The state Public Health Nurse Supervisor for the two county area stated that the voucher system employed WIC Program is an educational experience for the participants since they have to read labels in order to use them correctly, thus learning the difference between juice and juice drinks etc.

M. B. joined the WIC Program during her fourth month of pregnancy. Her diet was lacking adequate milk, vegetables and grains. She delivered an 8 lb. 4 oz. baby boy 11/24/74. She put the baby on whole milk, refusing to use high iron infant formula, thus making the baby ineligible for the program. By March the baby, fussy from birth, was having respiratory distress and diarrhea which led to hospitalization. By then M. B. was willing to try infant formula feeding which was initiated successfully. The baby has been improving since high iron infant formula feeding was initiated.

B. D. joined the WIC Program 6/18/74. She was breast feeding her baby who was under three weeks of age. The baby's birth weight was 7 lb. 8 oz. The mother's diet was limited. She was drinking no milk, eating no lunch, a reasonable supper and occasional poor quality snacks. She had not yet established breast feeding successfully, probably due to inadequate diet and fluids. With counseling and WIC foods, she has been successful in breast feeding. The baby appears healthy and well nourished and extremely alert. The mother's appearance and energy seem improved.

S. J., whose husband was a graduate student, joined the WIC Program 5/17/74. She was breast feeding the youngest of her three children, born 10/17/73. The mother was very thin and had been suffering from cold sores and red and swollen gums. The older child, born 4/14/72, had constipation and skin problems. S. J. was using what money was available to provide as nutritious a diet as possible. The diets lacked vegetables, whole milk, and her diet was almost completely devoid of milk. WIC foods enabled her to provide a more nutritious diet for herself and her family. Her health status had improved by the time her husband finished his studies. According to her, the WIC Program was their salvation at a crucial time in their childrens' growth.

G. K., born 6/4/72, was put on the WIC Program 6/24/74. Her diet consisted of sugared cereal, canned soups, canned spaghetti, no fruit or fruit juice, minimal protein and inadequate vegetables. Her mother had no money for milk, so was giving the child koolaid to drink. Nine months later the child's diet is much improved; she receives orange juice every day and milk with each meal; protein intake is improved and the nutritionally worthless foods have been removed from the diet. The mother states, "She has seemed to be growing more. She seems better natured from getting more nourishment." Her mother is able to buy more meats and vegetables with money saved by having WIC foods provided.

F. K. was an LPN, age 27. She had had four previous pregnancies: one miscarriage, one low birthweight baby, one who died prior to six months of age and one eight year old son with a birth defect. She had previously had toxemia of pregnancy. She was enrolled as a student in a diploma nursing program, scheduled to graduate and take the state board examinations about the time the baby was due. With the WIC foods and nutrition counseling the course of her pregnancy went well. She stayed healthy, attended all classes and passed her state board examinations just prior to delivery of a healthy 7 lb. 8 oz. baby girl. O. C., age 33 and pregnant for the fourth time was put on the WIC Program 7/5/74. Her diet was woefully inadequate; in a one day period her total intake was 4 glasses of water, 1 pepsi, 1 glass koolaid, 1 hamburger, 1 piece of pizza. The next day she had 3 glasses of water, 1 tuna sandwich, 1 serving of spaghetti and cookies. She was anemic, obese, and suffering from constipation and skin problems. She was eating poorly herself in an effort to reserve the nutritious foods available to the family for the other children. She was also attempting to regulate her weight by not eating at all; eventually she would become so hungry that she would eat whatever was handy, usually a high calorie food of no nutritional value. She was counseled about the nutritional vulnerability of her unborn child and taught that dieting for weight control during pregnancy was extremely dangerous. She was also taught that weight control would be an ever diminishing problem provided she ate the proper amounts of nutritious foods and avoided "empty calories". She delivered a healthy 8 lb. 5 oz. baby girl on 10/24/74. Since delivery much of her excess weight has been lost and she appears healthy and energetic.

DEPARTMENT OF HEALTH,

Attention: Mr. Charles Peck:

City of Bangor, Maine, April 2, 1975.

The Honorable Senator WILLIAM D. HATHAWAY,
Russell, Senate Office Building, Washington, D.C.

DEAR MR. PECK: Thank you very much for your recent phone call and your indication that Senator Hathaway may take special attention to the current plight of Senate Bill S 850; namey, that the U.S.D.A. Section 32 funding provision in this bill was "apparently" inadvertently deleted by members of the Education and Labor Committee, thus potentially lending "instant political unpopularity" to it.

Please convey our sincere thanks to the Senator for his strong support of WIC. Below are some details on the program. We are preparing more to follow shortly.

The Bangor Health Department has been involved in many Federally-supported programs over the years. Cooperating health and social service agencies in the area have too. I think it is safe to say, however, that we have never experienced a Federal program such as WIC, where so much good has been done for so many people in such a short time, with so little administrative overheaded. On April 1st, we were notified by the U.S.D.A. that a request for client load increase from 1,000 to 1,500 women, infants and children had been approved. The new allowances permit us to serve up to 360 women, 495 infants and 645 children. The funding proportions of the new allocation will be the same. Of a total budget of $225,500 to serve 1,000 clients (approved last November) 87% of these funds are expended on food. Only 10% is allowed for administrative costs. Although another worker must be added now to handle the increased client load, all of the work for processing of the 1,000 clients has been done by three fulltime individuals and a part-time dietary consultant. Only one of these workers presently grosses over $100 a week-the Supervisor-and she grosses less than $140. They are totally devoted and committed to the program, and in truth they have made it work. It is a singularly un-bureaucratic effort. Virtually all outreach and channeling from clients of distant parts of the project area to the clinic sites involve a good deal of added work on the part of agencies allied with WIC, such as Penquis CAP, Eastern Maine Medical Center, State Division of Public Health Nursing, Orono Nursing Service, Old Town/Milford/Bradley Nursing Service, and the City's own Division of Public Health Nursing. Their efforts have been strictly in kind services for which no reimbursements are made.

In March 1974, when we were notified of our immediate funding (with literally no forewarning) no service organization whatever existed. Through the efforts of allied agencies, the Health Department and Northeast Food Action, we hired a staff and had an organization by May with 233 recipients enrolled. By February of this year, 930 clients were enrolled logging roughly 50 to 60 client visits per day in two closet-sized offices furnished with four used desks, one loaned calculator, a second hand adding machine and a typewriter. It was not until January that the program got its own phone.

Something specific should be said about the dietary consultant for the program. She has been one of the principal and devoted figures. Mrs. Phyllis Williams. She combines the unique qualifications of nurse and dietary expert, and has written articles and a book on prenatal and early childhood nutrition. She gives a great deal of herself to the program and in coordinating the efforts with physicians and other health personnel.

The administration of the program is and will remain spartan, but processes by hand (and this must change to preserve the sanity of the staff) over $12,000 worth of food vouchers per month.

This then is one of two aspects of cost effectiveness; the daily operation of the program.

In terms of what the program is supposed to accomplish, its second measure, the outcome of pregnancy and program effectiveness on infant and toddler health has been reviewed.

Essentially and as FNS intended, pregnant women who have been on the program have had a lower incidence of low birth weight babies, compared with a non-WIC group from the same economic level.

In Penobscot County for example, the incidence of low birth weight babies for all economic groups is 8%. To women who were on the program three months

52-880 0-75- -20

or longer, 4.5% of the babies born weighed less than 5%1⁄2 pounds (the criteria for low birth weight).

To women who entered the program some time during the last trimester of pregnancy, 5.4% of the babies weighed less than 51⁄2 pounds.

A sampling of children born to a similar group before the program started, showed that 15% of the infants had a birth weight of less than 51⁄2 pounds

In processing families for WIC, we have been able to identify both nutritional and other problems and referrals are made.

The Public Health Nurse carry out follow-up on both state and local levels. In this way, WIC is serving as a catalyst for improvement in delivery of health care services.

Without the WIC program, it is known that the majority of non-breast fed infants would have been on whole milk or non-fat milk diets with accompanying problems.

Diets for toddlers have generally been high in starch and sweets and low in vegetables, meats and fruits. Although iron deficiency anemia has not been observed to be a major problem, some older infants and toddlers have been seriously affected. WIC foods and nutrition information along with referral and follow-up have been successful in combating those problems identified.

Two examples of these cases are outlined below:

Case: 13 months old child, weighing 16 pounds. Very pale, nervous, upper respiratory infection. Refused food, mother very distraught and concerned. Placed on WIC, referred for checkup with hemoglobin, hematocrit determinations. Taught how to approach feeding and increase iron intake. One month later, child weighed 20 pounds, eating well, no longer fussy. Hemoglobin and hematocrit increased to near normal from very low level.

Case Pregnant woman, aged 28, gravida 8, para 7. First infant weighed 8 pounds; subsequent infants all weighed less than 6 pounds. Had one set of twins, and two girls, all of whom died. All weighed less than 51⁄2 pounds at birth. Eating very poorly, little money for food because of alcoholic husband. Placed on WIC, instructed in importance of prenatal nutrition, followed up by Public Health Nurse. Baby weighed 7 pounds, 15 ounces at birth, 21 inches long.

The existing network of outreach feeding into the two clinic sites has produced a rapid build-up of caseload. It is fortunate that we have received the approval for caseload increase to 1,500, but this will do little good if the program is eliminated or so drastically cut in finances as to be worthless. Mrs. Williams has been doing superb work in individualized nutrition education. This is particualy true considering the limited resources available to her through the current program so that we hope that more education money can be made available through the bill.

We hope that at least as a beginning this will give you some indication of how the program is running. As indicated above, more information will be coming as it is put in presentable form. Thank you again for interest and support. Sincerely,

WILLIAM M. SHOOK, Jr.,
Director of Public Health.

NATIONAL PEANUT GROWER GROUP,
GEORGIA FARM BUREAU,
Macon, Ga., May 1, 1975.

Hon. JAMES B. ALLEN,

Chairman, Subcommittee on Agriculture Rescarch__and General Legislation, Senate Committee on Agriculture and Forestry, Russell Senate Office Building, Washington, D.C.

DEAR SIR: In behalf of the National Peanut Grower Group, I wish to strongly endorse and urge approval of S. 850 and other bills relating to the National School Lunch Program and Child Nutrition Act which currently are before the Subcommittee. The Peanut Grower Group represents some 80,000 peanut farm families in nine states.

We feel this legislation is urgently needed to continue the commodity distribution program past its June 30, 1975, expiration date and to strengthen the national school lunch program, certainly one of the most enlightened and worthwhile programs ever to be enacted by the Congress.

Indeed, the commodity distribution program performs an unique two-fold purpose that has far-reaching benefits to America. While helping to provide our

children and adequate diet based on wholesome, nutritious farm commodities such as milk, peanut butter and oil, beef and poultry products, etc., the distribution program also provides a means for government purchases of agriculture commodities in temporary surplus for donations. In this way, the commodity distribution program is an important tool for helping to maintain a measure of balance and stability in farm markets and farm prices. To abandon this valuable program, which has proved its worth and effectiveness over the years, would inflict a severe penalty on American farmers and American school children alike. Neither deserves such treatment.

That National Peanut Grower Group, while strongly urging continuation the commodities distribution program, also gives full support to the provision of S. 850 which would require that not less than 75 percent of the assistance provided under Section 6 of the National School Lunch Act be in the form of foods purchased by USDA. Indeed, we respectfully urge the Subcommittee and the full Committee to give careful consideration to raising the required level of purchased food even higher-perhaps to 100 percent.

The termination of the food distribution program to needy families and replacement of this assistance by food stamps drastically reduced available outlets for utilizing farm commodities in temporary surplus. It likewise reduced the capacity of the commodity distribution program to act as a stabilizer of farm markets and prices. We feel, therefore, that the school lunch program and the few other remaining distribution programs should be so structured as to operate more effectively as vehicles for channeling surplus commodities and food products into highly desirable donation uses. The school children of America would be the principal beneficiaries of such action.

Mr. Chairman, again we urge favorable action on S. 850 and related bills and ask that this statement be made a part of the hearing record.

Re S 850.

H. EMMETT REYNOLDS,

Chairman.

BISMARCK-MANDAN (N.D.) NUTRITION COUNCIL, INC.,
Bismarck, N. Dak., March 19, 1975.

The Honorable MILTON YOUNG,
United States Senate,
Washington, D.C.

DEAR SENATOR YOUNG: The Bismarck-Mandan Nutrition Council, Inc., is comprised of interested persons from various professional and community organizations. The principal purpose of this Council is to coordinate nutrition education and resources, and to promote good nutrition practices for citizens of all ages in the Bismarck-Mandan area.

The proposed drastic FY 1976 budget cut for Child Nutrition Programs has been brought to the attention of Council members. Realizing the potential effects of such a reduction to longstanding worthwhile programs and effective new programs such as the Supplemental Food Program for Women, Infants and Children (WIC), the Council has expressed their concern in the attached Resolution and request that this Resolution be submitted as testimony in committee hearings pertaining to S 850.

The Council would appreciate your support of legislation for continuation and expansion of these food assistance programs.

Sincerely,

DARLENE GHERING, President, Board of Directors (And six others).

Enclosure.

RESOLUTION

The FY 1976 proposed federal budget contains a block grant for child nutrition programs and reduces or eliminates such food assistance programs as: The Supplemental Food Program for Women, Infants and Children (WIC). Child Nutrition Programs, e. g. :

School Breakfasts.

School Lunch Reimbursements (Section 4).

Free and Reduced School Lunches.

Non-School Feeding (Child Day Care, Head Start, and Summer Feeding).

Commodity Foods.

Non-Food Assistance.

Special Milk Program.

Termination and/or reduction of these programs would create a health hazard to millions of children: be it

Resolved, That the Bismarck-Mandan (N.D.) Nutrition Council, Inc., support legislation for continuation, expansion and adequate funding of the above food assistance programs which are included in S 850

Mrs. HELEN LOVELL,

U.S. SENATE,

Washington, D.C., February 28, 1975.

Director, Nutrition Section, the Department of Health and Hospitals, The City and County of Denver, Denver, Colo.

DEAR HELEN: Thanks very much for your letter in opposition to the administration's sharp cutbacks in federal nutrition programs including the experimental "women, infants and children diet supplement program."

I fully agree with you and shall do everything in my power to prevent the proposal from taking effect. Enclosed for your information is a press release stating my position on the issue.

Meanwhile, because your letter is so well-stated, I am forwarding it to the Senate Agriculture Committee and the Senate Select Committee on Nutrition and Human Needs to be made part of the official record on the issue.

Thank you again for your helpful comments and for letting me know of your shared concern about this matter.

DEAR SENATOR HASKELL: The Denver Department of Health and Hospitals has participated in the USDA Commodity Supplemental Food Program since late 1969. This program was designated to provide highly nutritious foods to those groups considered most vulnerable to malnutrition, e.g., women during pregnancy and up to one year after and children under six years of age.

Last year an average of 6,659 women and children in Denver received foods monthly. However, food was issued to 7,920 patients in January, 1975. The increased case load is a reflection of the need created by current economic conditions. The estimated annual retail value of the food in 1974 was almost one million dollars and the key nutrient value was as follows: 104,417,735 mgs. protein, 29,346, 174 mgs. iron, 2,840,016 mgs. calcium, 5,153,682,900 IU vitamin A, and 276,743,896 mgs. vitamin C. These foods enabled many of these individuals and families to have optimum nutrition rather than mere existence or be malnourished.

We can certify eligible patients for supplemental foods who are in need of these foods for medical and health reasons and receive free or reduced cost health care. In 1974, 38 percent of the people actually receiving the food received food stamps. In addition, even for those who do receive food stamps, there is no increase in the food stamp allotment for the pregnant woman who has significant increase in her nutritional needs created by the demands of her unborn infant.

An infant who is malnourished in early life or who's mother is malnourished may have irreversible brain damage. The commodity supplemental food program is in the end less costly and certainly is more humane.

The government will get more for the dollar on a national procurement basis than many individuals can get from the dollar at the retail grocery store.