Sir.—In his recent response1 to the report of Keating et al2 on water intoxication in infants in St Louis, Mo, Graham implies that the counseling provided by Special Supplemental Food Program for Women, Infants, and Children (WIC) nutritionists may be responsible for the striking increase in this serious syndrome. However, the article by Keating et al notes that the advice given by WIC nutritionists regarding water feedings has not changed since the program began in 1976; thus, such advice by itself could not account for the dramatic increase in water intoxication documented in their report.
Graham1 also states: "If many mothers 'presume that WIC provides everything the infant needs,' it is because the advocates and operators of the program have so implied." Yet, the Keating report notes that "The WIC workers emphasize the word supplemental in the program title, but they recognize that many mothers presume
MEYERS A, SARGENT JD. Water Intoxication and Women, Infants, and Children Program. Am J Dis Child. 1993;147(4):367-368. doi:10.1001/archpedi.1993.02160280017005