Transcript No Slide Title

Infant Meals Component
of the Child and Adult Care Food
Program -CACFP
Ann-Marie Martin
CACFP Coordinator
Alaska Department of Education &
Early Development
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Definition of Infant in
the CACFP
Birth through 11
Months
Up to the child’s
first birthday
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Infant Meals
CACFP Centers/Providers
caring for infants must
offer meals to them
All centers/providers
must offer ironfortified formula to
infants under one
year of age
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To 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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5
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One Month Enrollment Report (OMER
Infants must be listed on the Center’s 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.
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USDA Infant Meal Pattern
Meal pattern is grouped into three
age categories:
birth-3 mo
4-7 mo
8-11 mo
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Required 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
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• 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
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When parents provide noncreditable 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
<1 mg iron per 100 kcals
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Breast Milk
Credited the same as
formula
Chapter 3
provides information on
handling breast milk
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CACFP Infant Meal Pattern
Age
Birth
through
3 months
4
through
7
months
8
through
11
months
Breakfast
Lunch and Supper
Snack
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
4-8 fluid ounces formula1 and/or
breast milk
4-8 fluid ounces formula1 and/or
breast milk
4-6 fluid ounces formula1 and/or
breast milk
0-3 Tbsp infant cereal2 (ready)
0-3 Tbsp infant cereal2 (ready)
0-3 Tbsp fruit and/or vegetable
(ready)
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)
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Birth 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
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Reimbursable meals for
Birth 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)
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4 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
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Reimbursable meals for
4 through 7 month olds
Center provided formula
Parent provided formula
Parent provided breast milk
Foods added, as appropriate per
infant, provided by Center
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Reminders
Ages 4-7 months:
• 0-3 T cereal or veg./fruit means
that the meal component is
optional dependent on the
infant’s needs.
• Portion size not listing zero as a
measurement indicates the
component must be offered, i.e.
formula.
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8 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
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Reimbursable meals for
8 through 11 month olds
Center must
offer meal
components
with either
breast milk or
formula
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8 through 11 months
Required at Breakfast:
• Iron-fortified formula and/or breast
milk
• Iron-fortified infant cereal (IFIC)
• Fruit and/or vegetable (not juice)
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8 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
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Meat Portions for 8 - 11 Month Olds
Lunch 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
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8 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
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Reminders
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
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Introducing 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
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Table 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
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Infant 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
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calories of formula
Parent 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)
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Food 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.
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Food 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.
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When 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
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Is this infant meal
reimbursable?
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Is this infant meal
reimbursable?
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Infant 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
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Individual Infant Menu/Meal
Count
Pont of service
(POS) – write food
offered at time of
service & include
count
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Infant menus must contain the
following information:
• Food
components
offered.
• Meal type.
• Names of
infant.
• Date of meal
service.
• Infant’s age
and date of
birth.
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Common Menu
Documentation Errors
Non-creditable foods
Missing required components
Breast fed infants are included in
the meal counts (and no other
component supplied by the site).
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Common Menu
Documentation 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.
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Transitional Period
After the 1st Birthday
• Between the 12th and 13th month
Transition from IFIF to cows milk
• Offer as a mixture
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Happy
st
1
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
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Medical Statements
Also required for serving:
• Cows milk to children
under 1 year
• Formula to children over
13 months
• An alternate meal
pattern
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Creditable 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
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Iron 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 don’t like infant
cereal for breakfast, but it is required
to claim the meal – mix in fruit and
they like it
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Iron Fortified Infant Cereal
Not creditable:
• Cereal in jars
• Infant Cereal with fruit
flakes
• Regular family breakfast
cereals (hot or cold)
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Vegetables and Fruits
Commercially
Prepared
Center Prepared
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Commercially Prepared Infant Food
Fruits and Vegetables
Creditable
Non-Creditable
The fruit or vegetable is Baby dinners
the first ingredient
Jarred cereal with fruit
Contain multiple fruits
or vegetables
Desserts
Water is not the first
ingredient
Water is the first
ingredient
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Commercial Fruits and Vegetables
Vegetable or fruit must be listed
as first ingredient (no sugar)
Plain vegetables and fruits are
preferred
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Rice Cereal with Apples
Beech-Nut Naturals First Advantage
4 oz.
Cereals
Not Creditable
Cereals with fruit not creditable.
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.
Pasta Vegetable Medley
4 oz.
Vegetables
Not Creditable
- Water 1st ingredient.
- Has 2 food components,
making it a dinner.
Ingredients:
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.
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Center 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
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Center Prepared
Fruits and Vegetables
Choking dangers:
• Raw vegetables
• Corn kernels
• Hard fruits: apples, etc.
• Whole fruits: grapes, etc.
• Uncooked dried fruits
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Meat and Meat Alternates
Eggs
• Egg yolks at 8
months
• Yolk must be hard
cooked
• Avoid egg whites
until after 1 year.
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Meat and Meat Alternates
Cheese
• Introduced at 8
months or older
• Natural cheese
rather than
processed cheese
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Meat and Meat Alternates
Avoid:
• Peanut butter,
seeds, nuts
• Fish and shell fish
• Processed meats
(chicken nuggets)
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Commercially Prepared Infant Food
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.
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Vegetables & Beef
Not Creditable
Beech-Nut Naturals Stage 2
4 oz.
Dinners
- Has more than 1 food component.
- Considered a “Dinner”.
Ingredients:
vegetables (carrots, rehydrated potatoes, peas), water and beef
Chicken Lasagna
Beech-Nut Naturals Stage 3
6 oz
Dinners
Not Creditable
- Water 1st ingredient
- More than 1 food component.
Making it a “dinner”.
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).
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Grains/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)
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Grains/Breads
Avoid:
• Snacks such as pretzels or
chips
• Cookies or granola bars
• Crackers with seeds, nuts, etc.
• Whole kernels, such as rice.
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Non-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
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Meal 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
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Meal Times for Infants
•On-Demand Infant
Feeding
•Feed when hungry
•Only approved meal
types can be claimed
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Division of Responsibility
Caregiver/Parent
Whether breast or formula fed and make baby
feel comfortable/secure
Help baby feel calm & alert
Learn cues of baby
Don’t 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
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Division of Responsibility
Baby
How much
How often
What level of capability
How fast
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Solid Foods
Studies show solid foods do not help with
sleep patterns
Do not add solids to bottle
Don’t pressure – pressure sets up feeding
problems and children don’t grow as well
Look for clear feeding signals
Leaning forward
Opens mouth -
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Question
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?
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Answer
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.
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Question
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?
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Answer
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.
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Question
Is yogurt a creditable food for infants?
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Answer
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.
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Question
Are meals served to a child who just turned one year old
reimbursable if they contain infant formula?
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Answer
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 doctor’s statement will be needed for
formula to continue in place of fluid milk.
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Question
If a physician prescribes whole cow’s milk as a substitute for
breast milk or formula for an infant under 12 months of age,
are meals reimbursable?
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Answer
If a physician prescribes whole cow’s 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.
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State of Alaska CACFP web site
http://education.alaska.gov/tls/cnp/CACFP1.html
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WIC Breastfeeding
Information
http://www.hss.state.ak.us/dpa/p
rograms/nutri/WIC/default.htm
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Want more on infant feeding?
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www.fns.usda.gov/tn/Resources/feeding_infants.html
Ellyn Satter’s Feeding with
Love and Good Sense II DVD
The Infant
The Transitional Child
The Toddler
The Preschooler
www.ellynsatter.com
Or
www.ellynsatterinstitute.org
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Special thank you to the Washington State CACFP & Nebraska State CACFP for some of the training materials.
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