Miss. Code. tit. 15, pt. 11, subpt. 55, ch. 3, app 15-11-55-3-A
Meals shall meet the nutritional standards as prescribed in this section. A childcare family home shall provide adequate and nutritious meals prepared in a safe and sanitary manner.
Healthy diets help children grow, develop, and perform well in learning environments. Proper nutritional care during the early years is essential for intellectual, social, and emotional growth. It is also necessary that a meal environment be provided which encourages the development of good eating habits.
Nutritional Goals:
1. Menus shall be nutritionally adequate.
2. Foods shall be provided in quantities that balance energy and nutrients with children's ages, appetites, activity levels, special needs, and cultural and ethnic differences in food habits.
3. Parents shall be involved in the nutrition component of the childcare family home.
4. A variety of fruits, vegetables, and whole-grain products shall be offered to children for meals and snacks. Mealtime should be used as an opportunity to teach nutrition concepts.
5. The addition of fat, sugar, and sources of sodium shall be minimal in food preparation and service.
6. Food preparation and service shall be consistent with best practices for food safety and sanitation.
7. Furniture and eating utensils shall be age-appropriate and developmentally suitable to encourage children to accept and enjoy mealtime.
8. Childcare caregivers shall encourage positive experiences with food and eating.
9. Childcare family homes shall obtain assistance as needed from the MSDH Childcare Licensure Bureau.
10. Nutrition education for children and for their parents shall be encouraged as a component of the childcare program.
11. Family style dining is encouraged.
Mealtime Environment:
1. Meals and snacks shall be served at regularly scheduled times each day.
2. Age-appropriate utensils, plates, bowls, cups, and dining area shall be provided.
3. Children shall not wait longer than fifteen minutes at the table for food to be served.
3. Sufficient time shall be allowed for children to wash their hands and prepare for the meal.
4. Mealtime shall be used for socialization, and shall be a relaxed, happy time for the children. No televisions, videos, or DVD's may be viewed during meal and snack times.
5. Family style dining is encouraged with serving platters, bowls, and pitchers on the table so that everyone can serve him/herself. Children are encouraged to assist with table setting.
6. A caregiver shall sit and join the children while they are eating. It is suggested that the staff eat the same food items that are served to the children. The staff will encourage social interaction, conversation, and use the mealtime for education purposes. Extra assistance and time shall be provided for slow eaters.
7. Additional servings shall be provided for the child who requests more food at a meal or snack. This is a time to teach children on portion control, monitoring extra intake, and better food selections.
9. Meals and snacks provided by a parent must not be shared with other children, unless a parent is providing baked goods for a celebration or party being held at the operation.
10. Children will be permitted in meal preparation areas when under the direct supervision of a staff person, when there is no danger of injury from equipment, and for instruction/teaching purposes only.
Choking Prevention
1. Raw vegetables and foods that may cause choking in young children shall not be served to children less than two years of age.
2. Children should be encouraged to eat slowly, take small bites, and chew well before swallowing.
3. Cook food until soft and cut into thin slices or small pieces. Remove bones from meat, chicken, and fish, and remove seeds and pits from fruit. With toddlers, cutting foods into "pea" size is recommended.
FOODS THAT MAY CAUSE CHOKING
Sausage shaped meats (hot dogs)* | Pop Corn Hard Candy* Chips* |
Nuts | Dried Fruits |
Grapes | Chunks of peanut butter |
Gum* | Marshmallows |
Thick Pretzels Rods* Thin pretzel sticks and rounds would be allowed.
*Not allowed to be served
Child Requiring a Special Diet: A child requiring a special diet due to medical reasons, allergic reactions, or religious beliefs, shall be provided meals and snacks in accordance with the child's needs. If medical reasons exist for the special diet, a medical diagnosis from the child's physician stating that the special diet is medically necessary is required. Information required for dietary modifications include:
* Child's full name and date of instructions, updated annually
* Any dietary restrictions based on the special needs
* Any special feeding or eating utensils
* Any foods to be omitted from the diet and any foods to be substituted
* Limitations of life activities
* Any other pertinent special needs information
* What, if anything, needs to be done if the child is exposed to restricted foods.
1. Religious or ethnic requests should include the above information as needed, plus a certified statement of request based upon the religious or ethnic beliefs of the family.
2. The child's parent shall meet with the operator to review the written instructions.
3. Parents of children with severe restrictions and special dietary needs will need to provide written documentation to the operator.
4. The childcare family home may request the parent to supplement food served by the childcare family home. When food is supplied by the parent, the childcare family home shall be responsible for assuring that it is properly stored and served to the child in accordance with the diet instructions on file. Meals and snacks provided by a parent must not be shared with other children, unless a parent is providing baked goods for a celebration or party being held at the operation.
5. Records of food intake shall be maintained when indicated by the child's physician.
6. Request for a vegetarian/vegan diet shall be accommodated with the same information completed as for dietary modifications. Specialty items may be supplied by the parent to meet nutritional needs.
Infants
1. Breast milk or formula shall be brought to the childcare family home daily, ready to be warmed and fed. Each bottle shall be labeled with the infant's name and the date. No cereal, juice or other foods may be added to the infant's breast milk/formula without a physician's written request.
2. Bottles should not be warmed in the microwave.
3. At the end of each feeding, discard any milk left in the bottle. Staff will send all used bottles home with the parent for proper cleaning and sanitizing.
4. Age-appropriate solid foods (complimentary foods) may be introduced no sooner than when the child has reached four months of age, but ideally at six months. The first food introduced usually is cereal mixed with breast milk or formula (not in a bottle). Adding juice to dry cereal is not allowed.
5. Commercially prepared baby foods shall be brought in unopened jars and labeled with the infant's name. A childcare family home may choose to mash and puree the foods served to older children for the infants seven months to one year. No additional juice, sauces, or fats may be added to the pureed foods.
6. Iron-fortified dry infant cereal shall be brought in sealed container premeasured for each feeding and labeled with the infant's name.
7. Breast milk is the recommended feeding for infants and should be encouraged and supported by childcare family home personnel. The mother may choose to come to the childcare family home to nurse her infant or may choose to supply bottles of expressed breast milk for the childcare personnel to feed the infant. To help a mother be successful with breastfeeding the childcare family home may provide the following:
* A quiet, comfortable and private place for feeding.
* A place to wash the hands.
* A comfortable chair, stool for feet while breast feeding.
8. If infant is breast-fed, encourage the mother to provide a back-up supply of frozen breast milk that is labeled with the infant's name and date of expression. The mother's expressed milk shall be used for her infant only.
9. Refer to the Centers for Disease Control for guidelines on the storage and preparation of breast milk.
10. For a breast fed infant, it is acceptable to introduce iron-fortified cereal earlier, at four months if desired, but preferably at 6 months.
11. A written schedule for feeding a breast-fed infant shall be provided by the parent and posted for reference by the childcare family home staff.
12. Feeding should be by hunger cues whenever possible. Hunger cues may include:
* Sucking on tongue, lips, hands, or fingers while asleep
* Moving his arms and hands toward mouth
* Restless movements while asleep
* Opening mouth when his lips are touched
* "Rooting" or searching for the nipple
13. Infants are fed when hungry by noting hunger cues, such as crying, being restless. Feeding is stopped when it is determined that the infant is satisfied. Signs of satiety include, refusing the nurse, turning away from the nipple, falling asleep.
14. Infants shall be held cradled in the arms during feeding. At no time shall an infant be fed by propping a bottle.
15. Introduction of solid foods to an infant should be done in consultation with the parent.
16. Juice shall not be served to infants (children less than 12 months of age).
17. A small amount of water is encouraged at 8-12 months.
18. Solid foods must be spoon-fed. No solid food shall be fed by bottle or infant feeder without written direction from a physician.
19. Infants are encouraged to start using a cup at six to nine months, based upon motor skills. By the age of one, all children should be off a bottle.
20. Older infants are encouraged to hold and drink from cups and to use child appropriate eating and serving utensils. Self-feeding should be encouraged.
21. Breast milk or formula is served to at least 12 months of age. Children ages one to two, shall be served whole milk, after age two, toddlers should be served fat-free/skim milk or 1% milk.
22. When centers are reimbursed for meals and must supply formula for their infants, only ready to use formula may be purchased for use. The center may require the parents to supply clean bottles daily. If the center supplies the bottles, there must be provisions in place for the proper cleaning, sanitizing, and drying of all bottles and supplies outside of the infant room.
Meal Planning for Infants through One Year
1. Infant food needs are based on the amount of time spent in the childcare family home.
2. Any infant in a childcare family home at the time of a meal or snack, shall be served foods appropriate to age.
Meal/Snack | Birth through 5 Months | 6 Months through 12 Months |
Breakfast | 4-6 fl. oz. breast milk or formula | 6-8 fl. oz. breast milk or formula 2-4 Tbsp. prepared infant cereal (optional) 1-4 Tbsp. fruit and/or Vegetable (infant or mashed) |
Lunch or Supper | 4-6 fl. oz. breast milk or formula | 6-8 fl. oz. breast milk or formula 2-4 Tbsp. prepared infant cereal (optional) 1-4 Tbsp. fruit and/or vegetable (infant or mashed) 1-4 Tbsp. infant meat |
Supplement/Snack | 4-6 fl. oz. breast milk or formula | 2-4 fl. oz. breast milk or formula 0-1/2 dry bread or 0-2 crackers (optional) |
Meal Schedule for Children One year and older:
1. Children's food needs are based on the amount of time spent in the childcare family home.
2. Any child in a childcare family home at the time of a meal or snack will be served that meal or snack.
IF YOU ARE OPEN | YOU MUST SERVE | ||
Nine hours or less | Two snacks and one meal | OR | One snack and two meals |
Over nine hours | Two snacks and two meals | OR | Three snacks and one meal |
24 hours or during all meals | Three meal and three snacks: one snack should be a late night snack only served to children who are awake. | ||
Parties and Special Occasions: Parties and party events should not be held more than once a month.
Meal Planning for Children in Family Childcare Homes:
Breakfast/Lunch/Dinner/Snack
Milk:
Milk shall be served at breakfast, lunch, and dinner. The milk shall be pasteurized fluid milk, fortified with vitamin A and D. Whole milk is served to infants and toddlers less than two years of age. After age two fat-free/skim milk or 1% milk shall be served. Milk alternatives may be served when indicated with dietary restrictions.
Provisions must be made to serve calcium in alternate forms when no milk/substitute may be served to the child due to dietary restrictions.
If a child cannot be served milk for medical reasons or upon parent's instructions, then that child is not to be served high content milk products, e.g., pudding, ice cream, cheese, etc.
Bread and Bread Alternates:
Use enriched whole-grain breads and bread alternatives. Dry cereals need to be high fiber and not sugar coated. Whole grain pasta, noodles, or brown rice are encouraged at all meals.
The following breakfast breads may be served: muffin, biscuit, toast, breakfast bread, pancake or waffle. These items should be limited: doughnuts, honey buns, breakfast tarts, pastries, packaged snack cakes, and other high fat/sugar foods.
Plain, low sugar type cookies and snacks, including animal crackers, graham crackers, vanilla wafers, oatmeal, oatmeal raisin, peanut butter, low-fat granola bars, whole grain fruit and cereal bars, and Rice Krispie treats, and ginger snaps may be served as a snack occasionally. Other snack suggestions include cheddar cheese, plain or vegetable flavored crackers or trail mix made of various dry, no sugar-coated cereals, dried fruits, and small marshmallows Items that may not be served include chocolate chip cookies and most pre-packaged cookies/snack cakes.
Fruits and Vegetables:
Use fresh, canned, dried, or frozen fruit for every meal. No sugar may be used in the packaging or preparation of the fruit. Canned or frozen fruit should be packed in juice or water - not syrup or sugar packed.
Vegetables may be used for the breakfast meal.
Serve a variety of fruits and vegetables.
Use a different combination of two or more fruit/vegetables during meals.
Use fresh, canned, dried, or frozen vegetables and fruits for meals.
Avoid serving two forms of the same fruit or vegetable in the same day.
Limit serving starchy vegetables. Starchy vegetables include white/sweet potatoes, lima beans, butter beans, English peas, black-eye peas, field peas, crowder peas, cream and whole kernel corn, and any dried bean/pea (unless counted for a meat alternate).
The use of high sodium/salt and high fat seasonings should be limited.
Fruit juice (100%) is allowed once a day.
Water:
Water is to be made available with all meals and snacks. Tap or bottled water may be served. Water should be encouraged before and after all meals and snacks.
Meat and Meat Alternates:
Meats and meat alternates that would be acceptable include eggs, fat-free yogurt, low-fat cheese, fat-free cottage cheese, lean ham, Canadian bacon, and peanut butter. Bacon is not considered a meat and shall not be served infrequently.
Edible portion for meats and meat alternates is used. No bones may be served. One ounce of cooked meat is equal to one medium cooked chicken leg with bone removed.
Processed, pre-fried meats should be limited due to the sodium/salt and fat content. Meats not allowed include hot dogs, corndogs, bologna, bacon, sausage, pancake sticks, small chicken nuggets, fish sticks, and steak fingers.
Processed cheese, such as cheese spread, canned cheese sauce, and cheese in packaged snack crackers is not allowed. Low-fat or fat-free cheese can be served.
Serving nuts and seeds is not recommended due to the prevalence of nut/seed allergies.
VITAMIN C SOURCES VITAMIN C SOURCES VITAMIN C SOURCE MUST BE SERVED DAILY **BEST CHOICE *GOOD CHOICE #ACCEPTABLE CHOICE (ONLY COUNT FOR A VITAMIN SOURCE ONCE PER WEEK) | |||||
Fruits | Vegetables | ||||
Food | Serving Size | Food | Serving Size | ||
Blackberries | ¼ c. | # | Asparagus | ¼ c. | * |
Blueberries | ¼ c. | # | Artichoke | ¼ medium | * |
Cantaloupe | ¼ c | ** | Bok Choy | ¼ c. | * |
Grapefruit | ¼ medium | ** | Broccoli | ¼ c. | ** |
Grapefruit Juice | ½ c | ** | Brussel Sprouts | ¼ c. | ** |
Grapefruit-Orange Juice | ½ c. | ** | Cabbage | ¼ c. | * |
Guava | ¼ c. | ** | Cauliflower | ¼ c. | * |
Honeydew Melon | ½ c. | * | Chicory | ¼ c. | * |
Kiwi | ½ medium | ** | Collard Greens | ¼ c. | * |
Mandarin Orange Sections | ¼ c. | * | Kale | ¼ c. | # |
Mango | ¼ medium | * | Kohlrabi | ¼ c. | ** |
Melon balls | ¼ c. | * | |||
Orange | ½ medium | ** | Mustard Greens | ¼ c. | # |
Orange Juice | ¼ c. | ** | Okra, not fried | ¼ c. | # |
Papaya | ¼ c. | * | Peppers, green & red | ¼ c. | ** |
Peach, frozen only | ¼ c. | ** | Potato, White, or Red Skinned Baked only-no instant/fries/tots | ½ medium | * |
Pineapple | ¼ c. | # | Rutabagas | ¼ c. | # |
Pineapple Juice | ¼ c. | * | Snow Peas | ¼ c. | # |
Pineapple-grapefruit or orange juice | ¼ c. | ** | Spinach | ¼ c. | # |
Raspberries | ¼ c. | * | Sweet Potato | ½ medium | * |
Starfruit | ¼ c. | # | Tomato | ½ medium | * |
Strawberries | ¼ c. | ** | Tomato or V-8 Juice | ¼ c. | ** |
Tangelo | ½ medium | ** | Turnip Greens | ¼ c. | * |
Tangerine | ½ medium | ** | Miscellaneous | ||
Tropical fruit mix | ¼ c. | * | |||
Watermelon | ½ c. | # | Liver, beef | 1 oz. | ** |
VITAMIN A SOURCES VITAMIN A SOURCES VITAMIN A SOURCE MUST BE SERVED EVERY OTHER DAY, 3 TIMES PER WEEK ** BEST CHOICE * GOOD CHOICE #ACCEPTABLE CHOICE (ONLY COUNT FOR A VITAMIN SOURCE ONCE PER WEEK) | |||||
Fruits | Vegetables | ||||
Food | Serving Size | Food | Serving Size | ||
Avocado | ¼ medium | # | Asparagus | ¼ c. | # |
Apricot | 2 halves | * | Artichoke | ½ medium | # |
Cantaloupe | ¼ c. | * | Bok Choy | ¼ c. | * |
Cherries, red sour | ¼ c. | * | Broccoli | ¼ c. | * |
Mandarin Orange Segments | ¼ c. | * | Brussels Sprouts | ¼ c. | * |
Mango | ¼ medium | ** | Carrots | ¼ c. | ** |
Melon Balls | ¼ c. | * | Collard Greens | ¼ c. | ** |
Nectarine | ¼ medium | # | |||
Papaya | ¼ c. | * | Kale | ¼ c. | ** |
Peaches | ¼ c. | # | Lettuce, Green, Romaine, or Red - NOT Iceberg | ½ c. | # |
Plantain | ¼ c. | # | Mixed Vegetables | ¼ c. | ** |
Prunes | ¼ c. | * | Mustard Greens | ¼ c. | ** |
Tangerine | ½ medium | * | Okra, not fried | ¼ c. | # |
Peas & Carrots | ¼ c. | ** | |||
Peppers, red | ¼ c. | ** | |||
Miscellaneous | Pumpkin | ¼ c. | ** | ||
Egg | 1 medium | * | Rutabagas | ¼ c. | # |
Liver, beef | 1 oz. | ** | Spinach | ¼ c. | ** |
Liver, chicken | 1 oz. | ** | Sweet Potato | ½ medium | ** |
Tomato or V-8 Juice | ¼ c. | ** | |||
Turnip Greens | ¼ c. | ** | |||
Winter Squash, Butternut or Hubbard | ¼ c. | ** | |||
Miss. Code. tit. 15, pt. 11, subpt. 55, ch. 3, app 15-11-55-3-A