Feeding Infants in the Child and Adult Care Food Program (CACFP)

1
Feeding Infants in the Child and Adult Care Food
Program (CACFP)
Bureau of Nutrition Programs Services New
Hampshire State Department of Education March 23,
2015
2
Infant Feeding Evolves

• USDA issues a clarifying memorandum
• May 17, 2002
• CCCs and FDCHs participating in CACFP must
  offer program meals to all eligible children who
  are enrolled. Infants must be provided with
  access to meals.
• USDA issues a rule update
• April 28, 2003
• Non-food related costs associated with feeding
  infants are recognized by USDA. Reimbursement
  for meals containing only infant formula is
  allowed, whether supplied by caregiver or by the
  parent.

3
Obligation to Offer Infant Meals

• CACFP centers and homes must
  offer program meals to all eligible
  enrolled children
• a child whose parent or guardian has
  submitted to an institution a signed
  document which indicates that the
  child is enrolled for child care
• Must offer the infant a meal that complies with
  program requirements
• Parent/guardian may decline what is offered and
  supply the infants meals instead
• Key factor infant provided access to meals

Section 226.2 of CACFP regulations
Page 3-5
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Infant Meal Pattern

• Shows types and amounts of foods which meet CACFP
  requirements
• Three age groups each 4 months
• Meals are specified as a guideline only babies
  should be fed when they are hungry

Page 3-6
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Age of Baby by Month Birth 1 2 3 4 5 6 7 7 8 9 10 11 12
Age Grouping in Infant Meal Pattern Birth through 3 months Birth through 3 months Birth through 3 months Birth through 3 months 4 through 7 months 4 through 7 months 4 through 7 months 4 through 7 months 4 through 7 months 8 through 11 months 8 through 11 months 8 through 11 months 8 through 11 months 8 through 11 months
Sequence of Introducing Foods in the Infant Meal Pattern Breast Milk or Formula Breast Milk or Formula Breast Milk or Formula Breast Milk or Formula Infant Cereal Vegetables and/or Fruits Infant Cereal Vegetables and/or Fruits Infant Cereal Vegetables and/or Fruits Infant Cereal Vegetables and/or Fruits Infant Cereal Vegetables and/or Fruits Meat or Meat Alternates Crackers or Bread Fruit Juice (only in a cup) Meat or Meat Alternates Crackers or Bread Fruit Juice (only in a cup) Meat or Meat Alternates Crackers or Bread Fruit Juice (only in a cup) Meat or Meat Alternates Crackers or Bread Fruit Juice (only in a cup) Meat or Meat Alternates Crackers or Bread Fruit Juice (only in a cup)
Texture of Solid Foods Strained/Pureed (thin consistency for cereal) Strained/Pureed (thin consistency for cereal) Strained/Pureed (thin consistency for cereal) Strained/Pureed (thin consistency for cereal) Strained/Pureed (thin consistency for cereal) Strained/Pureed (thin consistency for cereal) Strained/Pureed (thin consistency for cereal) Strained/Pureed (thin consistency for cereal) Strained/Pureed (thin consistency for cereal)
Texture of Solid Foods Mashed Mashed Mashed Mashed Mashed Mashed Mashed
Texture of Solid Foods Ground/Finely Chopped Ground/Finely Chopped Ground/Finely Chopped Ground/Finely Chopped Ground/Finely Chopped
Texture of Solid Foods Chopped Chopped Chopped Chopped
Feeding Style Breastfeeding or Bottle Feeding Breastfeeding or Bottle Feeding Breastfeeding or Bottle Feeding Breastfeeding or Bottle Feeding Breastfeeding or Bottle Feeding Breastfeeding or Bottle Feeding Breastfeeding or Bottle Feeding Breastfeeding or Bottle Feeding Breastfeeding or Bottle Feeding Breastfeeding or Bottle Feeding Breastfeeding or Bottle Feeding Breastfeeding or Bottle Feeding Breastfeeding or Bottle Feeding Breastfeeding or Bottle Feeding
Feeding Style Spoon Feeding Spoon Feeding Spoon Feeding Spoon Feeding Spoon Feeding
Feeding Style Cup Feeding Cup Feeding Cup Feeding Cup Feeding Cup Feeding Cup Feeding Cup Feeding Cup Feeding Cup Feeding
Feeding Style Self Feeding/Finger Food Self Feeding/Finger Food Self Feeding/Finger Food Self Feeding/Finger Food Self Feeding/Finger Food
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Infant Meal Pattern Breakfast
Birth through 3 months 4 months through 7 months 8 months through 11 months
Breakfast 46 fluid ounces (fl. oz.) breast milk1, 2 or iron-fortified formula3, 4 48 fl. oz. breast milk1, 2 or iron-fortified formula3, 4   03 tablespoons (Tbsp.) iron-fortified dry infant cereal (optional)5 68 fl. oz. breast milk1, 2 or iron-fortified formula3   24 Tbsp. iron-fortified dry infant cereal6   14 Tbsp. fruit and/or vegetable6
Page 3-7
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Infant Meal Pattern Lunch
Birth through 3 months 4 months through 7 months 8 months through 11 months
Lunch or Supper 46 fluid ounces (fl. oz.) breast milk1, 2 or iron-fortified formula3, 4 48 fl. oz. breast milk1, 2 or iron-fortified formula3, 4   03 Tbsp. iron-fortified dry infant cereal (optional)5   0-3 Tbsp. fruit and/or vegetable (optional)5 68 fl. oz. breast milk1, 2 or iron-fortified formula3   24 Tbsp. iron-fortified dry infant cereal and/or 14 Tbsp. meat, fish, poultry, egg yolk or cooked dry beans or peas or ½2 oz. cheese or 14 oz. cottage cheese, cheese food or cheese spread6   14 Tbsp. fruit and/or vegetable6
Page 3-7
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Infant Meal Pattern Snack
Birth through 3 months 4 months through 7 months 8 months through 11 months
Snack 46 fluid ounces (fl. oz.) breast milk1, 2 or iron-fortified formula3, 4 48 fl. oz. breast milk1, 2 or iron-fortified formula3, 4   03 Tbsp. iron-fortified dry infant cereal (optional)5   0-3 Tbsp. fruit and/or vegetable (optional)5 24 fl. oz. breast milk1, 2 or iron-fortified formula3 or fruit juice7   0½ slice bread or 02 crackers8 (optional)6
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Meeting Infant Meal Pattern Requirements

• Birth through 7 months
• breast milk or iron-fortified infant formula is
  only required component at breakfast,
  lunch/supper and snack

Page 3-9
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Meeting Infant Meal Pattern Requirements

• Ages 4 through 7 months
• iron-fortified infant cereal is an optional
  component at breakfast
• both iron-fortified infant cereal and
  fruit/vegetable are optional components at
  lunch/supper

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Meeting Infant Meal Pattern Requirements

• Ages 8 through 11 months
• Breakfast must contain
• iron-fortified infant cereal
• fruit/vegetable
• breast milk or iron-fortified infant formula
• Lunch/supper must contain 3 components
• breast milk or iron-fortified infant formula
• vegetable/fruit
• iron-fortified infant cereal and/or one of the
  specified meat or meat alternates
• Snack
• must include breast milk or iron-fortified infant
  formula or 100 fruit juice
• may include bread or crackers as optional
  component

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Optional Components

• Optional components become required (and must be
  served by the center/home) when the infant is
  developmentally ready to accept them
• When optional components are required
• the center/home must provide at least one
  component
• a complete meal (all components the infant is
  developmentally ready to accept) must be supplied
  between parent-provided and facility-provided
  components

13
Documentation Requirements

• CACFP Infant Menu Forms
• Must keep posted menu
• simple or cycle
• Must keep daily dated records of all meals
  served to each infant enrolled in the CACFP
• Helps develop POS meal counts
• (in addition to enrollment attendance records)

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Posted Menu

• All centers and homes must develop a written
  infant menu
• Tool to communicate types of meals provided to
  Parents, Sponsors, State Agency
• Cycle or Simple
• As elaborate as a 4 week cycle
• As simple as identifying a house formula, house
  cereal, and other foods served.

15
Daily Dated Records of Meals Served

• Must keep dated daily records of all meals served
  to each infant enrolled in CACFP
• Provides record of meal components and meal
  counts for infants
• Sample menu form (not required,
• may choose to use or adapt)

16
Child and Adult Care Food Program Weekly Menu
for Infants Infants Name

Age
0 through 3 months 4 through 7 months 8 through 11 months Month and Day Year Month and Day Year Month and Day Year Month and Day Year Month and Day Year
0 through 3 months 4 through 7 months 8 through 11 months Monday Tuesday Wednesday Thursday Friday
Breakfast 4-6 oz. breast milk1, 2 or IFIF3, 4 4-8 oz. breast milk1, 2 or IFIF3,5 6-8 oz. breast milk1,2 or IFIF3, 7
Breakfast 0-3 Tbsp. iron-fortified dry infant cereal (optional)6 2-4 Tbsp. iron-fortified dry infant cereal7
Breakfast 1-4 Tbsp. fruit/vegetable7
AM Snack 4-6 oz. breast milk1, 2 or IFIF3, 4 4-6 oz. breast milk1, 2 or IFIF3, 4 2-4 oz. breast milk1, 2 or IFIF3, 5 or fruit juice8
AM Snack 0-½ slice bread or 0-2 crackers9 (optional)6
Lunch 4-6 oz. breast milk1, 2 or IFIF3, 4 4-8 oz. breast milk1, 2 or IFIF3,5 6-8 oz. breast milk1,2 or IFIF3, 7
Lunch 0-3 Tbsp. iron-fortified dry infant cereal (optional)6 2-4 Tbsp. iron-fortified dry infant cereal7 and/or 1-4 Tbsp. meat/meat alternate7,10
Lunch 0-3 Tbsp. fruit/vegetable (optional)6 1-4 Tbsp. fruit/vegetable7
PM Snack 4-6 oz. breast milk1, 2 or IFIF3, 4 4-6 oz. breast milk1, 2 or IFIF3, 4 2-4 oz. breast milk1, 2 or IFIF3, 5 or fruit juice8
PM Snack 0-½ slice bread or 0-2 crackers9 (optional)6
Supper 4-6 oz. breast milk1, 2 or IFIF3, 4 4-8 oz. breast milk1, 2 or IFIF3,5 6-8 oz. breast milk1,2 or IFIF3, 7
Supper 0-3 Tbsp. iron-fortified dry infant cereal (optional)6 2-4 Tbsp. iron-fortified dry infant cereal7 and/or 1-4 Tbsp. meat/meat alternate7,10
Supper 0-3 Tbsp. fruit/vegetable (optional)6 1-4 Tbsp. fruit/vegetable7
Parent Provided foods ___________________________
_____________________Parent Signature_____________
_______
17
In Obligation to Offer Infant Meals

• Key factor consistent polices equal access
• CACFP centers and homes must offer program meals
  to all eligible enrolled children
• Must offer the infant a meal that complies with
  program requirements
• Parent/guardian may decline what is offered and
  supply the infants meals instead

Section 226.2 of CACFP regulations
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Breast Milk

• Optimal food for babies
• USDA recommends breast milk
  in place of formula from birth
  through 11 months
• Minimum Quantities
• May initially offer less than the minimum
  required serving if
• infant does not regularly consume the specified
  amount and
• additional breast milk is offered if the infant
  is still hungry

Page 3-13
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Reimbursement for Meals Containing Only Breast
Milk

• May claim reimbursement of meals
  in which breast milk is the only
  required component
• Breakfast, lunch or supper and snack for ages
  birth through 7 months
• Snack for ages 8 through 11 months

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Transitioning from Breast Milk to Formula
(Infants under 12 months of age)

• Meals containing both breast milk and formula are
  reimbursable as long as the total number of
  ounces offered meets or exceeds the minimum
  required amount
• All other components must be provided

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Use of Breast Milk for
Babies Over 12 Months of Age

• Centers and day care homes may continue to serve
  babies their mothers milk as long as the mother
  is able and wishes to provide it
• Mothers can continue to provide breast milk for
  babies older than 12 months
• Breast milk is a substitute for cows milk in the
  CACFP Meal Pattern for Children

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Mothers Breastfeeding in
the Center or Day Care Home

• Birth through 3 months not reimbursable

Page 3-15
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Mothers Breastfeeding in
the Center or Day Care Home

• Breakfast and lunch/supper Mother breastfeeds 4
  through 7 month old who is developmentally ready
  for solid foods
• Meal is reimbursable if
• at least one other component is provided (paid
  for) by the center or day care home
• the infant receives a complete meal (all of the
  components that the child is developmentally
  ready to accept) between parent-provided and
  facility-provided components

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Mothers Breastfeeding in
the Center or Day Care Home

• Breakfast and lunch/supper Mother breastfeeds 8
  through 11 month old who is developmentally ready
  for solid foods
• Meal is reimbursable if
• the center or day care home pays for at least one
  component
• the infant receives a complete meal (all three
  components), between parent-provided and
  facility-provided components

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Mothers Breastfeeding in
the Center or Day Care Home

• Snack Mother breastfeeds 8 through 11 month old
  who is developmentally ready for solid foods
• Meal is only reimbursable if
• Infant is developmentally ready for bread or
  crackers
• the center or day care home serves bread or
  crackers

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Breastfeeding Scenarios
A mother comes in at lunch to breastfeed her
3-month-old infant.
Meal Pattern Lunch (Birth through 3 months) Parent Provides Center/Home Provides Reimbursable Meal?
46 fl. oz. breast milk or iron-fortified formula breast milk (mother breastfeeds the child)
No

• Breast milk or iron-fortified formula is the only
  required component for birth through 3 months, so
  the center/day care home has not incurred any
  expense for which reimbursement can be claimed

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Breastfeeding Scenarios
A 5-month-old infant is eating iron-fortified dry
infant cereal but is not yet eating baby food
fruits and vegetables. The mother comes in at
lunch to breastfeed and the center/day care home
supplies a serving of iron-fortified dry infant
cereal.
Meal Pattern Lunch (4 through 7 months) Parent Provides Center/Home Provides Reimbursable Meal?
48 fl. oz. breast milk or iron-fortified formula breast milk (mother breastfeeds the child)
03 Tbsp. iron-fortified dry infant cereal (optional) iron-fortified dry infant cereal
0-3 Tbsp. fruit and/or vegetable (optional)
Yes
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Breastfeeding Scenarios
A 5-month-old infant is eating iron-fortified dry
infant cereal but is not yet eating baby food
fruits and vegetables. The mother comes in at
lunch to breastfeed and the center/day care home
supplies a serving of iron-fortified dry infant
cereal.

• Center/day care home has provided at least one
  component (iron-fortified dry infant cereal)
• A complete meal has been served since the other
  required component (breast milk or iron-fortified
  infant formula) has been provided by the
  parent/guardian (optional components become
  required if infant is developmentally ready to
  accept them)
• Fruit/vegetable is still optional, since the
  infant is not yet developmentally ready

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Breastfeeding Scenarios
A 6-month-old infant is eating iron-fortified dry
infant cereal and baby food fruits and
vegetables. The mother comes in at lunch to
breastfeed and the center/day care home supplies
a serving of iron-fortified dry infant cereal.
Meal Pattern Lunch (4 through 7 months) Parent Provides Center/Home Provides Reimbursable Meal?
48 fl. oz. breast milk or iron-fortified formula breast milk (mother breastfeeds the child)
03 Tbsp. iron-fortified dry infant cereal (optional) iron-fortified dry infant cereal
0-3 Tbsp. fruit and/or vegetable (optional)
No
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Breastfeeding Scenarios
A 6-month-old infant is eating iron-fortified dry
infant cereal and baby food fruits and
vegetables. The mother comes in at lunch to
breastfeed and the center/day care home supplies
a serving of iron-fortified dry infant cereal.

• A complete meal (all three components) has not
  been served to the infant
• Since the infant is developmentally ready for
  both optional components, they are now required
• In order for this meal to be reimbursable, a
  fruit or vegetable must be provided by the
  center/day care home or, if they choose to, by
  the parents/guardians

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Breastfeeding Scenarios
A mother comes in at lunch to breastfeed her
10-month-old infant. She also supplies baby food
peaches, because she prefers a different brand
than the one purchased by the center/day care
home. The center/day care home supplies a
serving of cheese.
Meal Pattern Lunch (8 through 11 months) Parent Provides Center/Home Provides Reimbursable Meal?
68 fl. oz. breast milk or iron-fortified formula breast milk (mother breastfeeds the child)
24 Tbsp. iron-fortified dry infant cereal and/or 14 Tbsp. meat, fish, poultry, egg yolk or cooked dry beans or peas or ½2 oz. cheese or 1/8½ cup cottage cheese or 14 oz. cheese food or cheese spread cheese
14 Tbsp. fruit and/or vegetable peaches
Yes
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Breastfeeding Scenarios
A mother comes in at lunch to breastfeed her
10-month-old infant. She also supplies baby food
peaches, because she prefers a different brand
than the one purchased by the center/day care
home. The center/day care home supplies a
serving of cheese.

• Center/day care home has paid for at least one
  component (cheese)
• Infant has received a complete meal (all three
  required components), between parent-provided and
  facility-provided components

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Day Care Home Providers Breastfeeding their Own
Infant

• To claim meals served to the providers own
  child, the infant must be
• eligible for free and reduced price meals
• enrolled in the day care program
• participating in the program during the time of
  meal service
• At least one other nonresident child must also be
  enrolled in the day care program and
  participating in the meal service

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Center Staff Breastfeeding Their Own Infant

• Reimbursement may be claimed for meals when a
  center employee breastfeeds her own infant if
• mother is employee of child care center, e.g.,
  teacher, aide, administrative staff, food service
  worker, etc.
• mother has infant who is enrolled in the center

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Obligation to Offer Infant Formula

• Infant formula must always be offered
  in order to obtain CACFP reimbursement, unless
  infants mother provides breast milk
• Must offer at least one infant formula that meets
  CACFP requirements
• Strongly encouraged to select infant formula(s)
  which satisfies the needs of one or more infants
  
• Decision to decline the infant formula offered by
  the center or day care home rests with the
  parents or guardian

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CACFP Regulatory Definition of Infant Formula

• Any iron-fortified infant formula intended for
  dietary use solely as a source of food for
  normal, healthy infants served in liquid state at
  manufacturers recommended dilution
• OR
• A formula which does not meet the regulatory
  definition of infant formula but for which a
  medical statement has been provided

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Infant Formula

• Low-Iron Infant Formulas
• Follow-Up Formulas
• Exempt Infant Formulas
• Other Milks (not for babies less than 12 months)
• cows milk
• evaporated cows milk or home-prepared evaporated
  cows milk formula
• sweetened condensed milk
• goats milk
• soy milk (usually called soy beverage
• imitation milks, including those made from rice
  or nuts (such as almonds) or nondairy creamer

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Cows Milk for Infants 11 Months and Younger

• Cows milk is not a creditable component of CACFP
  infant meal pattern
• Meals containing whole cows milk in place of
  breast milk or iron-fortified formula are only
  reimbursable if authorized in writing by the
  infants doctor (medical statement)

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• Do not serve to babies or young children less
  than 2 years old
• fat-free (skim) milk
• reconstituted nonfat dry milk
• low-fat (1) milk
• reduced-fat (2)

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Crediting of Infant Formula
Provided by Parents

• Meals containing parent-provided infant formula
• may be claimed for reimbursement when
• a formula meeting CACFP requirements was offered
• the decision to decline the offered infant
  formula was made by the
  parents/guardian
• the center/day care home provides (pays for) at
  least one component of the
  infant meal when other components are required
• the infant receives a complete meal (all of
  the components that the
  child is developmentally
  ready to accept) between parent-provided and
  facility-provided components

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Crediting of Infant Formula
Provided by Parents

• A signed statement must be obtained from the
  parent/guardian if offered formula is declined

• Must be maintained on file
• Will be reviewed by Bureau of Nutrition Programs
  Services
• Day care home sponsors must maintain this
  documentation with day care home providers menu
  records

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Reimbursement for Meals Containing Only
Parent-Provided Formula

• Meals containing only parent-provided infant
• formula may be claimed for reimbursement when
• a formula meeting CACFP requirements was offered
• the decision to decline the offered infant
  formula was made by the parents/guardian
• the infant is not yet developmentally ready for
  any optional meal component(s)
• the meal is fed to the infant by center staff/day
  care provider

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Accepting/Rejecting Infant Formula in the Child
and Adult Care Food Program (CACFP)
This section to be competed by the center or day care provider.
Name of Center/Provider Infant formula
served by center/provider
This section to be completed by parent/guardian.
Name of Infant Name of Parent/Guardian ?
YES, I would like my child to receive the formula
indicated above. ? NO, I do not want my child to
receive the formula indicated above. I am
providing my own formula.
Formula provided by parent/guardian ___ The
infant formula provided must be one of the
formulas indicated on the Child Nutrition
Programs list. If another formula is provided, a
medical statement documenting the childs
required formula must be given to the
center/provider. Signature of Parent/Guardian Da
te
Page 3-33
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Feeding Infant Formula to
Children 12 Months and Older

• Over Age 1 CACFP Meal Pattern for Children
• Reimbursable during one month transition period
• 13 months of age and older meals containing
  infant formula are only reimbursable with medical
  statement
• Use only whole milk for transitioning infants

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Responsibility to Provide Solid Foods

• Center or day care home provider is responsible
  for purchasing solid foods and serving them to
  the infant if
• infant is developmentally ready
• parent/guardian requests that solid foods are
  served

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46
Once a child is dev ready to eat solid foods
there are two KEY POINTS.

• Meal is reimbursable if the baby is offered the
  minimum serving size of the required meal
  components
• The food does not have to be totally consumed by
  the baby for the meal to be reimbursable
• Meal is reimbursable if required meal components
  are offered to baby during course of day while
  baby is in child care
• If baby is not hungry for a meal component
  required at lunch, it can be offered as a snack
  when baby is hungry

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Readiness for Solid Foods

• Baby only requires breast milk for iron-fortified
  infant formula for first 4 to 6 months
• Decision to introduce solid foods in consultation
  with parents

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Readiness for Solid Foods

• Feeding Solids Too Early
• Avoid feeding solids before infant is
  developmentally ready
• Risk of choking
• Can develop food allergies or intolerance
• May consume less breast milk or formula and not
  get enough calories and other nutrients for
  proper growth and development
• Babies should never be fed bottles with added
  infant cereal

Page 3-49
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Readiness for Solid Foods

• Feeding Solids Too Late
• Delaying introduction of solid foods beyond the
  time when a baby is developmentally ready for
  them increases the risk that babies will
• not learn to eat solid foods properly
• become malnourished
• develop iron-deficiency anemia
• not grow normally

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Foods That Should Not Be Served

• Cows milk
• Common allergens chocolate, egg
  whites, whole eggs, honey and
  shellfish (shrimp, lobster, crab, crawfish,
  scallops, oysters, clams)
• Citrus fruits (e.g., orange, tangerine,
  grapefruit), pineapple or
  tomato juices or foods
• Shark, swordfish, king mackerel or
  tilefish
• Peanut butter, other nut or seed butters (e.g.,
  soy nut, almond, cashew or sunflower seed
  butter), nuts and seeds
• Honey
• Raw milk (e.g., raw cows or
  goats milk)
• Raw or undercooked eggs, meat, poultry or fish

• Home-canned foods
• Sweeteners (e.g., sugars, syrups)
• Sugar and fat
• Frankfurter rounds, popcorn, grapes, peanut
  butter or nuts
• Hard pieces of raw vegetables and fruits (except
  mashed ripe bananas)
• Home-prepared high-nitrate vegetables such as
  beets, carrots, collard greens, spinach and
  turnips
• Large amounts of high fiber foods, e.g., bran and
  raw vegetables,
• Artificially sweetened foods or beverages

Page 3-51 to 3-52
51
Introducing Solid Foods

• Start with infant rice cereal, then
• Oat and barley (one-week intervals)
• Single food strained vegetables and fruits
• Meats
• Breads
• Introduce one food at a time
• Communicate closely with parents
• Recommended that centers/homes obtain written
  instructions on introduction and feeding of foods
  from parent/guardian and babys doctor
• Centers/homes should provide daily information to
  parent/guardian on what and how much is eaten

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Claiming Reimbursement for Meals with
Parent-Provided Components

• Two Criteria
• Center/day care home must provide (pay for) at
  least one component of the infant meal -
  Exceptions
• center/home feeds expressed breast
  milk to an infant
• center/day care home feeds parent-provided
  formula to an infant who is not yet
  developmentally ready for any optional meal
  components

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Claiming Reimbursement for Meals with
Parent-Provided Components

• Two Criteria
• Infant must receive complete meal (all components
  the infant is developmentally ready to accept)
  between parent-provided and facility-provided
  components
• When optional components are listed, the number
  of other components that must be provided depends
  on what the infant is developmentally ready to
  accept

Page 3-56
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Claiming Reimbursement for Meals with
Parent-Provided Components

• For infants 8 through 11 months, breakfast and
  lunch/supper do not contain any optional
  components all 3 must be served
• If center/home provides at least one component
  and parent/guardian provides (by choice) all
  other required components, meal is reimbursable
• Food items provided by parent/guardian must meet
  criteria for creditable foods

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Parent-Provided Components Scenarios
A 7-month-old infant is eating infant cereal and
baby food fruits and vegetables. The parent has
chosen to decline the center/day care home
formula and provide her own. In addition, the
parent provides commercial baby food strained
peas for lunch. The center/day care home
supplies the iron-fortified infant cereal.
Meal Pattern Lunch (4 through 7 months) Parent Provides Center/Home Provides Reimbursable Meal?
48 fl. oz. breast milk or iron-fortified formula Iron-fortified formula
03 Tbsp. iron-fortified dry infant cereal (optional) iron-fortified dry infant cereal
0-3 Tbsp. fruit and/or vegetable (optional) strained peas
Yes

• Center/day care home has supplied at least one
  component
• Complete meal has been served since other
  required components have been provided by the
  parent

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Parent Provided Components Scenario
A 4-month-old infant consumes formula and has
begun to eat infant cereal, but is not yet ready
for fruits and vegetables. The infants parents
choose to provide both the iron-fortified infant
formula and the infant cereal.
Meal Pattern Lunch (4 through 7 months) Parent Provides Center/Home Provides Reimbursable Meal?
48 fl. oz. breast milk or iron-fortified formula Iron-fortified formula
03 Tbsp. iron-fortified dry infant cereal (optional) iron-fortified dry infant cereal
0-3 Tbsp. fruit and/or vegetable (optional)
No

• Center/day care home has not supplied at least
  one component
• Parents have supplied both components that the
  infant is developmentally ready to eat

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Parent-Provided Components Scenarios
The parents of an 11-month-old infant provide
commercial baby food prunes and strained chicken
for lunch. The center/day care home supplies the
iron-fortified infant formula.
Meal Pattern Lunch (8 through 11 months) Parent Provides Center/Home Provides Reimbursable Meal?
68 fl. oz. breast milk or iron-fortified formula iron-fortified formula
24 Tbsp. iron-fortified dry infant cereal and/or 14 Tbsp. meat, fish, poultry, egg yolk or cooked dry beans or peas or ½2 oz. cheese or 1/8½ cup cottage cheese or 14 oz. cheese food or cheese spread strained chicken
14 Tbsp. fruit and/or vegetable pureed prunes
Yes

• Center/day care home has supplied at least one
  component
• Parents have supplied other required components

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Parent-Provided Components Scenarios
The parent of an 8-month-old infant provides a
commercial baby food combination dinner for
lunch. The center/day care home supplies the
iron-fortified infant formula and baby
applesauce.
Meal Pattern Lunch (8 through 11 months) Parent Provides Center/Home Provides Reimbursable Meal?
68 fl. oz. breast milk or iron-fortified formula iron-fortified formula
24 Tbsp. iron-fortified dry infant cereal and/or 14 Tbsp. meat, fish, poultry, egg yolk or cooked dry beans or peas or ½2 oz. cheese or 1/8½ cup cottage cheese or 14 oz. cheese food or cheese spread strained chicken
14 Tbsp. fruit and/or vegetable applesauce
No

• Parent has provided a food item (baby food
  combination dinner) that does not meet criteria
  for meat or meat alternate
• A complete meal has not been provided since only
  2 of the 3 items are creditable foods

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Infant Cereal

• Any iron-fortified dry cereal specially
  formulated for and generally recognized as cereal
  for infants that is routinely mixed with breast
  milk or iron-fortified infant formula prior to
  consumption

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Infant Cereal

• Ages 4 through 7 months
• can be served as an optional component at
  breakfast and lunch/supper
• Ages 8 through 11 months
• must be served at breakfast
• can be served in addition to or instead of
  meat/meat alternate foods at lunch/supper

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Infant Cereal, continued

• Cereal in bottles
• Adult cereal
• Not recommended before 8-9 months
• Can be fed to older babies as
  additional foods (not creditable)

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Crediting Infant Cereal
Infant Cereal Infant Cereal
Creditable Noncreditable

1Mixed grain cereals should not be served until the baby has successfully tolerated each single grain cereal. Wheat cereal should not be served until babies are 8 or 9 months old, due to potential intolerances. 1Mixed grain cereals should not be served until the baby has successfully tolerated each single grain cereal. Wheat cereal should not be served until babies are 8 or 9 months old, due to potential intolerances.

• Any iron-fortified dry cereal specially
  formulated for and generally recognized as cereal
  for infants that is routinely mixed with breast
  milk or iron-fortified infant formula prior to
  consumption, including rice cereal, barley
  cereal, oat cereal1

• Iron-fortified dry infant cereals containing
  fruit
• Commercial jarred baby food cereals (wet not dry)
• Ready-to-eat breakfast cereal (cold dry) and
  breakfast cereals (cooked, e.g., oatmeal, farina,
  Wheatina, etc.)

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63
Crediting Commercial Baby Food Fruits and
Vegetables
Fruits and Vegetables Fruits and Vegetables
Creditable Noncreditable

• Commercial baby food fruits and vegetables which
  list fruit or vegetable as the first ingredient
• Commercial baby food fruits and vegetables which
  contain multiple fruits or multiple vegetables,
  and list fruit or vegetable as the first
  ingredient
• Baby food fruits and vegetables with modified
  food starch if water is not the first ingredient
• Full strength fruit juice (regular or infant),
  only at snack for infants 8 through 11 months of
  age

• Commercial baby food dinners which list fruit or
  vegetable as the first ingredient
• Commercial baby foods in the jarred cereal with
  fruit category
• Commercial baby foods in the dessert category
  (these generally have dessert or pudding as
  part of the product name on the front of the
  label) which list a fruit as the first ingredient
• Baby food fruits and vegetables with modified
  food starch if water is the first ingredient
• Vegetable juices
• Fruit juices with yogurt
• Baby food fruits and vegetables containing
  Docosahexaenoic Acid (DHA)

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Fruit Juice

• Must be full-strength fruit juice (regular or
  infant juice)
• May only be creditable at snack for infants ages
  8 through 11 months
• When purchasing fruit juice for infants
• Choose fruit juice containing or fortified with
  Vitamin C
• Choose only pasteurized fruit juice
• Avoid orange juice and grapefruit juice

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65
Crediting Commercial Baby Food Meats and Meat
Alternates
Meat and Meat Alternates Meat and Meat Alternates
Creditable Noncreditable

• Commercial plain strained baby food meats
  (including those with beef, chicken, turkey,
  lamb, veal and ham)
• Gerbers 2nd Foods? Meats baby food meat
  products, including Beef and Beef Gravy, Chicken
  and Chicken Gravy, Ham and Ham Gravy, Lamb and
  Lamb Gravy, Turkey and Turkey Gravy, and Veal and
  Veal Gravy. (May include additional ingredients
  such as corn starch and lemon juice concentrate)

• Commercial baby food combination dinners1
• Meat sticks or finger sticks
• Home-canned meats
• Commercial fish sticks, other commercial breaded
  or battered fish or seafood products, canned fish
  with bones, hot dogs, and sausages
• Yogurt
• Nuts, seeds and nut and/or seed butters

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66
Crediting Commercial Bread and Crackers
Bread and Crackers Bread and Crackers
Creditable Noncreditable

• Bread
• Breads (white, wheat, whole wheat, French,
  Italian, and similar breads, all without nuts,
  seeds or hard pieces of whole-grain kernels)
• Biscuits
• Bagels (made without nuts, seeds or hard pieces
  of whole-grain kernels)
• English Muffins
• Pita bread (white, wheat, whole wheat)
• Rolls (white, wheat, whole wheat, potato, all
  without nuts, seeds or hard pieces of whole-grain
  kernels)
• Soft tortillas (wheat or corn)

• Pancakes, waffles, or muffins made with whole
  eggs
• Hard pretzels, certain cookies, bread sticks,
  tortilla chips, granola bars, rice cakes
• Croutons, pieces of crunchy waffles, and many
  ready-to-eat breakfast cereals
• Doughnuts, cake and brownies

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Crediting Commercial Bread and Crackers
Bread and Crackers Bread and Crackers
Creditable Noncreditable

• Cracker-Type Products
• Crackers
• saltines or snack crackers without nuts, seeds or
  hard pieces of whole-grain kernels
• matzo crackers
• animal crackers
• graham crackers made without honey (honey, even
  possibly in baked goods, could contain
  Clostridium botulinum spores which can cause a
  type of serious foodborne illness in infants)
• Teething biscuits
• Zwieback

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Crediting Guide for Infant Foods

• Feeding Infants A Guide for Use in the Child
  Nutrition Program
• Assists sponsors in determining whether or not a
  food item is creditable

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Key Resources

• Special thanks to Susan Fiore, MS, RD and the
  Conneticutt State Department of Education,
  Bureau of Early Childhood, Family and Student
  Services for their assistance with this
  presentation.
• Feeding Infants A Guide for Use in the Child
  Nutrition Programs. USDA, Revised
  December 2001 www.fns.usda.gov/tn/Resources/f
  eeding_infants.html
• Bright Futures for Babies Three Appropriate
  Feeding Practices in Early Infancy.
  Susan Miller. 2000 www.nal.usda.gov/wicworks/Lea
  rning_Center/BF_babies.pdf
• Infant Nutrition and Feeding Resource List. Food
  and Nutrition Information
  Center, National Agricultural Library,
  U.S Department of Agriculture, September
  2001. www.nal.usda.gov/fnic/pubs/bibs/topics/pregn
  ancy/infnut.html

70
Key Resources, continued

• Team Nutrition http//www.fns.usda.gov/tn/
• The Child Care Nutrition Resource System
• http//www.nal.usda.gov/childcare/
• WIC Works Resource System http//www.nal.usda.gov
  /wicworks/
• National Food Service Management Institute
  (NFSMI) http//www.nal.usda.gov/fnic/
• Food and Nutrition Information Center (FNIC)
  http//www.nal.usda.gov/fnic

71
Questions?????
72
For more information
Resources
Help
Questions

• Carole Dennis Program Specialist II
• Bureau of Nutrition Programs Services
• New Hampshire State Department of Education
• [phone]