Twenty Years of WIC: A review of Some Effects of the Program

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) began in 1974 after a 2-year pilot program. WIC links food assistance and nutrition education to health care for at-risk persons. The program had approximately 344,000 participants in 1975 and has grown to provide services to nearly 6 million participants. Infants born to women who participate in WIC during pregnancy tend to have a slightly higher mean birth weight than those born to women who were eligible but did not participate in WIC. Higher birth weight has been associated with a slightly higher mean gestational age. The prevalence of low birth weight and very low birth weight among infants and the prevalence of iron deficiency anemia among toddlers and preschool children is lower for those participating in WIC than for those not participating in WIC.     

Does Persistent Inflammatory Catabolic Syndrome Exist in Critically Ill Neonates?

Background: Persistent inflammatory catabolic syndrome (PICS) has not been described in the infant population. This study proposes a definition of PICS in critically ill infants. Methods: A published adult criterion of PICS was modified using anthropometric and biochemical reference ranges for infants. A prospective chart review of admissions to a tertiary surgical neonatal intensive care unit (NICU) was performed over 65 days. Demographic, anthropometric, biochemical, and other clinical variables such as length of stay and medication use were collected daily throughout admission. Infants were categorized as having or not having PICS. Results: Twenty percent of admitted infants (n = 15) developed PICS using the proposed criteria. Infants with PICS were more likely to be classified as failure to thrive (53%), meeting only 75% of their anticipated weight gain. Significantly more infants with PICS had undergone surgery (100%; P = .01), received inotropic medication (40%; P = .05), and had longer NICU and total hospital length of stay (P < .001 and P < .001). Infants with PICS had higher peak glucose levels (11.8 ± 7.3 mmol/L) and elevated urea concentrations (7.9 ± 4.6 mmol/L). Conclusions: PICS does exist in a critically ill neonatal population and may be identified using the definition proposed in this study. Infants with PICS displayed metabolic dysregulation, impaired expected growth velocity, and longer length of stay despite no differences in severity scores or diagnosis between the groups. Validation of this work is required, and research into timely identification of infants with PICS is needed to inform whether these infants would benefit from earlier and novel nutrition intervention.