Md. Code Regs. 10.54.01.11
A. For purposes of the WIC Program, to be considered at nutritional risk:
C. Chart A.
| Nutrition Risk Criteria (Women) | Pregnant | Breastfeeding | Postpartum |
|---|---|---|---|
| Underweight, prepregnancy | 1 | N/A | N/A |
| Underweight, postpartum | N/A | 1 | 3 |
| Overweight, prepregnancy | 1 | N/A | N/A |
| Overweight, postpartum | N/A | 1 | 3 |
| Low maternal weight gain | 1 | N/A | N/A |
| Maternal weight loss | 1 | N/A | N/A |
| High maternal weight gain | 1 | 1 | 6 |
| Low hemoglobin/hematocrit | 1 | 1 | 3 |
| Elevated blood lead | 1 | 1 | 3 |
| Hyperemesis gravidarum | 1 | N/A | N/A |
| Gestational diabetes | 1 | N/A | N/A |
| History of gestational diabetes | 1 | 1 | 3 |
| History of preterm delivery | 1 | 1 | 3 |
| History of low birth weight | 1 | 1 | 3 |
| History of spontaneous abortion, fetal, or neonatal loss | 1 | 1 | 3 |
| Pregnancy at a young age | 1 | 1 | 3 |
| Closely spaced pregnancies | 1 | 1 | 3 |
| High parity and young age | 1 | 1 | 3 |
| Late to prenatal care | 1 | N/A | N/A |
| Multifetal gestation | 1 | 1 | 3 |
| Fetal growth restriction | 1 | N/A | N/A |
| History of birth of a large-for-gestational-age infant | 1 | 1 | 3 |
| Medical condition, nutrition related | 1 | 1 | 3 |
| Maternal smoking | 1 | 1 | N/A |
| Alcohol and substance use | 1 | 1 | 3 |
| Dental problems | 1 | 1 | 6 |
| Failure to meet dietary guidelines | 4 | 4 | 6 |
| Vegan diet | 4 | 4 | 6 |
| Highly restrictive diet | 4 | 4 | 6 |
| Excessive caffeine | N/A | 4 | N/A |
| Pica | 4 | 4 | 6 |
| Inadequate diet—requires that 2 or more food groups be determined to be inadequate, based upon the food frequency questionnaire or 24-hour dietary recall. | 4 | 4 | 6 |
| Dietary supplements—inappropriate or excessive intake | 4 | 4 | 6 |
| Inadequate vitamin or mineral supplementation | 4 | 4 | 6 |
| Possibility of regression of nutritional status | 4 | 4 | 6 |
| Transfer | N/A | N/A | N/A |
| Breastfeeding mother of infant at nutritional risk | N/A | 1, 2, or 4 | N/A |
| Breastfeeding complications | N/A | 1 | N/A |
| Homelessness | 4 | 4 | 6 |
| Migrancy | 4 | 4 | 6 |
| Limited ability to make feeding decisions | 4 | 4 | 6 |
D. Chart B.
| Nutrition Risk Criteria (Infants and Children) | Infant | Child |
|---|---|---|
| Underweight, infant, child | 1 | 3 |
| Overweight, infant, child | 1 | 3 |
| Short stature, infant, child | 1 | 3 |
| Failure to thrive | 1 | 3 |
| Inadequate growth, infant, child | 1 | 3 |
| Low birth weight | 1 | 3 |
| Prematurity | 1 | N/A |
| Small for gestational age | 1 | N/A |
| Large for gestational age | 1 | N/A |
| Low hemoglobin or hematocrit | 1 | 3 |
| Elevated blood lead | 1 | 3 |
| Medical condition, nutrition-related | 1 | 3 |
| Dental problems | 1 | 3 |
| Fetal alcohol syndrome | 1 | 3 |
| Neonatal abstinence syndrome | 1 | 3 |
| Failure to meet dietary guidelines | N/A | 5 |
| Vegan diet | N/A | 5 |
| Highly restrictive diet | 4 | 5 |
| Inappropriate infant feeding | 4 | N/A |
| Solid foods introduced early | 4 | N/A |
| Fed cow's milk first 12 months | 4 | N/A |
| No dependable iron source | 4 | N/A |
| Improper formula dilution | 4 | N/A |
| Fed foods low in nutrients | 4 | N/A |
| Lack of sanitation, formula or breast milk | 4 | N/A |
| Infrequent breastfeeding if sole source of nutrition | 4 | N/A |
| Inappropriate use of bottle | 4 | 5 |
| Pica | N/A | 5 |
| Inadequate diet — requires that 2 or more food groups be determined to be inadequate, based on food frequency questionnaire or 24-hour dietary recall | N/A | 5 |
| Dietary supplements—inappropriate or excessive intake | 4 | 5 |
| Inadequate vitamin or mineral supplementation | 4 | 5 |
| Inappropriate child feeding | N/A | 5 |
| Possibility of regression of nutritional status | 4 | 5 |
| Transfer | N/A | N/A |
| Breastfeeding complications, infant | 1 | N/A |
| Mother in WIC or eligible while pregnant | 2 | N/A |
| Breastfeeding infant of woman at nutritional risk | 1 or 4 | N/A |
| Homelessness | 4 | 5 |
| Migrancy | 4 | 5 |
| Limited ability to make feeding decisions | 4 | 5 |
| Foster care | 4 | 5 |
| Complementary feeding process for an infant or child <2 | 4 | 5 |
Authority: Health-General Article, §18-107(a), Annotated Code of Maryland
Effective date:
Regulations .01—.12 adopted as an emergency provision effective February 21, 1986 (13:6 Md. R. 670); emergency status expired May 31, 1986
Regulations .01—.12 adopted as an emergency provision effective June 4, 1986 (13:13 Md. R. 1477); adopted permanently effective October 20, 1986 (13:21 Md. R. 2321)
Regulation .03 amended as an emergency provision effective January 15, 2002 (29:3 Md. R. 214)
Regulation .03B amended effective March 19, 1990 (17:5 Md. R. 638)
Regulation .04 amended as an emergency provision effective January 15, 2002 (29:3 Md. R. 214)
Regulation .04B amended effective March 19, 1990 (17:5 Md. R. 638)
Regulation .06C, E amended effective March 19, 1990 (17:5 Md. R. 638)
Regulation .07 amended effective March 19, 1990 (17:5 Md. R. 638)
Regulation .09D amended effective March 19, 1990 (17:5 Md. R. 638)
Regulation .10 amended effective March 19, 1990 (17:5 Md. R. 638)
Regulations .01—.12 repealed and Regulations .01—.24 adopted effective March 25, 1996 (23:6 Md. R. 476)
Regulation .02A amended effective May 18, 2020 (47:10 Md. R. 519)
Regulation .03 amended as an emergency provision effective January 15, 2002 (29:3 Md. R. 214); amended permanently effective May 13, 2002 (29:9 Md. R. 745)
Regulation .03 amended effective April 16, 2012 (39:7 Md. R. 494)
Regulation .04 amended as an emergency provision effective January 15, 2002 (29:3 Md. R. 214); amended permanently effective May 13, 2002 (29:9 Md. R. 745)
Regulation .04B amended effective April 16, 2012 (39:7 Md. R. 494); May 18, 2020 (47:10 Md. R. 519)
Regulation .05B amended effective May 18, 2020 (47:10 Md. R. 519)
Regulation .06B, C amended effective May 18, 2020 (47:10 Md. R. 519)
Regulation .07 amended as an emergency provision effective January 15, 2002 (29:3 Md. R. 214); amended permanently effective May 13, 2002 (29:9 Md. R. 745)
Regulation .07 amended effective May 18, 2020 (47:10 Md. R. 519)
Regulation .07D amended effective November 29, 1999 (26:24 Md. R. 1858)
Regulation .07E amended effective April 16, 2012 (39:7 Md. R. 494)
Regulation .08 amended as an emergency provision effective January 15, 2002 (29:3 Md. R. 214); amended permanently effective May 13, 2002 (29:9 Md. R. 745)
Regulation .08 amended effective May 18, 2020 (47:10 Md. R. 519)
Regulation .09 amended as an emergency provision effective January 15, 2002 (29:3 Md. R. 214); amended permanently effective May 13, 2002 (29:9 Md. R. 745)
Regulation .09B amended effective May 18, 2020 (47:10 Md. R. 519)
Regulation .10 amended as an emergency provision effective January 15, 2002 (29:3 Md. R. 214); amended permanently effective May 13, 2002 (29:9 Md. R. 745)
Regulation .10A, B amended effective May 18, 2020 (47:10 Md. R. 519)
Regulation .11 amended as an emergency provision effective January 15, 2002 (29:3 Md. R. 214); amended permanently effective May 13, 2002 (29:9 Md. R. 745)
Regulation .11 amended effective May 18, 2020 (47:10 Md. R. 519)
Regulation .12A, G amended effective May 18, 2020 (47:10 Md. R. 519)
Regulation .13 amended as an emergency provision effective January 15, 2002 (29:3 Md. R. 214); amended permanently effective May 13, 2002 (29:9 Md. R. 745)
Regulation .13 amended effective May 18, 2020 (47:10 Md. R. 519)
Regulation .14A, B, C amended effective May 18, 2020 (47:10 Md. R. 519)
Regulation .15A amended effective May 18, 2020 (47:10 Md. R. 519)
Regulation .16 amended effective May 18, 2020 (47:10 Md. R. 519)
Regulation .17 amended effective May 18, 2020 (47:10 Md. R. 519)
Regulation .18 amended effective May 18, 2020 (47:10 Md. R. 519)
Regulation .19 amended effective March 31, 2014 (41:6 Md. R. 380); May 18, 2020 (47:10 Md. R. 519)
Regulation .20C, D amended effective May 18, 2020 (47:10 Md. R. 519)
Regulation .22 amended effective May 18, 2020 (47:10 Md. R. 519)