Better Nutrition for Young Children

The logical next step is to improve the array of child and maternal services currently provided to low-income families. These services are offered through programs such as the Title V Maternal and Child Health Block Grant and, in particular, the Special Supplemental Food Program for Women, Infants, and Children (wic).

wic is a Federally financed program that provides screening, nutritional counseling, and food supplements for low-income pregnant women and for children up to age five who are diagnosed as nutritionally at risk. Under wic, the U.S. Department of Agriculture allocates Federal funds to state health departments. These state agencies fund local health departments, hospitals, and health clinics to determine eligibility, offer education about nutrition, and prescribe proper foods for eligible recipients.

Several studies have found that this program can make a difference. Compared with similar groups of women who are not in the program, high-risk mothers in wic tend to have a lower incidence of late fetal deaths and to deliver larger, healthier, less premature babies. The wic newborns have larger head sizes, possibly implying better brain development. Babies and preschoolers in the program demonstrate superior cognitive development and less anemia than comparable infants and children who do not receive the assistance.

The payoff of wic services seems clear, but our commitment to the program has been feeble. At present, states have the option of offering or not offering the wic program to women with incomes of up to 185 percent of the poverty line. Because wic is a discretionary program, states can and often do choose to serve only a limited number of those who are eligible and some states are reluctant to search vigorously for needy children who qualify for the program. Only about half of the eligible women and children are reached by the wic program as it is currently constituted.

In recent years a few states (such as South Carolina and Massachusetts) have taken the initiative in trying to bolster the Federal wic program with supplemental funding. As we will show later, a number of state and local models also seek to coordinate services to meet the multifaceted health and nutritional needs of young and vulnerable families. These efforts are laudable, but they must be bolstered by adequate investment at the national level so that services are available to all those who need them.

We recommend full funding for the wic program as an entitlement for nutritionally at-risk women and children with incomes of up to 185 percent of the Federal poverty line. In addition to increased funding for wic, greater attention should