FD: 12 Issuing Formula Samples

Effective Date: 05/01 Downloads: PDF Version    Revised Date: 04/09


Clinics may issue infant formula samples, if available, to WIC participants (or potential WIC participants) who have specific and unusual circumstances that limit their short-term access to formula. Clinics MAY NOT issue formula samples to participants who run out of formula before their next benefit becomes effective. It is important that infant caregivers understand that WIC is a supplemental food program and may not provide enough formula to meet all of an older infant’s needs. Additional formula may need to be purchased by the caregiver.                     

Documentation of the receipt and issuance of contract formula samples is required.



Receipt of Samples

Local agencies are required to document on the Contract Formula Log the date and case quantities of each type of formula received by the clinic. 

Clinic staff must store formula samples out of participant view, in a storage room/closet, file cabinet, etc. Clinic staff will monitor expiration dates monthly and dispose of out-dated formula. Destroyed formula should be recorded on the Contract Formula Log with the date.

Issuing Samples

Valid reasons for issuing samples include the following:

  • When an applicant is waiting for an initial certification, has no formula, and there are no community resources available.
  • When transitioning from a non-contract formula to a contract formula.
  • When an exclusively breastfeeding woman needs to stop breastfeeding for a very short period of time for medical reasons (e.g., drug therapy, surgery) and will return to exclusive breastfeeding after the problem is resolved. Participant may be issued a manual breast pump at this time to maintain her milk supply. Refer to Policies BF-1 and BF-5.
  • Emergency situations when the contract brand is not available at the store.
  • When community resources cannot supply formula during an emergency or natural disaster.