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Infant Meals Component of the Child and Adult Care Food Program -CACFP. Ann-Marie Martin CACFP Coordinator Alaska Department of Education & Early Development. Definition of Infant in the CACFP. Birth through 11 Months. Up to the child’s first birthday. Infant Meals. - PowerPoint PPT Presentation
Citation preview
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Infant Meals Component of the Child and Adult Care Food Program -CACFP
Ann-Marie Martin
CACFP Coordinator
Alaska Department of Education & Early Development
Definition of Infant in the CACFP
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Birth through 11 Months
Up to the child’s first birthday
Infant Meals
CACFP Centers/Providers caring for infants must offer meals to them
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All centers/providers must offer iron-fortified formula to infants under one year of age
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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One Month Enrollment Report (OMER
Infants must be listed on the Center’s One Month Enrollment Report (OMER) that is completed each year
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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.
USDA Infant Meal PatternMeal 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 non-creditable infant formulas
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• 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
Breast Milk
Credited the same as formula
Chapter 3 provides information on handling breast milk
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Age Breakfast Lunch and Supper Snack
Birththrough
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
4through
7months
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
8through
11 months
6-8 fluid ounces formula1 and/or breast milkand2-4 Tbsp infant cereal2
and1-4 Tbsp fruit and/or vegetable
6-8 fluid ounces formula1 and/or breast milkand2-4 Tbsp infant cereal2
and/or1-4 Tbsp lean meat, fish, poultry, egg yolk, cooked dry beans or cooked dry peas5
or ½-2 ounces (weight) cheeseor1-4 ounces (volume) cottage cheese or1-4 ounces (weight) of cheese food or cheese spreadand1-4 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)
CACFP Infant Meal Pattern
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Birth through 3 months
Required at all meals and snacks:
• Iron-fortified formula and/or
• Breast milk
OK to offer less than the minimum amount of breast milk 14
Breakfast Lunch or Supper
Snack
Breast Milkor 4-6 ozFormula
Breast Milkor 4-6 ozFormula
Breast Milkor 4-6 ozFormula
Reimbursable 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)
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4 through 7 months
Required at all meals and snacks:
• Iron-fortified formula and/or
• Breast milk
Solid foods when developmentally ready16
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
Reimbursable 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
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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
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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
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 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
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8 through 11 months
Required at Snacks:• Iron-fortified formula and/or
• Breast milk or
• Fruit Juice (full strength)
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When developmentallyready:
•Crusty bread or •Crackers
RemindersAges 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 food26
Table food for older infantsYou 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
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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
Infant FormulaCenter 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
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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
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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
Is this infant meal reimbursable?
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Is this infant meal reimbursable?
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Infant Menu/Meal Count RecordsWeekly or Monthly Record
One per individual per weekOR
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
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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.
• Names of infant.
• Infant’s age and date of birth.
• Meal type.
• Date of meal service.
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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).
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• 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.
Common MenuDocumentation Errors
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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 41
Happy 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
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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 Prepared47
Commercially Prepared Infant Food
Fruits and Vegetables
CreditableThe fruit or vegetable
is the first ingredient
Contain multiple fruits or vegetables
Water is not the first ingredient
Non-CreditableBaby dinners
Jarred cereal with fruit
Desserts
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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Pasta Vegetable Medley4 oz.Vegetables
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.
Rice Cereal with ApplesBeech-Nut Naturals First Advantage4 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
- Water 1st ingredient. - Has 2 food components,
making it a dinner.
Not Creditable
Cereals with fruit not creditable.
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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
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Eggs
•Egg yolks at 8 months•Yolk must be hard cooked•Avoid egg whites until after 1 year.
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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Meat and Meat Alternates
Commercially Prepared Infant Food
Meat & Meat Alternates
Creditable
Plain strained baby foodmeats - 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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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).
Vegetables & 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”.
Not Creditable
- Water 1st ingredient - More than 1 food component.
Making it a “dinner”.
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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
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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Caregiver/Parent
Division of Responsibility
How much
How often
What level of capability
How fast
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Baby
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
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http://www.hss.state.ak.us/dpa/programs/nutri/WIC/default.htm
Want more on infant feeding?
www.fns.usda.gov/tn/Resources/feeding_infants.html78
Ellyn Satter’s Feeding with Love and Good Sense II DVD
The Infant
The Transitional Child
The Toddler
The Preschooler
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www.ellynsatter.comOr
www.ellynsatterinstitute.org
Special thank you to the Washington State CACFP & Nebraska State CACFP for some of the training materials.
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