When Christina Wilder went grocery shopping at her neighborhood Walmart in February, she did not expect to see the shelves bare of the infant formula she fed her twins.
"I didn't realize what a state of panic was until that," Wilder said. "There was like a two-week period where my babies, and they [were] like 7 months old, I was forced to give them whole milk."
(Photo by Zach Cusson/Newsy)
Christina Wilder, 28, with three of her four kids, from left 3-month-old Cutter Dees and 1-year-old twins Penelope Wilder-Poe and Turner Wilder-Poe at their home in Paintsville, Kentucky. (Photo by Zach Cusson/Newsy)
To provide her babies the nutritious food they need to thrive, Wilder, 28, relies on the Special Supplemental Nutrition Program for Women, Infants, and Children, better known as WIC.
"I live off of WIC for the babies," Wilder said. "I live off of the government right now because I've not been able to work."
After spending her days hunting for formula, Wilder was relieved to find cans at a Walmart in a nearby town. But when she went to check out with her WIC card, the cashier stopped her because that Walmart was not a WIC-approved store.
"She said, 'Honey, if this is for WIC, then you can't purchase it with WIC.' And my jaw hit the floor," Wilder said. "I'm just like it's there, but it's out of reach."
The infant formula shortage has exposed multiple weaknesses in the WIC system. Families on the federal program can only use their benefits in person at select stores to buy formula, but the number of stores accepting WIC benefits has seen a decade of decline. What’s more, families on WIC are automatically at a disadvantage when they try to buy formula because they compete with customers who can buy online.
This has left Wilder and other WIC parents out of options to use their benefits for formula, which puts their babies at risk for malnutrition.
"It hurt my feelings and it made me equally as upset because these are my kids," Wilder said.
A Newsy analysis of U.S. Department of Agriculture data for all states and Washington, D.C., found between 2011 and 2020, the number of WIC-approved stores declined nationally by about 16%. During that time, more than half of counties across the United States lost at least one WIC-approved store.
In 2020, there were thousands of women living in poverty and potentially eligible for the federal program without access to a store accepting WIC benefits.
Wilder lives in Eastern Kentucky, a rural region that has seen one of the country’s largest percent decreases in WIC-approved stores. The 28 counties in this area of Kentucky with more than 1 in 4 women living in poverty had nearly half the number of WIC-approved stores they did in 2011.
Nationwide, urban and rural areas both saw decreases in WIC-approved stores, but rural counties were disproportionately affected.
"I think it's a very big problem. I think it's a problem almost regardless of what scale," said Allison Karpyn, a professor in the Department of Human Development and Family Sciences at the University of Delaware. "Whether or not it's larger grocery retailers that are no longer accepting WIC or ... it's corner stores that have closed down."
Some states do not track why stores voluntarily leave WIC, but Newsy spoke to more than a dozen store owners in multiple states about why they left the program. Some stopped accepting WIC benefits because they closed their doors, some saw a decrease in WIC customers, some saw a financial burden and others were tired of the paperwork and requirements.
Additionally, stores can be kicked off for violating the WIC program.
Federal law dictates how the program is run and sets minimum requirements for retailers. States can add requirements and have discretion over how stores are monitored and approved. The result is a regulatory maze.
"I think finding ways to streamline that process and make it easier for stores to stay on would be really helpful and that is action that USDA can take," said Brian Dittmeier, senior director of public policy for the National WIC Association, the nonprofit voice for state and local WIC agencies.
Waiting for WIC approval
In 2011, Estill County, Kentucky, had eight stores participating in the WIC program, but closures and changes in ownership have cut the number to one, the local Save-A-Lot.
Down the street from the Save-A-Lot, Irvine Stop & Shop has been waiting about a year for its WIC vendor application to be approved.
"We are the second-largest store in the whole town," said Kartik Aaryan, 30, who helps his brother, Sahil Parmar,32, manage the store. "If I get the WIC like people want us, all people want to come over here to get the products."
Before Aaryan’s brother bought the store at the start of the pandemic, it accepted WIC, but the store was kicked off the program because WIC authorization does not transfer to new owners. That meant they had to submit a new vendor application. Aaryan says most of his customers come in asking if they accept WIC.
"I'm living in the hope that I'm going to get the WIC," Aaryan said.
Kartik Aaryan, 30, shows Newsy investigative reporter Lori Jane Gliha the old WIC stickers he left on the shelves of Irvine Stop & Shop in Irvine, Kentucky. (Photo by Zach Cusson/Newsy)
An empty shelf with an old WIC program sticker at Irvine Stop & Shop in Irvine, Kentucky. (Photo by Zach Cusson/Newsy)
Meanwhile, the shelves of Irvine Stop & Shop still bear the remnants of the WIC program, because Aaryan left the stickers signaling which products are WIC-approved.
Newsy asked the Kentucky Cabinet for Health and Family Services, the agency that manages WIC vendor applications, why it's taken so long to process Irvine Stop & Shop’s application.
The state declined Newsy’s request for an interview and said it does not comment on specific vendor applications, but said it has been working with the store to "resolve issues associated with their application."
'Not the world's easiest program'
As for why Kentucky had one of the largest decreases of vendors, the state said some stores left the program when the payment technology was upgraded.
The Healthy, Hunger-Free Kids Act of 2010 gave USDA funding for states to upgrade from WIC paper vouchers to Electronic Benefits Transfer (EBT) cards.
An EBT card operates like a debit card and allows the WIC recipient to receive WIC benefits more directly. The move modernized parts of the program, making it easier for families to keep track of benefits and use them throughout the month.
Any store unable to accept EBT cards could not remain part of the WIC program.
"States did see declines in vendors as a result of the shift to EBT," Dittmeier said. "But a lot of steps were made to try and retain vendors as much as possible."
Dittmeier says some states provided stores with devices to exclusively process WIC EBT transactions and remain on the WIC program.
Researchers point to a lack of flexibility as another reason vendors are dropping WIC.
Karpyn, the University of Delaware professor,and a team combed through documents outlining WIC retailer requirements for all 50 states, Washington, D.C., tribes and territories.
One key finding is that 20 states and D.C. limited the number of WIC-approved stores.
"It all comes down to the number of WIC-approved stores that the state is willing to regulate," said Karpyn.
Map by Jared McGuirt, assistant professor, department of nutrition, University of North Carolina Greensboro, for the study "USDA Special Supplemental Nutrition Program for Women, Infants and Children (WIC) Vendor Criteria: An Examination of US Administrative Agency Variations."
"In all the conversations we've had with many states, it feels reasonable when you talk to them that they would be very concerned about the workload burden," Karpyn said. "That very easily translates into fewer stores because you just can't afford to get out to them as frequently as you need to and to get the paperwork that you need to prove that they are in compliance."
The program adds to the workload of the stores themselves, too.
Paul Throne, director of the Washington state WIC program, summed up the web of regulations this way: "WIC is not the world's easiest program to be a part of. You know, it has requirements, it has inspections. It has consequences if you fail an inspection."
One of the requirements is WIC-approved stores must carry a minimum amount of produce and a variety of healthy foods. This can limit which stores are eligible to be a part of the program.
Throne said this requirement is necessary to make sure families get proper nutrition but agrees the WIC program could use more flexibility.
"We have had some proposals out that are very interesting, such as allowing a formula-only store," said Throne. "That would greatly expand the number of places people could spend their WIC benefits. And we could even apply it to some other staples."
Many states already have a little bit more flexibility. Kentucky, for example, allows some pharmacies to be WIC vendors, but only for specialty formula.
After we started asking questions about the decline in stores accepting WIC, the USDA recommended that stateagencies evaluate access to WIC-approved stores.
Newsy asked the USDA if this was the first time it has made this recommendation to states; the department responded: "USDA conducts evaluations in an ongoing basis to ensure that the needs of WIC individuals are being met in their community. USDA also provides technical assistance to state agencies when they request it."
Desperate for online shopping
Many families Newsy spoke to remain frustrated with the program's restrictions, like the fact they can’t use their WIC benefits online.
"I can't go on the Walmart app and get some cans of formula and check out with my WIC card," said Katey Morgan, 33, a Michigan mom who relies on WIC.
WIC-approved stores can sometimes be the only store in an area with formula readily available to purchase for both WIC and non-WIC shoppers. Some of those stores offer online ordering and grocery store pickup, but those services aren't available for WIC.
The 2014 Farm Bill mandated the USDA to test the use of online Supplemental Nutrition Assistance Program (SNAP) transactions, formerly known as food stamps. In 2019 the agency began pilot studies that expanded throughout the pandemic as the need for online use grew. But WIC was left out of the online push.
"If you could use your WIC online, that would be a game changer," said Wilder, the mom of four from Kentucky. "Because you can find it online at some stores and you can't purchase it."
Throne, the WIC director in Washington state, said, "WIC is about to be 50 years old in 2024. In many ways, it's still operating on a 1974 model of how you issue benefits to people and how you make sure they're worthy or deserving of the benefits, and we need to modernize this program."
In 2021 the American Care Rescue Plan gave USDA $390 million to update WIC, providing funding to test online use of benefits. But some efforts to modernize WIC have hit technological hurdles.
In a statement a spokesperson for USDA said: "Our goal over the next several years is to modernize the WIC program so that many of these frustrations disappear — for both the store and the participant. We are exploring online shopping, as well as in-store experiences like mobile scanners to help identify eligible products."
Meanwhile, families remain desperate, searching for formula to feed their children.
Frustrated, and no relief in sight
"I'm frustrated because the first thing I have to do in the morning is now figure out how my daughter is going to eat," said Annika Hardy, 22, a first-time mom and WIC recipient in Mesa, Arizona. "I call CVS, they tell me they have formula. I say, 'OK, I'm going to come buy it with my WIC,' and then they're like, 'We don't accept WIC.' Are you serious?"
Annika Hardy, 22, and her 5-month-old daughter Wren Hartley McKinney in Mesa, Arizona. (Photo by: Annika Hardy)
Hardy is from one of nine families across the country Newsy spoke to about their daily struggles to buy formula with WIC benefits.
Some families were forced to change their baby's formula multiple times depending on what they were able to find on store shelves.
To ease the impact of the formula shortage on families who use WIC, the USDA granted a slew of temporary waivers. Some of the waivers, expiring on Jan. 31, 2023, allow families to buy other sizes and brands of formula instead of limiting purchases to the state-contracted brand. But none of the waivers expanded where families can use their benefits.
The shortage forced desperate families to make their own formula or ration and dilute the formula they could get, which led to increased hospitalizations.
Dr. Mark Corkins of the American Academy of Pediatrics Committee on Nutrition is also concerned about the long-term effects of the shortage on brain development and overall health of babies.
"It sets you up, if you're malnourished as an infant, to be heavy and have heart disease and those kinds of issues later on," Dr. Corkins said.
In Kentucky, Wilder’s twins turned 1 in October. They no longer depend on formula for nutrition. She now struggles to find formula and donated breastmilk for her new baby boy. When he was born in October, the hospital sent her home with a few bottles of infant formula.
"I was like, oh my gosh, here we go again," Wilder said. "It's almost like a game at this point, cat and mouse."
Learn more about the investigation's data methodology here.
