Volume 19, Number 3
Growing Up Healthy with WIC
Improving the Nutrition and Health of Children
Breastfeeding: No Limits
New Zobey Adventures Coming Soon
Creative Outcomes of Client-Centered Nutrition Education: Getting Kids Involved
Low Fat Education Campaign Has WIC Families Mooving in the Right Direction
WIC Wellness Works
How Can We Keep Children on WIC Until Their 5th Birthday?
Rediscover Nature Through the Eyes of a Child
Growing Meals: Cooking, Gardening and Making Memories with Your Children
Looking for 10 New Dietetic Interns!
Test Your Nutrition IQ
Improving the Nutrition and Health of Children
From the Texas WIC Director
— Mike Montgomery
This time of year, with the ending of the school year and the beginning of summer vacation, marks a transitional period for many families. Young children ages one through four in these families make up the largest category of participants that we serve. They constitute 52 percent of our caseload. Historically, WIC tends to see a slight increase in enrollment beginning in May and lasting throughout the summer months. Unfortunately these children are being faced with two seemingly contradictory issues — childhood hunger and childhood obesity. In reality these issues are closely interrelated. Budget constraints faced by low income households often lead to hunger. Limited resources and a lack of access to affordable healthy foods can contribute to obesity. Households with limited resources may try to stretch their food dollar by purchasing cheaper, higher fat, calorie dense foods that are filling.
WIC plays a key role in simultaneously addressing both issues. We offer a combination of preventative health services and counseling as well as nutritious foods which can help lessen the impact of food insecurity, help expand tight budgets, and give families the knowledge and ability they need to select healthy foods rich in vitamins, minerals, and fiber and lower in empty calories. WIC benefits are available to all infants and children who qualify based on income, residency and identification criteria.
To get the full benefits the WIC program offers, children should stay on the program until their fifth birthday. Unfortunately, the Texas statistics on enrollment demonstrate there are key “drop-off” times for children who are enrolled in the WIC program. I encourage you to read Kate Sullivan’s article on page 11 to learn more about those key periods. We are currently exploring interventions which capture the participants’ attention at those key periods and encourage them to remain on the program.
To further encourage children’s participation in the WIC Program, I urge you to make WIC a place where children want to go. The Zobey article on page 6, the Client-Centered Nutrition education article on page 8 and the growing meals article on page 14 all highlight activities and creative techniques for keeping the 1- to 5-year old fully involved in the WIC process.
Involving the children engages the parents and helps them make healthy choices. Thank you for the role you play in working to assure that parents have the knowledge and tools needed to help their children eat nutritious foods and at the same time combat childhood obesity.
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Breastfeeding: No Limits
Cristina García, R.D., L.D.
Breastfeeding Promotion Nutritionist
Lindsey Randall, B.S.
Breastfeeding Promotion Nutritionis
As WIC professionals, we are familiar with the popular and effective breastfeeding messages such as Loving Support Makes Breastfeeding Work and Breastmilk, Every Ounce Counts.
We know that breastfeeding provides positive health benefits, nutritional value, and a bonding experience between mother and child. That is why the WIC program goes above and beyond to encourage and support breastfeeding efforts. Breastfeeding promotion focuses on those families who are expecting a baby or have a newborn child. What most people do not realize is that nursing beyond infancy and into childhood continues to provide important benefits for both mom and child.
Both the American Academy of Pediatrics and American Dietetic Association recommend exclusive breastfeeding for the first six months of life, with a continued duration at least through an infant’s first birthday. Additionally, the World Health Organization and United Nations International Children’s Emergency Fund promote continued breastfeeding along with appropriate complementary foods through the first two years of life and beyond. WIC shares common breastfeeding goals with these organizations and encourages breastfeeding duration for at least the first year and continuing onward as long as it is mutually agreeable between mom and child.
WIC staff should remember that breastfeeding support may be needed beyond the timeframe in which a woman is categorically eligible to receive a food package for herself. It is important to remember that breastfeeding support is not contingent upon food package issuance and should be provided for as long as a woman breastfeeds her child. This support includes the continued encouragement and sharing of breastfeeding information well beyond the first few weeks postpartum, through the early months and for as long as the child is enrolled and is being breastfed.
WIC’s role is to help participants understand how extending the duration of breastfeeding can positively affect their lives as well as the lives of their children. We can do this by sharing information like the following:
• The benefits of breastfeeding increase the longer breastfeeding continues. Research has shown that there is a 4.3 percent reduction in the risk of breast cancer linked to each year a woman chooses to breastfeed.
• Nursing provides comfort for a child when he is upset, tired, ill or hurt. It can soothe the discomforts of teething and it enhances the relationship between a mother and her child. Many women agree that extended breastfeeding makes mothering a toddler or child easier during those often trying times.
• Breastmilk contains protective factors and is constantly changing to meet the individual needs of each nursing toddler or child.
WIC staff can positively influence breastfeeding duration and success. Yet some mothers may be hesitant to ask questions about nursing a toddler or child. This can make breastfeeding support tricky. During child certifications, staff should review the Health History form for children (WIC44a), which identifies children who are currently breastfed. If a parent indicates a child is being breastfed, congratulate mom for her breastfeeding accomplishments. This creates an opportunity to explore any questions or concerns the mother may have about breastfeeding.
Keep in mind that breastfeeding a toddler or child introduces new challenges that were probably not discussed in previous consultations. Some mothers may need reassurance about their decision to continue breastfeeding, while others need help responding to the social pressures of weaning. When counseling a mom, be aware that she may be feeling vulnerable. Make sure to acknowledge and respect her feelings. Nursing a toddler or child should be treated as the normal thing to do.
In many communities, WIC is often the best breastfeeding resource available. It is our responsibility to ensure that we provide our mothers with a support system from day one. Breastfeeding support does not have a time limit attached; it begins prenatally and should continue throughout the entire breastfeeding relationship, no matter the age of the child.
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New Zobey Adventures Coming Soon
by Amanda Hovis, M.P.H.
Nutrition Education Consultant
The Adventures of Zobey are back and better than ever with two new adventures: Barn Dance Party and Jungle Jive. Zobey’s latest adventures include nutrition messages that support and promote the foods in the new WIC food package and of course, lots of fun physical activity.
In Barn Dance Party, Zobey and the kids help Scarecrow, Tractor and the animals bring in the harvest and prepare for a special harvest celebration. Key nutrition messages include: eat a variety of fruits and vegetables, drink low fat milk, and eat whole grains like whole wheat bread.
In Jungle Jive, Zobey and the kids help the animals throw a surprise party for Elephant. They help Monkey make a fruit-a-licous sculpture cake-o-rama, help her transport it to the party, and help Lion with his Jungle Jive dance for Elephant. Key nutrition messages include: healthy foods can be used for celebration, eat a variety of fruits and vegetables, and drink water.
In addition, each of the new DVDs for WIC will include recipes and nutrition tips (like before), as well as video clips of five fun physical activities that families can try at home, and a new behind the scenes segment for families on how to best use the Zobey videos.
Zobey’s latest adventures are the result of a collaborative partnership between DSHS WIC and the Child and Adult Care Food Program (CACFP) at the Texas Department of Agriculture. WIC staff member Amanda Hovis oversaw the production and WIC staff member Irma Choate oversaw the art direction. The project was completed in association with Brainy Bee Productions and AMS Pictures.
What is CACFP?
What is CACFP?
The Child and Adult Care Food Program provides reimbursement for meals at participating daycares and day homes in Texas. Currently over 13,000 daycares and day homes across Texas participate in this program.
How will CACFP be using the Zobey Programs?
CACFP providers will be receiving special training on ways to incorporate the Zobey programs into their classroom along with a special CACFP provider DVD package that includes both of the new programs on one DVD and a second DVD that incorporates information on childhood obesity. The second DVD includes segments on:
• Using the Zobey DVD with children
• My Pyramid
• Fitness activities
• Shopping on a budget for CACFP providers
A copy of the CACFP provider DVD will be sent to all WIC clinics so clinics are aware of what the child-care providers in their areas are receiving.
How will WIC clinics be using the Zobey Programs?
Just like the previous Zobey DVDs the Zobey programs (Jungle Jive and Barn Dance Party) will be packaged separately and WIC clinics will be able to give the DVDs and collateral materials to participants. Each Zobey program will have its own set of take-home and group class lessons that clinics can use in conjunction with the DVDs. In addition several collateral pieces are in development and should be ready by early summer.
Have the new Zobey Programs been evaluated?
WIC will conduct a formal evaluation once the programs are provided to CACFP and WIC. However, the results from our informal evaluation show that the new programs are already getting rave reviews from parents and kids:
“My daughters loved the colors and dancing. They could not get enough of Zobey. They kept saying ‘play it again.’”
“The Zobey DVD was a great way to encourage my daughter to eat her vegetables. Since the first time she watched it she kept asking about the green beans. Tomatoes was something she never liked and now she asks for it all the time.”
“My daughter can’t stop talking about Zobey. We love to dance along with him.”
The first two Zobey programs were evaluated by The University of Texas at Austin. The results found that
• Parents and kids give Zobey an average of 3.6 out of 4 stars.
• 95 percent of kids watch Zobey multiple times – 54 percent watch Zobey six or more times.
• 94 percent of parents said that the DVDs gave them ideas to help their child be more active.
• 93 percent of parents said the DVDs helped them offer fruits and vegetables to their child.
• 82 percent of parents said that after watching the Rainbow DVD their child asked for water more often.
What Zobey materials are currently available and when will the new Zobey materials be available?
The adventures of Zobey series includes the following available DVDs:
• Trip to Bugland
• Searching for a Rainbow
The following additions to the series will soon be available:
• CACFP Provider DVD with both new adventures and Obesity Prevention DVD
• Barn Dance Party
• Jungle Jive
The following accessory materials are currently available:
• Trip to Bugland children’s book
• Searching for a Rainbow coloring sheets
• Zobey – Healthy Drinks magnet
• Zobey sticker
• Zobey clinic poster
The following accessory materials will be available soon:
• Take-home lessons and group class lessons for each DVD
• Zobey’s Trip to the Farm children’s book
• Zobey’s placemat
Please see the Texas WIC Materials Catalog for ordering instructions.
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Creative Outcomes of Client-Centered Nutrition Education: Getting Kids Involved
by The University of Texas at Austin Nutrition Education Group
Every WIC client is important, especially the youngest ones. In previous articles we have discussed small steps we can take to make nutrition education more client centered. This article focuses on WIC kids and how you can make small steps to be more kid-centered in classes. This can be done by creating child-friendly spaces, getting children involved in nutrition education lessons, and offering nutrition education classes and materials that are developed specifically for kids. By taking a client-centered approach to nutrition education for all clients, you can bring new and relevant topics to life for parents and children alike.
Creating a child-friendly space
In WIC, children are clients; so it makes sense to create spaces where they feel welcome and comfortable and where their caregivers can relax and engage in the learning process. Clinics around the state have done many things to construct an inviting atmosphere for children, including child-sized furniture and children’s activities. Here are several tips to help craft a child- and parent-friendly learning environment:
• Set aside a corner of the room with child-sized furniture, big cushions or a rug. Keep a supply of coloring sheets, puzzles, or other activities.
• Childproof the room by covering outlets and keeping wires and hazards out of reach. This will provide a safe space for toddlers who get fussy sitting on a lap.
• At the beginning of class, be clear about the expectations for children. For example, let parents know that children are welcome at WIC and that they can use their best judgment if a child becomes upset or noisy. Mention that it is okay to leave the room for a few moments to calm down a child.
• Look at the room and see if a pathway can be created, so parents and children can remain in class and pace. Sometimes, walking crying children will sooth them and eventually quiet them.
• If a child’s behavior becomes a minor distraction, try to use it as a teaching point. If talking about child development, point out something that is typical for the child’s age group. If the child is old enough, ask the child a question about the topic.
• If the child’s behavior is so distracting that others in the class cannot pay attention, ask whether the parent would like to take the child outside. Communicate sympathy for the parent’s problem, rather than anger or irritation. The parent is probably doing his or her best.
Getting children involved in lessons
Beyond creating a child-friendly environment, there are small ways that you can incorporate children into your planned lessons. Whatever the class topic, you can find a way to get children involved with their parents.
• With the new client-centered lesson titled “Introducing vegetables: a conversation about getting children to eat vegetables,” consider giving kids coloring pages that highlight fun fruits and various veggies.
• If you are facilitating the “Mooving to low-fat milk” lesson, have the children taste-test as well.
• In a dental health class, grab toothbrushes and teeth models. Get the kids to start playing with the models and brushing them.
• Some clinics are creating gardens to encourage the use of fresh vegetables and herbs. If this is an option for your clinic, let children experience one of nature’s best treasure hunts. There is nothing more fun than digging for treasure and finding carrots, potatoes and turnips. One word of caution before heading out on this treasure hunt—make sure you get parents’ permission before you go digging in the dirt.
• For a lesson about whole grains, consider printing pictures of different whole grains. Have the parents and children work together to identify the different types of grains while teaching about the “powers” of whole grains.
• If you are teaching a lesson on physical activity, incorporate some small activities for both parents and kids to do in the class. The Zobey DVDs created by Texas WIC are one way to get kids moving in class and at home.
• Consider the creative outcomes a lesson can generate. One clinic found that as the parents started talking about their experiences, great ideas emerged among clients. In one class, the clients decided to exchange contact information and start a playgroup.
Remember, the more a child can identify and positively associate with a nutrition topic (like whole grains, fruits, vegetables, and low-fat milk) the less resistance a parent may encounter when introducing these items in meals. In fact, the Texas Child Feeding Study found that child preference was the number one motivator for parents when they decided what to feed their children for dinner.
Nutrition Education Tailored for Children
Finally, WIC has an opportunity to develop a child’s interest and enthusiasm for proper nutrition and health. Below are a couple kid-centered materials to consider incorporating into your NE offerings, if you haven’t already!
• The Zobey DVDs: An evaluation of the Zobey DVDs developed by Texas WIC showed that parents whose children watched Zobey reported that their children asked for specific fruits and vegetables that are featured in the videos. For example, three-quarters of children who watched Zobey’s Adventures in Bugland asked their parents for strawberries; two-thirds of those who watched Searching for a Rainbow asked for apples and four out of five children asked for water to drink after viewing the video. Most parents reported that their children danced to the videos when they watched them. Look for more Zobey DVDs coming soon.
• Get Healthy Now: The Sesame Street Work Shop Get Healthy Now Show DVD and accompanying lesson promotes movement and active participation to the games suggested in the video. Following the video children are invited to play the “sometimes/anytime food game” where they pick a food and have to decide if it is a “sometimes” food or an “anytime food.”
At times it is easy to forget that in WIC, children are clients. It is important to get them involved as much as possible. In fact, getting kids involved in nutrition education helps make it easier for parents to make healthy choices. WIC has a golden opportunity to impact an entire family’s decisions about nutrition and health, so let’s make sure to get every client involved.
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Low Fat Education Campaign has WIC Families Mooving in the Right Direction
by Lisa Rankine, R.D.
Clinic Services Program Coordinator
In April 2009, WIC families were introduced to the Low-Fat Milk group lesson and other educational materials to help make the transition to low-fat milk.
From April through June, prior to the official kick-off of the New Food Rules and the mandatory implementation of low-fat milk, over 29,000 WIC families attended low-fat milk education classes. Approximately 27,000 families attended “Make the Moove to Low-Fat Milk” group classes in WIC clinics and 2600 families completed the online version of “Moove to Low-Fat Milk.”
For families that attended class at WIC clinics, the number that purchased only low-fat milk increased from five percent during January through March 2009 to 14 percent during July through September 2009, nearly tripling the percentage of people who followed the low-fat milk recommendations. For families that completed the online class, the number that purchased only low-fat milk doubled from 10 percent to 20 percent.
New Low-Fat Milk Nutrition Education Materials
Interestingly, the number of families that did not attend the low-fat milk class or complete the online course also increased from 7 percent to 14 percent. It’s likely that this increase is due to exposure in the clinic to posters encouraging the move to low-fat milk as well as families receiving copies of the Moove to Low-fat or Fat Free Milk pamphlet and the Carlos and Clarice Move to Low Fat Milk bilingual children’s book.
WIC does make a difference
Although all families were more likely to follow WIC recommendations for milk purchases during July through September, taking the classes in the clinics or online significantly increased the odds that families would buy low-fat milk. The results suggest that classes have a significant and meaningful impact on encouraging families to buy low-fat milk, the healthier option. Also, the data indicates that overall efforts (such as pamphlets, brochures, and posters) had a substantial effect on families’ milk purchases. This is measurable evidence that WIC families benefit from the hard work of WIC staff that teach classes and provide nutrition education, which is valuable to the WIC program and invaluable to our participants’ families.
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Focusing on Physical Activity for Toddlers
As you’ve probably observed, most toddlers and preschoolers have an innate desire to run and play. Continuing to provide opportunities for this type of natural movement can set the foundation for a lifetime habit of physical activity and a healthy heart.
According to the American Heart Association, children in the United States are showing early signs of cardiovascular risk factors such as physical inactivity, excess weight, and higher blood cholesterol. Fortunately, it is never too early to instill a lifelong love of movement in young children.
Habits develop as early as the preschool years. Children should be encouraged to practice movement skills in a variety of activities and settings. Play and physical activity go hand in hand. Bouncing balls, playing hide and seek, and leap frog are just a few examples of toddler games that involve movement. Consider these recommendations if you have toddlers in your family, or ‘pass it on’ to your WIC participants
Recommendations for Toddlers and Preschoolers
(share with your WIC participants)
For toddlers, basic movement skills such as running, jumping, throwing and kicking are learned behaviors and don’t just appear with age, but develop over time. These behaviors are influenced by the environment, movement experience, and genetics. Toddlers and preschoolers should:
• Be involved in at least 30 minutes of organized active play such as Follow the Leader, Red Light/Green Light, and dancing games.
• Be engaged in at least 60 minutes and up to several hours per day of unstructured active play (such as riding a tricycle, kicking a ball, etc…).
• Not be sedentary for more than 60 minutes at a time except when sleeping.
• Have indoor and outdoor areas that are safe and include any necessary safety equipment (helmets, knee pads, etc.).
Parents and caregivers should provide opportunities for physical activity: invite friends and neighbors over for tag or hide and seek, take children to a park to play, and show children the way by being active themselves.
How can you encourage a toddler to be more physically active?
• Offer toys that encourage toddlers to use their muscles. Provide building toys, riding toys, balls and beanbags, and climbers.
• Provide plenty of time for active free play. Morning, afternoon, and evening—let them set their own pace! They can walk, run, roll, climb, slide, pull, push, throw, and jump until they’re tired.
• Turn off the TV, DVD player, and computer. Toddlers should not sit in one place or lie down for more than an hour at a time except when sleeping.
• Find ways to make exercise fun. Try these:
• Toddlers can pretend to be animals, workers, or machines. Teach them group games like Follow the Leader or Ring around the Rosie. They can practice their skills and learn new ways to move.
• Make an obstacle course. Indoors or out, toddlers can take turns going over, under, around, and through furniture, boxes, and child-safe climbing equipment.
• Move to music! Bounce, sway, clap, march, dance, or play rhythm instruments.
• Exercise together. Make it a part of your routine. Do stretches before lunch. Play in the park or take a walk before the sun goes down (but not too close to bedtime!).
• Set a good example. Let toddlers see you walk, run, bike, build, dance, climb, or play ball.
• Share books about people who lead active lives. Stories of athletes, dancers, astronauts, farmers, and other physically fit people show children that exercise is important.
Pass these ideas on to your WIC participants and consider encouraging your family to become more physically active as well. It is never too early to start healthy habits.
Reference: Circulation, Journal of the American Heart Association, American Heart Association Childhood Obesity Research Summit, Executive Report, 2009
LA 26 Powers Up 2010 with Veggies and Beans!
Local Agency 26 (City of Houston) jump-started 2010 with an agency-wide training and recipe contest entitled “Power Up with Veggies and Beans!” The contest wrapped up their “Smart Choices, Healthy Staff!” program and was also the wellness kickoff for 2010. Approximately 200 staff from all 16 clinics attended the training. “The goal of the recipe contest is to provide Houston Health and Human Services Department WIC staff with the opportunity to create and share healthy and inexpensive recipes with their families and clients,” said Rosana Arruda, nutrition consultant with LA 26, who organized the event.
LA 26 staff submitted recipes for entry into the contest during fall 2009. The recipes had to meet the following guidelines:
1. Contain vegetables or dry beans as first ingredients.
2. Contain at least ½ cup cooked or 1 cup raw vegetables or ½ cup of dry beans per serving per person.
3. Be preferably low in fat (<35% calories from fat) and saturated fat (<10% total calories).
4. Be easy to prepare.
5. Be an original or modified recipe of the contestant or contestant’s family or friends.
The submitted recipes were analyzed, prepared, and tasted by staff from the Houston Food Bank who then selected the top ten finalists. These finalists moved on to the “Power Up” event held on Jan. 4, 2010. On the day of the event, the ten recipes were prepared, sampled, and judged by six guest judges.
While the cooks were preparing recipes for the contest, Local Agency 26 staff participated in creating a “30 Day Wellness Challenge” for their clinics. WIC Wellness Works staff, Gina Akin and Robin Atwood from The University of Texas at Austin, led the agency staff through an activity designed to help each clinic come up with their own “30 Day Wellness Challenge.” The clinic staff had a great time generating ideas and every clinic came up with activities to implement during January including instituting a daily stretch break, organizing a group walk at least once a week, placing a water station in the break room to reduce soda intake, sharing a weekly potluck salad with each other, encouraging each other to take the stairs, and trying to smile more often and working on positive thinking. While the ideas varied, everyone shared enthusiasm for the challenges.
A fierce competition ensued among the “WIC Chefs” who prepared their recipes on site, skillfully presented their creations, served the judges, and answered questions about their recipes. The judges were asked to score the recipes based on ingredient content, creativity, taste, appeal, and ease of preparation.
While the judges tallied the scores, the LA 26 staff tasted the recipes.
All the dishes were excellent and certificates were awarded to every participant. Highest honors and prizes were presented to the top five winners. The Fruity Bean Wrap, created by the Foody Lovers, won 1st place (see recipe below).
One of the judges described this recipe as, “…pleasing to the palate, a blend of flavors, a mixture of textures, and demanding of a second taste.”
One of the chefs, Sheela Kore, says she enjoys cooking and eating healthy foods and she plans to “Share this recipe with [her] WIC clients.”
Congratulations to LA 26 for jump-starting their wellness program in 2010 and for creating a fun and informative recipe contest that wraps up “Smart Choices, Healthy Staff,” which focused on foods from the new WIC food package.
Winning Recipe: Fruity Bean Wrap
Prepared by: Foody Lovers -- Tejal Patel, Jocelyn Church and Sheela Kore
Preparation time: 15-20 minutes
2 green or red bell peppers, seeded, chopped
1 onion, peeled, sliced
15 ounce can black beans, drained, rinsed
2 mangos, chopped
½ cup cilantro, chopped
1 cup grapes, halved
4-10 inch fat-free flour tortillas
1. In a nonstick pan, sauté bell peppers and onion for 5 minutes over medium heat. Add beans. Stir well. Reduce heat to low. Simmer about 5 minutes.
2. In a small bowl, combine mangoes, lime juice, cilantro, and grapes. Reserve ½ mixture for topping.
3. Fill warmed tortillas with ¼ bean mixture and ¼ mango mixture.
4. Fold ends of tortillas over. Roll up to make wraps. Top wraps with remaining mango mixture.
Calories: 447.5 kcal
Protein: 13.0 g
Total Fiber: 8.0g
Total Fat: 7.1g
Saturated Fat: 2.1g
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How Can We Keep Children On WIC Until Their 5Th Birthday?
by Kate Sullivan, Ph.D., M.A.
Office of Program Decision Support
There is concern among WIC staff over the substantial number of children who are dropping out of the program before they become five years old.
Who is dropping out and at what age?
Before we can implement procedures that help keep these kids enrolled with WIC through their fifth birthday, we first need to learn the risk factors for dropping out of WIC – which kids drop out and when?
To answer this question, we studied the children who were enrolled as newborns in Texas WIC in 2003. In 2003, there were almost 165,000 newborns enrolled in WIC. Over the next five years, these children had the opportunity to recertify every six months in order to remain eligible for their WIC benefits.
We used the recertification patterns of these children over the next five years to track if and when they dropped out of WIC. For the nearly 165,000 newborns enrolled in WIC that year, four predominant recertification patterns emerged from 2003 through 2008.
Enrolled through age 5
The good news is that almost one out of three children is recertified on time every six months until they turn 5. That means that over 30 percent receive the full nutritional benefits from birth through their fifth birthday. These children come from large families who are less likely to receive other forms of governmental financial assistance. They are primarily Hispanic with mothers who are older. With the strains of large families and no other support, these families rely on the WIC benefits for their children.
Drop out during childhood
Some children are recertified after infancy but do not stay long. Nineteen percent of children drop out at 18 months and 14 percent drop out at 36 months. Though these children also come from large families, their families are more likely to receive other forms of governmental financial assistance. Their mothers also tend to be younger and Hispanic.
Drop out after infancy
Unfortunately, nearly four out of ten children never recertify after their initial infancy certification. These children receive WIC benefits only before or until their first birthday. They are substantially more likely to come from white or African-American families. They tend to come from smaller families and receive other sources of governmental financial assistance. These children also have the youngest mothers. This group of children is the most at risk. Additional attention and effort must be given to prompt families that fit this general profile to return after the certification of their infant has expired.
Using this information, state agency staff has begun planning next steps. As it is troubling that only one out of three children remains enrolled in WIC through their fifth birthday, focus groups of WIC clients with infants are being planned. The state agency is especially interested in finding out why so many families never recertify their children after they become one year old. While the state agency works on that, it is important that local agencies make clients aware that many children are missing out on all the benefits that WIC can provide. If your agency does anything special to encourage retention, we’d like to hear from you.
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Rediscover Nature Through the Eyes of a Child
by Lauren Christian, R.D.
Nutrition Education Consultant
Ever play by a creek bed and let your thoughts slip away with the sound of the water flowing? How about your children? Have you experienced the true magic of a waterfall or noticed the wonder in your child’s eyes as they experience their first nature hike?
Sedentary lifestyle changes during the last 20 to 30 years have had detrimental effects on children. In our technologically consumed society, we’re moving farther away from nature and getting more out of touch with the outdoors.
There is a strong body of evidence associating improved health with physical activity. In addition, there is evidence suggesting that nature can improve attention and other aspects of health. This article reviews why children should be spending more time outdoors, what’s being done and some helpful ways to encourage parents to get their kids outside.
According to the National Environmental Education Foundation, a group who teaches kids to protect their environment and health, “Sedentary lifestyle and physical inactivity have contributed greatly to the numerous health problems plaguing today’s children. Chronic conditions such as childhood obesity, asthma, and attention-deficit disorder have all increased over the past few decades.”
They believe, “Outdoor activity in the natural environment has taken a back seat to television, video games, the computer, and a demanding schoolwork schedule. Today’s youth are losing the contact with the natural environment that is extremely beneficial for their health and well-being.”
To overcome this “nature-deficit disorder,” the American Academy of Pediatrics encourages children to have unstructured, free play not only for their physical development, but also for their emotional, social, and cognitive development as well. Research shows that being outdoors can increase levels of physical activity in children, reduce childhood stress, aid in healthy childhood development and serve as a coping mechanism for children with attention disorders such as attention-deficit/hyperactivity disorder.
Government officials have started taking notice of the epidemic and are putting policies in place to enable children to have more exposure to nature. In February 2010, Secretary of the Interior Ken Salazar said, “Youth are the future conservation leaders in the United States of America.”
Here in Texas, the Texas Children in Nature Network has been busy collaborating with parents, educators, health professionals and community educators to help children get outside and connect with nature.
WIC staff can have a positive impact on motivating parents to get their kids outside and some have been able to see the results first-hand. At the South Austin WIC clinic, staff member Jessica Coll remembers a particularly inspiring comment from a 10-year-old child participating in the “Walk with WIC” program exclaiming “I feel energized after I walk outside compared to staying at home and playing video games.”
Tips for WIC staff to get clients outside
• Try planning a family road trip to one of the areas listed below or schedule weekly nature walks.
• Plan a family trip to one of Texas’ many natural areas or 90 state parks. Use the Texas Parks and Wildlife “find a park” feature: http://www.tpwd.state.tx.us/spdest/findadest/s
• Take advantage of the multitude of opportunities to experience the wonders of nature that are available in Texas.
In West Texas, experience a beautiful sunset or nature hike at Big Bend National Park.
In the South, check out the many beaches and parks.
When traveling east, visit the Pineywoods.
In the Northwest, visit Caprock Canyons State Park and Trailway to explore the canyonlands.
In the Rio Grande Valley, try Resaca de la Palma, Texas’ newest state park and unit of the World Birding Center network.
Here are more ways to help children connect with nature this spring and summer:
• Plant something.
• Reuse everyday household materials that would otherwise be thrown out to create a mural outside.
• Camp under the stars.
• Find a safe place to get some fresh air and explore nature.
• Meet park rangers at a nearby park and have them explain the local ecosystem.
• Visit your local farmer’s market.
“Kids who have contact with nature are happier, healthier and smarter.”www.naturerocks.org/
Playing in nature can positively impact children’s health and well-being. Let’s encourage parents to get their children out into the natural environment. Together we can teach them how to protect their health and the environment. Remind your clients that most activities in nature are free and help create a lasting bond between them and their children.
Last Child in the Woods, Saving our children from Nature Deficit Disorder, second edition, by Outdoor advocate Richard Louv, includes a user’s guide for parents and caregivers.
www.tpwd.state.tx.us/outdoorfamily - Texas Outdoor Family program
www.tpwd.state.tx.us/kids/ - Interactive website for kids with nature and wildlife-related games and activities
http://www.eeweek.org/suggested-reading - Environmental Education week, link to green reading for kids
www.neefusa.org/health/children_nature.htm - National Environmental Education Foundation
http://www.nwf.org/Kids/Ranger-Rick/Explore-MoreBook-Nook/Outside/Outdoor-Fun/The-Green-Hour.aspx - The Green Hour (book)
www.health.gov/PAGuidelines/guidelines/default.aspx - Physical Activity Guidelines for Americans
Houston Wilderness has an online map and their passport for children and families get stamped at participating sites
National Environmental Education Foundation, Fact Sheet: Children’s Health and Nature
Clinical Report on the importance of play for children http://aappolicy.aappublications.org/cgi/content/full/pediatrics;119/1/182
Council on Sports Medicine and Fitness and Council on School Health (2006). Pediatrics, 117(5):1834-1842.
Committee on Public Education (2001). Pediatrics, 107(2):423
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Project 71 Obesity Prevention Mini-Grant FY 2009 - Growing Meals: Cooking, Gardening and Making Memories with Your Children
by Alicia C. Davis R.D., L.D.
Nutrition Education Coordinator
With a goal of encouraging clients to prepare healthier family meals at home, Project 71 in Collin County held a series of classes during March, April and May of last year. Two classes were held monthly, each focusing on topics relating to changes in the WIC food packages, for a total of three classes in English and two in Spanish. Families with children ages 2 to 5 years old were the primary target, although all participants were invited to attend classes.
The focus of the first class emphasized consuming fruits and vegetables through cooking and gardening. Demonstrating three easy recipes helped achieve our goal of getting the children in the class more involved. Following class, participants enjoyed activities such as taste tests and a basic discussion on gardening. Vegetable seeds were planted in paper seedling pots that families made from newspaper strips. Incentives included potted seeds and kid-friendly egg separators from WIC to correspond with an omelet recipe and wooden paper pot makers from the Collin County Master Gardener’s Association.
The second class featured three easy recipes using whole grains. Activities included taste tests, identifying whole grain breads by reading labels, and planting more seeds. Incentives at this class included additional seeds and mini liquid measuring cups, which corresponded with a stir-fry recipe that was served with brown rice.
Low-fat cooking techniques were the focus of the third class. Three simple, kid-friendly recipes demonstrated techniques using herbs and spices and lower fat dairy products. The demonstration was followed by taste tests. Incentives included a basil plant that participants potted and a copy of the Let’s Cook! cookbook, which contained many of the recipes demonstrated in all three classes.
This project was primarily geared towards our WIC clients, but we also included a segment for WIC staff. At three staff meetings in the spring, recipes were taste-tested and we also discussed nutrition information that pertained to each of the client classes. This gave staff members a better idea about what we were trying to accomplish with the project, therefore allowing them to better promote client participation in the series. Additionally, it helped prepare staff for the upcoming food package changes.
One month prior to the first class, we started recruiting participants. This was primarily done through the Plano office, which was closest to the Recreation Center. A bilingual flier was given to participants; and the classes were advertised on a bulletin board. Staff members encouraged families to participate. Those participating signed up or called with their contact information. To confirm their registration, tickets were mailed to the 10 to 12 families for each class. Classes were not tied to benefit issuance since there was no way to issue benefits at the Recreation Center. Although certificates of attendance for class credit were given after each class and could be taken back to the clinic for benefits issuance.
• Participants will increase their consumption of vegetables by at least one serving a day.
• Participants will identify whole grains and increase their consumption by at least one serving a day.
• Participants will identify two low-fat cooking techniques or foods, and include these techniques or foods at home.
Resources, Materials and Staffing
We collaborated with three community resources to provide a fresh and interesting experience for our clients. The City of Plano Parks and Recreation Department arranged for the wonderfully equipped kitchen classroom at the Carpenter Park Recreation Center to be available for our classes. We also partnered with the Collin County AgriLife Extension Service for assistance in conducting cooking demonstrations and discussions in English. The County Extension Agent in Horticulture and volunteers from the Collin County Master Gardeners Association were invaluable in helping families with gardening activities and information. We also contracted with a local registered dietitian, fluent in Spanish, with prior experience working with the Texas WIC Program to present the classes in Spanish. The NE coordinator was responsible for planning each lesson, setting up, purchasing supplies, cleaning up, and facilitating the class.
Pre- and post-surveys were handed out before and after each class. Additional post-surveys were mailed out approximately three months later to class participants. Participants were asked to return their post-surveys to the WIC office either by mail or in person. Results from the returned post-surveys were then compared to the pre-surveys. Unfortunately, the response rate for the returned post-surveys at three months past the finished series was lower than hoped for, with an 18 percent response rate.
A total of 44 families attended at least part of the series, with 22 families making it to at least two classes and 11 families attending all three classes. Twenty families participated in the English classes and 24 participated in the Spanish classes. Out of the 11 families that attended all three classes, eight attended the Spanish classes. Participants were encouraged to bring their children and any other interested family members. As a result, we had many children, some spouses, grandparents and friends in attendance along with the primary parent or guardian.
Surveys for self reporting indicated an increase in the number and variety of fruits and vegetables consumed by adults and children.
• 80 percent of participants were able to identify at least two low-fat cooking methods.
• 40 percent of participants reported increased consumption of whole wheat bread.
• Overall participants’ responses were positive and parents enjoyed involving their children in the classes both in helping with cooking and gardening.
• Taste tests were a big hit, and children surprised their parents by trying new fruits and vegetables.
Post follow–up was a challenge.
Here’s positive feedback from participants:
“I love the tofu. I liked so much the recipes — bananas and yogurt were so delicious. I really love it. Thank you so much.”
“The change I plan to make is to have my kids smell the herbs and get them more interested with gardening and cooking.”
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Looking for 10 new dietetic interns!
by Mary Van Eck, M.S., R.D.
Director, Texas WIC Dietetic Internship
Applications for the next Texas WIC Dietetic Internship Program are being accepted now through July 1, 2010. Information and instructions on how to apply are located on the Texas WIC website at http://www.dshs.state.tx.us/wichd/nut/intern-intro.shtm.
Here’s everything you ever wanted to know about the Texas WIC Dietetic Internship.
How do I get into the internship?
• You need to be employed by one of the 73 Texas WIC local agencies.
• You will need your WIC Director’s permission to apply.
• You need to have graduated from an approved Didactic Program in Dietetics with a signed verification statement.
• The higher your GPA , the more likely you are to be accepted.
How do I apply?
• Go to the website, download and print all the documents.
• Set aside a large amount of time to complete the process. You will need at least three recommendation letters, a signed verification statement from your DPD program director, an application letter, transcripts from everywhere you attended college, and lots of other required paperwork.
• So, if you are planning on applying, check it out and start early!
What can I expect after I apply?
• Each year is different, but we are especially looking for applicants from underserved areas of the state. This year we have interns from Eagle Pass, Corpus Christi, Stephenville, Denton, Dallas, Houston, Waxahachie, and College Station.
• It is a increasingly competitive process. Last year we accepted 10 of 30 applicants.
• The higher your GPA, the better your chance of being accepted.
• Applicants who are accepted into the program are notified by the end of August.
What can I expect after I get accepted?
• Your paycheck the entire time you are in the internship!
• You will need to sign a contract with your agency stating that you will keep working for WIC at least two years past the end of the internship.
• You will need to get a number of documents in order, such as immunizations records, health insurance, liability insurance, ADA student membership and possibly drug and background testing.
• Although the internship does not officially start until January, you will be very busy starting in September! From September through December you will be doing a vast number of assignments with strict due dates. These assignments prepare you for the clinical portion of the internship. Of course, you will continue to work full time in your WIC clinic until January.
• The internship is full time for nine months. You will not be working in your WIC clinic during the internship period from January through September. Your agency will be given funds to hire a temporary replacement.
• Most of your rotations are completed in your community. There are some exceptions to this, depending on where you live and the availability of facilities and preceptors in your community. Occasionally an intern needs to relocate for part of the internship.
• You will become very familiar with Austin. Seminars of one to two weeks in length are required five times during the internship. You will find your own lodging during these seminars.
• You will complete 1300 hours of supervised experiences during the internship period, most likely in your community or near by. These consist of food service management at a school district, nutrition therapy at a hospital, pediatrics at a children’s hospital, and community rotation at various locations in your own community. You will also complete an intensive community nutrition intervention project. During all these rotations, you will finalize lots of assignments to complete your learning experience.
• You will graduate at the end of September!
• You will be featured on the cover of a famous magazine (Texas WIC News).
• You will pass the registration exam!
• You will get the new initials R.D. after your name!
More questions? Contact Mary Van Eck, M.S., R.D., L.D., , Texas WIC Dietetic Internship Director at firstname.lastname@example.org or 1-512-341-4510.
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test your nutrition IQ
by Eaton Wright, BS, NUT
Hello everybody! Now that my officemate, Matt Harrington, has a baby I want to do everything in my power to ensure he doesn’t mess it up so I came up with a test to help him out. Let’s get started with the Preventing a Picky-Eater quiz.
1. Stay determined and focused when introducing a new food. It may take ____ tries for a child to accept a new food.
c. 32- 42
2. True or False. Picky eating parents make for a picky eating child.
3. When it comes to family mealtime which word doesn’t fit?
f. How much
4. True or False. It’s ok to be a short-order cook for a child.
5. True or False. Restricting certain foods is a sure fire way to increase its appeal.
1. The answer is b. Be patient, but not 1000 times patient. If your child won’t eat liver after the 1000th try, you can be pretty sure that your energies would be better directed toward some other task, like brushing up on your algebra. Your child may need repeated exposure to a new food before he or she accepts the food. Encourage your child by talking about a food’s color, shape, aroma and texture and not whether it tastes good.
2. The answer is true. Parents who only eat chips, ice cream sandwiches and cheese burgers should not expect their child to eat broccoli, whole wheat bread and drink fat-free milk. What can a parent do to make mealtime less stressful? Eat meals with your child whenever possible. Let your child see you enjoying fruits, vegetables and whole grains at meals and snacks. Set a good example for physical activity, too. Walk, run, and play with your child rather than sitting in front of a screen.
3. The answer is d. When it comes to mealtime, no whining is allowed. Parents decide when the family will eat together, what foods will be served, and where the meal will be eaten. The child decides if they will eat and how much. Use this plan from the get-go and you’ll save yourself a lot of tears.
4. The answer is false. Preparing a separate meal for your child will only encourage picky eating habits. Eating habits won’t change immediately, but the small steps you take each day can help promote a lifetime of healthy eating.
5. The answer is true. Restricting certain foods will only increase the interest for that food. Help your child learn that healthy food like fruits and vegetables are “anytime” foods and that food like cake, chips, soda, and candy are “sometime” foods that can be eaten during weekly movie night or grandpa’s birthday party.
About the author: Eaton Wright is a certified NUT based in Austin, Texas.
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