At a grocery store at 183 Street on the Grand Concourse (left and upper right) and at a New York City GreenMarket (lower right) in the Fordham section of the Bronx, WIC moms can redeem vouchers for specific foods they need to raise healthy kids.

The waiting room on the first floor of St. Barnabas Hospital’s ambulatory care unit was a dizzying maze of strollers, wobbly toddlers and weary-eyed moms spread out along the theater-style rows of cracked vinyl chairs.

First-time mother Nancy Jilah and her 18-month old daughter waited in the clamor one October morning for their wellness check up in the state-subsidized clinic at Third Avenue and 183rd Street. Jilah’s toddler was having trouble keeping her milk down.

This WIC clinic has embraced the new transformation of the 38-year-old federal program from simply attacking hunger, to providing healthy eating choices for low-income Women, Infants and Children.  The policy change took place two years ago.

Above the rows of chairs, the clipboards, the Dora the Explorer dolls, the din of playing children, hung a cheerful plastic banner with an apple and a determined message: “New York State WIC. Together Growing Stronger Families.“

That’s the promise of this new WIC program. Nutrition experts and nurses are expected to work with pregnant moms until their children turn five-years-old, offering individualized dietary advice and vouchers for free food such as brown rice and fresh vegetables, and any specialty items they might need.

The question is now, how is it working? Politicians, nutritionists and public health advocates are all rushing to develop metrics to monitor progress and define success.  Early evidence points to some positive results.

“In comparison to before the roll out of the new program in January 2009, there is a reduction in total TV hours, an increase in low-fat milk consumption and an increase in the intake of fresh fruits and vegetables,” said Dr. Sally Findley, professor at Columbia University’s Mailman School of Public Health. Findley has been following the WIC program for over three years to see how recent program changes are affecting the mothers and their children.

For Jilah, the program was a godsend. A nurse took a blood sample and weighed the 28-year-old mother and her daughter. The nutritionist told Jilah her daughter may have inherited her lactose intolerance condition. That’s why the baby was throwing up her milk. The nurse gave Jilah a voucher to use at the grocery store specifically for lactose-free milk.

“It’s more expensive, you know. So it’s great that they can help with that,” said Jilah as she pushed her daughter along in the stroller on the way to the store. “But they say we’re healthy so that’s good news.”

A single mother, or mother-to-be, qualifies for WIC if she makes less than $22,340 a year. Two parent households qualify if they bring in less than $30,260 a year. In 2011, the average New York State WIC participant received $57.24 in monthly benefits from the program.

Much of value of the WIC program is in the nutritional advice and support it provides to mothers, but there are also sizable benefits in the form of foods and free vitamins that many low-income mothers could not afford without the program.

“They are very informative,” said Jilah. “Whatever I say, the nutritionists are ok with it.”

Raising healthy kids is the key for WIC. The program was started in 1974 after physicians reported that low-income mothers and their children complained of not having enough food during routine public health clinic visits. In response, the federal government began attaching food pantries to public health clinics. The goal of WIC when it began was to fight hunger and to improve birth outcomes among low-income mothers.

By the 2000’s, the needs of low-income mothers had changed. Now the main concern of WIC mothers was the type of food they could find–and afford–to feed their children.

One still unanswered question is whether the program may have an effect on early childhood obesity rates in New York.  “Healthy eating goes a long way to combating obesity,” said Marci Natale, spokeswoman for the New York State Department of Health. Still, she cautioned against defining the program’s success too narrowly. “The primary goal is health,” she said.

WIC’s newest offering, the Farmers’ Market Nutrition program, subtly strikes at the increasingly dangerous issue of obesity. The farmers’ market program focuses on providing mothers and young children with access to locally grown fruits and vegetables. The program also strives to educate mothers on the value of cooking with fresh produce.

Most mothers become involved with WIC when they are pregnant or nursing. The Farmers’ Market Nutrition program extends the options women have through consultation with a nutritionist and it helps mothers think about healthy eating options when they are shopping for themselves.

The fresh and local produce element of WIC services has received some marketing assistance from the work of First Lady Michelle Obama through her Let’s Move! campaign.  Food writers like Michael Pollan and New York Times columnist Mark Bittman, and chefs Alice Waters and Peter Hoffman, have also helped to raise public awareness of the importance of providing low-income families with easy access to healthy, affordable food.

Their advocacy is contributing to some results (although many other factors are involved). In 1997, New York City had 27 Greenmarket locations. Today, there are 54 Greenmarkets in New York City, with 11 locations across the Bronx.

All of these programs accept the $24 WIC vouchers issued the New York State WIC Farmers’ Market Nutrition program. The vouchers can be used anytime during the farmers’ market season at approved markets. Purchases made with WIC Farmers’ Market vouchers are largely restricted to fresh fruits and vegetables.

Many nutritionists and public health advocates hope WIC’s new health and wellness focus will have a positive impact on some of the health concerns that plague low-income communities.

Dr. Findley and a team of researchers from the New York State Department of Health are conducting extended surveys around the state and completing a series of focus groups to try to determine what is, and what is not, working with the new WIC program. The results of Dr. Findley’s work will be completed and submitted for publication sometime early next year.

In the Bronx, the new WIC program results are in for at least one mom. Nancy Jilah depends on WIC to help her understand nutrition labels, address food allergies, and develop healthy eating habits.  “I’m happy it’s here,” said Jilah. “I don’t know all this stuff so the nutritionist helps a lot with putting us, you know, on the right track.”