Screening for receipt of WIC benefits during pregnancy: feasible or illusory?

The US Department of Agriculture has contracted with the National Academy of Sciences to convene an expert panel to create and refine dietary criteria for entry into the Special Supplemental Food Program for Women, Infants and Children (WIC). This paper explores the technical requirements for successful screening under the assumption that the criterion for receipt of program benefits for pregnant women is the prevention of low birthweight. To succeed, the proposed screening program would have to: identify women likely to bear low birthweight infants, offer an intervention that can reverse low birthweight, and distinguish women who are likely to be responsive to the intervention from those who are not. It appears that these requirements are impossible to meet at this time, and it is unlikely they can be met in the foreseeable future. It is suggested that nutrition education may be a more appropriate application for dietary assessment, and that screening and education cannot optimally be done simultaneously.