Title: Infant Meals Component of the Child and Adult Care Food Program -CACFP
1Infant Meals Component of the Child and Adult
Care Food Program -CACFP
- Ann-Marie Martin
- CACFP Coordinator
- Alaska Department of Education Early
Development
2Definition of Infant in the CACFP
Birth through 11 Months
Up to the childs first birthday
3Infant Meals
- CACFP Centers/Providers caring for infants must
offer meals to them
All centers/providers must offer iron-fortified
formula to infants under one year of age
4To claim infant meals for reimbursement
- To Claim Reimbursement for Infant Meals
- Parents complete CACFP Enrollment form that
includes infant section or complete an Infant
Formula/Feeding Selection form - Include infants in your One Month Enrollment
Report (OMER) - Follow the CACFP Infant Meal Pattern
- Take point of service meal counts
- Maintain Infant Menus/Meal Count records
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7- One Month Enrollment Report (OMER
- Infants must be listed on the Centers One Month
Enrollment Report (OMER) that is completed each
year
Center administrators complete the OMER annually
for documenting family income which is directly
associated with reimbursement for the center. For
more information on completing the OMER please
contact EED.
8 USDA Infant Meal Pattern
- Meal pattern is grouped into three age
categories -
- birth-3 mo
- 4-7 mo
- 8-11 mo
9Required Components
- May offer either
- Breast Milk and/or
- Iron-fortified Infant Formula (IFIF)
- Solids when infants are developmentally ready
- 4-7 months optional (only if not developmentally
ready) - 8-11 months required
10- Must provide at least one infant formula
- Parents may decline infant formula
- Bring their own iron-fortified infant formula
- Bring their own pumped breast milk
11When parents provide non-creditable infant
formulas
- Provide a Specialty Formula
- That does not meet CACFP Requirements
- Need
- Signed Medical Statement
- Diagnosis must be identified and authorized
Example Low-iron formulas lt1 mg iron per 100
kcals
12Breast Milk
- Credited the same as formula
- Chapter 3 provides
information on handling breast milk
13CACFP Infant Meal Pattern
Age Breakfast Lunch and Supper Snack
Birth through 3 months 4-6 fluid ounces formula1 and/or breast milk 4-6 fluid ounces formula1 and/or breast milk 4-6 fluid ounces formula1 and/or breast milk
4 through 7 months 4-8 fluid ounces formula1 and/or breast milk 0-3 Tbsp infant cereal2 (ready) 4-8 fluid ounces formula1 and/or breast milk 0-3 Tbsp infant cereal2 (ready) 0-3 Tbsp fruit and/or vegetable (ready) 4-6 fluid ounces formula1 and/or breast milk
8 through 11 months 6-8 fluid ounces formula1 and/or breast milk and 2-4 Tbsp infant cereal2 and 1-4 Tbsp fruit and/or vegetable 6-8 fluid ounces formula1 and/or breast milk and 2-4 Tbsp infant cereal2 and/or 1-4 Tbsp lean meat, fish, poultry, egg yolk, cooked dry beans or cooked dry peas5 or ½-2 ounces (weight) cheese or 1-4 ounces (volume) cottage cheese or 1-4 ounces (weight) of cheese food or cheese spread and 1-4 Tbsp fruit and/or vegetable 2-4 fluid ounces formula1 and/or breast milk or fruit juice3 0 to ½ slice of crusty bread4 (optional) or 0 to 2 crackers4 (optional)
14Birth through 3 months
Breakfast Lunch or Supper Snack
Breast Milk or 4-6 oz Formula Breast Milk or 4-6 oz Formula Breast Milk or 4-6 oz Formula
- Required at all meals and snacks
- Iron-fortified formula and/or
- Breast milk
- OK to offer less than the minimum amount of
breast milk
15Reimbursable meals forBirth through 3 months
- Center provided formula
- Parent provided breast milk
- Parent provided formula
- Staff mother breast feeding during work hours
(not on break) - Only exception is when visiting mother
(non-staff) breastfeeds infant (not reimbursable)
164 through 7 months
Breakfast Lunch or Supper Snack
Breast Milk or 4-8 oz. Formula Breast Milk or 4-8 oz. Formula Breast Milk or 4-6 oz. Formula
0-3 Tbsp. Infant Cereal 0-3 Tbsp. Infant Cereal
0-3 Tbsp. Fruit and/or Vegetable
- Required at all meals and snacks
- Iron-fortified formula and/or
- Breast milk
- Solid foods when developmentally ready
17Reimbursable meals for4 through 7 month olds
- Center provided formula
- Parent provided formula
- Parent provided breast milk
- Foods added, as appropriate per infant, provided
by Center
18Reminders
- Ages 4-7 months
- 0-3 T cereal or veg./fruit means that the meal
component is optional dependent on the infants
needs. - Portion size not listing zero as a measurement
indicates the component must be offered, i.e.
formula.
198 through 11 months
Breakfast All 3 components must be offered Lunch or Supper All 3 components must be offered Snack
Breast Milk or 6-8 oz. Formula Breast Milk or 6-8 oz. Formula Breast Milk or 2-4 oz. Formula
2-4 Tbsp. Infant Cereal 2-4 Tbsp. Infant Cereal Or 1-4 Tbsp. Meat Or 2 - 4 oz. Fruit Juice
1-4 Tbsp. Fruit and/or Vegetable 1-4 Tbsp. Fruit and/or Vegetable 0-1/2 Crackers/ Bread
20Reimbursable meals for 8 through 11 month olds
- Center must offer meal components with either
breast milk or formula
218 through 11 months
- Required at Breakfast
- Iron-fortified formula and/or breast milk
- Iron-fortified infant cereal (IFIC)
- Fruit and/or vegetable (not juice)
228 through 11 months
- Required at Lunch and Supper
- Iron-fortified formula and/or breast milk
- Fruit and/or vegetable (not juice)
- Iron-fortified infant cereal (IFIC) and/or
- Meat/meat alternate
- Lean meat, fish, poultry, egg yolk, cheeses, and
beans or peas
23Meat Portions for 8 - 11 Month OldsLunch and
Suppers
- 1 - 4 tablespoons of meat, poultry, egg yolk,
cooked dry beans or peas - or
- 1/2 - 2 ounces of cheese
- or
- 1 - 4 ounces (volume) of cottage cheese
-
248 through 11 months
- Required at Snacks
- Iron-fortified formula and/or
- Breast milk or
- Fruit Juice (full strength)
- When developmentally
- ready
- Crusty bread or
- Crackers
25Reminders
- Ages 8-11 months
- Breakfast - infant cereal
- is required to be offered
- (you can add fruit to the cereal you can make
with formula vs. water) - Lunch Supper
- infant cereal and/or meat/meat alternate must be
offered
26Introducing Solids
- Introduce new food one at a time
- Allow 3 to 5 days between each new food
- Observe infant closely for any reaction to new
food items - Serve appropriate textures in small amounts
- Do not add sugar, salt, fat,
- or spices to food
27Table food for older infants
- You can serve table food to older infants claim
meal if - You have checked with parents on items you can
serve to the infant from the big kids menu - The infant still gets all required components of
the Infant Meal Pattern
- Big kids menu hamburger so you
- To serve/claim for Infants
- Cut it up
- write hamburger on the infant menu in the
meat/meat alternate column - You still need to serve infant formula/breast
milk and vegetable/fruit
28Infant Formula
- Center must supply at least one creditable infant
formula - USDA is no longer keeping an approved infant
formula list on their website - Ensure formula is not an FDA exempt Infant
Formula - Look for the statement Infant Formula with Iron
- Use the nutrition facts label as a guide
- Must have 100 mg of iron or more per 100 calories
of formula
29Parent Provided Food Formula
- A parent may choose to provide food and/or
formula for their own child. - Must be an iron-fortified infant formula
- Maintain documentation that the parent declined
offered food and/or formula (CACFP enrollment
form or the infant formula/feeding selection form)
30Food Provided by Parents
- Parents may provide breast milk, formula, and/or
foods, - However, the center/provider must
-
- -Supply at least one required component when
two or more components are offered (not earlier
than 4 months) , in order to claim the meal for
reimbursement.
31Food Provided by Parents
- When mom comes to the site and nurses their
child - the meal is not reimbursable
- UNLESS
- the center or provider supplies an additional
required component. -
32When staff member nurses their own child
- the meal is reimbursable if they are working
- If on break you will treat as if they are a mom
coming in to breastfeed their infant -
33Is this infant meal reimbursable?
34Is this infant meal reimbursable?
35Infant Menu/Meal Count Records
- Weekly or Monthly Record
- One per individual per week
- OR
- Daily Record
- One per day for multiple infants of the same age
group - List what food and the amount of food offered at
each meal immediately after feeding the child. - Mark the meals on a point-of-service menu/meal
sheet
36Individual Infant Menu/Meal Count
Pont of service (POS) write food offered at
time of service include count
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38Infant menus must contain the following
information
- Food components offered.
- Names of infant.
- Infants age and date of birth.
- Meal type.
- Date of meal service.
39 Common MenuDocumentation Errors
- Non-creditable foods
- Missing required components
- Breast fed infants are included in the meal
counts (and no other component supplied by the
site).
40 Common MenuDocumentation Errors
- Not moving to next set of meal pattern
requirements at start of their 4th and 8th
months. - Infants are moved to the Toddler Room and their
meals are no longer recorded on individual daily
infant meal records or are fed the child meal
pattern. - Children over age 1 are still in the infant room
and fed infant meal pattern.
41Transitional Period
- After the 1st Birthday
- Between the 12th and 13th month
- Transition from IFIF to cows milk
- Offer as a mixture
42Happy 1st Birthday!
- After the 1st Birthday
- Use the 1 through 2 year old meal pattern
- Cows milk full fat for 1 to 2 yr. olds
- Medical statements required
- Infants not ready to be served the1-2 year old
meal pattern
43Medical Statements
- Also required for serving
- Cows milk to children under 1 year
- Formula to children over 13 months
- An alternate meal pattern
44Creditable Foods for Infants
- Foods prepared at the center, with appropriate
modifications - Commercially prepared foods must be plain fruits,
vegetables, and meats - Infant cereal must be iron fortified
45Iron Fortified Infant Cereal
- Iron-fortified (45 mg. of iron for every 100 g.
of dry cereal) - Mix with breast milk or formula
- Feed with a spoon not from a bottle
- Many older infants dont like infant cereal for
breakfast, but it is required to claim the meal
mix in fruit and they like it
46Iron Fortified Infant Cereal
- Not creditable
-
- Cereal in jars
- Infant Cereal with fruit flakes
- Regular family breakfast cereals (hot or cold)
47Vegetables and Fruits
- Commercially Prepared
- Center Prepared
48Commercially Prepared Infant Food
Fruits and Vegetables Fruits and Vegetables
Creditable The fruit or vegetable is the first ingredient Contain multiple fruits or vegetables Water is not the first ingredient Non-Creditable Baby dinners Jarred cereal with fruit Desserts Water is the first ingredient
49Commercial Fruits and Vegetables
- Vegetable or fruit must be listed as first
ingredient (no sugar) - Plain vegetables and fruits are preferred
50Rice Cereal with Apples Beech-Nut Naturals First Advantage 4 oz. Cereals Ingredients apples, apple juice from concentrate (water and apple juice concentrate), water, dried egg yolks, rice flour, cinnamon, ascorbic acid (vitamin c), ferrous sulfate (source of iron), citric acid, zinc sulfate (source of zinc), niacinamide, calcium pantothenate, thiamine mononitrate (vitamin b1), riboflavin (vitamin b2), pyridoxine hydrochloride (vitamin b6), vitamin b12 and folic acid.
Not Creditable Cereals with fruit not creditable.
Not Creditable - Water 1st ingredient. - Has 2
food components, making it a dinner.
Pasta Vegetable Medley 4 oz. Vegetables Ingredien
ts water, tomato paste, pear concentrate,
carrots, dried egg yolks, enriched macaroni
product (durum wheat semolina, niacin, ferrous
sulfate, thiamine mononitrate, riboflavin and
folic acid), romano cheese (made from partially
skimmed cow's milk, cheese cultures, salt and
enzymes) and zinc sulfate.
51Center Prepared Fruits and Vegetables
- Texture must be appropriate
- usually cooked
- Avoid canned vegetables that are high in sodium
- Avoid canned or frozen fruits with added sugar
- Do not add sugar or salt
52Center Prepared Fruits and Vegetables
- Choking dangers
- Raw vegetables
- Corn kernels
- Hard fruits apples, etc.
- Whole fruits grapes, etc.
- Uncooked dried fruits
53Meat and Meat Alternates
- Eggs
- Egg yolks at 8 months
- Yolk must be hard cooked
- Avoid egg whites until after 1 year.
54Meat and Meat Alternates
- Cheese
- Introduced at 8 months or older
- Natural cheese rather than processed cheese
55Meat and Meat Alternates
- Avoid
- Peanut butter, seeds, nuts
- Fish and shell fish
- Processed meats
- (chicken nuggets)
56Commercially Prepared Infant Food
Meat Meat Alternates Meat Meat Alternates
Creditable Plain strained baby food meats - Including those with beef, chicken, turkey, lamb, veal, and ham. Non-Creditable Combination dinners. Meat sticks. Breaded/battered seafood and canned fish with bones. Yogurt. Nuts, seeds, and nut/seed butters.
57Vegetables Beef Beech-Nut Naturals Stage 2
4 oz. Dinners Ingredients vegetables
(carrots, rehydrated potatoes, peas), water and
beef
Not Creditable - Has more than 1 food
component. - Considered a Dinner.
Chicken Lasagna Beech-Nut Naturals Stage 3 6
oz Dinners Ingredients water, tomato
paste, finely ground chicken, carrots, pear puree
concentrate, enriched macaroni product (durum
wheat semolina, niacin, ferrous sulfate, thiamine
mononitrate, riboflavin and folic acid) and
romano cheese (made from partially skimmed cow's
milk, cheese cultures, salt and enzymes).
Not Creditable - Water 1st ingredient - More
than 1 food component. Making it a
dinner.
58Grains/Breads
- (1st ingredient is whole or enriched grain)
- Strips of dry bread, toast, tortillas
- Plain crackers - saltines
- Teething biscuits
- English muffins
- Pita bread
- Animal crackers
- Graham crackers (without honey)
59Grains/Breads
- Avoid
- Snacks such as pretzels or chips
- Cookies or granola bars
- Crackers with seeds, nuts, etc.
- Whole kernels, such as rice.
60Non-Creditable Breads and Crackers for Infants
- Allergies (whole eggs)
- pancakes
- waffles
- muffins
- Calories
- brownies
- cakes
- doughnuts
- Choking
- hard pretzels
- breadsticks
- tortilla chips
- granola bars
- some ready to eat cereals
61Meal Times for Infants
- No specified meal time
- May offer meal at more than one sitting
- Claim if around normal meal time
- Breakfast not claimed at 11 a.m.
- Complete one meal before serving the next
62Meal Times for Infants
- On-Demand Infant Feeding
- Feed when hungry
- Only approved meal types can be claimed
63Division of Responsibility
Caregiver/Parent
- Whether breast or formula fed and make baby feel
comfortable/secure - Help baby feel calm alert
- Learn cues of baby
- Dont push or continue to feed if baby is not
interested - Introduce solid foods when baby is interested and
able to eat, versus by their age
64Division of Responsibility
Baby
- How much
- How often
- What level of capability
- How fast
65Solid Foods
- Studies show solid foods do not help with sleep
patterns - Do not add solids to bottle
- Dont pressure pressure sets up feeding
problems and children dont grow as well - Look for clear feeding signals
- Leaning forward
- Opens mouth -
66Question
- If a parent wants an infant to have more than
three meals during the day, who should furnish
the formula for the meals that cannot be claimed?
67Answer
- If a parent wants an infant to have more than
three meals during the day, who should furnish
the formula for the meals that cannot be claimed? - The parent because the center is not required to
provide formula for more than three meals per
infant per day.
68Question
- If a parent wants an infant to have only a
- limited number of bottles/formula, which
- is less than the infant wants, what are
- you to do?
69Answer
- If a parent wants an infant to have only a
- limited number of bottles/formula,
- which is less than the infant wants,
- what are you to do?
- Since infants are fed on demand and
- unless there is a medical statement,
- honor your responsibility to the infant.
70Question
- Is yogurt a creditable food for infants?
71Answer
- Is yogurt a creditable food for infants?
- No. Commercially prepared, plain yogurt can be
served as an extra to infants 8 months and older,
but it is not creditable as a meat/meat
alternate. The same would go for mixed dinners.
72Question
- Are meals served to a child who just turned one
year old reimbursable if they contain infant
formula?
73Answer
- Are meals served to a child who just turned one
year old reimbursable if they contain infant
formula? - Yes, for a period of one month. After the 13th
month, a doctors statement will be needed for
formula to continue in place of fluid milk.
74Question
- If a physician prescribes whole cows milk as a
substitute for breast milk or formula for an
infant under 12 months of age, are meals
reimbursable?
75Answer
- If a physician prescribes whole cows milk as a
substitute for breast milk or formula for an
infant under 12 months of age, are meals
reimbursable? - Yes, with a medical statement, the meal pattern
can be amended.
76State of Alaska CACFP web site
- http//education.alaska.gov/tls/cnp/CACFP1.html
77WIC Breastfeeding Information
http//www.hss.state.ak.us/dpa/programs/nutri/WIC/
default.htm
78Want more on infant feeding?
www.fns.usda.gov/tn/Resources/feeding_infants.html
79Ellyn Satters Feeding with Love and Good Sense
II DVD
- The Infant
- The Transitional Child
- The Toddler
- The Preschooler
www.ellynsatter.com Or www.ellynsatterinstitute.o
rg
80Special thank you to the Washington State CACFP
Nebraska State CACFP for some of the training
materials.