Low WIC Food Redemption Linked to Higher Risk of Program Dropout

Longer participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program improves child diet quality, yet many families discontinue early.¹ A new Southern California study of 188,368 children finds that lower redemption of highly valued foods, including fruits, vegetables, eggs, and infant formula, significantly increases the risk of program dropout, especially among children under 2 years. Understanding these redemption patterns may help sustain WIC engagement and optimize child nutrition.

The retrospective cohort study is published in JAMA Network Open.

“This cohort study suggests that fruits and vegetables, eggs, infant formula, and whole milk are WIC participants’ most highly valued food benefits and that redemption patterns of these foods could assist in identifying children at risk for program discontinuation,” wrote the researchers of the study.

Rising grocery prices, particularly for healthy foods, are driving many Americans toward cheaper, ultraprocessed alternatives, raising concerns about diet quality and widening health disparities.² Surveys show most adults report higher food costs are affecting their diets, with lower-income and minority households disproportionately impacted.

This study analyzed WIC redemption and administrative data from November 11, 2019, to June 30, 2023, including 188,368 participants from birth to 3 years in Southern California.¹ Household-level redemption of WIC food benefit categories—such as fruits and vegetables, eggs, whole milk, cheese or tofu, 100% juice, legumes, canned fish, cereals, bread, yogurt, and infant formula—was averaged across certification periods and scaled in 10% increments.

The primary outcome was WIC program discontinuation, defined as failure to complete eligibility recertification within 12 months, operationalized as no food benefit issuance in the 2 months following certification expiration. The researchers examined associations between redemption rates and discontinuation risk, with analyses stratified by child age and conducted between May 22, 2024, and August 26, 2025.

In this study of 188,368 WIC participants, the foods most often redeemed were infant formula (86%), fruits and vegetables (70%), eggs (67%), and whole milk (61%). Children who redeemed smaller portions of these key foods were more likely to leave the program. For example, children who redeemed less than 10% of their fruits and vegetables benefits had a 2.08-fold higher risk of discontinuation (95% CI, 2.01-2.14).

Risk steadily decreased as redemption increased, with children redeeming 60% to less than 70% of benefits still showing a 24% higher dropout risk compared with those redeeming 70% to 100% of their benefits. Similar patterns were seen for formula, eggs, and milk, especially among children under age 2, highlighting the link between using key WIC foods and staying in the program.

However, the researchers noted the study had several limitations. First, its observational design prevented causal conclusions between WIC food redemption and program discontinuation. Second, the study period overlapped with the COVID-19 pandemic, during which supply chain disruptions and changes in shopping behavior may have influenced redemption patterns despite WIC’s brand and package flexibilities. Lastly, the study was conducted in urban Southern California, and the findings may not generalize to less urban areas, regions with fewer WIC vendors, or populations with different racial and ethnic compositions.

Despite these limitations, the researchers believe the study highlights how lower redemption of popular WIC foods may be associated with higher risk of program discontinuation.

“Identifying children at risk of WIC discontinuation is crucial for WIC retention efforts, which could be realized via targeted text messages to families with low or no redemption and/or tailored nutrition education addressing how to incorporate WIC foods into children’s diets for families with low redemption,” wrote the researchers.

References

1. Chaparro MP, Whaley SE, Anderson CE. Redemption of specific categories of WIC food benefits and risk of program discontinuation. JAMA Netw Open. 2025;8(12):e2546544. doi:10.1001/jamanetworkopen.2025.46544

2. Santoro C. The high cost of healthy: How grocery prices shape American diets and health. AJMC®. June 24, 2025. Accessed December 3, 2025. https://www.ajmc.com/view/the-high-cost-of-healthy-how-grocery-prices-shape-american-diets-and-health