. protein isolate Suitable as an oral supplement, snack, or mini-meal. Flavors: Vanilla, Chocolate, Strawberry. Fat (44% kcals) Per 237 mL: 250 kcals (1.06 kcals/ mL), 14 g protein, 20 g CHO, 12 g fat - High oleic sunflower oil, soy oil

CAUTION: Use only under medical supervision. Carbohydrate (33% kcals) - Hydrolyzed corn starch

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Boost High Protein (Nestle) 8 fl. oz. ready-to-use Protein (24% kcals) carton - Sodium and calcium caseinates, soy USE: Nutritionally complete, lactose-free, low-osmolality, liquid supplement. protein isolates 27 cartons/ case 30 kcals/oz. Per 8 oz.: 240 kcals (30 kcal/oz.), 15 g protein, 6 g fat, 33 g CHO Fat (22% kcals) Flavors: Vanilla - Canola oil, high oleic sunflower oil, corn oil Similar to Ensure High Protein. Carbohydrate (54% kcals) CAUTION: For use only under medical supervision. - Sucrose, corn syrup

Boost Kid Essentials 1.0 Cal (Nestle) 8 oz. ready-to-use Protein (12% kcals) 27 cartons/case USE: Nutritionally complete, pediatric oral liquid supplement with probiotics for children Fat (34%% kcals) ages 1-13. Indicated for inadequate oral intake, increased energy needs, malnutrition, Flavors: Chocolate, and weight maintenance. Lactose free, gluten-free, low residue, kosher. Strawberry, Vanilla. Carbohydrate (54% kcals)

30 kcals/oz. Per 8 oz.: 240 kcals, 7g Protein, 32 g Carbohydrate, 9 g Fat

CAUTION: Use only under medical supervision. Refrigerate after opening.

Boost Kid Essentials 1.5 Cal (Nestle) 8 oz. ready-to-use Protein (11% kcals) cartons USE: Nutritionally complete, pediatric oral liquid supplement with probiotics for children Fat (45% kcals) ages 1-13. Indicated for inadequate oral intake, elevated caloric needs, volume 27 cartons/case intolerance, shortened feeding schedules, and malnutrition. For tube feeding or oral use. Carbohydrate (44% kcals) Lactose free, gluten-free, low residue, kosher Flavors: Chocolate, Strawberry, Vanilla. 30 kcals/oz. Per 8 oz.: 360 kcals,10 g Protein, 39 g Carbohydrate, 18 g Fat

CAUTION: Use only under medical supervision. Refrigerate after opening.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Boost Kid Essentials 1.5 Cal with Fiber (Nestle) 8 oz. ready-to-use Protein (11% kcals) cartons USE: Nutritionally complete, pediatric oral liquid supplement with probiotics for children Fat (45% kcals) ages 1-13. Indicated for inadequate oral intake, elevated caloric needs, volume 27 cartons/case intolerance, shortened feeding schedules, and bowel function. For tube feeding or oral use. Carbohydrate (44% kcals) Lactose free, gluten-free, low residue, kosher Vanilla flavor

30 kcals/oz. Per 8 oz.: 360 kcals,10 g Protein, 39 g Carbohydrate, 18 g Fat

CAUTION: Use only under medical supervision. Refrigerate after opening.

Boost Plus (Nestle) . 8 oz. RTU Protein (15% kcals) Available at retail - Calcium and sodium USE: High-calorie, low-residue, lactose-free oral supplement. For inadequate oral intake, stores in 6-packs. caseinate protein-calorie malnutrition, and fluid restriction who cannot consume adequate calories from solid foods. Fat (22 % kcals) Flavors: Chocolate, - Corn oil 45 kcals/oz. Strawberry, Vanilla Per 8 oz.: 360 kcals, 14 g protein, 14 g fat, 45 g CHO. Carbohydrate (15% kcals) - Corn syrup solids, sucrose CAUTION: For use only under medical supervision. Not for individuals with galactosemia.

Boost Pudding (Nestle) 5 oz. cans Protein (11% kcals) USE: Nutritional supplement in pudding form for persons with chewing or swallowing 48 cans / case - Nonfat milk problems. Flavors: Vanilla, Fat (34% kcals) 5 oz. serving provides: 240 kcals, 7 g protein, 9 g fat, 33 g CHO. Chocolate. - Partially hydrogenated soy oil Similar to Ensure Pudding and Resource Pudding. Carbohydrate (55% kcals) - Sucrose, modified food starch, lactose

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Bright Beginnings Infant Formulas

Bright Beginnings Premium Bright Beginnings Gentle Bright Beginnings Soy Bright Beginnings Organic Milk Bright Beginnings Organic Soy

Additional information is available at http://www.brightbeginnings.com/

(800) 272-5095

Use: Standard formulas manufactured in the US under private brand labels. Available online at amazon.com, diapers.com, overstock.com and Fareway Foods.

CAUTION: Evaluate if formula is mixed, used, and stored properly.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Bright Beginnings Pediatric Drink 8 fl. oz. ready-to-feed Protein (12% kcals) Bright Beginnings Pediatric Drink w/ Fiber cans - Sodium caseinate, whey protein 24 cans / case concentrate Additional information is available at: http://www.brightbeginnings.com/ Bright Beginnings Fat (44.1% kcals) 1-800-272-5095 Pediatric Drink: - High oleic safflower oil, soy oil, MCT, Vanilla, Chocolate, and lecithin Bright Beginnings is a “National Brand Label” for PBM products. They are manufactured Strawberry. by Wyeth-Nutritionals Inc. Essentially Bright Beginnings formulas /products are the same Carbohydrate (43.9% kcals) as the “Store Brand formulas” except for the label. Bright Beginnings - Maltodextrin, sucrose Pediatric Drink with

Fiber: Vanilla. USE: Nutritionally complete, lactose-free, gluten-free supplement for children 1 to 10

years of age with chronic illness (e.g., CP, trauma) or oral motor feeding problems. May 33 oz. powder be used as the sole source of nutrition or as a supplement. For tube or oral feeding. 4 cans / case Kosher.

30 kcals/oz. Vanilla flavor. Per 8 fl. oz.: 237 kcals, 7.1 g protein, 11.8 g fat, 26 g CHO, 3.3 mg iron.

Similar to PediaSure, PediaSure w/Fiber, Kindercal, and Kindercal with Fiber.

CAUTION: Not for parenteral use. Not for children with galactosemia.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Bright Beginnings Soy Pediatric Drink 8 fl. oz. ready-to-feed Protein (12% kcals) cans - Soy protein isolate Additional information is available at: 24 cans / case http://www.pbmstore.com/soypedr.html Fat (44.1% kcals) (800) 485-9969 Vanilla flavor. - High oleic safflower oil, soy oil, MCT

Bright Beginnings is a “National Brand Label” for PBM products. They are manufactured Carbohydrate (43.9% kcals) by Wyeth-Nutritionals Inc. - Sucrose, maltodextrin,

USE: Soy based, nutritionally complete supplement for children 2-10 years of age that are lactose intolerant. Can be used as sole source nutrition under a physician's guidance.

30 kcals/oz. Per 8 fl. oz.: 240 kcals, 7 g protein, 12 g fat, 26 g CHO

CAUTION: Not for parenteral use.

Calcilo XD (Abbott) 13.2 oz. (400 g) Protein (9% kcals) USE: Low-calcium, vitamin D-free formula for infants whose calcium and/or vitamin D powder - Whey protein must be restricted, as in hypercalcemia (may occur in Williams Syndrome). Some medical 6 cans / case concentrate conditions may necessitate issuing to children. Fat (50% kcals) Standard dilution is 20 kcals/oz. - Corn oil, coconut oil 100 kcals provides: 9 g protein, 28.7 g fat, 52.3 g CHO One can powder provides approximately Carbohydrate (41% kcals) CAUTION: For use only under medical supervision. Does not contain adequate levels of 96 fl. oz. - Lactose calcium, vitamin D, or phosphorus to meet the RDA. (standard dilution).

Camino Pro Bettermilk http://www.cambrookefoods.com/products/bettermilk/

USE: Dietary management of phenylketonuria in people age 1 and older.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Carnation Breakfast Essentials Nutritional Drink (Nestle) 8 oz. (250 mL) ready- Protein (17% kcals) to-drink bottles USE: Complete and balanced nutritional drink for oral feeding in children and adults with a Fat (15% kcals) medical condition or disease resulting in decreased food intake or increased nutrient Sold at retail in 6 requirements. Can be used as an oral supplement to meet energy or protein needs packs. 4 – 6 Carbohydrate (48 % kcals) associate with an underlying condition such as malnutrition, celiac disease, or impaired packs/case. growth. Ready-to-drink. Appropriate for diets that are gluten-free, low-residue, kosher, cholesterol restriced and lactose intolerance. Not for persons with galactosemia. Flavors: Vanilla, Chocolate, Strawberry Per 8 oz. 240 kcals, 10 g protein,4132 g CHO, 4 g fat

Comparable to Pediasure (oral). . CAUTION: Use only under medical supervision.

Compleat (Nestle) 8.45 oz. (250 mL) Protein (18% kcals) ready-to-use cartons - Sodium caseinate, chicken USE: Ready-to-use, blenderized tube feeding for adults formulated from traditional foods including meat, vegetables and fruit. For persons requiring long term tube feeding. 24 / case Fat (34% kcals) Lactose-free, gluten-free. - Canola oil, chicken

Per 250 mL: 265 kcals, 12 g protein, 32 g CHO, 10 g fat Carbohydrate (48 % kcals) . - Hydrolyzed cornstarch, vegetables, CAUTION: Use only under medical supervision. fruit

Compleat Pediatric (Nestle) 8.45 oz. (250 mL) 24 Protein (15% kcals) cartons USE: Blenderized medical food containing meat, vegetables and fruit. For children ages Fat (34% kcals) 1 - 13 years requiring chronic or long-term, total or supplemental tube feeding. Lactose- 24 cartons / case free, gluten-free. Carbohydrate (51% kcals)

Per 250 mL: 250 kcals (1.0 Kcal/mL), 9.5 g protein, 33 g CHO, 9.7 g fat

CAUTION: Not to be used for children with galactosemia. For use only under medical supervision. Not for parental use. Evaluate if formula is used and stored properly.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Compleat Pediatric Reduced Calorie (Nestle) 8.45 oz. (250 mL) 24 Protein (20% kcals) cartons USE: Blenderized reduced-calorie medical food for children who are tube fed with reduced Fat (30% kcals) energy needs. tube-feeding formulamedical food containing meat, vegetables and fruit. 24 cartons / case For children over 1 year of age. Lactose-free, gluten-free. Carbohydrate (50% kcals)

Per 250 mL: 150 kcals 0.6 Kcal/mL), 7.5 g protein, 18.8 g CHO, 5 g fat

CAUTION: Not to be used for children with galactosemia. For use only under medical supervision. Not for parental use. Evaluate if formula is used and stored properly.

Complete Amino Acid Mix 7 oz. cans powder Protein (100% kcals) Use: Unflavored powdered mixture of essential and non-essential amino acids for - Amino acids individuals over 1 year of age. Supplements increased protein needs in enteral formula. 2 cans/case Fat (0% kcals) - None

Carbohydrate (0% kcals) - None Complex MSUD Drink Mix (Applied Nutrition Corp) 1 lb. (454 g) powder Protein (25% kcals) http://medicalfood.com/complex_essential.php cans - Amino acids (without BCAAs) 4 cans / case USE: Branched chain amino acid free, vitamin and mineral fortified formula for use in the Fat (31% kcals) dietary management of maple syrup urine disease (MSUD). Intended as the primary Vanilla flavored. - Partially hydrogenated coconut oil, mono source of protein nutrition and a significant source of calories in the management of (item # 00847-0597-22) and diglycerides MSUD. Recommended dilution: Carbohydrate (44% kcals) Per 100 g powder: 410 kcals, 25 g protein, 14 g fat, 45 g CHO, 12 mg iron. 1 scoop (40g) with 4-8 - Sugar, corn syrup solids, food starch- oz. cold water. modified CAUTION: Must only be given to individuals with MSUD under medical supervision. Not 1 can yields intended as a sole source of nutrition. Must be taken in combination with low protein foods approximately 11.5 to complete a nutritionally balanced diet. Not for infants under one year of age. scoops/servings.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Cyclinex - 1 (Abbott) 14.1 oz. (400 g) Protein powder - L-amino acids USE: For the dietary management of infants and toddlers with urea cycle disorders, 6 cans / case gyrate atrophy of the choroid and retina, or HHH syndrome. Fat 1 can powder yields - High-oleic safflower oil, coconut oil, soy oil 100 g powder provides: 510 kcals, 7.5 g protein equivalent, 24.6 g fat, 57 g CHO approximately 102 fl. oz. (standard dilution). Carbohydrate - Corn syrup solids CAUTION: For use only under medical supervision. Not intended as the sole source of nutrition; must be supplemented with protein and fluid. Not for parenteral use.

Cyclinex - 2 (Abbott) 14.1 oz. (400 g) Protein powder - L-amino acids USE: For the dietary management of children and adults with urea cycle disorders, 6 cans / case gyrate atrophy of the choroid and retina, or HHH syndrome. Fat 1 can powder yields - High-oleic safflower oil, coconut oil, soy oil 100 g powder provides: 440 kcals, 15.0 g protein equivalent, 17 g fat, 45 g CHO approximately 88 fl. oz. (standard dilution). Carbohydrate CAUTION: For use only under medical supervision. Not intended as the sole source of - Corn syrup solids nutrition; must be supplemented with protein. Not for parenteral use.

Diabetisource AC (Nestle) 250 mL ready-to-use Protein (20% kcals) cans - Soy protein USE: Specialized ready-to-use formula made from traditional food ingredients. Designed Children / Women: for persons with diabetes, glucose intolerance and stress induced hyperglycemia. 107 Fat (44% kcals) - Canola oil, MCT 30 kcals/oz. 250 mL provides: 300 kcals, 15 g protein, 26 g CHO, 14.8 g fat Carbohydrate (36% kcals) - Hydrolyzed cornstarch, vegetables, fruit CAUTION: Use only under medical supervision.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Duocal (Nutricia) 14 oz. (400 g) powder Protein (0% kcals) cans - None USE: High-calorie, protein-free, lactose-free, carbohydrate and fat supplement. For 4 cans / case persons with electrolyte or protein restricted diets or conditions where extra calories are Fat (41% kcals) needed. For oral or tube feeding. - Blend of refined vegetable oil (corn, Can Yield varies. coconut), MCT (fractionated coconut oil), 4.9 kcals/g, 42 kcals/level T (8.5 g). mono and diglycerides Per 100 g: 492 kcals, 72.7 g CHO, 22.3 g fat, 0 g protein. Carbohydrate (59% kcals) CAUTION: Use only under medical supervision. Not suitable as the sole source of - Hydrolyzed cornstarch nutrition. Not for parenteral use.

Earth’s Best Organic (Earthsbest)

Milk based Sensitivity Soy

Elecare for Infants (Abbott) 14.1 oz. (400 g) Protein (15% kcals) powder cans - Free amino acids USE: Nutritionally complete amino acid-based formula for infants 0-12 months who cannot tolerate intact or hydrolyzed protein. Indicated for the nutritional management of 6 / case Fat (43% kcals) protein maldigestion, malabsorption, severe food allergies, short-bowel syndrome, - High oleic safflower oil, MCT oil, soy oil eosinophilic GI GI disorders, GI tract impairment, or other conditions in which an elemental Infants: 1 can powder diet is required. Clinically documented to be hypoallergenic. For oral or tube feeding. yields approximately 95 Carbohydrate (42% kcals) Lactose-, fructose-, galactose-, milk protein-, soy protein-, gluten-free, halal. fl. oz. (standard - Corn syrup solids Per 100 kcals: 3.1 g protein, 4.8g fat, 10.7g CHO dilution).

CAUTION: Use only under medical supervision.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Elecare – Unflavored or Vanilla (Abbott) 14.1 oz. (400 g) Protein (15% kcals) powder cans - Free amino acids USE: Nutritionally complete elemental formula specifically for children 1 year and up who need an amino acid-based medical food or who cannot tolerate intact or hydrolyzed 6 / case Fat (42% kcals) protein. Vanilla provides the same nutrition as Unflavored. Indicated for the nutritional - High oleic safflower oil, MCT oil, soy oil management of protein maldigestion, malabsorption, severe food allergies, short-bowel Children: 1 can powder syndrome, eosinophilic disorders, GI tract impairment, or other conditions in which an yields approximately 63 Carbohydrate (43% kcals) elemental diet is required. Clinically documented to be hypoallergenic. For oral or tube fl. oz. (standard - Corn syrup solids feeding. Lactose-, fructose-, galactose-, milk protein-, soy protein-, and gluten-free. Halal. dilution).

Note: Children older than 1 year: Standard dilution (30 Cal/fl oz.) is 4 unpacked, level scoops of powder (37.6 g) for each 5 fl oz. of water. • Powder Mixing Guide Dilution at 30 Cal/fl oz.

Measure Add scoop(s)of = Final volume water unpacked level powder (approx.) using enclosed scoop

5 fl oz. 4 scoops (38 g) 6 fl oz.

7.5 fl oz. 6 scoops (57 g) 9 fl oz.

CAUTION: Use only under medical supervision.

Enfalyte (Mead Johnson) .

USE: Oral electrolyte solution.

Enfagrow Toddler Next Step Vanilla (Mead Johnson) Sold in 6 packs

Enfagrow Toddler Next Step Natural Milk Flavor

Enfagrow Next Step ready-to-drink cartons – Natural Milk Flavor and Vanilla

USE: Milk-based drinks for older toddlers 1 year and up Note: *Please refer to the “Formula Amounts Guide”for allowed quantities. Manufacturers frequently alter the ingredients in their formula products, which may affect the nutrient content. For the most current and accurate information, refer to the product label and/or contact the manufacturer. Minnesota WIC accepts no liability for content errors in this document or for the misuse of formula products.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Enfagrow Toddler Transitions (Mead Johnson) 21 oz. powder Protein (10% kcals) - Nonfat milk USE: Milk-based formula for toddlers over 9 months of age. Casein dominant formula with One 21 oz. can powder a 18:82 whey-to-casein ratio. yields approximately Fat (48% kcals) 141 oz. of formula - Palm olein, soy oil, 100 kcals provides: 2.6 g protein, 5.3 g fat, 11.8 g CHO, 2.0 mg iron (standard dilution of 20 coconut oil, high kcals/oz). oleic sunflower oil, CAUTION: Evaluate if formula is mixed, used, and stored properly. DHA, ARA 32 oz. RTF Carbohydrate (42% kcals) - Corn syrup solids, lactose Enfagrow Toddler Transitions Gentlease (Mead Johnson) 20 oz. powder cans Protein 10 % kcals) 6 / case - Partially hydrolyzed nonfat milk and whey USE: Milk-based formula similar to Enfamil Gentlease tailord for toddlers 9 – 18 months. protein concentrate solids. Combines partially broken down proteins and reduced lactose (approximately 25 % of One 21 oz can powder 60% Whey, 40% casein. carbohydrates are from lactose versus 100% in a full-lactose, routine, milk-based formula). yields approximately Whey (60%) Casein (40%) 141 oz. (standard Fat (48 % kcals) dilution) Palm olein, soy oil, coconut oil, high oleic 20 kcals/oz. sunflower oil, DHA, ARA Per 100 kcals: 2.6 g protein, 5.3 g fat, 10.5 g CHO Carbohydrate (42 % kcals) CAUTION: Evaluate if formula is mixed, used, and stored properly. - Corn syrup solids (75 %), lactose (25%)

Enfagrow Toddler Transitions Soy (Mead Johnson) 20 oz. powder Protein (13% kcals) - Soy protein isolate USE: Soy-based formula for toddlers 9 – 18 months with lactose intolerance and One 21 oz. can powder galactosemia. Similar to Enfamil Prosobee. yields approximately Fat (40% kcals) 135 oz. of formula - Palm olein, soy oil, 100 kcals provides: 3.3 g protein, 4.4 g fat, 11.8 g CHO, 2.0 mg iron (standard dilution of 20 coconut oil, high kcals/oz). oleic sunflower oil, CAUTION: Evaluate if formula is mixed, used, and stored properly. DHA, ARA

Carbohydrate (47% kcals) - Corn syrup solids, sucrose

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Enfamil AR (Mead Johnson) 12.9 oz. powder cans Protein (10% kcals) - Non-fat milk USE: Milk-based, iron-fortified infant formula with added rice starch for infants who 20% Whey, 80% casein. frequently spit up. Thickening occurs when it comes in contact with stomach acid. One can powder yields approximately 91 oz. Fat (46% kcals) 20 kcals/oz. (standard dilution). - Palm oil, soy oil, coconut oil, high oleic Per 100 kcals: 2.5 g protein, 5.1 g fat, 11.3 g CHO, 1.8 mg iron sunflower oil, DHA, ARA Other container sizes CAUTION: For use only under medical supervision. Not recommended for pre-term and forms available. Carbohydrate (44% kcals) infants. - Lactose, rice starch, maltodextrin Enfamil EnfaCare (Mead Johnson) 12.8 oz. powder cans Protein (11% kcals) - Whey protein concentrate, non-fat milk One can powder yields USE: Transitional formula designed with higher amounts of some nutrients for premature approximately 82 oz. Fat (47% kcals) or low birth weight infants. Has increased calcium and phosphorus compared to term (standard dilution). - High oleic vegetable oil, soy oil, MCT infant formulas. (20%), coconut oil, DHA, ARA This formula is 22 kcals/oz. at standard dilution (one scoop to 2 oz. water). Use only in rare (Term infant formulas are 20 kcals/oz) circumstances: Carbohydrate (42% kcals) Powder: lactose 65%, corn syrup solids Per 100 kcals: 2.8 g protein, 5.3 g fat, 10.4 g CHO, 1.8 mg iron. 32 oz. ready-to-feed 35%

CAUTION: Enriched formula; use only under medical supervision. 2 oz. (89 mL) nursette Liquid: maltodextrin 60 %, lactose 40% Contains milk and soy. bottles 48 bottles / case Similar to Similac Neosure and Gerber Good Start Nourish.

Enfamil for Supplementing (Mead Johnson) 21.5 oz powder tub Protein (9 % kcals) One can powder yields - Reduced minerals whey, nonfat milk USE: Iron fortified, milk-based infant formula for full term newborns. approx. 155 fl. oz. (60% whey, 40% casein) (standard dilution at 20 Standard dilution is 20 kcals/oz. kcals/oz). Fat (48% kcals) 100 kcals provides: 2.3 g protein, 5.3 g fat, 10.8 g CHO, Vitamin D 75 IU, 1.8 mg iron. - Palm olein, soy, coconut, and high oleic sunflower oils, DHA, ARA Contains 400 IU of vitamin D in 27 oz. Carbohydrate (43% kcals) CAUTION: Evaluate if formula is mixed, used, and stored properly. - Lactose (21 %), GOS and PDX (5%)

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Enfamil Gentlease (Mead Johnson) 12.4 oz. powder cans Protein (9 % kcals) 6 / case - Partially hydrolyzed nonfat milk and whey USE: Milk-based infant formula with partially broken down proteins for the first 12 months. protein concentrate solids. 40% casein, According to the manufacturer it was designed as a first switch formula for babies who One can powder yields 60% whey. have fussiness or gas. Has reduced lactose (approximately 20% of carbohydrates are from approximately 90 oz. lactose versus 100% in a full-lactose, routine, milk-based formula). (standard dilution) Fat (48 % kcals) Palm olein, soy oil, coconut oil, high oleic 20 kcals/oz. Several sizes and sunflower oil, DHA, ARA Per 100 kcals: 2.3 g protein, 5.3 g fat, 10.8 g CHO forms available. Carbohydrate (43 % kcals) CAUTION: Evaluate if formula is mixed, used, and stored properly. - Corn syrup solids (75 %), lactose (20%)

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Enfamil Human Milk Fortifier Acidified Liquid (Mead Johnson) 200 (5 mL) vials per Protein (29% kcals) case - Milk protein isolate, whey protein USE: Supplement to be added to expressed breastmilk for premature or low-birth-weight hydrolysate infants. When mixed with mother's milk, increases the levels of protein, energy, calcium, phosphorus, and other nutrients. Fat (65% kcals) - MCT, soy oil Per 4 vials: 30 kcals, 2.2 g protein, 2.3 g fat, < 1.2 g CHO Carbohydrate (6% kcals) - Corn syrup solids Use only under medical supervision and . CAUTION: only as directed Should not be used for long periods of time. Generally only used in hospitals Do not add Enfamil Human Milk Fortier Acidified Liquid to breast milk in a ratio greater than 1 vial/25 mL.

If more than 20 vials daily are used, the infant should be monitored for evidence of excessive vitamins A and D intake.

Contains milk and soy.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Enfamil Human Milk Fortifier (Mead Johnson) 0.71 gm (0.025 oz.) Protein packets - Milk protein isolate, whey protein USE: Supplement to be added to expressed breastmilk for premature or low-birth-weight hydrolysate infants. When mixed with mother's milk, increases the levels of protein, energy, calcium, 100 packets / box; phosphorus, and other nutrients. 2 boxes / case Fat - MCT, soy oil 1 packet of powder added to: 50 mL human milk adds 2 kcals/fl. oz. (22 kcals/oz.) Carbohydrate 25 mL human milk adds 4 kcals/fl. oz. (24 kcals/ oz.) - Corn syrup solids Breastmilk is calculated and averaged at approximately 20 kcal/oz.

Nutrients per 4 packets of powder: 14 kcals, 1.1 g protein, 1 g fat, < 0.40 g CHO, 1.44 mg iron, 35 mOsm/kg water (per 4 packets added to 100 mL breast milk).

Similar to Similac Human Milk Fortifier.

CAUTION: Use only under medical supervision and only as directed. Should not be used for long periods of time. Generally only used in hospitals. If more than 25 packets are used daily infants should be monitored for evidence of excessive vitamin A & D intake. Do not add Enfamil Human Milk Fortifier to breast milk in a ratio greater than 1 packet for each 25 mL breast milk.

Regarding use in extremely-low-birth-weight infants (ELBW=1 kg or less): Hypercalcemia has been reported in some of these infants on full enteral feeds of mother's milk supplemented with human milk fortifiers.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Enfamil Infant (Mead Johnson) 12.5 oz. powder cans Protein (8.0% kcals) 6 cans / case - Reduced minerals whey, nonfat milk USE: Iron fortified, milk-based infant formula for feeding full term, healthy infants 0-12 (60% whey, 40% casein) months. One can powder yields approx. 90 fl. oz. Fat (48% kcals) Standard dilution is 20 kcals/oz. (standard dilution at 20 - Palm olein, soy, coconut, and high oleic 100 kcals provides: 2.0 g protein, 5.3 g fat, 11.2 g CHO, Vitamin D 60 IU, 1.8 mg iron. kcals/oz.). sunflower oils, DHA, ARA

CAUTION: Evaluate if formula is mixed, used, and stored properly. 22.2 oz. tubs Carbohydrate (44 kcals) 4 / case - Lactose (95%), GOS and PDX (5%) 1 can yields approx. 159 fl. oz.

13 oz. concentrate

Available in many more forms and sizes.

Enfamil Newborn (Mead Johnson) 12.5 oz. powder cans Protein (8.5% kcals) 6 cans / case - Reduced minerals whey, nonfat milk USE: Iron fortified, milk-based infant formula for full term newborns through 3 months of (80% whey, 20% casein) age. One can powder yields approx. 90 fl. oz. Fat (48% kcals) Standard dilution is 20 kcals/oz. (standard dilution at 20 - Palm olein, soy, coconut, and high oleic 100 kcals provides: 2.1 g protein, 5.3 g fat, 11.2 g CHO, Vitamin D 75 IU, 1.8 mg iron. kcals/oz). sunflower oils, DHA, ARA

400 IU of vitamin D in 27 oz. Other forms and sizes Carbohydrate (43.5% kcals) available. - Lactose (95%), GOS and PDX (5%) CAUTION: Evaluate if formula is mixed, used, and stored properly.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Enfamil Premature (Mead Johnson) 2 oz. ready-to-feed 20 Calories/oz iron-fortified nursettes 24 Calories/oz iron-fortified 24 Calories/oz high protein 48 bottles / case 30 Calories/oz

USE: For premature or low birth weight infants. Generally for hospital use. Some premature infants going home on these formulas

CAUTION: For use only under medical supervision.

Enfamil Prosobee (Mead Johnson) 12.9 oz powder cans Protein (10% kcals) 6 / case - Soy protein isolate USE: Soy protein isolate formula for the routine use of some infants with feeding problems resulting from sensitivity to milk-based formula. Milk-free, lactose-free. One can powder yields Fat (48% kcals) approximately 93 oz. - Palm olein, soy oil, Standard dilution is 20 kcals/oz. (standard dilution at 20 coconut oil, high oleic Per 100 kcals: 2.5 g protein, 5.3 g fat, 10.6 g CHO kcals/oz). sunflower oil, DHA, ARA

Similar to Similac Isomil and Gerber Good Start Soy Several forms and Carbohydrate (42% kcals) sizes are available. - Corn syrup solids CAUTION: Evaluate if formula is mixed, used, and stored properly. Avoid use for anyone with an allergy to soy protein. If used as a milk substitute for children the total calcium content of the diet should be assessed. Not recommended for very-low birth-weight infants.

This institution is an equal opportunity provider. Note: As of 2/1/2019 this manual is undergoing revision. 23

MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Enfamil Reguline (Mead Johnson) 12.4 oz powder cans Protein (9% kcals) 6 / case Whey, Casein USE: Milk-based infant formula that has 2 prebiotics and partially broken down proteins for infants through the first 12 months of age. Designed to be fed when perceived stooling One can powder yields Fat (48% kcals) issues, such as occasional difficult bowel movements (constipation), are causes of approximately 90 oz. - Palm olein, soy oil, parental concern. (standard dilution at 20 coconut oil, high oleic kcals/oz). sunflower oil, DHA, ARA Standard dilution is 20 kcals/oz. 20.4 oz powder tub Carbohydrate (43% kcals) Per 100 kcals: 2.3 g protein, 5.3 g fat, 11.1 g CHO, 1.5 mg Iron One can powder yields - 50% lactose approximately 155 oz. (standard dilution at 20 CAUTION: Evaluate if formula is mixed, used, and stored properly. kcals/oz).

8 oz RTF

Enfaport (Mead Johnson) 6 oz. Ready-to Feed Protein (14 % kcals) Sold in 6 packs Use: Intended for infants with chylothorax or LCHAD deficiency. Fat (46% kcals) 84% of fat is MCT.

30 kcal/oz. Carbohydrate (40 % kcals) Per 100 kcals: 3.5 g protein, 5.4 g fat, 10.2 g

Ensure Active High Protein (Abbott) 14 oz. ready-to-use Protein (47% kcals) bottles - Calcium and sodium caseinates, soy USE: High protein, low fat supplement for oral use. protein isolate Sold in 4 packs at 29 kcals/oz. retail stores. Fat (10% kcals) 14 fl. oz. provides: 210 kcals, 25 g protein, 2.5 g fat, 23 g CHO - High-oleic safflower, canola, soy oil, soy 3 - 4 packs per case lecithin CAUTION: Use only under medical supervision. Flavors: Vanilla, Carbohydrate 43% kcals) Chocolate - Sucrose, maltodextrin

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Ensure Clear - Retail (Abbott) 10 oz. ready-to-use Protein (14% kcals)`/ bottles. Whey protein isolate USE: Fruit flavored clear drink for older children and adults. Oral use only. High-calorie, fat-free oral supplement for adults and children over 4 years of age. May be used for Sold in 4 packs at Fat (0% kcals) people with cancer, heart disease, pancreatitis, and hyperlipidemia. Lactose-free, gluten retail. - None free, kosher, Halal. Flavors: Peach, Carbohydrate (86% kcals) 8 fl. oz. provides: 200 kcals, 7 g protein, 43 g CHO, 0 g fat Blueberry - Maltodextrin (corn), sucrose Pomegranate, Mixed CAUTION: For oral supplementation only. Fruit

Ensure Clear Therapeutic (Abbott) 6.8 oz. ready-to-use Protein (14% kcals) boxes. Whey protein isolate USE: Fruit flavored clear drink to increase calories May be used with children. Available in juice boxes. 32 / case Fat (0% kcals) Flavors: Apple, Mixed - None 6.8 fl. oz. provides: 200 kcals, 7 g protein, 43 g CHO, 0 g fat Berry Carbohydrate (86% kcals) CAUTION: For oral supplementation only. - Maltodextrin (corn), sucrose

Ensure Complete (Abbott) 8 oz. ready-to-use Protein (15% kcals) bottles. USE: Nutritionally complete supplement to increase calories for oral feeding normally for Available at retail Fat (28% kcals) adults. stores in 4 -packs. Carbohydrate 57% kcals) 43.7 kcal/oz. Flavors: Vanilla, Milk 8 oz. RTU provides: 350 kcals, 13 g protein, 11 g fat, 51 g CHO Chocolate, Strawberry

CAUTION: For use only under medical supervision. Boost Kid Essentials and PediaSure are more appropriate for children.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Ensure Original (Abbott) 8 oz. ready-to-use Protein (14.1% kcals) bottles. - Calcium caseinate, soy protein isolate, USE: Nutritionally complete supplement for oral or tube feeding for adults and children Available at retail whey protein concentrate age 4 or older. May be used as sole source of nutrition when consumed in appropriate stores in 6-packs. amounts. Fat (22% kcals) Flavors: Vanilla, Dark - High-oleic safflower, canola and corn oils 27.5 kcals/oz. Chocolate, Milk 8 oz. RTU provides: 220 kcals, 9 g protein, 6 g fat, 32 g CHO Chocolate, Strawberry, Carbohydrate (63.9% kcals) Similar to Boost Butter Pecan - Sucrose, corn syrup, Coffee Latte. maltodextrin CAUTION: For use only under medical supervision. Boost Kid Essentials and PediaSure are more appropriate for children.

Ensure Plus (Abbott) 8 oz. ready-to-use Protein (15% kcals) bottles - Sodium and calcium USE: Nutritionally complete oral supplement for adults and older children that can caseinates, soy protein isolate benefit from concentrated calories to gain or maintain weight. Lactose-free and gluten- Sold in 6 packs at free, Kosher, Halal. retail stores. Fat (28% kcals) - Canola, corn oil, high-oleic safflower oil 44.4 kcals/oz. 4-6 packs/case 8 fl. oz. provides: 350 kcals, 13 g protein, 11 g fat, 51 g CHO Carbohydrate (57 kcals) Flavors: Vanilla, -Corn syrup, maltodextrin, sucrose CAUTION: Use only under medical supervision. Chocolate, Strawberry

Ensure Pudding (Abbott) 4 oz. ready-to-use Protein (9% kcals) cups - Condensed skim milk USE: Nutritionally complete supplement in pudding form. For adults and children age 4 Sold in 4 packs at or older on modified diets or who have swallowing problems, are underweight, or retail stores Fat (25% kcals) undernourished. Gluten-free. - Partially hydrogenated soy oil, soy oil 12 four packs / case Per 4 oz: 170 kcals, 4 g protein, 5 g fat, 30 g Carbohydrate (66% kcals) Flavors: Chocolate, - Sucrose, lactose, modified corn starch, CAUTION: For use under medical supervision. Vanilla, Butterscotch fructooligosaccharides (soluble fiber)

This institution is an equal opportunity provider. Note: As of 2/1/2019 this manual is undergoing revision. 26

MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Essential Amino Acid Mix (Nutricia) 7 oz. cans powder Children / Women: 20 Use: Unflavored powdered mixture of essential amino acids (including cysteine and cans histidine) for individuals over 1 year of age.

E028 Splash (Nutricia) 8 fl. oz. (237 mL) box Ready-To-Use 27 boxes / case Protein (10% kcals) USE: Medical food that is 100 % non-allergenic free amino acids. Indicated for cow and - Synthetic amino acids soy milk allergy, multiple food protein intolerance, food allergy associated conditions: short Flavors: Unflavored, bowel syndrome, eosinophillic esophagitis, gastroesophageal reflux, and other GI Grape, Orange- Fat (32% kcals) disorders. For children over 1 year of age. . pineapple - Fractionated coconut oil, canola oil, high oleic safflower oil 30 kcals/oz. 8 oz. provides: 237 kcals (1 kcal per mL), 5.9 g protein equivalent (7.1 g amino acids), 8.3 Carbohydrate (58% kcals) g fat, 34.6 g CHO - Maltodextrin, sucrose, corn syrup solids

CAUTION: Use only under medical supervision

Fibersource HN (Nestle) 250 mL cartons Protein (18% kcals) 24 cartons / case - Soy protein isolate, soy protein USE: Nutritionally complete, high-nitrogen, 100% soy protein supplement with fiber for concentrate oral or tube feeding. For persons with abnormal bowel function, extended inactivity, neurologic impairment, or developmental disability. Fat (29% kcals) - Canola oil, MCT 36 kcals/oz. 250 mL provides: 300 kcal, 13.4 g protein, 9.84 g fat, 39.3 g CHO, 4.24 mg iron, fiber 2.5 Carbohydrate (53% kcals) g. Fiber content 10 g/1000mL (7.5 g insoluble, 2.5 g soluble - Corn syrup, hydrolyzed corn starch

CAUTION: Use only under medical supervision.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source GA (Mead Johnson) 1 lb. (454 g) powder Protein (12% kcals) cans - Amino acids USE: Lysine and tryptophan-free medical food powder for dietary management of infants, children and adults with glutaric acidemia type 1. 6 cans / case Fat (47% kcals) - Palm olein, soy oil, coconut oil, high oleic Per 100 g powder: 500 kcals, 26 g fat, 52 g CHO, 15.1 g protein equivalent. Yield varies sunflower oil

CAUTION: For use only under medical supervision. Not nutritionally complete. Enough Carbohydrate (41 % kcals) lysine and tryptophan must be provided to support growth - Corn syrup solids, sugar, modified corn starch, maltodextrin

Gerber Extensive HA (Gerber) 14.1 oz. powder cans Protein (11 % kcals) New to the market beginning May 2015 - Whey hydrolysate 1 can powder yields (100%) USE: Hypoallergenic formula for infants with cow’s milk protein allergy. 100% why protein. approximately 96 fl. oz. Extensively hydrolyzed. Contains probiotic B Lactis. (standard dilution). Fat (47% kcals) - soy oil, high oleic Standard dilution is 20 kcals/oz. 100 kcals provides: 2.2 g protein, 5.1 g fat, 11.6 g CHO safflower oil, MCT

CAUTION: Evaluate if formula is mixed, used, and stored properly. Carbohydrate (42% kcals) - Lactose (60%), maltodextrin (40%)

Gerber Good Start Gentle (Gerber) 12.1 oz. powder Protein (9% kcals) - Whey hydrolysate USE: Routine infant formula made with 100% whey protein partially hydrolyzed for 1 can powder yields (100% whey protein) infants from birth to 12 months of age. Includes prebiotic galacto-oligosaccharide approximately 90 fl. oz. (GOS,) which Nestle states is for digestive health. (standard dilution). Fat (46% kcals) - Palm olein, soy oil,

Standard dilution is 20 kcals/oz. 100 kcals provides: 2.2 g protein, 5.1 g fat, 11.6 g CHO coconut oil, high oleic safflower oil or high oleic sunflower, DHA (.32%), CAUTION: This formula is not hypoallergenic and contains only partially hydrolyzed ARA (.64%) protein. Made with cow’s milk protein Carbohydrate (46 % kcals) - Lactose (70%), corn maltodextrin (30%)

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Gerber Good Start Graduates Gentle (Gerber) 22 oz powder Protein (9% kcals) (formerly called Gerber Good Start 2 Gentle) - Whey hydrolysate (100% whey protein) USE: Older baby and toddler formula (9 to 24 months) with 100% whey protein partially hydrolyzed for infants from birth to 12 months of age. Includes prebiotic galacto- Fat (46% kcals) oligosaccharide (GOS,) which Nestle states is for digestive health. - Palm olein, soy oil, coconut oil, high oleic safflower oil or high oleic sunflower, Standard dilution is 20 kcals/oz. 100 kcals provides: 2.2 g protein, 5.1 g fat, 11.6 g CHO DHA (.32%), ARA (.64%) CAUTION: This formula is not hypoallergenic and contains only partially hydrolyzed protein. Made with cow’s milk protein Carbohydrate (46 % kcals) - Lactose (70%), corn maltodextrin (30%)

Gerber Good Start Gentle for Supplementing (Gerber) 12.1 oz. powder Protein (9% kcals) - Whey hydrolysate USE: Routine infant formula made with 100% whey protein partially hydrolyzed for 1 can powder yields (100% whey protein) infants from birth to 12 months of age. Includes prebiotic galacto-oligosaccharide approximately 90 fl. oz. (GOS,) which Nestle states is for digestive health. (standard dilution). Fat (46% kcals) - Palm olein, soy oil,

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Gerber Good Start Graduates Soy (Gerber) 24 oz. powder Protein (10% kcals) Discontinued 2/2016 -Soy protein hydrolyzed 1 can powder yields approximately 170 fl. Fat (46% kcals) oz. (standard dilution). (USE: Older baby and toddler formula (9 to 24 months) Milk-free, lactose-free, iron- -Palm olein, soy oil, coconut oil, high-oleic

fortified, soy protein formula. For lactose intolerance or galactosemia. Also used for safflower oil or high-oleic sunflower oil

vegetarian diets when animal protein formula is not desired.

Carbohydrate (44% kcals)

Standard dilution is 20 kcals/oz. Per 100 kcals: 2.8 g protein, 5 g fat, 10.9 g CHO -Corn maltodextrin, sucrose

CAUTION: Evaluate if formula is mixed, used, and stored properly. Avoid use for anyone with an allergy to soy protein.

Gerber Good Start Nourish (Gerber) 12.6 oz. powder cans Protein (11 % kcals) As of 3/12/2015 Not available - Whey hydrolysate 1 can powder yields (100%) USE: Iron-fortified, nutritionally complete infant formula with DHA & ARA. Contains 100% approximately 87 fl. oz. partially hydrolyzed cow’s milk whey-protein. Contains lactose. (standard dilution). Fat (47% kcals) - soy oil, high oleic Standard dilution is 22 kcals/oz. 100 kcals provides: 2.8 g protein, 5.2 g fat, 10.5 g CHO 3 oz. nursette safflower oil, MCT

CAUTION: This formula is not hypoallergenic and contains only partially hydrolyzed Carbohydrate (42% kcals) protein. Made with cow’s milk protein - Lactose (60%), maltodextrin (40%)

Gerber Good Start Soothe (Gerber) 12.4 oz. powder Protein (9% kcals) - Whey hydrolysate USE: Routine infant formula made with 100% whey protein partially hydrolyzed for 1 can powder yields (100% partially hydrolyzed why) infants from birth to 12 months of age. Includes the probiotic L. reuteri. Manufacturer approximately 90 fl. oz. states it’s shown to ease fussiness and gas (standard dilution). Fat (46% kcals) - Palm olein, soy oil, Standard dilution is 20 kcals/oz. 100 kcals provides: 2.2 g protein, 5.1 g fat, 11.2 g CHO coconut oil, high oleic safflower oil or high oleic sunflower, DHA (.32%), CAUTION: This formula is not hypoallergenic and contains only partially hydrolyzed ARA (.64%) protein. Made with cow’s milk protein Carbohydrate (46 % kcals) - Lactose (30%), corn maltodextrin (70%)

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Gerber Good Start Soy Infant and Toddler (Gerber) 12.9 oz. powder cans Protein (10% kcals) -Soy protein hydrolyzed USE: Milk-free, lactose-free, iron-fortified, soy protein infant formula. For infants and 1 can powder yields toddlers 9 to 24 months with lactose intolerance or galactosemia. Also used for vegetarian approximately 91 fl. oz. Fat (46% kcals) diets when animal protein formula is not desired. Kosher, Halal. (standard dilution). -Palm olein, soy oil, coconut oil, high-oleic Non-GMO safflower oil or high-oleic sunflower oil 12.1 oz. concentrate Standard dilution is 20 kcals/oz. Per 100 kcals: 2.5 g protein, 5.1g fat, 11.1 g CHO Yields 24.2 oz / Carbohydrate (44% kcals) container. -Corn maltodextrin, sucrose Similar to ProSobee and Isomil Use only in rare CAUTION: Evaluate if formula is mixed, used, and stored properly. Avoid use for anyone circumstances: with an allergy to soy protein. Not for infants weighing less than 4 pounds at birth. 4-packs 8.45 oz (33.8 oz) Gerber Good Start Premature 20 Cal (Gerber) 3 oz. RTF Nurser Gerber Good Start Premature 24 Cal 6 (8 x 3 fl oz) Gerber Good Start Premature High Protein 24 Cal Gerber Good Start Premature 30 Cal

Use: Casein-free premature infant formula with 100% whey protein, partially hydrolyzed.

Glucerna Shake (Abbott) 8 fl. oz. ready-to-use Protein (18% kcals) cans - Sodium and calcium caseinates USE: Nutritionally balanced oral supplement for persons with diabetes or abnormal Children / Women: glucose tolerance. Gluten-free, low-residue, Kosher, Halal. 113 Fat (35 % kcals) 24 cans / case - High oleic safflower oil, canola oil, lecithin 30 kcals/oz. Per 8 oz: 220 kcals, 9.9 g protein, 29.3 g CHO, 8.6 g fat Vanilla flavored. Carbohydrate (47% kcals) - Maltodextrin (corn), soy fiber CAUTION: For adult use only. Use under medical supervision only.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Glutarex - 1 (Abbott) 14.1 oz. (400 g) Protein powder - L- amino acids USE: Lysine- and tryptophan-free formula for the dietary management of glutaric aciduria Type I in infants and toddlers. 6 cans / case Fat (45% kcals) - High oleic safflower oil, coconut oil, soy oil 100 Kcals provides: 3.1 g protein equivalent, 4.5 g fat, 11 g CHO. 1 can powder yields Approximately 273 mOsm/kg water. approximately 96 fl. oz. Carbohydrate (standard dilution). - Corn syrup solids CAUTION: For use only under medical supervision. Not intended as the sole source of nutrition. Not for parenteral use. Must be supplemented with protein and fluid in prescribed amounts to completely meet lysine, tryptophan and water requirements. 1 Tbsp. = 7g. powder

Glutarex - 2 (Abbott) 14.1 oz. (400 g) Protein powder - L- amino acids USE: Lysine- and tryptophan-free formula for the dietary management of proven glutaric aciduria Type I in children and adults. 6 cans / case Fat (34% kcals) - High oleic safflower oil, coconut oil, soy oil At standard dilution, 100 g yields: 410 kcals, 30 g protein, 13 g fat, 35 g CHO 1 can powder yields approximately 82 fl. oz. Carbohydrate CAUTION: For use only under medical supervision. Not intended as the sole source of (standard dilution). - Corn syrup solids nutrition. Not for parenteral use. Must be supplemented with protein in prescribed amounts to completely meet lysine and tryptophan requirements. 1 Tbsp. = 8g. powder HCY 1 (Mead Johnson) 1 lb. (454 g) powder Protein (47% kcals) cans - Amino acids USE: Methionine-free dietary powder with cystine for infants and toddlers with 6 cans / case homocystinuria. (Persons with homocystinuria can’t metabolize methionine.) Fat (47% kcals) 1 can powder yields - Palm olein, soy oil, coconut oil, high oleic Per 100 g powder: 500 kcals, 26 g fat, 51 g CHO, 16.2 g protein equivalent approximately 73 fl. oz. sunflower oil (standard dilution). CAUTION: For use only under medical supervision. Care must be taken to provide enough Carbohydrate (40% kcals) methionine to support growth. 1 packed level scoop - Corn syrup solids, sugar, modified corn contains 17.3 g starch, maltodextrin powder.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source HCU Lophlex LQ (Nutricia) 4.2 oz. pouch

USE: Methionine free amino acid based medical food for children over 4 and adults 30/case (including pregnant women) with Homocystinuria. Flavor: Mixed berry CAUTION: For use only under medical supervision.

HCY 2 (Mead Johnson) 1 lb. (454 g) powder Protein (22% kcals) cans - Amino acids USE: Methionine-free dietary powder with cysteine for children and adults with homocystinuria. (Persons with homocystinuria can’t metabolize methionine.) Cystine is 6 cans / case Fat (19% kcals) added at an amount similar to the sum of cystine and methionine in cow’s milk. Vitamin - Soy oil and mineral levels are appropriate for older children and adults. 1 can powder yields approximately 73 fl. oz. Carbohydrate (59% kcals) Per 100 g powder: 410 kcals, 8.5g fat, 61 g CHO, 22 g protein equivalent, 13.8 mg. iron. (standard dilution). - Corn syrup solids, sugar, modified corn starch CAUTION: For use only under medical supervision. Total daily formula amount depends 1 packed level scoop on protein needs, usually based on age and body weight. In addition to HCY 2, it’s contains 17.3 g important to include enough fat, carbohydrate and methionine (depending on how much powder. can be tolerated) in the diet. Care must be taken to provide enough methionine to support growth. Frequent blood tests are needed.

Hominex – 1 (Abbott) 14.1 oz. (400 g) Protein powder - L- amino acids (without methionine) USE: Methionine-free medical food for infants and toddlers with vitamin B6 non- responsive homocystinuria. 6 cans / case Fat (41% kcals), - High oleic safflower, coconut oil, soy oil Per 100 grams: 480 kcals, 15 g protein equivalent, 53 g CHO, 21.7 g fat Carbohydrate CAUTION: For use only under medical supervision. Not intended as the sole source of Standard dilution: - Corn syrup solids nutrition. Must be supplemented with protein and fluid to meet methionine and water 1 Tbsp. = 7g. powder requirements.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Hominex – 2 (Abbott) 14.1 oz (400 g) cans Protein Infants: 9 - L-amino acids (without methionine) Children / Women: 10 USE: Methionine-free medical food for children and adults with vitamin B6 non- 6 cans / case Fat (31% kcals) responsive homocystinuria. - High oleic safflower oil, coconut oil, soy oil

100 g provides: 410 kcals, 30 g protein, 35 g CHO, 14 g fat 1 Tbsp. = 8 g. powder Carbohydrate - Corn syrup solids CAUTION: For use only under medical supervision. Not intended as the sole source of nutrition. Must be supplemented with protein to meet methionine requirements.

Human Milk Fortifier

See Enfamil Human Milk Fortifier Or Similac Human Milk Fortifier Impact (Nestle) 250 mL (8.45 oz.) Protein (22% kcals) ready-to-use cans - Sodium and calcium caseinates, L- USE: Lactose-free, gluten-free, low-residue enteral formula for critically ill persons. 24 cans / case arginine Suggested indications for use: trauma, surgery, cancer, and burns. Fat (25% kcals) 30 kcals/oz. - Palm kernel oil, sunflower oil, menhaden Per 250 mL: 250 kcals, 14 g protein, 32.9 g CHO, 6.9 g fat oil

CAUTION: Use only under medical supervision. Carbohydrate (53% kcals) - Hydrolyzed cornstarch

Impact with Fiber (Nestle) 250 mL (8.45 oz) Protein (22% kcals) ready-to-use cans - Sodium and calcium caseinates, L- USE: Lactose-free, gluten-free, low-residue enteral formula with fiber or critically ill 24 cans / case arginine persons. Suggested indications for use: trauma, surgery, cancer, and burns. Fat (25% kcals) 30 kcals/oz. - Palm kernel oil, sunflower oil, menhaden Per 250 mL: 250 kcals, 14 g protein, 33.8 g CHO, 6.9 g fat oil

CAUTION: Use only under medical supervision. Carbohydrate (53% kcals) - Hydrolyzed cornstarch

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Isosource 1.5 (Nestle) 250 mL (8.45 oz.) Protein (18% kcals) ready-to-use cans - Sodium and calcium caseinates USE: High-calorie, high-nitrogen, complete liquid formula with fiber. For persons with high 24 /case calorie and protein needs and/or limited volume tolerance, such as with pulmonary Fat (38% kcals) conditions. Lactose-free, gluten-free. - Canola oil, MCT, Soy oil

250 mL provides: 375 kcals, 16.9 g protein, 16.2 g fat, 42 g CHO Carbohydrate (44% kcals) - Hydrolyzed corn starch, sugar CAUTION: Use only under medical supervision. Isosource HN (Nestle) 250 mL (8.45 oz.) Protein (18% kcals) ready-to-use cans - Soy protein isolate USE: Provides concentrated nutrition with 1.2 kcals per mL, 100 % soy protein, with slightly higher protein levels than IsoSource Standard. For persons with malnutrition, 24 / case Fat (29% kcals) increased protein needs, or for transitional feeding. - Canola oil, MCT oil

35 kcals/oz. Carbohydrate (53% kcals) 250 mL provides: 300 kcals, 13.4 g protein, 9.84 g fat, 39.9 g CHO - Corn syrup, hydrolyzed cornstarch

CAUTION: Use only under medical supervision. I-Valex – 1 (Abbott) 14.1 oz powder cans Protein - L-amino acids USE: Lucien-free medical food for infants and toddlers with a disorder of leucine 6 cans / case catabolism. Fat (41% kcals) 1 Tbsp. = 7 g. powder - High oleic safflower oil, coconut oil, soy oil Per 100 g powder: 480 kcals, 15 g protein equivalent, 21.7 g fat, 53 g CHO Carbohydrate CAUTION: For use only under medical supervision. Must be supplemented with protein - Corn syrup solids and fluid to meet leucine and water requirements. Not intended as the sole source of nutrition. Not for parenteral use.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source I-Valex – 2 (Abbott) 14.1 oz. powder can Protein - L-amino acids 6 cans / case USE: Leucine-free medical food with iron for children and adults with a disorder of Fat (29% kcals) leucine catabolism. - High oleic safflower oil, coconut oil, soy oil

Per 100 g powder: 410 kcals, 30 g protein equivalent, 13 g fat, 35 g 1 Tbsp. = 8 g. powder Carbohydrate - Corn syrup solids CAUTION: For use only under medical supervision. Must be supplemented with protein to meet leucine requirements. Not intended as the sole source of nutrition. Not for parenteral use.

Jevity 1 CAL (Abbott) 8 fl. oz. ready -to-use Protein (16.7% kcals) cans - Sodium and calcium caseinates, soy USE: Nutritionally complete fiber-fortified formula for tube feeing. Lactose-free, gluten- protein isolate free, kosher, Kosher. 24 / case Fat (29% kcals) 32 kcals/oz. Women: 28 - High oleic safflower oil, canola oil, MCT 8 fl oz. provides: 250 kcals, 10.4 g protein, 36.5 g CHO, 8.2 g fat, 3.4 g dietary fiber 6 / case oil, lecithin

CAUTION: Use only under medical supervision. Carbohydrate (54.3% kcals) - Maltodextrin, corn syrup, soy fiber Jevity 1.2 CAL (Abbott) 8 fl. oz. ready -to-use Protein (18.5% kcals) cans - Sodium and calcium caseinates, soy USE: Nutritionally complete fiber-fortified, high-protein medical food which may be used protein isolate for short or long term tube feeding. Lactose -free, gluten-free, kosher, Halal. 24 / case Fat (29% kcals) 35.6 kcals/oz. - High oleic safflower oil, canola oil, MCT 8 fl. oz. provides: 285 kcals, 13.2 g protein, 40.2 g CHO, 9.3 g fat oil, lecithin

CAUTION: Use only under medical supervision. Carbohydrate (52.5% kcals) - Corn syrup solids, maltodextrin, fiber blend, FOS (fructooligosaccharides)

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Jevity 1.5 CAL (Abbott) 8 fl. oz. ready -to-use Protein (17% kcals) cans - Sodium and calcium caseinates, soy USE: Nutritionally complete, high-calorie, fiber-fortified, medical food for tube feeding. 24 / case protein isolate Lactose-free, gluten-free, kosher, Halal. Fat (29% kcals) 44 kcals/oz. - High oleic safflower oil, canola oil, MCT 8 fl. oz. provides: 355 kcals, 15.1 g protein, 51.1 g CHO, 11.8 g fat oil, lecithin

CAUTION: Use only under medical supervision. Carbohydrate (54% kcals) - Corn syrup solids, maltodextrin, fiber blend, FOS (fructooligosaccharides) KetoCal 3:1 (Nutricia) 11 oz. (300 g) powder Protein (8.8% kcals) cans USE: Nutritionally complete, ketogenic formula in a ratio of 3:1 (fat: carbohydrate + Fat (87.1% kcals) protein) for the dietary management of intractable epilepsy, pyruvate dehydrogenase 6 cans/ case deficiency (PDH), glucose transporter type-1 deficiency. Designed for children 1- 8 years Carbohydrate (4.1% kcals) of age. Medical food.

100 mL provides: 100 kcals, 2.2 g protein, 1 g CHO, 9.7 g fat.

CAUTION: Use only under medical supervision. Not for parenteral use. KetoCal 4:1 (powder) (Nutricia) 11 oz. (300 g) powder Protein (8.4% kcals) cans USE: Nutritionally complete, ketogenic formula in a ratio of 4:1 (fat: carbohydrate + Fat (90% kcals) protein) for the dietary management of intractable epilepsy, pyruvate dehydrogenase 6 cans/ case deficiency (PDH), glucose transporter type-1 deficiency. Designed for individuals over 1 Carbohydrate (1.6% kcals) year of age. Medical food.

100 mL provides: 144 kcals, 3 g protein, 0.6 g CHO, 14.4 g fat.

CAUTION: Use only under medical supervision. Not for parenteral use.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source KetoCal 4:1 LQ Vanilla (Nutricia) 8 oz. RTU Protein (8.4% kcals) KetoCal 4:1 LQ Unflavored 27 / case Fat (90% kcals) USE: Nutritionally complete, ready-to-feed ketogenic formula in a ratio of 4:1 (fat: carbohydrate + protein) for the dietary management of intractable epilepsy, pyruvate Carbohydrate (1.6% kcals) dehydrogenase deficiency (PDH), glucose transporter type-1 deficiency. Designed for individuals over 1 year of age. Medical food.

100 mL provides: 144 kcals, 3 g protein, 0.6 g CHO, 14.4 g fat.

CAUTION: Use only under medical supervision. Not for parenteral use. Shake vigorously for at least 5 seconds before use. Ketonex – 1 (Abbott) 14.1 oz (400 g) Protein powder cans - L-amino acids USE: Branched-chain amino acid-free medical food for infants and toddlers with branched- chain ketoaciduria (maple syrup urine disease - MSUD) or beta-ketothiolase deficiency. 6 / case Fat (41% kcals) - High oleic safflower oil, coconut oil, soy oil 100 g powder provides: 480 kcals, 15 g protein equivalent, 21.7 g fat, 53 g CHO Preparation: Follow Rx Carbohydrate CAUTION: Use only under medical supervision. Not intended as the sole source of as directed by - Corn syrup solids nutrition; must be supplemented with protein and fluid in prescribed amounts to completely physician. meet isoleucine, leucine, valine and water requirements. Not for parenteral use. 1 Tbsp. = 8 g. powder

Ketonex – 2 (Abbott) 14.1 oz. (400 g) Protein powder - L-amino acids USE: Branched-chain amino acid-free medical food for children and adults with branched-chain ketoaciduria (maple syrup urine disease - MSUD) or beta-ketothiolase 6 cans / case Fat (31% kcals) deficiency. - High oleic safflower oil, coconut oil, soy oil Preparation: Follow Rx 100 g powder provides: 410 kcals, 30 g protein equivalent, 14 g fat, 35 g CHO as directed by Carbohydrate physician. - Corn syrup solids CAUTION: Use only under medical supervision. Not intended as the sole source of 1 Tbsp. = 8 g. powder nutrition; must be supplemented with protein in prescribed amounts to completely meet isoleucine, leucine, and valine requirements. Not for parenteral use.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source L-Emental (Hormel Health Labs) 2.84 oz. (80.4 g) Protein (15% kcals) packet - Free amino acids USE: Elemental diet containing 100% free amino acids for persons with limited gut 60 packets / case function, e.g., short bowel syndrome, Crohn’s disease, GI fistula, or pancreatic disorders. Fat (2.5% kcals) For oral or tube feeding. - Safflower oil Standard dilution: 1 30 kcals/oz. packet plus 250 mL to Carbohydrate (82.2% kcals) Provides: 1 kcal/mL. Per Liter: 38 g protein, 205 g CHO, 2.8g fat, 460 mg sodium, 780 mg give 300 mLs. - Maltodextrin potassium. Kcal: N ratio is 175:1. Nonprotein Kcal: N ratio is 149:1. 630 mOsm/kg water.

CAUTION: Use only under medical supervision.

Liquigen (Nutricia)

USE: Emulsion consisting of approximately 50% MCT oil and 50% water. May be used in conditions requiring high energy were fat absorption is impaired and where a high MCT intake is indicated. Can be used as part of the MCT ketogenic diet or to fortify drinks and foods as an energy enhancer. For oral and entereal use.

Per 100mLs: 450 kcals, 0 g protein, 0 g CHO, 50g fat

CAUTION: Use only under medical supervision.

LMD (Mead Johnson) 1 lb. (454 g) powder Protein (13% kcals) cans - Amino acids USE: Leucine-free diet powder for dietary management of infants, children and adults with Infants: 8 inborn errors of leucine metabolism; including isovaleric acidemia. Children / Women: 9 Fat (47% kcals) 6 cans / case - Palm olein, soy oil, coconut oil, high oleic Per 100 g powder: 500 kcals, 26 g fat, 51 g CHO, 16.2 g protein equivalent, 9.6 mg. iron. sunflower oil

CAUTION: For use only under medical supervision. Not nutritionally complete. Enough Carbohydrate (40 % kcals) leucine must be provided to support growth - Corn syrup solids, sugar, modified corn starch, maltodextrin

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Lophlex (Nutricia) 14.3 gram packets Women: 285 packets USE: Medical food designed for the dietary management of phenylketonuria for persons (9 cases) over the age of 9, including adults and pregnant women. Low-Volume, phenylalanine-free, 30 packets / case amino acid-based powdered drink mix enriched with vitamins and minerals. Can be administered orally as a drink or paste or via tube. Flavors: Berry, orange Medical food.

Per 14.3 g packet: 41 kcals, 10 g protein equiv., .03 g fat, .14 g CHO

Caution: Must only be used under strict medical supervision. Not intended for use as the sole source of nutrition. Not suitable for infants under one year of age. Not for parenteral use. Not suitable for metabolic disorders other than PKU or as a supplement for individuals who do not have PKU.

MCT Oil (Nestle) Quart (32 oz.) glass Protein bottles - None USE: Modular source of medium chained triglycerides for persons with decreased pancreatic lipase, decreased bile salts, fat malabsorption, or defective lymphatic transport 6 bottles per case Fat of fat. Must be used in combination with other product(s) to formulate adequate nutrition. - coconut oil and/or palm kernel oil

Provides: 8.3 kcals/gram. Carbohydrate One TBSP (15mL) provides 115 kcals. - None 100% fat

CAUTION: MCT Oil should be used solely under the supervision of a physician.

Microlipid (Nestle) 3 oz. bottles Protein - None USE: Supplementary source of calories from fat (100%). May be used as a component of 48 bottles / case oral or tube feedings. Fat (100% kcals) - Safflower oil, soy lecithin Provides 4.5 kcals/mL (400 kcal/89mL). 1 Tbsp (15 mL) 67.5 calories Carbohydrate CAUTION: For use only under medical supervision. Not nutritionally complete. Unused - None portion should be recapped and refrigerated. Discard unused portion after 5 days.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Milk: Acidophilus Cow’s Milk Protein - Casein USE: For adults and children 2 year s and older who do not have an allergy to cow’s milk protein. May be helpful for lactose intolerance as it is a fermented milk (cultured with Fat Lactobacillus acidophilus, as well as Bifidobacterium in some brands) which can aid in the - Milk fat digestion of lactose. People who can tolerate yogurt generally can tolerate acidophilus milk. Sometimes used for individuals on continuous antibiotic therapy. Cooking will reduce Carbohydrate this effect. There is some evidence suggesting that fermented milk products containing - Lactose probiotic bacteria such as Lactobacillus acidophilus may be helpful in the management of urinary tract infections. Does not taste sweet like lactose reduced/free milk. Pasteurized, Vitamins A and D fortified.

2% Reduced fat milk: 15.12 kcals/oz. 1 cup = 120 kcals. Fat free (0% fat): 10.75 kcals/oz. 1 cup = 86 kcals.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Milk: Cow’s Milk, Pasteurized Half Gallon: Protein whole, - Casein (primarily alpha caseins), whey USE: For adults and children over 1 year of age who do not have an allergy to cow milk 2% reduced fat, protein. Supplies calcium, phosphorus, and vitamin D for healthy bones and teeth. Also 1% low-fat, Fat supplies Vitamin A, riboflavin and protein for growth. fat free - Milk fat

Whole milk (3.5% fat): 18.75 kcals/oz. 1 cup = 150 kcals. Gallon: Carbohydrate 2% Reduced fat milk: 15.12 kcals/oz. 1 cup = 121 kcals. whole, - Lactose 1% Low-fat milk: 12.75 kcals/oz. 1 cup = 102 kcals. 2% reduced fat, Fat free (0% fat): 10.75 kcals/oz. 1 cup = 86 kcals. 1% low-fat, fat free. Provides only 0.48 mg iron/quart. 280 mOsm/kg water. Quarts: whole, CAUTION: WIC recommends whole milk for children until the age of 2 years to ensure 2% reduced fat, sufficient energy and to provide linoleic acid, an essential fatty acid needed for growth and 1% low-fat, development of body tissues, including the brain. A specific form of eczema has been fat free observed in infants deficient in linoleic acid.

Pasteurized cow’s milk is not recommended for infants because: 1) it can cause gastrointestinal blood loss, 2) the solute load is too heavy for the infant’s renal system to Refer to Minnesota handle, 3) it is low in vitamin C and iron, and 4) the early introduction of cow’s milk may Operations Manual for increase the incidence of cow’s milk allergy and the possibility of increased incidence of amounts. diabetes.

Children less than 1 year of age should not drink skim milk. It contains excess protein and minerals in proportion to its caloric content and lacks essential fatty acids, which are needed for optimal growth and brain development, as well as maintenance of skin integrity.

Ingestion of unpasteurized dairy products is associated with illness due to group C streptococcal infections, staphylococcal enterotoxin, salmonella, Escherichia coli, Mycobacterium tuberculosis, Campylobacter fetus jejuni, and Listeria monocytogenes (meningitis and sepsis).

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Milk: Goat Milk (Poplar Hill, Meyenberg) Evaporated 12 oz. Whole (fluid and evaporated): cans Protein (23% kcals) USE: May be helpful when there is a cow’s milk sensitivity and/or intolerance or allergy to Children: - Goat milk protein, casein (mainly beta- soy milk. The types of casein in goat milk, plus the evaporation process (in evaporated Standard: 21 cans caseins), whey milk), render the milk more digestible and less allergenic. The fat has a high proportion of Maximum: 26 cans short chain and medium-chain fatty acids and thereby may be more digestible. The Fat (48% kcals) lactose content is slightly less (9 gm/ 8 oz) than cow’s milk (12 gm/8 oz). Can be issued to Women - - Milk fat (higher in short- and medium- women & children. Breastfeeding / PG: chain fatty acids, and more linoleic and 30 cans arachidonic acids than cow’s milk) Only goat milk that has been pasteurized and fortified with vitamin D is WIC-allowed. (Evaporated milk has additional folic acid fortification.) Women - Carbohydrate (29% kcals)

Postpartum: - Lactose Whole milk - per 8 oz: 142 kcals, 8 g protein, 8 g fat, 10 g CHO, 316 IU Vitamin A, 100 IU Standard: 21 cans Vitamin D. Maximum: 26 cans 1% Low-fat Milk - per 8 oz: 100 kcals, 8 g protein, 2.5 g fat (1.5 g saturated, .74 g polyunsaturated, .14 g monounsaturated), 11 g CHO, 500 IU Vitamin A, 100 IU Vitamin D. 1% Low-fat: Evaporated Whole Milk - per 8 oz: 145 kcals, 8 g protein, 8 g fat (4.8 saturated, 2.4 Protein (33% kcals) polyunsaturated, .49 monounsaturated), 10 g CHO, 343 IU vitamin A, 100 IU vitamin D, 80 Fat (24% kcals) mcg folic acid. Carbohydrate (42% kcals) Fresh (pasteurized) 1 qt. (32 oz.) cartons Provides only 0.48 mg iron/quart. 348 mOsm/kg water when reconstituted 12 oz. milk with 12 oz. water. Children: Standard: 20 qts. CAUTION: Many goat milk proteins co-react with cow’s milk proteins so that many children Maximum: 24 qts. allergic to cow’s milk are / or will become allergic to goat’s milk. Women - Goat's milk should not be used for infants under one year of age because of the high Breastfeeding / PG: potassium and chloride content, and inadequate amounts of vitamin C, vitamin D, vitamin 28 qts. B6, iron, folic acid, niacin, riboflavin, thiamin, and pantothenic acid. Goat’s milk has a higher renal solute load than cow’s milk and can place stress on an infant’s kidneys. It can Women - cause metabolic acidosis in vulnerable infants. Postpartum: Standard: 20 qts. Maximum: 24 qts.

Refer to Minnesota Operations Manual for additional information.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Milk: Lactose Free. Half-gallon Protein Includes products such Dairy Fresh, Dean’s, Kemps, and LACTAID. - Casein Refer to WIC UPC Listing for additional brands. Quart (if listed on voucher) Fat USE: Adults and children with primary and secondary lactose intolerance. Lactase has - Milk fat been added to hydrolyze the lactose. Pasteurized, vitamins A and D fortified. Refer to Minnesota Carbohydrate Can be purchased as whole, 2% reduced fat, 1% low-fat, fat free, and calcium-fortified fat Operations Manual for - Hydrolyzed lactose free (Lactaid). amounts

Whole (3.5% fat): 18.75 kcals/oz. 1 cup = 150 kcals. 2% Reduced fat: 15.12 kcals/oz. 1 cup = 120 kcals. 1% Low-fat: 12.75 kcals/oz. 1 cup = 102 kcals. Fat free (0% fat): 10.75 kcals/oz. 1 cup = 86 kcals.

.48 mg iron/quart. 280 mOsm/kg water.

CAUTION: WIC does not recommend lower fat milk for children under 2 years of age. Other sources of dietary fat should be recommended if used for toddlers. Soy formula or lactose free formula is more appropriate than low-fat milks for 1 year olds with lactose intolerance that are at risk for inadequate growth.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Milk Substitute: Rice Beverage

USE: Beverage made from rice. There are significant nutritional differences between rice beverage and cow’s milk. Rice beverage contains a lot of carbohydrate and is low in protein. Cow’s milk has protein, fat, and carbohydrate. If a participant plans to purchase it on their own, suggest they purchase “fortified” or ‘enriched’ rice beverage.

Rice beverages are not WIC-allowed because they do not meet the FDA’s standard of identity for milk.

CAUTION: Not recommended for infants less than 1 year of age. While rice beverage may be used as a beverage, it should not be used as a substitute for milk. Rice beverage is low in protein. Products that are not fortified do not contain calcium and vitamin D.

Milk Substitute: Soy Beverage Half-gallons: USE: Beverage made from soybeans. Lactose- and casein-free. Soy beverage might be 8th Continent Original used by persons who are lactose intolerant, vegetarians, or for religious reasons. brand (refrigerated)

Although many brands do not provide the amount of protein and nutrients that milk Quarts: provides, the WIC-allowed soy beverages contain a nutrient profile comparable to milk. Pacific Ultra Soy brand (shelf-stable) CAUTION: Not recommended for infants less than 1 year of age. Availability is limited. In addition to inappropriate composition for infants, an estimated 20-50% of infants with cow’s milk allergy have an adverse reaction to soy beverage as well. Many toddlers later outgrow cow’s milk allergy, but are less likely to outgrow a soy allergy. Therefore some specialists do not recommend giving soy-based beverages to Refer to Minnesota infants and toddlers with cow’s milk allergy (J. Joneja). Operations Manual for amounts.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Monogen (Nutricia) 14 oz. (400 g) powder Fat (24% kcals) (80% MCT) Use: Milk protein-based powder low in fat, high in medium chain triglycerides. Designed 6 cans / case for the dietary management of GI and Lymphatic disorders (e.g. chylothorax, intestine lymphangiectasia, intractable malabsorption) and metabolic diseases (e.g. hyperlipoproteinemia type 1 and long chain fatty acid oxidation disorders) in individuals over one year of age, including adults.

100 g provides: 420 kcals, 12.5 g protein, 68 g CHO, 11 g fat.

CAUTION: Use only under medical supervision. Not for parenteral use. MSUD Analog (Nutricia) 14 oz. (400 g) powder Protein (11% kcals) 6 cans / case - Amino acids (without valine, leucine and USE: Valine-, leucine- and isloeucine-free infant formula for dietary management of isoleucine) maple syrup urine disease (MSUD). Contains all other essential and non-essential amino Unflavored. acids, carbohydrate, fat, vitamins, minerals, and trace elements. Additional protein must Fat (40% kcals) also be given as breastmilk or standard infant formula to supply the isoleucine, leucine, Yield varies. - High oleic safflower oil, refined valine and other nutrient requirements. Vegetable oil

100 grams provides: 475 kcals, 13 g protein equivalent, 20.9 g fat, 59 g CHO Carbohydrate (50% kcals) CAUTION: Must only be given under medical supervision. Not intended as a sole source - Corn syrup solids of nutrition. Not for parenteral use.

MSUD Lophlex LQ (Nutricia) 4.2 oz. pouches

USE: Isoleucine-, leucine- and valine-free medical food used in the dietary management of 30 / case maple syrup urine disease (MSUD) for children over 4 and women (including pregnant) in the childbearing years. Contains a balanced mixture of all other essential and non- essential amino acids, carbohydrate, vitamins, minerals and trace elements. Does not contain fat.

Per pouch: 120 kcals, 20 g protein equivalent, 0.44 g fat, 9.3 g CHO

CAUTION: Must only be given under medical supervision. Not intended as a sole source of nutrition.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source MSUD Maxamum (Nutricia) 1 lb. (454 g) powder Protein cans - Amino acids (without isoleucine, leucine USE: Isoleucine-, leucine- and valine-free medical food used in the dietary management of 6 cans / case valine) maple syrup urine disease (MSUD) for older children and women (including pregnant) in the childbearing years. Contains a balanced mixture of all other essential and non- Yield varies. Fat essential amino acids, carbohydrate, vitamins, minerals and trace elements. Does not - Negligible contain fat. Carbohydrate Per 100 g powder: 305 kcals, 40 g protein equivalent, <1 g fat, 34 g CHO - Corn syrup solids, sucrose

CAUTION: Must only be given under medical supervision. Not intended as a sole source of nutrition.

MSUD Maxamaid (Nutricia) 1 lb. (454 g) powder Protein (28.5% kcals) can - Amino acids (without valine, leucine, USE: Valine-, leucine-, and isoleucine-free medical food used in the dietary management 6 cans / case isoleucine) of maple syrup urine disease (MSUD) for toddlers and children 1 to 8 years of age. Contains a balanced mixture of all other essential and non-essential amino acids, Orange flavored. Fat (< %kcals) carbohydrate, vitamins, minerals and trace elements. Does not contain fat; allows for - Negligible modification of energy intake. Yield varies. Carbohydrate (71% kcals) Per 100 g powder: 324 kcals, 25 g protein equivalent, <0.1 g fat, 56 g CHO. - Corn syrup solids, sucrose

CAUTION: Must only be given under medical supervision. Not intended as a sole source of nutrition. Not for parenteral use.

MSUD Maxamum (Nutricia) 1 lb. (454 g) powder Protein cans - Amino acids (without isoleucine, leucine USE: Isoleucine-, leucine- and valine-free medical food used in the dietary management of 6 cans / case valine) maple syrup urine disease (MSUD) for older children and women (including pregnant) in the childbearing years. Contains a balanced mixture of all other essential and non- Yield varies. Fat essential amino acids, carbohydrate, vitamins, minerals and trace elements. Does not - Negligible contain fat. Carbohydrate Per 100 g powder: 305 kcals, 40 g protein equivalent, <1 g fat, 34 g CHO - Corn syrup solids, sucrose

CAUTION: Must only be given under medical supervision. Not intended as a sole source of nutrition.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Neocate Infant with DHA and ARA (Nutricia) 14.1 oz. powder Protein (11.2% kcals) 4 cans / case - Free amino acids USE: Hypoallergenic amino acid-based infant formula with DHA & ARA. for infants with cow’s milk allergy, multiple food protein intolerance, soy formula intolerance, protein 1 can powder yields Fat (45.7% kcals) hydrolysate intolerance, short bowel syndrome, gastroesohageal reflux, transition from approximately 97 fl. oz. - Hybrid safflower oil, refined coconut oil, parenteral to enteral nutrition or for other medical conditions for which an amino acid-based (standard dilution). (95% LCT, 5% MCT) diet is required. Contains 100% free amino acids. Can be used for oral or tube feeding. Milk protein-, lactose-, sucrose-, and galactose-free. Halal certified. Carbohydrate (43.1% kcals) Does not contain soy oil. - Corn syrup solids

Standard dilution is 20 kcals/oz. 100 kcals provides (at standard dilution): 2.8 g protein, 5.1 g fat, 10.8 g CHO 375

CAUTION: Use only under medical supervision.

Neocate Junior (Nutricia) 14.1 oz. (400 g) Protein (13% kcals) powder cans - Free amino acids USE: Nutritionally complete, hypoallergenic medical food. For children with GI tract 4 cans / case impairment, malabsorption, multiple food protein intolerance, cow’s milk protein Fat (45% kcals) intolerance, and other medical conditions indicating an elemental diet. Contains 100% 1 can powder yields - Fractionated coconut oil, canola oil, hybrid non-allergenic free amino acids. For complete or supplemental nutrition support. approximately 62 fl. oz. safflower oil, (65% LCT, 35 % MCT) (standard dilution). Standard dilution is 30 kcals/oz. Carbohydrate (42% kcals) Flavors: Unflavored, - Corn syrup solids 100 kcals provides (at standard dilution): 3.3 g protein equivalent (3.6 g a.a.), Tropical, Strawberry, 5 g fat, 10.4 g CHO Chocolate

CAUTION: Use only under medical supervision. Recommended concentration is 1 Preparation: Measure the required amount of water first. Then add the prescribed kcal/mL mixing: 200 mL amount of powder formula to the water. (6.5 oz) water with 52 g powder (1/2 cup) to yield total volume of 240 mL (8 fl. oz.)

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Neocate Junior with Prebiotics (Nutricia) 14.1 oz. (400 g) Protein (13% kcals) powder cans - Free amino acids USE: Nutritionally complete, hypoallergenic medical food with prebiotic fiber for children 4 cans / case over 1 year of age with GI tract impairment, malabsorption, multiple food protein Fat (42% kcals) intolerance, cow’s milk protein intolerance, and other medical conditions indicating an 1 can powder yields - Fractionated coconut oil, canola oil, hybrid elemental diet. Contains 100% non-allergenic free amino acids. For complete or approximately 62 fl. oz. safflower oil, (65% LCT, 35 % MCT) supplemental nutrition support. (standard dilution). Carbohydrate (45% kcals) Standard dilution is 30 kcals/oz. Flavors: Unflavored, - Corn syrup solids Vanilla, Strawberry 100 kcals provides (at standard dilution): 3.3 g protein equivalent (3.6 g a.a.), 5 g fat, 10.4 g CHO Recommended concentration is 1 CAUTION: Use only under medical supervision. kcal/mL mixing: 200 mL (6.5 oz) water with 52 g Preparation: Measure the required amount of water first. Then add the prescribed powder (1/2 cup) to amount of powder formula to the water. yield total volume of 240 mL (8 fl. oz.)

Neocate Nutra (Nutricia) 14.1 oz. (400 g) Protein (7% kcals) powder cans - Free amino acids USE: Nutritionally complete, hypoallergenic medical food with prebiotic fiber for infants 4 cans / case over 6 months of age and children with cow and soy protein allergy, and multiple food Fat (36% kcals) protein intolerance: Short bowel syndrome, Eosinophilic esophagitis, malabsorption, gastroesohageal reflux and other GI disorders. Carbohydrate (57% kcals)

Beginning in September 2012 hypoallergenic rice starch replaced thera will be updated to include a highly refined pre-gelatinized rice starch as the thickening agent. This hypoallergenic rice starch will replace the cornstarch currently in Neocate Nutra.

Per 100 grams: 472 Kcals, 8.2 g protein equiv, 18.8 g fat, 67.4 g CHO

CAUTION: Use only under medical supervision. Not suitable as a sole source of nutrition. Not intended for bottle or tube feed.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Neocate (E028) Splash (Nutricia) 8 fl. oz. (237 mL) box Ready-To-Use 27 boxes / case Protein (10% kcals) USE: Medical food that is 100 % non-allergenic free amino acids. Indicated for cow and - Synthetic amino acids soy milk allergy, multiple food protein intolerance, food allergy associated conditions: short Flavors: Unflavored, bowel syndrome, eosinophillic esophagitis, gastroesophageal reflux, and other GI Grape, Orange- Fat (32% kcals) disorders. For children over 1 year of age. . pineapple - Fractionated coconut oil, canola oil, high oleic safflower oil 30 kcals/oz. Unflavored available 8 oz. provides: 237 kcals (1 kcal per mL), 5.9 g protein equivalent (7.1 g amino acids), 8.3 July 2014 Carbohydrate (58% kcals) g fat, 34.6 g CHO - Maltodextrin, sucrose, corn syrup solids

CAUTION: Use only under medical supervision

Nepro (Abbott) 8 fl. oz. ready-to-use Protein (18% kcals) cans - Calcium, magnesium and sodium USE: Amino acid-based semi-solid medical food for children and infants over 6 months of caseinates, milk protein isolate age. Nutritionally complete, high-calorie, moderate-protein, specialized formula for 24 cans per case persons with chronic or acute renal failure requiring dialysis. Can be used as either a Fat (48% kcals) primary or supplemental source of nutrition. For oral or tube feeding. Flavors: Vanilla, - High-oleic safflower oil, canola oil, soy Cherry Supreme, Butter lecithin 53 kcals/oz Pecan. 8 oz. provides: 425 kcals, 19.1 g protein,37.9 g carbohydrate, 22.7 g fat Carbohydrate (34% kcals) - Corn syrup solids, sucrose, CAUTION: Use only under medical supervision. fructooligosaccharides

Novasource Renal (Nestle) 8 fl. oz. ready-to-use Protein (18% kcals) box - Sodium and calcium caseinates, L- USE: Nutritionally complete, high-calorie formula for persons with acute or chronic renal arginine failure, or those who are electrolyte or fluid restricted. Lactose-free, gluten-free, low- 27 / case residue. Fat (37% kcals) Vanilla flavored. - High oleic sunflower oil, corn oil, MCT oil 60 kcals/oz. Per 237 mL: 475 kcals, 21.6 g protein, 43.5 g CHO, 23.8 g fat Carbohydrate (37% kcals) - Corn syrup, fructose CAUTION: Use only under medical supervision.

Nutramigen (Mead Johnson) Changed name to Pur Amino

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Nutramigen Liquids (Mead Johnson) 13 oz. concentrate Protein (11% kcals) 12 / case - Casein hydrolysate, amino acids USE: Iron-fortified, lactose-free, hypoallergenic infant formula for newborns and infants who are allergic to the intact proteins in cow’s milk and soy formulas, as well as other Use only in rare Fat (48% kcals) foods. . Contains extensively hydrolyzed protein to avoid an immune system response circumstances: - Palm olein oil, soy oil, coconut oil, high by reducing the allergen exposure. Such infants may have colic, congestion, runny nose, oleic sunflower oil, DHA, ARA wheezing, vomiting, diarrhea, bloody stools, mucus in stools, rash, or eczema. Lactose- 32 fl oz. ready-to-feed free 6 / case Carbohydrate (41% kcals) - Corn syrup solids, 20 kcals/oz. 2 oz. nursette Bottles modified corn starch 100 kcals provides: 2.8 g protein, 5.3 g fat, 10.3 g CHO 48 bottles / case

CAUTION: Contains milk and soy. Occasionally an infant may have an allergic reaction to extensively hydrolyzed casine formula.

When this product is used as milk substitute for children beyond 12 months of age, the total calcium content of the diet should be assessed.

Not recommended for very low birth weight infants. Evaluate if formula is mixed, used, and stored properly.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Nutramigen with Enflora LGG (Mead Johnson) 12.6 oz Powder Protein (11% kcals) (this is the only powder form of Nutramigen) 6 / case - Casein hydrolysate, amino acids

USE: Iron-fortified, lactose-free, galactose-free, gluten-free hypoallergenic infant formula One 12.6 oz. can Fat (48% kcals) for newborns and infants who are allergic to the intact proteins in cow’s milk and soy powder yields - Palm olein oil, soy oil, coconut oil, high formulas, as well as other foods. Contains extensively hydrolyzed protein to avoid an approximately 87 oz. oleic sunflower oil, DHA, ARA immune system response by reducing the allergen exposure. Such infants may have colic, (standard dilution, 20 congestion, runny nose, wheezing, vomiting, diarrhea, bloody stools, mucus in stools, rash, kcals/oz). Carbohydrate (41% kcals) or eczema. Lactose-free. Galactose-free. - Corn syrup solids, Only available in modified corn starch Also appropriate for infants with galactosemia. powder form

LGG is a probiotic. Nutramigen Liquids does not have LGG, only powder does.

20 kcals/oz. 100 kcals provides: 2.8 g protein, 5.3g fat, 10.3 g CHO

CAUTION: Contains milk and soy. Occasionally an infant may have an allergic reaction to extensively hydrolyzed casine formula.

Not recommended for very low birth weight infants. Evaluate if formula is mixed, used, and stored properly.

Nutramigen with Enflora LGG Toddler (Mead Johnson) 12.6 oz Powder Protein (10% kcals) 6 / case - Casein hydrolysate, amino acids USE: Iron-fortified, lactose-free, galactose-free, gluten-free hypoallergenic formula for older infants and toddlers age 9-36 months with cow’s milk allergy. Contains extensively One 12.6 oz. can Fat (39% kcals) hydrolyzed protein. powder yields - Palm olein oil, soy oil, coconut oil, high approximately 86 oz. oleic sunflower oil, DHA, ARA LGG is a probiotic. . (standard dilution, 20 kcals/oz). Carbohydrate (51% kcals) 20 kcals/oz. - Corn syrup solids, 100 kcals provides: 2.5 g protein, 4.3 g fat, 12.8 g CHO Only available in modified corn starch powder form CAUTION: Contains milk and soy. Occasionally an infant may have an allergic reaction to extensively hydrolyzed casine formula.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Nutren 1.0 (Nestle) 8.45 fl. oz. (250 mL) Protein (16% kcals) Nutren 1.0 with Fiber ready-to-feed - Calcium-potassium caseinate

USE: Nutritionally complete, isotonic supplement for persons needing complete or 24 / case Fat (34% kcals) supplemental nutrition with normal protein and calorie requirements. For short or long term - Canola oil, MCT oil, corn oil, soy lecithin tube feeding. Lactose-free, gluten-free, low-residue, kosher. Flavors: Vanilla Carbohydrate (50% kcals) 30 kcals/oz. - Maltodextrin, corn syrup solids Per 250 mL: 250 kcals (30 kcals/oz.), 10 g protein, 9.5 g fat, 31.8 g CHO

CAUTION: Not for parenteral use.

Nutren 2.0 (Nestle) 8.45 fl. oz. (250 mL) Protein (16% kcals) ready-to-feed - Casein USE: Nutritionally complete, very high-calorie supplement designed for oral or tube feeding for persons with very high calorie needs and/ or severely restricted fluids. May be 24 / case Fat (45% kcals) used as the sole source of nutrition or as a supplement. - MCT, canola oil, corn oil, soy lecithin Lactose-free, gluten-free, low-residue, kosher. Vanilla flavored. Carbohydrate (39% kcals) 60 kcals/oz. - Corn syrup solids, maltodextrin, sucrose 250 mL provides: 500 kcals (60 kcals/oz., 2 kcals/mL), 20 g protein, 26 g fat, 49 g CHO

CAUTION: Not for parenteral use. Nutren Glytrol (Nestle) 8.45 fl. oz. (250 mL) Protein (18% kcals) ready-to-use cans - Calcium-potassium caseinate USE: Nutritionally balanced supplement for persons with diabetes. 24 / case Fat (42% kcals) 30 kcals/oz. - Canola oil, high-oleic safflower oil, MCT Provides per 250 mL: 250 kcals, 11.3 g protein, 25 g carbohydrate, 11.9 g Vanilla flavored. oil, soy lecithin

CAUTION: To be used under medical supervision only. Evaluate if formula is used and Carbohydrate (40% kcals) stored properly. - Maltodextrin, corn starch, fructose, pectin, gum arabic

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Nutren Junior (Nestle) 8.45 oz. (250 mL) Protein (12% kcals) Nutren Junior with Fiber ready-to-feed - Milk protein concentrate, whey protein concentrate, (50% whey, 50% casein) USE: Complete liquid nutrition or use as a supplement for children ages 1-13. For use as 24 / case oral or tube feeding. Available with and without fiber to provide flexibility in bowel Fat (44% kcals) management. Lactose-free, gluten-free, low-residue, kosher. Vanilla flavored. - Soybean oil, MCT (25 %) (fractionated coconut oil), canola oil, soy lecithin 30 kcals/oz. Per 250 mL: 250 kcals, 7.5 g protein, 12.4 g fat, 27.5 g CHO Carbohydrate (44% kcals) - Maltodextrin, sucrose CAUTION: Not for parenteral use. Not recommended for infants under one year unless prescribed by a physician. Fiber (Nutren Junior with Fiber) - Soy fiber Nutren Pulmonary (Nestle) 8.45 fl. oz. (250mL) Protein (18% kcals) ready-to-use cans - Calcium-potassium caseinate USE: Nutritionally compete, calorically-dense, low carbohydrate, high-protein formula for persons with limited respiratory function, e.g., COPD. Lactose-free, gluten-free, low- 24 / case Fat (56% kcals) residue, kosher. - Canola oil, MCT oil (40%), corn oil Vanilla flavor. 45 kcals/oz. Carbohydrate (26% kcals) Per 250 mL: 375 kcals (1.5 kcal/mL), 17 g protein, 25 g CHO, 23.7 g fat, 5.3 mg iron. - Maltodextrin

CAUTION: To be used only under medical supervision. Not for parenteral use.

NutriHep (Nestle) 8.45 fl. oz. (250mL) Protein (11% kcals) ready-to-use cans - Crystalline L-amino acids, whey protein USE: Enteral nutrition for hepatic insufficiency or liver disease. Lactose-free, gluten-free, concentrate low-residue, kosher. 24 / case Fat (12% kcals) 45 kcals/oz. Unflavored. - MCT (fractionated coconut oil), canola oil, Per 250 mL: 375 kcals (1.5 kcal/mL), 10 g protein, 72.5 g CHO, 5.3 g fat corn oil

CAUTION: To be used only under medical supervision. Not for parenteral use. Evaluate Carbohydrate (77% kcals) for proper use and storage of formula. - Maltodextrin, modified corn starch

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source OA 1 (Mead Johnson) 1 lb. (454grams) cans Protein (12% kcals) powder - Amino acids USE: Isoleucine-, methionine-, threonine- and valine-free dietary powder for infants and toddlers with propionic acidemia or methylmalonic aciduria. 6 cans / case Fat (47% kcals) - Palm olein oil, soy oil, coconut oil, high Per 100 g: 500 kcals, 15.7 g protein equiv., 51 g CHO, 26 g fat oleic sunflower oil Yield varies. Osmolality and kcals/oz. depend on the prescription. Carbohydrate (41% kcals) - Corn syrup solids, sugar, modified corn CAUTION: For use only under medical supervision. Not intended as a sole source of starch, maltodextrin nutrition. Other sources of isoleucine, methionine, threonine, and valine must be supplied from other sources to support growth.

OA 2 (Mead Johnson) 1 lb. (454grams) cans Protein (21% kcals) powder - Amino acids USE: Isoleucine-, methionine-, threonine- and valine-free dietary powder for children and adults with propionic acidemia or methylmalonic aciduria. 6 cans /case Fat (20% kcals) - Soy oil Per 100 g: 410 kcals, 21 g protein equiv., 59 g CHO, 9 g fat Yield varies. Carbohydrate (59% kcals) Osmolality and kcals/oz. depend on the prescription. - Corn syrup solids, sugar, modified corn starch, maltodextrin CAUTION: For use only under medical supervision. Not intended as a sole source of nutrition. Other sources of isoleucine, methionine, threonine, and valine must be supplied from other sources to support growth. Organic B.R.A.T. bratdietdrink.com 8 oz. RTU boxes

USE: Organic non-dairy wellness drink.

Per 8 oz: 100 kcals, < 1 g protein, 20 g CHO, 2.5 g fat

Parent’s Choice Infant Formula See Store Brand Formulas

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Pedialyte (Abbott) 8 fl. oz. Ready-To-Feed Protein (0% kcals) - None USE: To restore fluid and minerals lost in diarrhea and vomiting in infants and children; for 1 liter (33.8 fl. oz.) maintenance of water and electrolytes following corrective parenteral therapy for severe ready-to-feed Fat (0% kcals) diarrhea. - None 2.1 fl. oz. freezer pops 8 kcals/oz. Provides: 10.6 mEq sodium, 4.7 mEq potassium, 8.3 mEq chloride, 1.7 mEq Carbohydrate (100% kcals) citrate, 5.9 g glucose. - Dextrose

CAUTION: Use only under medical supervision. Do not continue for long periods of time Electrolytes without consultation with physician. Does not meet the caloric or nutrition needs of infants - Sodium, potassium, chloride and children.

PediaSmart Complete Organic Nutrition Beverage Dairy Beverage (Nature’s One) http://www.naturesone.com/

USE: Organic formula for children 12 months and older. Organic, lactose-free, gluten-free and corn-free pediatric nutrition beverage. Meets or exceeds 100% of the Dietary Reference Intakes (DRI) for protein, fat, carbohydrate, vitamins and minerals and can be used as sole source of nutrition for tube feedings under the supervision of a medical professional. For children ages 1 through 13 years. The product is not intended for infants less than 12 months of age unless directed by a healthcare professional. Appropriate for children with medical issues who are unable to maintain their nutritional health through typical daily meals and snacks; for children who suffer from chronic illness, growth failure, eating disorders or who suffer from food sensitivities such as lactose intolerance, corn, peanut, soy, wheat and gluten allergies and chemical sensitivities. It may be consumed orally or by tube feeding.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source PediaSmart Soy Complete Organic Nutrition Beverage (Nature’s One) http://www.naturesone.com/

USE: Nutritionally complete organic soy formula for children 1 to 13 years of age with chronic illness (e.g., CP, trauma) or oral motor feeding problems. Organic, soy-based, lactose-free, corn-free pediatric nutrition beverage. Meets or exceeds 100% of the Dietary Reference Intakes (DRI) for protein, fat, carbohydrate, vitamins and minerals and can be used as sole source of nutrition for tube feedings under the supervision of a medical professional. For children 1-13 years of age who may have increased nutrient need due to growth failure, medical or digestive problems.

PediaSure (Abbott) 8 fl. oz. plastic bottles PediaSure PediaSure with Fiber Available at retail Protein (12% kcals) stores in 6-packs - Sodium caseinate, whey protein USE: Nutritionally complete, lactose-free, gluten-free enteral formula for children 1 to 13 concentrate years of age with chronic illness (e.g., CP, trauma) or oral motor feeding problems. For Flavors: oral feeding. May also be tube fed (see also PediaSure Enteral). May be used as the sole PediaSure: Vanilla, Fat (34% kcals) source of nutrition or as a supplement. Suitable for lactose intolerance, gluten-free, Chocolate, Strawberry, - High oleic safflower oil, soy oil, MCT, Kosher, Halal. Banana lecithin

30 kcals/oz. Carbohydrate (54% kcals) Per 8 fl. oz.: 240 kcals, 7 g protein, 9 g fat, 33 g CHO PediaSure with Fiber: - Maltodextrin, sucrose Vanilla. PediSure with Fiber: 3 g dietary fiber per 8 oz. CAUTION: Not for parenteral use. Not for children with galactosemia. Contains milk and soy ingredients.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source PediaSure Enteral (Institutional) (Abbott) 8 fl. oz. ready-to-feed Protein (12% kcals) PediaSure Enteral with Fiber (Institutional) cans - Sodium caseinate, whey protein concentrate USE: Nutritionally complete, lactose-free, gluten-free formula designed for tube feeding 24 cans / case (can be fed orally). For children 1 to 13 years of age with chronic illness (e.g., CP, Fat (34% kcals) trauma) or oral motor feeding problems. May be used as the sole source of nutrition or as Vanilla flavor. - High oleic safflower oil, soy oil, MCT, a supplement. 1000 mL to meet 100% RDA for children 1-8 years. lecithin

30 kcals/oz. Carbohydrate (54 % kcals) Per 8 fl. oz.: 237 kcals, 7 g protein, 9 g fat, 33 g CHO - Maltodextrin, sucrose, soy fiber (PediaSure w/ fiber) CAUTION: Not for parenteral use. Not recommended for infants under 1 year of age. Not for children with galactosemia. Not for parenteral use. Contains milk and soy ingredients.

PediaSure 1.5 Cal (Abbott) 8 fl. oz ready-to-feed Protein (16% kcals) PediaSure 1.5 Cal with Fiber bottles - Sodium caseinate, whey protein concentrate USE: 50 % more calories and twice the protein of regular PediaSure for children who 24 / case require higher caloric concentrated feedings. Nutritionally complete, lactose-free, gluten- Fat (41% kcals) free enteral formula for children 1 to 13 years of age with chronic illness (e.g., CP, Vanilla flavor - High oleic safflower oil, soy oil, MCT, trauma) or oral motor feeding problems. For oral or tube feeding (May be used as the sole lecithin source of nutrition or as a supplement. Gluten-free, Kosher, Halal, low residue. Carbohydrate (43% kcals) 43 kcals/oz. - Maltodextrin, sucrose Per 8 fl. oz.: 350 kcals, 14 g protein, 16 g fat, 38 g CHO

CAUTION: Not for parenteral use. Not for children with galactosemia. Contains milk and soy ingredients.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source PediaSure Peptide 1.0 Cal (Abbott) 8 fl. oz. ready-to-feed Protein (12% kcals) bottles - Sodium caseinate, whey protein USE: Nutritionally complete, peptide based formula for the nutritional needs of children concentrate ages 1-13 with malabsorption, maldigestion, and other GI conditions. For oral or tube 24/ case feeding. Kosher, Halal, gluten-free, low residue. Fat (35% kcals) Flavors: Vanilla, 50/50 MCT:LCT Abbott product information states only peptide-based product with kosher status. strawberry, unflavored. Carbohydrate 53 % kcals) 30 Kcals/oz. - Maltodextrin, sucrose, Per 8 fl. oz.: 237 kcals, 7.1 g protein, 9.6 g fat, 31.7 g CHO soy fiber (PediaSure w/ fiber)

CAUTION: Not for parenteral use. Not recommended for infants under 1 year of age. Not for children with galactosemia.

PediaSure Peptide 1.5 Cal (Abbott) 8 fl. oz. ready-to-feed Protein (12% kcals) bottles - Sodium caseinate, whey protein USE: Nutritionally complete, peptide based formula for the nutritional needs of children concentrate ages 1-13 with malabsorption, maldigestion, and other GI conditions. Designed to meet 24/ case the nutritional needs of kids who require higher caloric density, have fluid restrictions, and Fat (35% kcals) are at risk for malnutrition. For oral or tube feeding. Kosher, Halal, gluten-free, low Flavors: Vanilla 50/50 MCT:LCT residue. Carbohydrate 53 % kcals) Abbott product information states only peptide-based product with kosher status. - Maltodextrin, sucrose, soy fiber (PediaSure w/ fiber) 44.5 Kcals/oz. Per 8 fl. oz.: 356 kcals, 10.7 g protein, 14.4 g fat, 47.6 g CHO

CAUTION: Not for parenteral use. Not recommended for infants under 1 year of age. Not for children with galactosemia.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source PediaSure SideKicks (Abbott) 8 fl. oz. plastic bottles Protein (19% kcals) - Sodium caseinate, whey protein USE: Lower calorie supplement for for children ages 1-13 years old similar to Pediasure Available at retail concentrate but with less calories and less fat. Gluten-free, Kosher, Halal. stores in 6-packs. Fat (30% kcals) 18 kcals/oz. Flavors: Vanilla, - High oleic safflower oil, soy oil, MCT, Per 8 fl. oz.: 150 kcals, 7 g protein, 5 g fat, 21 g CHO chocolate, strawberry lecithin

CAUTION: Not for parenteral use. Not for children with galactosemia. Carbohydrate (51% kcals) - Maltodextrin, sucrose

Pepdite Junior (Nutricia) 51 g (1.8 oz) packet of Protein (12% kcals) powder - Hydrolyzed protein (pork, soy) USE: Nutritionally complete powdered medical food, based on free amino acids and non- dairy hydrolysates. For children ages 1-10. For children with gastrointestinal impairment 15 packets / case Fat (46% kcals) where a hydrolyzed, non-dairy formula is indicated. Can be used as a follow-up for -Fractionated coconut oil, canola oil, hybrid Neocate Infant Formula. Cow’s milk protein-, lactose-, galactose-, fructose-, and sucrose- Flavors: Unflavored. safflower oil free. (35% MCT, 65% LCT)

30 kcals/oz. . Carbohydrate (42% kcals) Per 1 packet (51 g): 240 kcals, 7.4 g protein equiv., 25.5 g CHO, 12 g fat - Corn syrup solids

CAUTION: Use only under medical supervision. Not for parenteral use.

Peptamen (Nestle) 8.45 oz. (250 mL) Protein (16% kcals) ready-to-feed - Hydrolyzed whey protein USE: USE: Nutritionally complete, isotonic, elemental formula for persons with GI impairment, e.g., inflammatory bowel disease, malabsorption syndromes, pancreatic 24 cartons / case Fat (33% kcals) insufficiency. For tube feeding or oral supplement. Lactose-free, gluten-free, low-residue. - MCT (70%), soy oil Flavors: Vanilla or 30 kcals/oz. unflavored. Carbohydrate (51% kcals) Per 250 mL: 250 kcals, 10 g protein, 32 g CHO, 9.8 g fat - Maltodextrin, corn starch

CAUTION: Not for persons with cow’s milk protein allergy. Not for parenteral use. Use only under medical supervision.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Peptamen 1.5 (Nestle) 8.45 oz. (250 mL) Protein (18% kcals) ready-to-feed - Hydrolyzed whey protein USE: Nutritionally complete, high calorie, elemental formula for persons 24 cartons / case with impaired gastrointestinal function and increased caloric requirements. Lactose-free, Fat (33% kcals) gluten-free, low-residue. Flavors: Unflavored, - MCT, soy oil vanilla. 45 kcals/oz. Carbohydrate (49% kcals) 250 mL provides: 375 kcals (1.5 kcals/mL), 17 g protein, 46 g CHO, 14 g fat - Maltodextrin, corn starch

CAUTION: Use only under medical supervision. Not intended for parenteral use. Contains ingredients (e.g., partially hydrolyzed whey protein from cow's milk) that may not be appropriate for individuals with cow’s milk protein allergies.

Peptamen Junior (Nestle) 8.45 oz (250 mL) Protein (12% kcals) ready-to-feed - Enzymatically hydrolyzed whey protein USE: Nutritionally complete enzymatically hydrolyzed 100% whey protein for children ages 1-13 with impaired GI function. Indications include cerebral palsy, cystic fibrosis, 24 cartons / case Fat (34% kcals) malabsorption, growth failure. For tube feeding or oral supplement. Lactose-free, gluten- - MCT 60% (fractionated coconut oil), soy free, low-residue. Flavors: Unflavored, oil, canola oil, soy lecithin vanilla, chocolate, 30 kcals/oz. strawberry Carbohydrate (54% kcals) Per 250 mL: 250 kcals, 7.5 g protein, 34 g CHO, 9.6 g fat - Maltodextrin, corn starch

CAUTION: Not for parenteral use. For use only under medical supervision. Not appropriate for individuals with cow’s milk protein allergy. Not for persons with Galactosemia.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Peptamen Junior Fiber (Nestle) 8.45 oz (250 mL) Protein (12% kcals) ready-to-feed - Enzymatically hydrolyzed whey protein USE: Nutritionally complete, peptide based, elemental formula with soluble and insoluble fiber for oral or tube feeding of children 1 – 13 years of age with impaired gastrointestinal 24 cartons / case Fat (34% kcals) function. Indications for use include: short-bowel syndrome, cerebral palsy, cystic fibrosis, Flavors: vanilla - MCT 60% (fractionated coconut oil), soy chronic malabsorption / diarrhea, delayed gastric emptying, growth failure. Lactose-free, oil, canola oil, soy lecithin gluten-free, low-residue. Carbohydrate (54% kcals) 30 kcals/oz. - Maltodextrin, corn starch Per 250 mL: 250 kcals, 7.5 g protein, 34.4 g CHO, 9.6 g fat

CAUTION: Not for parenteral use. For use only under medical supervision. Contains partially hydrolyzed whey protein and may not be appropriate for persons with food allergies. Not for persons with Galactosemia.

Peptamen Junior with Prebio (Nestle) 8.45 oz (250 mL) Protein (12% kcals) - Enzymatically hydrolyzed whey protein USE: Nutritionally complete, peptide based elemental formula with soluble fiber for oral 24 cartons / case or tube feeding of children 1 - 13 years of age with impaired gastrointestinal function. Fat (34% kcals) Indications for use include: short-bowel syndrome, cystic fibrosis, chronic malabsorption / Flavors: Vanilla - MCT 60% (fractionated coconut oil), soy diarrhea, cerebral palsy, delayed gastric emptying, growth failure. Lactose-free, gluten-free, oil, canola oil, soy lecithin low-residue. Carbohydrate (54% kcals) 30 kcals/oz. - Maltodextrin, corn starch Per 250 mL: 250 kcals, 7.5 g protein, 34.4 g CHO, 9.6 g fat

CAUTION: Not for parenteral use. For use only under medical supervision. Contains milk. Not appropriate for individuals with cow’s milk protein allergy. Not for persons with Galactosemia.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Peptamen Junior 1.5 (Nestle) 8.45 oz (250 mL) Protein (12% kcals) ready-to-feed - Enzymatically hydrolyzed whey protein USE: Nutritionally complete enzymatically hydrolyzed 100% whey protein for children ages 1-13 with impaired GI function. Indications include cerebral palsy, cystic fibrosis, 24 cartons / case Fat (40% kcals) malabsorption, growth failure. For tube feeding or oral supplement. Lactose-free, gluten- - MCT 60% (fractionated coconut oil), soy free, low-residue. Unflavored oil, canola oil, soy lecithin

44 kcals/oz. Carbohydrate (48 kcals) Per 250 mL: 375 kcals, 11.3 g protein, 45 g CHO, 17 g fat - Maltodextrin, corn starch

CAUTION: Not for parenteral use. For use only under medical supervision. Not appropriate for individuals with cow’s milk protein allergy. Not for persons with Galactosemia.

Periflex Advance (Nutricia) 1 lb. (454 g) powder cans USE: Phenylalanine-free powdered medical food for older children and adults including 6 cans / case pregnant women and women of child bearing age. Children are often transitioned from Periflex Junior to this product. Flavors: Unflavored, orange, chocolate 100 g (flavored powder) provides: 385 kcals, 35 g protein equivalent, 12.6 g fat, 33 g CHO

CAUTION: For use only under medical supervision. Not intended as the sole source of Yield varies. nutrition. Not for parenteral use. Not intended for infants under 1 year of age. Periflex Infant (Nutricia) 14 oz. (400 grams) powder USE: Phenylalanine-free formula for infants for use in the dietary management of PKU. Contains a balanced mixture of all other essential and non-essential amino acids, CHO, 6 cans / case fat, vitamins, minerals and trace elements. The diet prescription will usually include an additional prescribed amount of breast milk or standard infant formula to supply the Unflavored. phenylalanine and other nutrient requirements of the infant. Yield varies. Per 100 g powder: 421 kcals, 13 g protein equivalent, 19.1 g fat, 49.3 g CHO

CAUTION: Must only be given under medical supervision.

Periflex Junior (Nutricia) See PKU Periflex Junior Plus

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Periflex XQ (Nutricia) 8.45 oz. (250 mL) Old Name was XPhe MAXAMUM Drink ready-to-feed

USE: Phenylalanine-free medical food formula for the dietary management of PKU in 18 boxes / case children over age 1 and adults. Contains a mixture of essential and non-essential amino Flavors: Orange acids, CHO, vitamins, minerals and trace elements. cream, berry cream

Per 250 mL : 160 kcals, 15 g protein equivalent, 5 g fat, 13.8 g CHO Yield varies.

PFD Toddler (Mead Johnson) 1 lb. (454 g) powder Protein (0% kcals) cans - None USE: Amino acid and protein free formula for children 1-3 years of age with various amino 6 cans / case acid metabolic disorders. Lactose-free. Fat (54% kcals) Yield varies. Use as - Palm olein oil, soy oil, coconut oil, high Per 100 g powder: 530 kcals, 0 g protein, 32 g fat, 60 g CHO directed by the oleic sunflower oil physician. CAUTION: Use only under medical supervision. Not nutritionally complete. Care must be Carbohydrate (46% kcals) taken to provide enough protein or amino acids to support growth, using other foods as - Corn syrup solids, sugar, modified corn required. starch

PFD 2 (Mead Johnson) 1 lb. (454 g) powder Protein (0% kcals) cans - None USE: Amino acid and protein free formula for children and adults with amino acid 6 cans / case metabolic disorders. Fat (11% kcals) Yield varies. Use as - Soy oil Per 100 g powder: 400 kcals, 0 g protein, 4.8 g fat, 88 g CHO directed by the physician. Carbohydrate (88% kcals) CAUTION: Use only under medical supervision. Not nutritionally complete. Care must be - Corn syrup solids, sugar, modified corn taken to provide enough protein to support growth, using other foods as required. starch

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Phenex-1 (Abbott) 14.1 oz. (400 g) Protein powder - L-amino acids USE: Amino acid modified medical food for the dietary management of phenylketonuria 6 cans / case (PKU) or hyperphenylalaninemia in infants and toddlers. Phenylalanine-free. Lactose- Fat (41% kcals) free, gluten-free, Halal. - High oleic safflower, coconut, and soy oils 100 g powder provides: 480 kcals, 15 g protein, 21.7 g fat, 53 g CHO. Carbohydrate CAUTION: For use only under medical supervision. Not intended as the sole source of - Corn syrup solids nutrition; must be supplemented with protein and fluid in prescribed amounts to completely meet phenylalanine and water requirements. Not for parenteral use.

Phenex-2 (Abbott) 14.1 oz. (400 g) Protein powder - L-amino acids USE: Phenylalanine-free formula for the dietary management of phenylketonuria (PKU) or hyperphenylalaninemia in children and adults. Lactose-free, gluten-free, Halal. 6 cans / case Fat (31% kcals) - High oleic safflower oil, coconut oil, soy oil 100 g powder provides: 410 kcals, 30 g protein, 14 g fat, 35 g CHO. Phenex-2 Vanilla is also available (item # Carbohydrate At standard dilution: 469 mOsm/kg water. 55755). Refer to label - Corn syrup solids for specific nutrition CAUTION: For use only under medical supervision. Not intended as the sole source of information. nutrition; must be supplemented with protein and fluid in prescribed amounts to completely meet phenylalanine and water requirements. Not for parenteral use.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source PhenylAde Drink Mix (Applied Nutrition Corp.) 16 oz (454 g) Protein (25% kcals) resealable jar - Amino acids (without phenylalanine) USE: Medical food intended to be used as the primary source of protein nutrition, and a 4 cans / case significant source of calories in the treatment of PKU. Note this product is higher in protein Fat (31% kcals) equivalent than some other PKU products. PhenylAde can be used by children, adults, Flavors: Vanilla, - Partially hydrogenated coconut oil, mono and pregnant women. Must be taken in combination with low phenylalanine foods to Orange Crème, and diglycerides complete a nutritionally balanced diet. Strawberry. Carbohydrate (44% kcals) Provides per 100 g powder: 410 kcals, 25 g protein, 45 g CHO, 14 g fat (saturated fat 13 1 Tbsp = 8 g drink mix - Sugar, corn syrup solids, food starch- g, monounsaturated fat 46 g, polyunsaturated fat 44 g), 12 mg iron. = 2 g protein modified 238 mOsm/kg water. equivalent. 1 scoop = 40 g drink CAUTION: For use only under medical supervision. Not for infants under one year of age. mix = 10 g protein Not for parenteral use. Not intended as sole source of nutrition. equivalent. 1/2 cup = 65 g drink mix = 16 g protein equivalent.

Phenyl-Free 1 (Mead Johnson) 1 lb. (454 g) powder Protein (12.9% kcals) cans - Amino acids USE: Phenylalanine-free diet powder for infants and toddlers with Phenylketonuria (PKU). 6 cans / case Fat (47% kcals) - Palm olein oil, soy oil, coconut oil, high Per 100 g powder: 500 kcals, 16.2 g protein equivalent, 26 g fat, 51 g CHO Yield varies. oleic sunflower oil

CAUTION: For use only under medical supervision. Not for parenteral use. Nutritionally Carbohydrate (40.8% kcals) incomplete. Care must be taken to provide enough phenylalanine to support growth using - Corn syrup solids, sugar, modified corn other sources with phenylalanine as required. Total daily formula amounts depend on the starch, maltodextrin individual protein needs and phenylalanine tolerance. Frequent blood tests are needed.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Phenyl-Free 2 (Mead Johnson) 1 lb. (454 g) powder Protein (22% kcals) cans - Amino acids USE: Phenylalinine-free diet powder for children and adults with phenylketonuria (PKU). 6 cans / case Fat (19% kcals) Per 100 g powder: 410 kcals, 22 g protein equivalent, 8.6 g fat, 60 g CHO, 12.2 mg iron. - Soy oil

CAUTION: For use only under medical supervision. Not for parenteral use. Should not be Yield varies. Carbohydrate (59% kcals) used as a sole source of nutrition. Intended to be used as part of a low-phenylalanine diet - Sugar, corn syrup solids, modified corn that includes other foods to provide adequate nourishment and sufficient phenylalanine to starch support growth.

Phenyl-Free 2 HP (Mead Johnson) 1 lb. (454 g) powder Protein (41% kcals) cans - Amino acids USE: Amino acid food specially formulated without phenylalanine to aid in the nutrition management of children and adults with PKU. Appropriate for women with maternal PKU 6 cans / case Fat (14% kcals) or for children and adults who require fewer calories than provided by Phenyl-Free 2. - Soy oil Higher in protein and most vitamins and minerals than Phenyl-Free 2. Yield varies. Carbohydrate (45% kcals) Per 100 g powder: 390 kcals, 40 g protein equivalent, 6.3 g fat, 44 g CHO Preparation: Follow Rx - Sugar, corn syrup solids, modified corn as directed by starch CAUTION: For use only under medical supervision. Not for parenteral use. Should not be physician. used as a sole source of nutrition; it is intended to be used as part of a low-phenylalanine 16.3 g of product per diet which includes other foods to provide adequate nourishment and sufficient scoop. phenylalanine to support growth. After mixing, use immediately or cover and refrigerate; use within 48 hours.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Phlexy - 10 Drink Mix (Nutricia) 20 g packet of powder Protein (53% kcals) Children / Women: - Amino acids USE: Oral supplement containing a balanced mixture of essential and non-essential 204 amino acids (free of phenylalanine), and carbohydrate for the nutrition management of 30 packets / case Fat (0% kcals) children and adults (including pregnant women) with phenylketonuria. Can be used - None independently or in combination with other phenylalanine-free products or protein sources. This product does not contain vitamins, minerals, trace elements, or significant amounts of Carbohydrate (47% kcals) fat (must be supplied elsewhere). - Sucrose Medical food.

Per 20 g packet: 69 kcals, 8.33 g protein equivalent, 0 g fat, 8.8 g CHO. 1 to 5 dilution = 1172 mOsm/kg.

CAUTION: For use only under and frequent medical supervision. Not for parenteral use. Should not be used as a sole source of nutrition.

PKU Lophlex LQ (Nutricia) 4.2 oz pouch

USE: Phenylalanine-free, ready to drink medical food containing amino acids, vitamins 30/case and minerals, based on fruit juice (from concentrate) for the dietary management of PKU for children 4 years and older, including pregnant women.

Per 4.2 oz pouch: 116 kcals, 20 g protein equivalent, 0 g fat, 9.3 g CHO

CAUTION: For use only under and frequent medical supervision. PKU Periflex Junior Plus (Nutricia) 14 oz. (400 grams) (August 2014 changed from Periflex Junior to Periflex Junior Plus) powder

USE: Phenylalanine-free formula for infants for use in the dietary management of PKU. 6 cans / case Contains a balanced mixture of all other essential and non-essential amino acids, CHO, fat, vitamins, minerals and trace elements. The diet prescription will usually include an Unflavored. additional prescribed amount of breast milk or standard infant formula to supply the phenylalanine and other nutrient requirements of the infant. Yield varies.

Per 100 g powder: 394 kcals, 25 g protein equivalent, 14 g fat, 42 g CHO

CAUTION: Must only be given under medical supervision.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Polycal (Nutricia) Powder: 14.1oz. (400 Protein g) cans - None USE: Easily digested concentrated source of carbohydrate (maltodextrin) for use when additional calories are required. For conditions where a high energy, low fluid or modular 12 cans / case Fat diet is indicated. May be used in the dietary management of energy needs in people with - None inborn errors of metabolism. Rapid absorption. For oral or tube feeding. Carbohydrate 100 g powder provides: 384 kcals, 0 g protein, 0 g fat, 96 g CHO.

Scoop in can holds about 5 grams of powder (100 kcals).

CAUTION: Use only as specifically directed by a physician. Polycal is not a balanced diet and should not be used as a sole source of nutrition. Not for parental use. Portagen (Mead Johnson) 16 oz. powder cans Caloric distribution is for 30 kcals/oz 6 cans / case USE: Nutritional powder for children and adults with defects in the intraluminal hydrolysis Protein (14% kcals) of fat (decreased pancreatic lipase, decreased bile salts); defective mucosal fat absorption - Sodium caseinate (decreased mucosal permeability, decreased absorptive surface); and/or defective 1 can yields lymphatic transport of fat (ie. Intestinal lymphatic obstruction). approximately 70 fl. oz. Fat (40% kcals) (2.2 qts.) of 30 - MCT, corn oil 87% of fat from MCT kcals/oz. formula. Carbohydrate (46% kcals) Can be prepared at either 20 kcals/oz. or 30 kcals/oz. - Corn syrup solids, sugar Per 100 g powder: 470 kcals, 16.5 g protein, 22 g fat, 54 g CHO

CAUTION: Not recommended for infants. Not nutritionally complete. If used long term, supplementation of essential fatty acids and ultra-trace minerals should be considered.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Pregestimil (Mead Johnson) 16 oz. powder Protein (11% kcals) Pregestimil 20 Calories/fl oz. 6 cans / case - Casein hydrolysate, amino acids Pregestimil 24 Calories/fl oz. One 16 oz. can of Fat (48% kcals) USE: Nutritionally complete, hypoallergenic, casein hydrolysate infant formula for infants powder yields - MCT (55% kcals), corn oil, soy oil, high who experience fat malabsorption and who may also be sensitive to intact proteins (severe approximately 112 fl oz. oleic (safflower or sunflower) oil food allergies, sensitivity to intact protein). Fat malabsorption or steatorrheas may be (standard dilution). associated with cystic fibrosis, short bowel syndrome, intractable diarrheas and severe Carbohydrate (41% kcals) protein calorie malnutrition. Some medical conditions may necessitate issuing to children. Pregestimil LIPIL 20 - Corn syrup solids, dextrose, modified corn Lactose-free, sucrose-free. Calories starch 2 oz. ready-to-use Per 100 kcals (at 20 kcals/oz): 2.8 g protein, 5.6 g fat, 10.2 g CHO 48 bottles / case

CAUTION: For use only under medical supervision. Pregestimil LIPIL 24 If used as a milk substitute beyond 12 months of age, the total calcium content of the diet Calories should be assessed. 2 oz. ready-to-use 48 bottles / case Product 3232A (Mead Johnson) 1 lb. (454 g) powder cans USE: Hyperallergenic, protein hydrolysate formula base to be used with added Infants: 8 Children: carbohydrate. Contains tapioca starch. Can be used in the identification and dietary 9 management of persons with disaccharidase deficiencies (lactose, sucrose, or maltose) or 6 cans / case disorders of carbohydrate metabolism. Also used for intractable diarrhea of infancy. Adequate carbohydrate must be supplied. 1 can powder yields Allows adjustment of added carbohydrate according to patient’s tolerance approximately 179 fl. oz. (standard dilution). Hypoallergenic, protein hydrolysate Follow Rx as directed 85% of fat from MCT by physician.

Per 100 kcals: 2.8 g protein, 4.2 g fat, 13.4 g CHO

CAUTION: For use only under medical supervision. Not nutritionally complete.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Promote (Abbott) 8 fl. oz. ready-to-feed Protein (25% kcals) cans - Sodium and calcium caseinates, soy USE: Nutritionally complete, high protein formula designed for persons who need a higher protein isolate proportion of calories from protein. For oral or tube feeding use. Lactose-free, gluten-free, 24 / case low-residue, kosher, Halal. Fat (23% kcals) Vanilla flavor. - High oleic safflower oil, canola oil, MCT oil 30 kcals/oz. Per 8 fl. oz: 237 kcals, 14.8 g protein, 30.8 g CHO, 6.2 g fat Carbohydrate (52% kcals) - Maltodextrin (corn), sucrose CAUTION: Use only under medical supervision. Not for parenteral use.

Promote with Fiber (Abbott) 8 fl. oz. ready-to-feed Protein (25% kcals) cans - Sodium and calcium caseinates, soy protein isolate USE: Nutritionally complete, high protein, fiber fortified formula designed for persons that 24 / case may benefit from increased protein intake; those recovering from infection, injury, or Fat (25% kcals) surgery; those at risk for protein-energy malnutrition; or those chronically ill, inactive or Vanilla flavor. - High oleic safflower oil, canola oil, MCT oil nonambulatory. For oral or tube feeding use. Lactose-free, gluten-free, low-residue, (fractionated coconut oil) kosher, Halal. Carbohydrate (50% kcals) Per 8 fl. oz: 237 kcals, 14.8 g protein, 32.8 g CHO, 6.7 g fat, 3.4 total dietary fiber - Maltodextrin (corn), sucrose, oat fiber, soy fiber CAUTION: Use only under medical supervision. Not for parenteral use. Pro-Phree (Abbott) 14.1 oz. (400 g) powder USE: Nutrition support of infants and toddlers who require extra calories, minerals, and vitamins and/or protein restriction. Lactose-free, gluten-free, Halal. 6 cans / case

Per 100 g powder: 0 protein, 28 g fat, 65 g CHO. One can powder yields approx. 102 fl. oz. CAUTION: For use only under medical supervision. Must be used with a source of intact (standard dilution at 20 protein or amino acids and fluid to meet nutrient and water requirements. kcals/oz.). Not a substitute for standard infant formula or intended for use as the sole source of nutrition. One can powder yields approx. 68 fl. oz. (standard dilution at 30 kcals/oz.).

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Propimex - 1 (Abbott) 14.1 oz. (400 g) Protein powder cans - L-amino acids USE: Methionine-free, valine-free, low-isoleucine, low-threonine medical food for infants and toddlers with propionic or methylmalonic acidemia. 6 cans / case Fat (41% kcals) - High oleic safflower oil, coconut oil, soy oil Per 100 g powder: 480 kcals, 15 g protein, 21.7 g fat, 53 g CHO Dilution: Follow Carbohydrate CAUTION: For use only under medical supervision. Not intended as the sole source of prescription per - Corn syrup solids nutrition. Not for parenteral use. Must be supplemented with protein and fluids in physician prescribed amounts to completely meet isoleucine, methionine, threonine, valine, and water requirements.

Propimex - 2 (Abbott) 14.1 oz. (400 g) Protein powder cans - L-amino acids USE: Methionine-free, valine-free, low isoleucine, low threonine medical food for children and adults with propionic or methylmalonic acidemia. 6 cans / case Fat (29% kcals) - High oleic safflower oil, coconut oil, soy oil Per 100 g powder: 410 kcals, 30 g protein, 13 g fat, 35 g CHO Carbohydrate CAUTION: For use only under medical supervision. Not intended as the sole source of - Corn syrup solids nutrition. Not for parenteral use. Must be supplemented with protein and fluid in prescribed amounts to completely meet isoleucine, methionine, threonine, valine and water requirements.

ProViMin (Abbott) 5.3 oz cans Protein - Casein, L-amino acids USE: For persons who require a formula modified in carbohydrate, fat, and/or increased 6 cans / case protein: cholestasis; chylothorax; fatty acid oxidation defects; glutaric aciduria type II. Fat Virtually carbohydrate- and fat-free; provides flexibility in which the amount and type of - Coconut oil carbohydrate and fat can be added per individual infant’s need and tolerance. Very low fat and carbohydrate content. Carbohydrate - NA Per 100 g powder: 313 Kcals, 73 g protein, 1.4 g fat, 2.0 g CHO, 40 mg iron. 200 mOsm/kg water.

CAUTION: Use only under medical supervision. Not intended as sole source of nutrition. Does not supply sufficient amounts of energy as carbohydrate and fat, or linoleic acid. These nutrients should be supplied from other nutrients.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Pulmocare (Abbott) 8 fl. oz. ready-to-feed Protein (16.7% kcals) cans - Sodium and calcium caseinates USE: Nutritionally complete high-calorie, modified carbohydrate and fat, enteral formula that may help reduce diet-induced carbon dioxide production. For persons with pulmonary 24 / case Fat (55.1% kcals) disease, cystic fibrosis, or respiratory failure. For oral or tube feeding. Lactose-free, - Canola oil, MCT oil, corn oil, high oleic gluten-free, low-residue, kosher. Flavors: Vanilla safflower oil, soy lecithin

45 kcals/oz. Carbohydrate (2802% kcals) Per 8 fl. oz: 355 kcals, 14.8 g protein, 25 g CHO, 22.1 g fat - Sucrose, maltodextrin

CAUTION: Use only under medical supervision.

PurAmino (Mead Johnson) 14.1 oz. powder Protein (11% kcals) (formerly called Nutramigen AA) 4 / case - Amino acid premix composed of 100% ` free amino acids USE: Iron-fortified, hypoallergenic, amino acids based infant formula for infants and One 14.1 oz. can toddlers with severe cow’s milk protein and/or multiple food allergies, not effectively powder yields Fat (48% kcals) managed by an extensively hydrolyzed formula approximately 98 oz. - Palm olein oil, soy oil, coconut oil, high (standard dilution, 20 oleic sunflower oil, DHA, ARA 20 kcals/oz. kcals/oz). 100 kcals provides: 2.8 g protein, 5.3 g fat, 10.3 g CHO Carbohydrate (41% kcals) - 90% Corn syrup solids, 10% CAUTION: In cases of severe allergies or intolerances it may be continued as a milk modified corn starch substitute in a child’s diet. If used as a milk substitute, the total calcium content of the diet should be assessed.

For use only under medical supervision. Evaluate if formula is mixed, used, and stored properly.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source RCF (Abbott) 13 fl. oz. concentrate Protein (12%) - Soy protein isolate, USE: For use in the dietary management of persons who are unable to tolerate the type or 12 / case L-Methionine amount of carbohydrate in milk or conventional infant formulas; seizure disorders requiring a ketogenic diet. Carbohydrate-free, soy protein formula base, with iron. Lactose-free, Fat (48%) gluten-free, Kosher, Halal. - High oleic safflower oil, soy oil, coconut oil

20 kcals/oz. Carbohydrate (40%) Per 100 Kcals: 3 g protein, 5.3 g fat, 10.1 g CHO. - None

CAUTION: For use only under medical supervision.

Renalcal (Nestle) 8.45 fl. oz. (250 mL) Protein (7% kcals) - Whey protein concentrate, amino acids USE: High calorie, low-electrolyte supplement for persons with renal failure. Lactose-free, 24 / case gluten-free, low-residue, kosher. Fat (35% kcals) Unflavored. - MCT Oil (70%), canola oil, corn oil, soy 60 kcals/oz. lecithin Per 250 mL: 500 kcals (2.0 kcals/mL), 8.6 g protein, 72.6 g CHO, 20.6 g fat Carbohydrate (58% kcals) CAUTION: Use only under medical supervision. Not for parenteral use. - Maltodextrin, modified corn starch

Rena Start www.vitaflo usa.com 14.11 oz powder

USE: Nutritionally uncomplete powder medical food designed for use in the dietary management of renal failure in persons over 1 year of age.

CAUTION: Use only under medical supervision.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Resource Breeze (Nestle) 8 oz. cartons Protein (14% Kcals) (also may be called Boost Breeze) - Whey protein isolate 27/case USE: Juice-based nutritional drink for persons who require pre- or post-op clear diets or Fat (0%) need additional nutrition in the diet. Lactose-free, gluten-free, low residue, kosher, halal Flavors: orange, (all flavors). peach, wild berry, Carbohydrate (86 % Kcals) variety case - Fructose, juice concentrate, sugar 20 kcals/oz. Per 8 oz.: 250 kcals, 9 g. protein, 0 g. fat, 54 g carbohydrate

CAUTION: Contains milk protein. Not for persons with galactosemia.

Scandishake (Scandipharm) 3 oz (85 g) envelope Protein (4% kcals) Children / Women: 48 - Nonfat milk, sodium caseinate USE: Nutritionally incomplete, high-calorie shake mix designed to be mixed with whole (12 boxes) milk. Intended for those who need to maintain or gain weight with conditions such as 4 envelopes / box Fat (43% kcals) cancer or cystic fibrosis. - Partially hydrogenated vegetable oils Flavors: Vanilla, (including coconut or soybean oils), MCT 75 kcals/oz. Chocolate, Strawberry. oil, monoglycerides

CAUTION: Use primarily as a source of calories. Evaluate if mixed, used and stored Recommendations: Carbohydrate (53% kcals) properly. Mix with 8 oz whole - Maltodextrin, sugar, nonfat milk, corn milk to yield 600 kcals. syrup solids

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Similac Advance Stage 1 (Abbott) 12.0 oz. powder can Protein (8% kcals) 6 cans / case - Nonfat milk, whey protein concentrate USE: Routine milk-based, iron-fortified infant formula for feeding full term, healthy infants. 1 can powder yields (52% casein, 48% whey) Some medical conditions may necessitate issuing to children. approximately 90 fl. oz. (standard dilution). Fat (49% kcals) - High-oleic safflower oil, soy oil, coconut 20 kcals/oz. 13 oz. concentrate Per 100 kcals (5 fl. oz.): 2.7 g protein, 5.40 g fat, 10.8 g CHO, 1.8 mg iron oil, can < 0.2% M. alpina & C. cohinii oils (0.15% 24 cans / case Similar to Enfamil Premium Infant. DHA, 0.40% ARA)

Use only in rare (43% kcals) CAUTION: Evaluate if mixed, used, and stored properly. Carbohydrate circumstances: Contains milk and soy ingredients. - Lactose, GOS 6-packs of 8 oz RTF Available at retail stores.

2 oz. ready-to-feed bottles 48/case If 2 oz. RTF requested contact state nutrition consultant.

Similac Advance Stage 1 (Abbott) 1.45 ib powder Protein (8% kcals) 1 can powder yields - Nonfat milk, whey protein concentrate USE: Routine milk-based, iron-fortified infant formula for feeding full term, healthy infants. approximately 176 fl. (52% casein, 48% whey) Some medical conditions may necessitate issuing to children. oz. (standard dilution). Fat (49% kcals) 19 kcals/oz. Not MN WIC Allowed 2 oz RTF - High-oleic safflower oil, soy oil, coconut Per 100 kcals (5 fl. oz.): 2.7 g protein, 5.40 g fat, 10.8 g CHO, 1.8 mg iron oil, < 0.2% M. alpina & C. cohinii oils (0.15% Similar to Enfamil Premium Infant. DHA, 0.40% ARA)

(43% kcals) CAUTION: Evaluate if mixed, used, and stored properly. Carbohydrate Contains milk and soy ingredients. - Lactose, GOS

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Similac Advance Stage 2 (Abbott) 1.93 lb powder Protein (8% kcals) - Nonfat milk, whey protein concentrate USE: Routine milk-based, iron-fortified infant formula for feeding full term, healthy infants 1 can powder yields (52% casein, 48% whey) 6-12 months of age. approximately 234 fl. oz. (standard dilution). Fat (49% kcals) 19 kcals/oz. - High-oleic safflower oil, soy oil, coconut Per 100 kcals (5 fl. oz.): 2.7 g protein, 5.40 g fat, 10.8 g CHO, 1.8 mg iron oil, < 0.2% M. alpina & C. cohinii oils (0.15% Similar to Enfamil Premium Infant. DHA, 0.40% ARA)

CAUTION: Evaluate if mixed, used, and stored properly. Carbohydrate (43% kcals) Contains milk and soy ingredients. - Lactose, GOS

Similac Advance Organic (Abbott) Various sizes Protein (8% kcals) available - Organic nonfat milk USE: Organic, milk-based, iron-fortified infant formula for feeding full term, healthy infants. Fat (49% kcals)

20 kcals/oz. - Organic high-oleic sunflower, organic soy Per 100 kcals (5 fl. oz.): 2.07 g protein, 5.63 g fat, 10.4 g CHO, 1.8 mg iron and organic coconut oils

CAUTION: Evaluate if mixed, used, and stored properly. Carbohydrate (43% kcals) - Organic maltodextrin, organic lactose, organic sugar, FOS

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Similac Expert Care Alimentum (Abbott) 16 oz. powder cans Protein (11% kcals) - Casein hydrolysate, One can powder yields L-cystine, L-tyrosine, USE: Hypoallergenic formula for infants with protein sensitivity. Also for those with severe approx. 115 fl. oz. L-tryptophan food allergies, sensitivity to intact protein, or fat malabsorption. Contains predigested (standard dilution at 20 protein (casein hydrolysate) to eliminate allergic reactions in most babies. Lactose-free. kcals/oz.). Fat (48% kcals) Some medical conditions may necessitate issuing to children. - Safflower, MCT (33%), Use only in rare soy oil, DHA (.15 %), NOTE: Powder Alimentum is not corn-free and has a different carbohydrate circumstances: ARA (.40 %) composition than ready-to-feed. Some infants may need ready-to-feed Qts (946 mL) (41% kcals) because they have a corn allergy. 6/case Carbohydrate - Sucrose, modified

tapioca starch 20 kcals/oz. 8 oz. RTF

100 kcals provides: 2.75 g protein, 5.54 g fat, 10.2 g CHO. 1.8 mg iron. 6/case Powder has corn maltodextrin. CAUTION: For use only under medical supervision. Evaluate if formula is mixed, used, 2 oz. RTF RTF does not. and stored properly. 48/case If 2 oz. RTF requested contact state nutrition consultant.

Similac Expert Care for Diarrhea (Abbott) Qts (946 mL) ready-to- Protein (11% kcals) feed - Soy protein isolate, USE: Milk-free, lactose-free, iron-fortified, soy protein formula with fiber. Designed for L-methionine infants over 6 months of age for the dietary management of diarrhea. Should only be 6/case used for a short duration – 7 to 10 days (or as directed by physician). Lactose-free, Fat (49% kcals) gluten-free, Kosher, Halal. - Soy oil, coconut oil

20 kcals/oz. Carbohydrate (40% kcals) Per 100 kcals: 2.66 g protein, 5.46 g fat, 10.1 g CHO 1.8 mg iron. - Corn syrup, sucrose

CAUTION: Avoid use for anyone with an allergy to soy protein. Evaluate if formula is mixed, used, and stored properly.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Similac Expert Care Neosure (Abbott) 13.1 oz. powder can Powder: 6/case Protein (11% kcals) Use: Nutrient enriched infant formula for babies who were born prematurely. Designed to - Nonfat milk, whey protein concentrate be used as a preterm post-discharge formula. Has extra calories for growth, protein, 1 can powder yields 87 (50:50 whey: casein) vitamins and minerals than standard formula. Used for transition feeding after hospital oz. of prepared formula discharge (or after use of a premature formula) until a term formula is appropriate. (standard dilution, 22 Fat (49% kcals) Gluten-free, Kosher, Halal. kcals/oz). - Soy oil, coconut oil, MCT

Standard dilution of this formula is 22 kcals/oz. (standard dilution for term Carbohydrate (40% kcals) infant formulas is 20 Kcals/oz. - Corn syrup solids, lactose

Standard dilution is 1 unpacked level scoop of powder to 2 fl. oz. of warm water yields 22 1 Qt (946 mL) ready- kcals/oz. to-feed plastic bottles

Per 100 kcals: 2.8 g protein, 5.5 g fat, 10.1 g CHO, 1.8 mg iron. Use in rare 250 mOsm/kg water. circumstances: 2 fl oz. ready-to-feed Similar to Enfamil EnfaCare. bottles

CAUTION: For use only under medical supervision. Evaluate if formula is mixed, used and stored properly.

Similac Expert Care 20 Calorie w/Iron (Abbott) 2 oz. ready-to-feed Protein - Nonfat milk bottles Use: Iron-fortified premature infant formula for growing, low-birth-weight infants until they Fat (59% kcals) reach approximately 8 lbs. Can be mixed to a variety of caloric densities (26, 27, 28 Cal). 48/case - soy oil, coconut oil Also can be used as human milk fortifier. Carbohydrate - lactose 20 kcals/oz. Per 100 kcals: 2.71 g protein, 5.27 g fat, 10.5g CHO, 1.8 mg iron. Protein (8% kcals) 325 mOsm/kg water. - Nonfat milk, whey protein concentrate

CAUTION: Evaluate if formula is mixed, used, and stored properly.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Similac Human Milk Fortifier (Abbott) .90 g packets Protein (28% kcals) Infants: 600 - Nonfat milk, whey protein concentrate USE: For low birth weight and premature infants as a supplement to add to breast milk. 50 / carton; 3 inner May be used until infant reaches 8 pounds (3600 g) or as directed by physician. cartons / case Fat (21% kcals) - Fractionated coconut oil (MCT) 1 packet of powder added to: Also available as 0.17- 50 mL human milk adds 2 kcals/fl. oz. (22 kcal/oz) fl-oz concentrated Carbohydrate (51% kcals) 25 mL human milk adds 4 kcal/fl. oz. (24 kcals/ oz) liquid. 144/case - Corn syrup solids Breastmilk is calculated and averaged at approximately 20 kcal/oz.

Nutrients per 4 packets of powder (3.6 g): 14 kcals, 1.0 g protein, .36 g fat, 1.8 g CHO, 0.4 mg iron.

Similar to Enfamil Human Milk Fortifier.

CAUTION: Use only under medical supervision and only as directed. Should not be used for long periods of time. Generally only used in hospitals.

Similac Human Milk Fortifier Hydrolyzed Protein (Abbott) 0.17-fl-oz concentrated liquid. USE: For low birth weight and premature infants as a nutritional supplement to add to 144/case breast milk.

CAUTION: Use only under medical supervision and only as directed. Generally only used in hospitals.

Similac with Iron-Kosher (Abbott) 32 oz. ready-to-feed cans USE: Milk-based, iron-fortified formula for routine feeding of infants. Produced under Infants: 25 Children: supervision of the Union of Orthodox Jewish Congregations of America. 28

Similac Liquid Protein Fortifier (Abbott) 1.8 fl. oz plastic bottles USE: Commercially sterile, extensively hydrolyzed liquid protein fortifier for preterm infants who require additional protein. Can be added to human milk, fortified human milk, or formula.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Similac PM 60/40 (Abbott) 14.1 oz. powder can Protein (9% kcals) - Whey protein concentrate, sodium USE: For infants who would benefit from lowered mineral intake, including those with 6 cans / case caseinate impaired renal function. Also designed to manage serum calcium disorders - both hypocalcemia and hypercalcemia due to hyperphosphatemia. Whey: casein (60:40). One can powder yields Fat (50% kcals) Lower in minerals and electrolytes. Additional iron should be supplied from other sources. approx. 102 fl. oz. - High oleic safflower oil, soy oil, coconut oil (standard dilution). 20 kcals/oz. Carbohydrate (41% kcals) Per 100 kcals: 2.20 g protein, 5.6 g fat, 10.2 g CHO, 0.7 mg iron. - Lactose

CAUTION: For use only under medical supervision. Evaluate if formula is mixed, used, and stored properly. Some may need additional minerals and electrolytes.

Similac Sensitive (Abbott) 12.0 oz powder cans Protein (9% kcals) - Milk protein isolate USE: Reduced-lactose infant formula that is an alternative to standard milk-based 6 / case formulas for milk tolerance symptoms such as fussiness and gas due to lactose sensitivity. 1 can powder yields Fat (49% kcals) Formula is lactose-free but does provide milk protein and can be helpful in ruling out or approximately 90 fl. oz. - High oleic safflower, soy, and coconut oils confirming lactose intolerance versus a milk protein sensitivity or allergy. Gluten-free, (standard dilution). Kosher, Halal. Carbohydrate (43% kcals) 13 oz. concentrate - Corn Maltodextrin, sugar, GOS If infant has severe allergic reactions to milk based formulas, infant should not try can ~ only available at this product, as it is also milk based. hospitals. Not available for MN WIC Standard dilution is 19 kcals/oz. participants or at Per 100 kcals: 2.14 g protein, 5.4 g fat, 11.1 g CHO, 1.9 mg iron. retail stores.

CAUTION: Evaluate if formula is mixed, used, and stored properly. Not intended for Use only in rare infants with galactosemia. Some infants may not be lactose intolerant long term and may circumstances: be able to use cow’s milk after 1 year of age. Qts (946 mL) ready-to- feed plastic bottle 6 bottles / case

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Similac Special Care 20 Calorie w/Iron (Abbott) 2 fl oz. ready-to-feed bottles Similac Special Care 24 Calorie w/Iron 48 bottles / case

Similac Special Care High Protein 24 Cal

Similac Special Care 30

USE: All of these formulas are for growing, low-birth weight infants and premature infants. These products are typically only used in hospitals.

CAUTION: For use only under medical supervision. Not intended for feeding low-birth-weight infants after they reach a weight of 3600 g (approximately 8 lb.) or as directed by a physician.

Similac Soy Isomil (Abbott) 12.4 oz powder cans Protein (10% kcals) - Soy protein isolate, L-methionine USE: Milk-free, lactose-free, iron-fortified, soy protein infant formula. For infants with 6 / case lactase insufficiency, lactose intolerance and galactosemia (powder only). Also used for Fat (49% kcals) vegetarian diets when animal protein formula is not desired. Some medical conditions may One can powder yields - High-oleic safflower oil, soy oil, coconut oil necessitate issuing to children. Gluten-free, Kosher, Halal. approx. 90 oz. (standard dilution). Carbohydrate (41% kcals) Standard dilution is 20 kcals/oz. - Corn syrup solids, sucrose, FOS 100 kcals provides: 2.45 g protein, 5.46 g fat, 10.4 g CHO Several container sizes available. CAUTION: Not recommended for premature infants, infants with birth weights less than 1800 g, or infants who might have immune problems. Evaluate if formula is mixed, used, and stored properly. Avoid use for anyone with an allergy to soy protein.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Similac Spit-Up (Abbott) 12.0 oz powder cans Protein (9% kcals) 6 / case - Milk protein isolate USE: Nutritionally complete milk-based infant formula with rice starch to help reduce 1 can powder yields frequent spit-up in healthy babies. Milk-based, reduced-lactose formula suitable for lactose approximately 90 fl. oz. Fat (49% kcals) sensitivity. Whey to casein ratio is approximately 18:82 (18 % whey, 82% casein). (standard dilution). - High oleic safflower oil, soy oil, coconut No palm olein oil. oil, (0.15% DHA, 0.40% ARA)

Rice starch makes it look more “grainy” than other formulas. The grains are small and Carbohydrate (43% kcals) should not cause issues with feeding through a nipple. Use only in rare - Corn syrup, rice starch, sucrose, GOS Mixes a little more slowly with water than other formulas. Abbott recommends mixing circumstances: powder and water, then wait 2 minutes. Qts (946 mL) oz. ready- to-feed Standard dilution is 19 kcals/oz. Per 100 kcals: 2.14 g protein, 5.4 g fat, 10.96g CHO, 1.8 mg iron.

CAUTION: Evaluate if formula is mixed, used, and stored properly. Not intended for infants or children with galactosemia.

Similac Total Comfort (Abbott) 12.0 oz powder Protein (9% kcals) 6 / case - whey protein hydrolysate (100 % partially USE: Infant formula with 100% partially hydrolyzed whey protein and has 98% less 1 can powder yields hydrolyzed) lactose than standard milk based formulas. approximately 90 fl. oz. (standard dilution). Fat (49% kcals) Standard dilution is 19 kcals/oz. - High oleic safflower oil, soy oil, coconut Per 100 kcals: 2.2 g protein, 5.4 g fat, 11 g CHO, 1.8 mg iron. 1.41 lb powder – not oil, < 0.5 % M. alpina & C. cohinii oils WIC approved (0.15% DHA, 0.40% ARA)

CAUTION: Evaluate if formula is mixed, used, and stored properly. Carbohydrate (42% kcals)

- Lactose (2 %) Corn syrup solids, sugar, GOS SimplyThick (Simplythick.com)

USE: Food thickener. For more information refer to the website at: simplythick.com.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source STORE BRAND FORMULAS (Storebrandformula.com) Can sizes vary depending on store. These formulas are manufactured by Perrigo Nutritionals for sale in the U.S. under private brand labels of individual grocery/drug store chains or mass merchandisers.

There are several types of formulas (milk-based, lactose-free, soy-based, toddler, etc.) manufactured under these store brand labels In Minnesota:

Store Name Formula Name Babies R Us Babies R Us Cub Foods Baby Basics CVS CVS Hy-Vee Mother’s Choice K-Mart Little Ones Sam’s Club Simply Right Smith’s Comfort for Baby Target Up & Up Toys R Us Babies R us Walgreens Walgreens Wal-Mart Parents Choice

All infant formulas manufactured in the US are regulated by FDA's Center for Food Safety and Applied Nutrition (CFSAN) who oversees manufacturers of infant formulas, and ensures that they comply with nutritional requirements. Divisions within CFSAN have program responsibility for infant formula products and their ingredients and packaging. In addition, FDA regulations for current good manufacturing practice requirements for foods apply to the production of infant formula. (FDA.GOV)

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Suplena (Abbott) 8 fl. oz. cans ready-to- Protein (10% kcals) feed - Sodium and calcium caseinates USE: Nutritionally complete, low-protein, high-calorie, low-phosphorus, low potassium, low sodium formula. For persons with chronic kidney disease (stages 3 & 4) dialysis. For oral 24 cans / case Fat (42% kcals) or tube feeding. Can be a supplement to the prescribed diet or for total nutrition. Lactose- - High oleic safflower oil, soy oil, lecithin free, gluten-free, Kosher, Halal. Vanilla flavored. Carbohydrate (48% kcals) 53 kcals/oz. - Maltodextrin, sucrose Per 8 fl. oz.: 425 kcals, 10.6 g protein, 22.7g fat, 46.4 g CHO

CAUTION: Use only under medical supervision. Not for parenteral use.

Thick AND Easy (American Institutional Products, Inc.) 8-oz powder Protein 12 / case - None USE: An instant food thickener used to thicken thin liquids to enable safe and effective swallowing for persons with dysphagia (swallowing disorders). Children with neurological Fat impairments may have difficulty swallowing adequate liquid to maintain hydration, and are - None at risk for choking and aspiration. Thickening liquids, along with correct positioning and oral motor therapy, are often needed. Does not bind liquid - 98% of liquid is available for Carbohydrate absorption. Stops thickening in 1 minute. Thickens uniformly without lumping. - Modified corn starch and maltodextrin (4 Metabolizes like fruit sugar. One tablespoon equals 1/3 fruit exchange or 4 grams gm/Tbsp.) carbohydrate.

Add 1 TBSP to 4 oz. clear and full liquids for syrup consistency, 1 1/2 T to 4 ounces for honey consistency, or 2 TBSP to 4 ounces for pudding consistency.

CAUTION: Use only under medical supervision, and in conjunction with oral-motor therapy.

THICKENED JUICES 4 fl oz frozen juice THICKENED NUTRA/SHAKE THICKENED PUDDING 6 fl oz frozen shake THICKENED WATER (Nutra/Balance; Abbott Distribution) 4 oz frozen pudding USE: Specifically designed for persons who have dysphagia and need texture modification. Available in nectar-like, honey-like and spoon-thick consistencies. 8 fl oz shelf stable Flavors: juice – apple, orange, cranberry/apple; shake – vanilla; pudding – vanilla, water chocolate; water – Unflavored..

CAUTION: Use only under medical supervision, and in conjunction with oral-motor therapy.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source THICKEN RIGHT (Diamond Crystals Brands Indianapolis) 8 oz cans powder Protein 12 / case - None USE: Food thickener. Dissolves instantly and react quickly in liquids and pureed foods. yield: 50 1 Tbsp. Powder will thicken to a honey-like consistency in most liquids. servings / can Fat Per 1 Tbsp.: kcal, 4 g CHO, 10 mg Na, no K. - None

CAUTION: Use only under medical supervision and in conjunction with oral-motor therapy. 2.5 lb. tubs Carbohydrate 9 month shelf life. - Modified food starch

6.75 g packets THICKEN RIGHT JUICE (Diamond Crystals Brands Indianapolis) 4 fl. oz shelf stable Protein containers - None USE: Thickened juices used for when a thickened product is needed to facilitate 48 / case swallowing and increase intake. Orange, apple and cranberry juice cocktail flavors. Honey Fat and nectar consistencies. 64 fl. oz. containers - None 8 / case CAUTION: Use under medical supervision and in conjunction with oral-motor therapy. 9 Carbohydrate month shelf life. - Orange juice concentrate, food starch modified

THICK-IT (Precision Foods) 8 oz. powder cans Protein 12 / case. - None USE: Instant food thickener for persons with dysphagia, to enable safe swallowing of liquids. Thickens hot or cold, thick or thin liquids and pureed foods to any desired 30 oz. powder cans Fat consistency quickly, easily and controllably, without changing taste or appearance. Won’t 6 / case. - None bind liquids, hydrates. Contributes calories. Metabolizes like fruit sugar. Available in three consistencies: nectar, honey and pudding. Available in two formula Carbohydrate One Tbsp. (4 g) provides: 16 kcals, 4 g CHO, 0 g protein, 0 g fat, 10 mg sodium. 1/3 fruit strengths: original - Original: modified corn starch, exchange. (regular strength) and maltodextrin concentrated strength. CAUTION: Use only under medical supervision, and in conjunction with oral-motor Both: 51 Tbsp. per 8- - Concentrated Formula: modified corn therapy. ounce can. starch

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Tolerex (Nestle) 2.82 oz powder Protein (8% kcals) USE: Nutritionally complete, low-residue, elemental diet containing free amino acids for packets - Free amino acids persons with impaired digestion and absorption or specialized nutrient needs. Lactose-free, gluten-free, low residue, kosher. 60 packets / case Fat (2% kcals) - Safflower oil THIS PRODUCT IS ONLY APPROPRIATE FOR USE IN INDIVIDUALS GREATER THAN 3

YEARS OLD. Carbohydrate (90% kcals) Standard Dilution: 1 - Maltodextrin, modified corn starch 30 kcals/oz. packet with 255 mL Per 1 packet, 300 mL: 300 kcals, 6.2 g protein, 68 g CHO, 0.6 g fat water to make 300 mL.

CAUTION: Use only under medical supervision. Not for parenteral use.

TwoCal HN (Abbott) 8 fl. oz ready-to-use Protein (16.7% kcals) cans - Sodium and calcium caseinates USE: Nutritionally complete, high-calorie formula designed to meet the increased protein and calorie needs of persons who may require low volume feedings. For oral or tube Flavors: Vanilla, Butter Fat (40.1% kcals) feeding. Can be a supplement to the prescribed diet or for total nutrition. Gluten-free, Pecan. - High oleic safflower oil , MCT oil, canola Kosher, Halal. oil, lecithin

60 kcals/oz. Carbohydrate (43.2 % kcals) Per 8 fl. oz: 475 kcals, 19.9 g protein, 51.8 g CHO, 21.5 g fat - Corn syrup solids, maltodextrin, sucrose, fructooligosaccharides CAUTION: Use only under medical supervision. Not for parental use.

TYR 2 (Nutricia) 500 gram powder Protein cans - Amino acids (without phenylalanine and USE: Mixture of L-amino acids free of phenylalanine and tyrosine, enriched with vitamins Children: 8 tyrosine) and minerals. For children with tyrosinemia type I inherited or tyrosinemia type II due to 2 cans / case tyrosine amino –transferase deficiency (Richner-Hanhart Syndrome). Fat Yield varies. - None Per 100 g powder: 300 kcals, 63 g protein, 12 g CHO, 0 g fat 15 mg iron. Carbohydrate CAUTION: For use only under medical supervision. Not intended as the sole source of - Sucrose nutrition. Adequate amounts of fat, carbohydrate, phenylalanine and tyrosine must be included in the diet along with TYR 2.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Tyrex - 1 (Abbott) 14.1 oz. (400 gm) Protein powder cans - L- Amino acids USE: Phenylalanine-free and tyrosine-free amino acid modified medical food for infants and toddlers with tyrosinemia type I, II, or III. 6 cans / case Fat (41% kcals) - High-oleic safflower oil, coconut oil, soy oil Per 100 g powder: 480 kcals, 15 g protein, 21.7 g fat, 53 g CHO Carbohydrate CAUTION: For use only under medical supervision. Not intended as the sole source of - Corn syrup solids nutrition; must be supplemented with intact protein and fluid in prescribed amounts to completely meet phenylalanine, tyrosine, and water requirements. Not for parenteral use.

Tyrex - 2 (Abbott) 14.1 oz. (400 g) cans Protein powder - L-Amino acids USE: Phenylalanine-free, tyrosine-free amino acid modified medical food for children and adults with tyrosinemia type I, II, or III. 6 cans / case Fat (31% kcals) - High-oleic safflower oil, coconut oil, soy oil Per 100 g powder: 410 kcals, 30 g protein, 14 g fat, 35 g CHO Carbohydrate CAUTION: Give only to children and adults with proven tyrosinemia type 1, II, or III who - Corn syrup solids are under medical supervision. Must be supplemented with intact protein in prescribed amounts to completely meet phenylalanine and tyrosine requirements. Not intended as the sole source of nutrition. Not for parenteral use.

TYR Lophlex LQ (Nutricia) 4.2 oz. pouch

USE: Tyrosine- and phenylalanine-free amino acid based ready-to-drink medical food for 30/case children over 4 years and adults (including pregnant women) who have tyrosinemia. Flavor: Mixed berry Per 4.2 oz pouch: 116 kcals, 20 g protein equivalent, 0 g fat, 9.3 g CHO

CAUTION: For use only under and frequent medical supervision.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Tyros 1 (Mead Johnson) 1 lb. (454 g) powder Protein (13% kcals) cans - Amino acids USE: Phenylalanine-free, tyrosine-free formula for infants and toddlers with tyrosinemia. 6 cans / case Fat (47% kcals) Per 100 g powder: 500 kcals, 16.7 g protein equivalent, 26 g fat, 51 g CHO - Palm olein oil, soy oil, coconut oil, high oleic sunflower oil CAUTION: For use only under medical supervision. Care must be taken to provide Use as directed by the enough tyrosine and phenylalanine to support growth, using other foods as required. Not physician. Carbohydrate (40% kcals) for parental use. - Corn syrup solids, sugar, modified corn starch, maltodextrin

Tyros 2 (Mead Johnson) 1 lb. (454 g) powder Protein (22% kcals) cans - Amino acids USE: Phenylalanine-free, tyrosine-free formula for children and adults with tyrosinemia. 6 cans / case Fat (19 % kcals) Per 100 g powder: 410 kcals, 22 g protein equivalent, 8.5 g fat, 60 g CHO - Soy oil

CAUTION: For use only under medical supervision. Care must be taken to provide Use as directed by the Carbohydrate (59 g kcals) enough tyrosine and phenylalanine to support growth, using other foods as required. Not physician. - Corn syrup solids, sugar, modified corn for parental use. starch

UCD Anamix Jr, Unflavored (Nutricia) 14 oz. powder cans 6 cans / case USE: Powdered medical food for the dietary management of urea cycle disorders (UCD) hyperammonemia, hyperornithinemia, homocitrullinemia (HHH) syndrome; and gyrate atrophy in patients over the age of 1. Use as directed by the physician. Per 100 g: 385 kcals, 12 g protein equivalent, 17 g fat, 46 g CHO

CAUTION: For use only under medical supervision.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Vital HN (Abbott) 2.79 oz. (79 g) powder Protein (16.7% kcals) packets - Partially hydrogenated whey, meat, and USE: Designed for persons with chronically impaired gastrointestinal function soy; free essential amino acids (maldigestion, malabsorption) who need a peptide-based, low fat enteral formula. For oral 6 packets / carton or tube feeding. 4 cartons / case Fat (9.5% kcals) 30 kcals/oz. - Safflower oil, MCT (45%) Per 255 mL (1 packet in standard dilution): 300 kcals, 12.5 g protein, 55.4 g CHO, 3.3 fat. Vanilla flavor. Carbohydrate (73.8 % kcals) CAUTION: Use only under medical supervision. Evaluate if product is used and stored - Maltodextrin, sucrose, lactose properly. Not for parenteral use.

Vivonex Pediatric (Nestle) 1.7 oz. packets Protein (12% kcals) - Free amino acids USE: Nutritionally complete elemental formula for oral or tube feeding. For 36 packets / case children ages 1 –13 with gastrointestinal impairment such as Crohn’s disease, short Fat (25% kcals) bowel syndrome, and intractable diarrhea. Lactose-free, gluten-free, low-residue kosher. - MCT oil, soybean oil

24 kcals/oz. Per 250 mL (1 packet prepared at standard dilution): 200 kcals, 6.0 g protein, Carbohydrate (63% kcals) 31.5 g CHO, 5.88 g fat - Maltodextrin, modified corn starch

CAUTION: For use only under medical supervision. This product is only appropriate for individuals over 1 year of age.

Vivonex Plus (Nestle) 2.8 oz. (79.5 grams) Protein (18% kcals) powder packets - Free Amino acids THIS PRODUCT IS NOT APPROPRIATE FOR INDIVIDUALS 0-3 YEARS OF AGE. Women: 51 packets (6% kcals) USE: 100 % free amino acids for severely compromised GI tracts. Nutritionally complete, 36 packets / case Fat high-nitrogen, low-fat, elemental diet powder. For persons with gastrointestinal impairment - Soybean oil including Crohn’s disease, malabsorption syndrome, pancreatitis, chylothorax. Lactose- free, low-residue. Can be used for tube feeding or oral supplementation. Carbohydrate (76% kcals) - Maltodextrin, modified corn starch 30 kcals/oz. One 2.8 oz. packet (mixed in 250 mL of water to make 300 mL) provides: 300 kcals, 13.5 g protein, 57 g CHO, 2 g fat, 3 mg iron.

CAUTION: For use only under medical supervision.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source Vivonex T.E.N. (Nestle) 2.84 oz. powder Protein (15% kcals) packets - Free amino acids THIS PRODUCT IS ONLY APPROPRIATE FOR USE IN INDIVIDUALS GREATER THAN 3 YEARS OLD. 60 packets / case Fat (3% kcals) - Safflower oil USE: 100% free amino acid diet for severely compromised GI tracts. Very low-fat elemental diet (lower fat level than Vivonex Plus). For persons with limited gut function Carbohydrate (82% kcals) such as bowel resection, Irradiated bowel, malabsorption syndrome, Crohn's disease, GI - Maltodextrin, modified corn starch fistula, and pancreatic disorders. Enriched with glutamine. Lactose-free, gluten-free, low- residue, kosher. Can be used for tube feeding or oral supplementation.

30 kcals/oz. One 80.4 gm. packet provides: 300 kcals, 11.5 g protein, 0.8 g fat, 61.7 g CHO.

CAUTION: For use only under medical supervision.

WND 1 (Mead Johnson) 1 lb. (454 g) powder Protein (5% kcals) cans - Amino acids USE: Designed to facilitate continued dietary restriction of sources of nitrogen for infants and toddlers with urea cycle disorders. 6 cans / case Fat (47% kcals) - Palm olein oil, soy oil, coconut oil, high Per 100 g powder: 500 kcals, 26 g fat, 71 g CHO, 6.5 g protein equivalent oleic sunflower oil

CAUTION: For use only under medical supervision. Not nutritionally complete. Enough Carbohydrate (48% kcals) protein must be provided to support growth. Not for parenteral use. - Corn syrup solids, sugar, modified corn starch

WND 2 (Mead Johnson) 1 lb. (454 g) powder Protein (8% kcals) cans - Amino acids USE: Designed to facilitate continued dietary restriction of sources of nitrogen for children and adults with urea cycle disorders. 6 cans / case Fat (23% kcals) - Soy oil Per 100 g powder: 410 kcals, 10.2 g fat, 71 g CHO, 8.2 g protein equivalent Carbohydrate (69% kcals) CAUTION: For use only under medical supervision. Total daily formula amount depends - Corn syrup solids, sugar, modified corn on protein needs, usually based on age and weight, as well as protein tolerance. In starch addition to WND 2, care must be taken to provide enough calories, protein, vitamins and minerals to support growth; using other foods as required. Frequent blood tests are needed. Not for parenteral use.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source XLeu ANALOG (Nutricia) 14 oz. (400 g) powder Protein (11% kcals) cans - Amino acids (without leucine) USE: Leucine-free powder formula for the dietary management of isovaleric acidemia or other proven disorders of leucine metabolism in infants. Contains a balanced mixture of 6 cans / case Fat (40% kcals) all other essential and non-essential amino acids, CHO, fat vitamins, minerals and trace - Peanut oil, refined animal fat, coconut oil elements. Additional protein must also be given as breastmilk or standard infant formula to Unflavored. supply the leucine and other nutrient requirements. Carbohydrate (50% kcals) Yield varies. - Corn syrup solids Per 100 grams: 475 kcals, 13 g protein equivalent, 20.9 g fat, 59 g CHO

CAUTION: Must only be given under medical supervision. Not for parenteral use. Not intended as a sole source of nutrition.

XLeu MAXAMAID (Nutricia) 16 oz. (454 g) powder Protein (28.5% kcals) cans - Amino acids (without leucine) USE: Leucine-free powder formula for the dietary management of isovaleric acidemia or other proven disorders of leucine metabolism in children 1 to 8 years of age. Contains a 6 cans / case Fat(<1% kcals) balanced mixture of all other essential and non-essential amino acids, CHO, vitamins, - Negligible minerals and trace elements. Does not contain fat, which allows for flexibility in modifying Orange flavor. energy intake. Carbohydrate (71% kcals) Yield varies. - Corn syrup solids, sucrose Per 100 g powder: 350 kcals, 25 g protein equivalent, <.5 g fat, 62 g CHO, 12 mg iron.

CAUTION: Must only be given under medical supervision. Not for parenteral use. Not intended as a sole source of nutrition.

XLeu MAXAMUM (Nutricia) 16 oz. (454 g) powder Protein (46% kcals) cans - Amino acids (without leucine) USE: Leucine-free powder formula for the dietary management of proven isovaleric academia and other disorders of leucine metabolism in children over 8 years and adults. 6 cans / case Fat(<1% kcals) Contains a balanced mixture of all other essential and non-essential amino acids, CHO, - Negligible vitamins, minerals and trace elements. Does not contain fat, which allows for flexibility in Orange flavor. modifying energy intake. Carbohydrate (52.9% kcals) Yield varies. - Corn syrup solids Per 100 g powder: 340 kcals, 39 g protein equivalent, < 1 g fat, 45 g CHO

CAUTION: Must only be given under medical supervision. Not for parenteral use. Not intended as a sole source of nutrition.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source XLys XTrp Analog (Nutricia) 14 oz. (400 grams) Protein (11% kcals) powder - Amino acids USE: Lysine- and tryptophan-free formula used in the dietary management of proven glutaric aciduria type I in infants. Contains a balanced mixture of all other essential and 6 cans / case Fat (40% kcals) non-essential amino acids, CHO, fat, vitamins, minerals and trace elements. Additional - Peanut oil, refined protein must also be given s breastmilk or standard infant formula to supply the lysine, Unflavored. animal fat, coconut oil tryptophan and other nutrient requirements of the infant. Yield varies. Carbohydrate (50% kcals) Per 100 g: 475 kcals, 13 g protein equivalent, 20.9 f fat, 59 g CHO - Corn syrup solids

CAUTION: Must only be given under medical supervision. Not for parenteral use. Not intended as a sole source of nutrition.

XLys XTrp MAXAMAID (Nutricia) 16 oz. (454 g) powder Protein (28.5% kcals) - Amino acids (without lysine and USE: Lysine- and tryptophan-free formula for the dietary management of glutaric aciduria 6 cans / case tryptophan) Type I in children 1 to 8 years of age. Contains a balanced mixture of all other essential and non-essential amino acids, CHO, vitamins, minerals and trace elements. Orange flavored. Fat (<.5% kcals) - Negligible Per 100 g powder: 324 kcals, 25 g protein equivalent, <0.1 g fat, 56 g CHO Yield varies. Carbohydrate (71% kcals) CAUTION: Must only be given under medical supervision. Not intended for infants under - Corn syrup solids, sucrose 1 year of age. Not for parenteral use. Not intended as a sole source of nutrition.

XLys XTrp MAXAMUM (Nutricia) 16 oz. (454 grams) Protein (49% kcals) powder - Amino acids (without lysine and USE: Lysine- and tryptophan-free medical formula for the dietary management of proven tryptophan) glutaric aciduria Type I in persons over 8 years of age. Contains a balanced mixture of all 6 cans / case other essential and non-essential amino acids, CHO, vitamins, minerals and trace Fat (<1% kcals) elements. Orange flavored. - Negligible

Per 100 g powder: 305 kcals, 40 g protein equivalent, <1 g fat, 34 g CHO Yield varies. Carbohydrate (51% kcals) - Corn syrup solids, sucrose CAUTION: Must only be given under medical supervision. Not for parenteral use. Not intended as a sole source of nutrition.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source XMet Analog (Nutricia) 14 oz. (400 grams) Protein (11% kcals) powder - Amino acids (without methionine) USE: Methionine-free medical formula for infants. For the dietary management of proven vitamin B6 non-responsive homocystinuria or hypermethioninemia. Contains a balanced 6 cans / case Fat (40% kcals) mixture of all other essential and non-essential amino acids, CHO, fat, vitamins, minerals - Peanut oil, refined and trace elements. Additional protein must also be given as breastmilk or standard infant Unflavored. animal fat, coconut oil formula to supply the methionine and other nutrient requirements of the infant. Yield varies. Carbohydrate (50% kcals) Per 100 g powder: 475 kcals, 13 g protein equivalent, 20.9 g fat, 59 g CHO - Corn syrup solids

CAUTION: Must only be given under medical supervision. Not for parenteral use. Not intended as sole source of nutrition.

XMet MAXAMAID (Nutricia) 16 oz. (454 grams) Protein (28.5% kcals) powder - Amino acids (without methionine) USE: Methionine-free formula for the dietary management of proven vitamin B6 non- responsive homocystinuria or hypermethioninemia in children 1 to 8 years of age. 6 cans / case Fat (<1% kcals) Contains a balanced mixture of all other essential and non-essential amino acids, CHO, - Negligible vitamins, minerals and trace elements. Does not contain fat, which allows flexibility in Orange flavored. modifying energy intake. Carbohydrate (71% kcals) Yield varies. - Corn syrup solids, sucrose Per 100 g powder: 324 kcals, 25 g protein equivalent, <0.1 g fat, 56 g CHO

CAUTION: Must only be given under medical supervision. Not for parenteral use. Not intended as a sole source of nutrition.

XMet MAXAMUM (Nutricia) 16 oz. (454 grams) Protein (49% kcals) powder - Amino acids (without methionine) USE: Methionine-free formula for the dietary management of proven vitamin B6 non- responsive homocystinuria or hypermethioninemia in persons over 8 years of age. 6 cans / case Fat (<1% kcals) Contains a balanced mixture of all other essential and non-essential amino acids, CHO, - Negligible vitamins, minerals and trace elements. Orange flavored. Carbohydrate (51% kcals) Per 100 g powder: 305 kcals, 40 g protein equivalent, <1 g fat, 34 Yield varies. - Corn syrup solids, sucrose

CAUTION: Must only be given under medical supervision. Not for parenteral use. Not intended as a sole source of nutrition.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source XMTVI ANALOG (Nutricia) 14 oz. (400 grams) Protein (11% kcals) powder - Amino acids (without methionine, USE: Methionine-, threonine-, valine-free, low isoleucine medical formula for infants. For threonine, valine, and low-isoleucine) the dietary management of methylmalonic acidemia or propionic acidemia. Contains a 6 cans / case balanced mixture of all other essential and non-essential amino acids, CHO, fat, vitamins, Fat (40% kcals) minerals and trace elements. Additional protein must also be given as breastmilk or Unflavored. - Peanut oil, refined animal fat, coconut oil standard infant formula to supply the methionine, threonine, valine, isoleucine and other nutrient requirements of the infant. Yield varies. Carbohydrate (50% kcals) - Corn syrup solids Per 100 g powder: 475 kcals, 13 g protein equivalent, 20.9 g fat, 59 g CHO

CAUTION: Must only be given under medical supervision. Not for parenteral use. Not intended as a sole source of nutrition.

XMTVI MAXAMAID (Nutricia) 16 oz. (454 grams) Protein (28.5% kcals) powder - Amino acids (without methionine, USE: Low-isoleucine, methionine-, threonine- and valine-free medical food used for the threonine, valine, and low in isoleucine) dietary management of methylmalonic acidemia or propionic acidemia for children 1 to 8 6cans / case years of age. Contains a balanced mixture of other essential and non-essential amino Fat (<1% kcals) acids, CHO, vitamins, minerals, and trace elements. Orange flavored. - Negligible

Per 100 g powder: 324 kcals, 25 g protein equivalent, <.0.1 g fat, 56 g CHO Yield varies. Carbohydrate (71% kcals) - Corn syrup solids, sucrose CAUTION: Must only be given under medical supervision. Not for parenteral use. Not intended as a sole source of nutrition.

XMTVI MAXAMUM (Nutricia) 16 oz. (454 grams) Protein (46% kcals) powder - Amino acids (without methionine, USE: Isoleucine-low, methionine-, threonine- and valine-free medical food used for the threonine, valine, and low in isoleucine) dietary management of methylmalonic acidemia or propionic acidemia for persons over 8 6 cans / case years of age. Contains a balanced mixture of other essential and non-essential amino Fat (<1% kcals) acids, CHO, vitamins, minerals, and trace elements. Does not contain fat, which allows for Orange flavor. - Negligible flexibility in modifying energy intake. Yield varies. Carbohydrate (54% kcals) Per 100 g powder: 305 kcals, 40 g protein equivalent, <1 g fat, 34 g CHO - Corn syrup solids, sucrose

AUTION: Must only be given under medical supervision. Not for parenteral use. Not intended as a sole source of nutrition.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source XPhe MAXAMAID (Nutricia) 16 oz. (454 grams) Protein powder - Amino acids (without phenylalanine) USE: Phenylalanine-free medical food used in the dietary management of phenylketonuria in children 1 to 8 years of age. Contains a balanced mixture of all other essential and 6 cans / case Fat (<1% kcals) non-essential amino acids, CHO, vitamins, minerals and trace elements - Negligible Flavors: Orange, Per 100 g powder: 324 kcals, 25 g protein equivalent, <0.1 g fat, 56 g CHO Strawberry, Unflavored. Carbohydrate (71% kcals) - Corn syrup solids, (flavored contains CAUTION: Must only be given under medical supervision. Not intended as a sole source Yield varies. sucrose) of nutrition.

XPhe MAXAMUM (Nutricia) 16 oz. (454 grams) Protein (49% kcals) powder - Amino acids (without phenylalanine) USE: Phenylalanine-free formula for the dietary management of PKU in children over age 8 years and adults (including pregnant women). Contains a balanced mixture of all 6 cans / case Fat (1% kcals) other essential and non-essential amino acids, CHO, vitamins, minerals and trace - Negligible elements. When given in prescribed amounts, it provides the correct amino acid profile for Flavors: Orange, the maternal patient during the first trimester for the above compounds. During the second Unflavored. Carbohydrate (51% kcals) and third trimesters, the need for tyrosine is increased and a supplement should be added - Corn syrup solids (flavored also contains separately to the diet. Yield varies. sucrose)

Per 100 g powder: 305 kcals, 40 g protein equivalent, <1 g fat, 34 g

CAUTION: Must only be given to persons under medical supervision. Not intended as a sole source of nutrition.

XPhe, XTyr ANALOG (Nutricia) 14 oz. (400 grams) Protein (11% kcals) powder - Amino acids (without phenylalanine or USE: Phenylalanine- and tyrosine-free medical formula for infants in the dietary tyrosine) management of tyrosinemia. Contains a balanced mixture of all other essential and non- 6 cans / case essential amino acids, CHO, fat, vitamins, minerals and trace minerals. Additional protein Fat (40% kcals) must also be given as breastmilk or standard infant formula to supply the phenylalanine, Unflavored. - Peanut oil, refined tyrosine and other nutrient requirements of the infant. animal fat, coconut oil Yield varies. Per 100 g powder: 475 kcals, 13 g protein equivalent, 20.9 g fat, 59 g CHO Carbohydrate (50% kcals) - Corn syrup solids CAUTION: Must only be given under medical supervision. Not intended as a sole source of nutrition.

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MN WIC FORMULA RESOURCE MANUAL Product Name Packaging Nutrient Source XPhe, XTyr MAXAMAID (Nutricia) 16 oz. (454 grams) Protein (28.5% kcals) powder - Amino acids (without phenylalanine and USE: Phenylalanine- and tyrosine-free medical formula for the dietary management of tyrosine) proven tyrosinemia in children 1 to 8 years of age. Contains a balanced mixture of all 6 cans / case other essential and not-essential amino acids, CHO, vitamins, minerals and trace Fat (<1% kcals) elements. - Negligible Yield varies. Per 100 g powder: 324 kcals, 25 g protein equivalent, <.0.1 g fat, 56 g CHO Carbohydrate (71% kcals) - Corn syrup solids, sucrose CAUTION: Must only be given under medical supervision. Not intended as a sole source of nutrition.

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