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4-2Job Aid: Selecting Risks – InfantsSelecting the answers in Bold assigns the risk.*Indicates a mandatory question.Other column - Doc indicates additional documentation required when the risk isassigned; High indicates risk level and a referral to the WIC nutritionist.Clinical (Health History)Questions in TWISTAnswers in TWISTRisk AssignmentTopic –health and growthTell me about your baby’sType in responseNonehealth.*Does your baby have any YesMedical risks selected byhealth problems or medical Nocertifier from pop-upconcerns?How do you feel about yourType in responseNonebaby’s growth?Is your baby taking any357 - Drug Nutrient Yes, there are drugmedicine now?nutrient interactions Interaction Yes, but no knownnutritional impact NoTopic – immunizations*Are DTaP vaccines up to Yes, record reviewed Nonedate? No, record reviewed,referral made Unknown, no recordavailable, referral made Younger than 3 months,no screeningOtherHighHighDocEnvironmental (Health History)Questions in TWISTAnswers in TWISTTopic - smokingDoes anyone living in your Yeshousehold smoke inside the Nohome?Topic – mother’s history1 Oregon WIC Certifier Refresher, 2019 in-serviceRisk Assignment904 - Exposure toEnvironmental TobaccoOther
Questions in TWISTAnswers in TWISTRisk Assignment*Was the baby’s mom on Yes and baby is less701 - Infant Born to WICMom or WIC Eligible MomWIC during the pregnancy?than 6 months old No and baby is less than6 months old Baby is older than 6months UnknownIf the baby’s mother was Yes, and the baby is 701 - Infant Born to WICnot on WIC during herless than 6 months old, Mom or WIC Eligible Mompregnancy, did she havedocument in notesany risks during her Nopregnancy that would havequalified her for WIC?Was there any use of703 – Infant Born to Yesalcohol or drugs during this NoWoman with Alcohol orpregnancy?Drug Use during the mostRecent PregnancyTopic - safety*In the past six months, has Yes901 – Recipient of abusesomeone pushed, hit, Noslapped, kicked, choked or Unable to ask questionphysically hurt your baby?OtherDocHighDocDietary (Diet Assessment)Questions in TWISTTopic – breastfeeding*How are you feedingyour baby?*If fully breastfeeding:How often does yourbaby breastfeed in 24hours?If fully breastfeeding: Isyour baby breastfeedingas often as he/she wants?*If partiallybreastfeeding: How oftendoes your baby breastfeedin 24 hours?Answers in TWISTRisk Assignment None BreastfeedingPartially breastfeedingFormula feedingAppropriate for ageLess than 8 feedingsin 24 hours beforeage 2 monthsYesNo, scheduledfeedingsNumeric2 Oregon WIC Certifier Refresher, 2019 in-service411.7 -InfrequentBreastfeeding411.7 -InfrequentBreastfeedingNoneOther
Questions in TWIST*If formula feeding only:How long did youbreastfeed?*If partially breastfeedingor formula feeding, atwhat age did you startgiving formula to yourbaby?Topic – bottle feedingIf partially breastfeedingor formula feeding, howmuch formula does yourbaby drink each day?*If offering formula, howare you preparing theformula?If using a bottle, whatdoes your baby drinkfrom the bottle?Answers in TWIST Length of timeRisk AssignmentNone AgeNone NumericNone CorrectIncorrect411.6 – Incorrect Dilutionof FormulaDoc 411.1 – Use of Substitutesfor Breast Milk orFormulaDocIf using a bottle, whatbesides breastmilk orformula do you put in thebottle? Breastmilk and/orformulaSubstitute forformula or breastmilk (cow’s milk,goat’s milk, soybeverage)Breast milk, formulaor water onlyJuice or othersweetenedbeveragesInfant cerealBoth sweetenedbeveragesand cerealOtherNoYes411.2 – Inappropriate Useof Bottles and CupsDoc411.2 – Inappropriate Useof Bottles and CupsDoc If using a bottle, does your baby fall asleep with the bottle at nap orbedtime?If using a bottle at oneType in responseyear, what is your planfor weaning?Topic – feeding skills (younger infants)How can you tell when Recognizesyour baby is hungry orappropriate cuesfull? Does not recognizecues3 Oregon WIC Certifier Refresher, 2019 in-serviceOtherNone411.4 – InappropriateFeeding PracticesDoc
Questions in TWISTWhat is/was your plan forintroducing infant cerealand baby foods to yourbaby?At what age did you startoffering infant cereal andbaby foods to your baby?Answers in TWIST Appropriate for age Introduce early,before 6 monthsRisk Assignment411.3 – Early Introductionof Solid Foods 411.3 – Early Introductionof Solid Foods What baby foods haveyou offered? Appropriate for ageIntroduce early,before 6 monthsIntroduce late, after8 monthsAppropriate for ageInappropriate forageType in responseWhat is your plan forintroducing finger foods?What is your plan forType in responseintroducing a cup?Topic – feeding skills (older infants)How well does your baby Appropriate for agefeed himself/herself? No self feedingHow well does your baby Appropriate for ageuse a cup? No cup useWhat finger foods do you Appropriate for ageoffer your baby? Inappropriate forageTopic – food safetyHow do you handle and Appropriatestore expressed breast Inappropriatemilk or leftover formula?Does your baby eat Nohoney, undercooked meat Yesor drink unpasteurizedjuice?Topic – supplementsIs your baby receiving a Yesvitamin D supplement? No but drinks 1 quartof formula/day No UnknownIs your baby receiving Yes, fluoridated waterfluoride after age 6or fluoridemonths?supplements No UnknownTopic – food security4 Oregon WIC Certifier Refresher, 2019 in-service411.4 – InappropriateFeeding Practices411.4 – InappropriateFeeding PracticesOtherDocDocNoneNone411.4 – InappropriateFeeding Practices411.4 – InappropriateFeeding Practices411.4 – InappropriateFeeding PracticesDoc411.9 – ImproperHandling of Breast Milkor Formula411.5 – FeedingPotentially Harmful FoodsDoc411.11 – InadequateFluoride and Vitamin DSupplementation411.11 – InadequateFluoride and Vitamin DSupplementationDocDocDoc
Questions in TWISTIn the past few months,were there ever timeswhen your family ran lowon food?Screened and offeredinfant FVB?Answers in TWIST Yes NoRisk AssignmentNone NoneYesNo5 Oregon WIC Certifier Refresher, 2019 in-serviceOther
baby breastfeed in 24 hours? Appropriate for age Less than 8 feedings in 24 hours before age 2 months 411.7 -Infrequent Breastfeeding If fully breastfeeding: Is your baby breastfeeding as often as he/she wants? Yes No, scheduled feedings 411.7 -Infrequent Breastfeeding *If partially breastfeeding: How often does your baby breastfeed in 24 hours?
