As the young mother of an infant who struggled to put on weight, Jasmine Jurado said doctors thought she was negligent.
She wasn't, but she needed help.
That's when Jurado, then 18, reached out to the Supplemental Nutrition Program for Women, Infants and Children. More commonly known as WIC, the program provides at-risk low-income pregnant people, postpartum people, infants, and children up to 5 with food, nutrition education, breastfeeding support, and health care referrals.
A lactation specialist soon arrived at Jurado's home in California. The specialist gave her breastfeeding classes, monitored how Jurado held the baby girl as she nursed and noticed that it had nothing to do with the mother. The child had a tied tongue, making it difficult for the infant to get the milk.
"It was like a relief to me when they told me that," said Jurado, noting: "The doctors had kind of made it seem like it was me."
That baby is 8 today and Jurado, now 26, has three more children, 4, 2, and an infant, also on WIC, making them part of the more than 6 million people in the program across the United States. But at this moment of increased economic uncertainty, food insecurity, and inflation at a near 40-year peak amid the COVID-19 pandemic, experts want to see more people turn to WIC.
Millions of eligible people do not participate in the program, which is mainly inflation-proof: Most food allowances, for example, are made by the size of the item as opposed to price. Many say outdated technology, stigma and parents' difficulty in getting to required health care checks remain as barriers.
"We hope that the number of people enrolled in WIC will continue to go up - not because we want to see the poverty increase, obviously, but because we know that there's a pretty large chunk of people who are eligible, or likely eligible, but not being served," said Sarah Diaz, policy and media coordinator at the California WIC Association - a nonprofit.
HOW WILL THE OBESITY EPIDEMIC END? With kids.
The Department of Agriculture, which has jurisdiction of the program, acknowledged the shortcomings of WIC's eligibility process in an interview with USA TODAY, adding that a "positive and improved customer experience" was among its goals.
"We want to make it as great experience from the moment someone has contact with the program through using the benefits and, hopefully, through their child continuing in the program until age 5," said Rebecca Piazza, senior advisor for delivery in the office of the under secretary for the food, nutrition and consumer services.
In 2019, 57% of people eligible to join the program did so, though enrollment in WIC has declined since at least 2010.
From February 2020 to February 2021, total participation in the program is projected to have increased by about 2%, while Supplemental Nutrition Assistance Program (SNAP) benefits and Medicaid benefits rose 14% and 16%, respectively, according to an early analysis from the Center on Budget and Policy Priorities, a nonpartisan research and policy institute.
WIC providers reported an projected 10% uptick in child participation from Feburary 2020 to October 2021, according to the National WIC Association - a nonprofit.
It is unclear whether those gains can be attributed to more people signing up because of economic hardship or whether the WIC eligibility gap is truly closing.
Since the onset of the pandemic, WIC has added telehealth, remote benefit issuance and other advances that advocates hope will spur more significant engagement. WIC has also increased the subsidy for the purchase of vegetables, said Brian Dittmeier of the National WIC Association.
Nearly 30 states, including California and North Carolina, have seen significant upticks in the number of people signing up, according to the nonprofit Food Research & Action Center. In contrast, the remaining states - such as Georgia, Pennsylvania, and Oklahoma - have seen declines.
Who qualifies for WIC?
To be eligible for WIC, a recipient must make at or below 185% of the federal poverty line, about $25,000 for a single parent or approximately $50,000 for a family of four. Other applicants may be able to enter the program through SNAP, Medicaid or Temporary Assistance for Needy Families (TANF).
There's also a large body of research linking WIC participation to lower levels of childhood obesity and food insecurity, as well as increased birth weight and Medicaid savings.
But nutritionists, policy experts and WIC advocates say the reason more people are not part of the program is varied, hampered by the slow rollout of technology for participants who are primarily tech-savvy millennials, the stigma associated with using the program and other factors.
Geri Henchy, director of nutrition policy at the Food Research & Action Center, said WIC could play a more prominent role by being more accessible and in more places.
"We need to promote benefits issuance and adult services and we need to make sure that everyone feels like they can fit WIC within their life," Henchy said.
Among the WIC barriers, experts and parents say:
Transportation to and from WIC offices for weight check-ins and other health updates can be challenging, particularly for parents who can't get off work.
The number of people eligible for the program tends to slump as children grow out of the often-expensive formula stage; there is less financial incentive to be part of the program.
Some stores do not accept WIC but do take SNAP, seeing the former as less labor intensive.
Experts also point to the stigma associated with using WIC.
Many undocumented immigrants believe that being part of the program could derail their prospects of gaining residency status. Others feel that some shoppers and grocery workers glare at them when using WIC.
Some places only recently moved from paper coupons to EBT cards, making checkouts more discreet.
Nicole Santos, a mother of three in Los Angeles, said shopping with WIC can be tricky.
The store catered toward WIC recipients doesn't often have a wide selection. The grocery open to the general population, meanwhile, often does not correctly label WIC-accepted items and that confusion can sometimes lead to frustration at the checkout line, she said.
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"So then it's like you either get out of line and go back to the store, go back shopping, or just forget about it," Santos told USA TODAY. "And a lot of the times after shopping for an hour or two already with kids, you just kind of forget about it and there's really no help in the stores."
But for Santos, who does delivery for Uber and DoorDash, the inconvenience of shopping in a store is still worth the $50 to 80 she can save through the program.
"Some people, they go for it. Some people don't," she said. "But I always tell people that I'm on WIC."
How COVID changed WIC for the better
In many ways, the pandemic pushed WIC toward modernization. Gone were many opportunities to meet for in-person health checkups amid fears of spreading COVID-19. Telehealth appointments and phone calls would have to do.
Now, food delivery is shaping up to be a focus, according to the USDA.
Piazza said the pandemic accelerated the pace of technology already being piloted by the USDA.
"So while the pandemic was a challenge, it was a powerful learning opportunity and WIC is working to build on and expand on those efforts that were successful," Piazza said.
Much of this innovation happened because Congress issued waivers during the pandemic to allow for increased use of technology. That could go away 90 days after the end of the national public health emergency, currently set to end in mid-October.
Still, USDA officials said they remain confident that the innovation will continue.
The Biden administration has helped, too, allocating $880 million for WIC in 2021, including $490 million earmarked for increasing benefits to purchase fruit and vegetables.
The remaining money was set aside for WIC outreach and modernization, including improvements to technological infrastructure and innovation through 2024, according to a report called Wiring WIC.
WIC is now 'just as fast as a debit card'
When food supplies dwindled on shelves during the pandemic, Cheryl Wells, 37, and her family were forced to make tough decisions.
The type of milk she could purchase under WIC was not in stock, Wells said. Eggs were challenging to find, too.
"There were definitely a lot of times where it was like, 'OK, we're going to have to choose between not eating certain foods and making up for them in our budget,'" she said.
Typically, Wells, her husband and their seven children ranging from 19 to 2 can subsist on their 99-acre farm in Northern California. The farm has livestock, plus a variety of fruit and vegetables.
Although Wells works as a nurse and her husband works in the school system, the size of their family allows them to qualify for WIC benefits and saves them up to $200 a month.
But for a few months out of the year, the goats need to build back their milk reserves and crops are out of season. That's when WIC is most crucial.
"We're still the same as everybody else, living paycheck to paycheck and sometimes there was extra room in the budget that we could afford to go to Costco and get milk and sometimes there wasn't," Wells told USA TODAY. "And on the weeks that there wasn't, and it wasn't available on the store shelves, then we would just not be able to get it."
And, by the time she gets to the checkout, Wells said, there's often another hurdle: The stigma of WIC.
"If I pull out my WIC card, and that's what I'm using to pay, I can feel the look of disgust from the cashier, from the person in line behind me," she said. "I'm always apologizing - even though it's a streamlined process now and it works just as fast as a debit card."
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Still, Wells believes WIC is worthwhile. She particularly likes the checkups to ensure children remain in good health and is glad more vegetables are now covered under WIC.
When she told a friend who would likely qualify for WIC to apply, she remembered the hesitation. They didn't want to accept money from the government.
"I still feel like there's a lot of judgment, stigma, guilt, shame attached to getting help," Wells said, adding: "But nobody's talking about the programs the way that I think they should be."
This article originally appeared on USA TODAY: Inflation, baby formula shortage: Why aren't more people using WIC?