HLTH 8573 Week 6 Child Nutrition Policy Analysis Example

Handed Off at a Birthday: A Policy Analysis of How WIC and the School Meal Programs Reach One Illustrative Child From Pregnancy to First Grade, and Who Falls Between Them

Student Name

Walden University

HLTH 8573: Child and Adolescent Health Issues

Instructor Name

Month Day, Year

Handed Off at a Birthday: A Policy Analysis of How WIC and the School Meal Programs Reach One Illustrative Child From Pregnancy to First Grade, and Who Falls Between Them

Introduction

Federal food policy for young children is not one program but a relay. The federal supplemental nutrition program for pregnant women, infants and young children, known as WIC, carries a child from before birth to the fifth birthday. The National School Lunch Program and School Breakfast Program pick the child up at school entry. Between them sit child care food programs and, since 2024, a summer benefit for school-age children. Each hand-off happens at an age written into law or regulation, not at a point defined by a child's development or a family's need. This analysis follows one illustrative child, Maya, from her mother's pregnancy to first grade and reads each program for whom it actually reaches at each birthday.

Pregnancy and Infancy: The Program Works as Written

Maya's mother enrolls in WIC during the second trimester. Her household income is under 185% of the federal poverty level, and because she is on Medicaid she is adjunctively eligible, which spares her separate income documentation. She receives a food package, nutrition education and referrals. Evidence on this stage is the strongest in the relay: Bitler and Currie (2005) found that WIC participation during pregnancy was associated with better birth outcomes among women whose characteristics suggested they were most in need, after accounting for many differences between participants and nonparticipants.

After Maya is born, the infant package supports breastfeeding or provides formula. Participation in the first year is high, partly because formula is costly and the benefit is easy to value.

Ages 1 to 4: The Same Program, Fewer Families

Maya remains eligible as a child until her fifth birthday, but the value of the package to her family changes. Formula ends at the first birthday, and the child package is smaller. Families must recertify periodically and attend appointments during working hours. Program evaluations have long noted that participation falls after infancy, even among children who remain eligible. The program's reach shrinks while its eligibility rule stays the same.

This matters because evidence suggests WIC helps beyond infancy. Kreider et al. (2016), using methods designed to address the fact that families who choose WIC differ from those who do not, found that WIC reduces food insecurity among eligible infants and children. Food insecurity in turn is associated with poorer health in children, including worse general health and higher rates of asthma and behavioral problems (Gundersen & Ziliak, 2015). A child who leaves WIC at 3 because the appointments became hard to keep may lose that protection two years early.

The food package itself has been revised to better match dietary guidance. A 2017 review recommended changes to increase the package's flexibility and appeal, partly to keep families enrolled (National Academies of Sciences, Engineering, and Medicine, 2017). Its recommendations show that program design, not only eligibility, governs who stays.

The Fifth Birthday: The Gap Statute Creates

Maya's fifth birthday falls in November. WIC eligibility ends that month. Her state sets kindergarten entry by age on the first of September, so she will not start kindergarten until the following August, nine months later. If she attended a public pre-kindergarten that participates in the school meal programs, or a child care center enrolled in the Child and Adult Care Food Program, she would continue to receive meals. Maya's mother works an evening shift and relies on a grandmother for child care, so neither applies.

For those nine months, the federal relay has dropped her. A child born in July, by contrast, leaves WIC and enters kindergarten within weeks. The difference between the two children is a birthday, not a need. Ralston et al. (2017) describe how USDA child nutrition programs, taken together, cover many but not all of the ages and settings where children eat, and the months between WIC and school are one of the clearest gaps.

School Entry: A Different Eligibility System

In kindergarten, Maya's eligibility is determined again, under different rules. Free meals are available to children in households at or below 130% of the poverty level, and reduced-price meals to those between 130% and 185%. Children in households receiving SNAP are directly certified without an application. If Maya's school participates in the Community Eligibility Provision, which allows schools with high shares of directly certified students to serve meals to all students at no charge, no application is needed at all.

The two programs use similar income limits but separate processes, so the family must prove eligibility twice, to two agencies, a year apart. The record of Maya's WIC participation does not travel with her.

First Grade and Summer

By first grade, Maya eats breakfast and lunch at school on school days. In summer, the Summer EBT program, launched nationally in 2024 in participating states, can provide a grocery benefit to school-age children who qualify for free or reduced-price meals. Children under school age are not its target. Maya's summer before kindergarten, which fell in her WIC gap, received no summer benefit at all.

Who the Relay Reaches

Table 1

Program Coverage for the Illustrative Child, by Age

Table summarizes the illustrative case; program rules vary by state where noted.

Recommendations

Three changes would close the gaps this analysis identifies. First, WIC eligibility for children could extend to kindergarten entry rather than the fifth birthday, so that the hand-off follows school entry rather than a birthday. Second, states could use WIC participation records for direct certification in the school meal programs, sparing families a second proof of eligibility. Third, WIC agencies could reduce the burden of recertification for children aged 1 to 4 through remote appointments, which would address the decline in participation where it begins.

Conclusion

Read as written, each program serves its intended population. Read through the life of one child, the relay shows gaps that no single program owns. The most important of them is created by the calendar: a child's fifth birthday ends one program months before the school year starts the next.

References

Bitler, M. P., & Currie, J. (2005). Does WIC work? The effects of WIC on pregnancy and birth outcomes. Journal of Policy Analysis and Management, 24(1), 73-91. https://doi.org/10.1002/pam.20070

Gundersen, C., & Ziliak, J. P. (2015). Food insecurity and health outcomes. Health Affairs, 34(11), 1830-1839. https://doi.org/10.1377/hlthaff.2015.0645

Kreider, B., Pepper, J. V., & Roy, M. (2016). Identifying the effects of WIC on food insecurity among infants and children. Southern Economic Journal, 82(4), 1106-1122. https://doi.org/10.1002/soej.12078

National Academies of Sciences, Engineering, and Medicine. (2017). Review of WIC food packages: Improving balance and choice: Final report. The National Academies Press. https://doi.org/10.17226/23655

Ralston, K., Treen, K., Coleman-Jensen, A., & Guthrie, J. (2017). Children's food security and USDA child nutrition programs (Economic Information Bulletin No. 174). U.S. Department of Agriculture, Economic Research Service.