Miss. Code. tit. 15, pt. 11, subpt. 55, ch. 4, app 15-11-55-4-C
Nutritional Standards
Introduction
Meals shall meet the nutritional standards as prescribed in this section. A child care facility 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. Healthy diets contain the amounts of essential nutrients and calories needed to prevent nutritional deficiencies while preventing an excess amount of discretionary calories. Planned meals and snacks provide the right balance of carbohydrate, fat, and protein to reduce risks of chronic diseases, and are part of a full and productive lifestyle. Such diets are obtained from a variety of foods.
Nutrition and feeding practices for children strongly affect the development and long-term health of the child. Proper nutritional care during the early years is essential for intellectual, social, emotional, and physical growth. It is also necessary that an environment be provided which encourages the development of good food habits.
Meals and vending services shall meet the standards from the Offices of Healthy Schools and Child Nutrition for the Mississippi State Department of Education as well as USDA Food and Nutrition Service guidelines.
THE GOALS OF A CHILD CARE FACILITY IN RELATION TO NUTRITION SHALL BE:
Based upon the American Dietetic Association Benchmarks for Nutrition Programs in Child-Care Settings
FEEDING SCHEDULE FOR INFANTS AND CHILDREN ONE YEAR AND OLDER
| 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. | ||
Meals and snacks shall be served at regularly scheduled times each day.
The same meal or snack shall not be served more than one time in any 24-hour (one-day) period.
No more than four and no less than a two and one-half hour period must elapse between the beginning of a meal and a snack.
If breakfast is not served, then a mid-morning snack shall be provided.
Since not all children arrive at the facility at the same time, certain parental options regarding breakfast will be allowed as follows:
Note: Either option above must be documented and included in the child's record.
Outside foods shall not be brought into the facility, with the exception of special dietary needs. Exempt facilities are facilities that operate less than six hours and as noted in the regulations, otherwise noted in other sections of the standards. Any outside foods shall meet the Office of Healthy School and MSDH Nutrition Standard guidelines.
Age appropriate utensils, plates, bowls, cups, and dining area shall be provided.
Children shall not wait longer than fifteen minutes at the table for food to be served.
Sufficient time shall be allowed for children to wash their hands and prepare for the meal.
Mealtime shall be used for socialization, and shall be a relaxed, happy time for the children. No media, e.g., televisions, videos, or DVD's may be viewed during meal and snack times. Family style dining is encouraged with serving platters, bowls, and pitchers on the table so that all present can serve him/her self. Children are encouraged to assist with table setting and bowling up fruits for dessert. All foods served must meet the serving guidelines, and be age appropriate. "Seconds" of foods can be served as indicated at the request of the child or by hunger cues.
A caregiver shall sit and join the children while they are eating. When caregivers are allowed to eat with the children, which is encouraged, staff will eat items that meet nutrition standards. 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.
Caregivers shall not eat foods outside of the foods served in the facility in front of the children.
Food shall not be used as a reward or punishment. Children will not be encouraged to "clean your plate," but encouraging children to try two bites of each food served is acceptable.
Additional servings shall be provided for the child who requests more food at a meal or snack. It is at the discretion of the facility and knowledge of the child's eating pattern to allow seconds on food items. This time to teach children on portion control, monitoring extra intake, and better food selections is higher in nutritional value.
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. Foods for a party or celebration shall meet the Office of Healthy School guidelines.
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.
A complete two-week cycle of menu plans shall be submitted annually to Child Care Licensure as part of the renewal process. Although a minimum complete, two-week cycle menu is required to be submitted annually, child care facilities at their discretion may submit a 4 to 8 week cycle of menu plans.
Daily menus for all meals and snacks prepared and/or served in the child care facility shall be plainly posted. Any substitution shall be of comparable food value and shall be recorded on the menu and dated.
Menus shall be written at least one week in advance. Menus can be completed on a rotating cycle for 4-12 weeks.
Menus shall be posted in the food preparation area and in a conspicuous place in the child care facility at all times.
Menus shall be planned to include food with variety in texture, color, and shape. Record of dated menus served, and any substitutions made, shall be kept on file for a minimum of one year.
New food shall be introduced to help develop good food habits. Introduce only one new food per meal or snack. Foods used for activities/teaching can be included on the written record of foods served for the day.
It is the facility's responsibility to discuss recurring eating problems with the child's parent.
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 prescription 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.
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.
The facility shall not serve nutrient concentrates and supplements such as protein powders, liquid protein, vitamins, minerals, and other nonfood substances without written instructions from the child's physician.
The child's parent shall meet with the facility staff and/or director to review the written instructions. Such instructions shall list any dietary restrictions/requirements and shall be signed and dated by the child's physician requesting the special diet.
Parents of children with severe restrictions and dietary needs will be given a copy of the facility's menu to pre-select foods to be served. The parents will be responsible for ensuring the accuracy of foods served based upon the preplanned menu.
The child care facility may request the parent to supplement food served by the child care facility. When food is supplied by the parent, the child care facility shall be responsible for assuring that it is properly stored and served to the child in accordance with the diet instructions on file at the child care facility. Any food item that must cooked, shall be prepared by the facility, such as a soy patties. 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.
Records of food intake shall be maintained when indicated by the child's physician.
Vegetarian/Vegan Dietary Requests
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. Contact with the nutritionist with MSDH is recommended.
To the extent authorized by Federal laws, the facility may determine that the special nutritional needs of a child cannot be met at the facility and the child may be excluded from admission into the facility.
Recipes shall be used and a file of recipes used to prepare the food shall be maintained.
Foods shall be prepared in a form that is easy for children to handle. Bite size pieces and finger foods are suitable. Bones shall be removed from any food served to any child in the child care setting.
Foods shall be prepared as close to serving time as possible to preserve nutrients, flavor, and color.
Food should not be highly seasoned. No extra salt or fats should be added to the foods in cooking. The use of salt free, low fat products is allowed. Children need to learn the flavors of food.
Raw vegetables and foods that may cause choking in young children shall not be served to children less than two years of age.
A caregiver shall join the children while they are eating. This is an opportunity to teach socialization skills, nutrition education, and is a safety measure to help prevent choking.
Children should be encouraged to eat slowly, take small bites, and chew well before swallowing.
FOODS THAT MAY CAUSE CHOKING
Sausage shaped meats (hot dogs)* Pop Corn
Hard Candy* Chips*
Nuts Thick Pretzels Rods* Thin pretzel sticks and rounds would be allowed
Grapes Chunks of peanut butter
Gum* Marshmallows
Dried Fruits
*Not allowed to be served
To Reduce Choking Hazards
Cook food until soft and cut into short strips, not round slices. Serve other foods in 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.
When a pregnant mother is visiting the facility to consider enrollment, breastfeeding should be encouraged.
Breast milk is the recommended feeding for infants and should be encouraged and supported by child care facility staff. The mother may choose to come to the child care facility to nurse her infant, or may choose to supply bottles of expressed breast milk for the child care facility staff to feed the infant. To help a mother be successful with breastfeeding the faculty may:
* Quiet, comfortable and private place to feed;
*Place to wash the hands;
* Pillow to support her infant if desired;
*A comfortable chair, stool for feet while nursing;
* The mother may opt to nurse while in the infants room;
The Centers for Disease Control's (CDC) guidelines for storage of frozen expressed breast milk are as follows:
* Freezer compartment of a refrigerator at a temperature of 5° F or -15° C the expressed breast milk can be safely stored for 2 weeks
* Freezer compartment of refrigerator with separate doors 0° F or -18° C the expressed breast milk can be safely stored for 3-6 months
" Freezer compartment of refrigerator with separate doors -4° F or -20° C the expressed breast milk can be safely stored for 6-12 months
Note: Store milk toward the back of the freezer, where temperature is most constant. Milk stored for longer durations in the ranges listed is safe, but some of the lipids in the milk undergo degradation resulting in lower quality. You can go to the CDC website at http://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm for more information.
A written schedule for feeding the infant shall be provided by the parent and posted for reference by the child care facility staff.
Feeding should be by hunger cues whenever possible. Hunger cues may include:
* Sucking on his tongue, lips, hands, or fingers while asleep
* Moving his arms and hands toward his mouth
*Restless movements while asleep
* Rapid eye movements under his eyelids
* Opening his mouth when his lips are touched
* "Rooting" or searching for your nipple
* Making small sounds
Late hunger cues include:
* Crying
* Fussiness
Signals when an infant is full and feeding should stop:
* "Falls off" your breast, releasing the nipple;
* Falls asleep; or " Relaxes his body and opens his fists.
Breast milk or formula shall be brought to the child care facility 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, as done for a child with special needs.
Bottles should be warmed for five minutes in a pan of hot, not boiling water; never microwave. Before feeding, test the temperature by squirting a couple of drops on the back of your hand.
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.
Age-appropriate solid foods (complimentary foods) may be introduced no sooner than when the child has reached 4 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.
Commercially prepared baby foods shall be brought in unopened jars and labeled with the infant's name. Home prepared/blended and home canned infant foods shall not be served. A facility may chose to mash and puree the foods served to older children for the infants 7 months to one year - no additional juice, sauces, or fats may be added to the pureed foods.
Iron-fortified dry infant cereal shall be brought in sealed container premeasured for each feeding and labeled with the infant's name.
Juice shall not be served to infants (children less than 12 months of age).
A small amount of water is encouraged at 8-12 months.
Infants shall be held cradled in the arms during feeding. At no time shall an infant be fed by propping a bottle.
Introduction of solid foods to an infant should be done in consultation with the parent and/or according to the schedule of the Mississippi State Department of Health Infant Feeding Guide.
Solid foods must be spoon-fed. No solid foods shall be fed by bottle or infant feeder without written direction from a physician.
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.
Infants are encouraged to start using a cup at six to nine months, based upon motor skills. When the cup is used, the breast milk or formula may be brought into the center in a clean closed container that is clearly labeled. By the age of one, all children should be off a bottle.
Older infants are encouraged to hold and drink from cups, to use child appropriate eating and serving utensils. Self-feeding should be encouraged. All food should be served in a manner to prevent choking, such as mashing, cutting in small "pea" size portions.
Breast or formula is served to at least 12 months. Cow's milk is not served until age one, unless provided with a written exception from the infant's physician. Children ages one to two, shall be served whole cow's milk, after age two, toddlers should be served fat free/skim milk. When there are children older than two in the classroom with younger children, all children shall be served the whole milk.
Guidelines for Milk Storage and Use for All Infants
| Storage Method and Temperature | Maximum Amount of Time For Storage |
| Room (25 C or 77 F) | 4 hours |
| Refrigerator (4 C or 39 F) | 48 hours |
| Previously thawed | |
| Refrigerated milk | 24 hours |
| Freezer (-20 C or 0 F) | 3 months |
From the ACOG/AAP publication: Breastfeeding Handbook for Physicians
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.
FEEDING SCHEDULE FOR INFANTS THROUGH ONE YEAR
INFANT'S FOOD NEEDS ARE BASED ON THE AMOUNT OF TIME SPENT IN THE CHILD CARE FACILITY.
ANY INFANT IN A CHILD CARE FACILITY AT THE TIME OF SERVICE OF A MEAL OR SNACK SHALL BE SERVED FOODS APPROPRIATE TO THE AGE.
| MEAL/SNACK | BIRTHTHROUGH 5 MONTHS | 6 THROUGH 12MONTHS |
| 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) |
Infant cereal and formulas shall be iron fortified. Infant feeding is individualized after consultation with the parent and by hunger cues from the infant.
MENU PLANNING
Dietary Guidelines for Americans provide assistance in planning meals for ages two and older, which will promote health and prevent disease.
The guidelines, applied to child care feeding are:
PARTIES AND SPECIAL OCCASIONS
Parties and special party type events should not be held more that once a month. Food for parties should be prepared at the facility when possible. It is recommended that if foods for the event are brought to the facility by parents it should be "store bought" and not "home cooked."
It is suggested that a plain "store bought" cake be served. Other items may include ice cream, fresh fruit, cheese and crackers, and party favors such as stickers, books, toothbrushes, crayons, etc., are encouraged.
Meal Pattern Points to Remember
Keep in mind the following points when you plan menus to meet meal pattern requirements for each of the food groups.
* Plan your meats first. Then select fruits and vegetables, making sure that you have a Vitamin C source daily and a Vitamin A source every other day, or three times a week. Refer to the vitamin tables. Limit starchy vegetables to once/day - these include lima beans, butterbeans, white/sweet potatoes, English peas, black-eye peas, field peas, Crowder peas, cream and whole kernel corn, any dried pea/bean(unless counted for a meat substitute).
* Two vegetables or two fruits may be served at the mealtime, but it is recommended to serve a vegetable and a fruit for variety. Including brightly colored fruits and vegetables, such as tomatoes, broccoli, carrots, greens, strawberries, melon, peaches, will help to meet the vitamin requirements.
* The same meal may not be served more than once in a day (i.e. facilities who are open for lunch and supper may not serve the same meal for both meals).
* Snacks are to be served mid-morning (if required), early afternoon, and late afternoon, usually 30-60 minutes before closing. Water can be used as the beverage while foods are served. Snack time is an excellent time to introduce fruits and vegetables.
* Use only 100-percent-strength juice for snack no more than once a day. Give fruit for breakfast/morning snack instead of juice.
* Juice should not be served as part of the snack when milk is the only other component. It is poor menu planning to offer such a combination since it provides too much liquid for children.
* Fruit-flavored drinks, sport drinks, soft drinks, caffeinated beverages, artificially sweetened beverages shall not be served.
* Avoid serving two forms of the same fruit or vegetable in the same day. Example: an orange and orange juice or an apple and applesauce are combinations that should not be used. Serve a variety of vegetables and fruits to ensure a nutritionally well-balanced meal.
* Dry milk shall not be used as a milk beverage, but may be used for cooking purposes.
* Guidelines from USDA FNS (US Department of Agriculture Food Nutrition Supplement) program are used as the standard for menu planning and guidelines. However, when one set of guidelines are stricter then the stricter guidelines shall be enforced (in comparing MSDH and USDA FNS). Emphasis shall be placed on serving more whole grains and fewer foods high in fat, sugar, and sodium.
* Drinking water shall be freely available to children of all ages and offered at frequent intervals. Extra water served with meals, snacks, and during and after physical activity is encouraged. Facilities may have water fountains in the classroom or dining area. This water source should be encouraged before and after all meals and snacks and takes the place of water served at the table.
* To prevent nutrient and vitamin loss from foods during preparation, cooking, or storage, try to
* Serve fruits and vegetables raw as appropriate for the age. The risk of choking is greater for the child under the age of two.
*Steam, boil, or simmer foods in a very small amount of water, or microwave for the shortest time possible.
* Cook potatoes in their skins. Be sure to wash the dirt off the outside of the potato.
* Refrigerate prepared juices and store them for no more than two to three days.
* Store cut raw fruits and vegetables in an airtight container and refrigeratedo not soak or store in water. Nutrients may be diluted from soaking in water. Manufacturer packaged fresh fruits and vegetables are the exception due to packaging processes.
MEAL PATTERNS FOR CHILDREN IN CHILDCARE FACILITIES: BREAKFAST
| BREAKFAST | AGES 1YR-2YR | AGES3 YR-5 YR | AGES6 YR12 YR |
| Milk (Must be fluid, skim/fat free) | 1/2 c. | 3/4 c. | 1 c. |
| Fruit or Vegetable | 1/4 c. | 1/2 c. | 1/2 c. |
| Grains/Breads | |||
| Enriched, Whole Grain Bread | 1/2 slice | 1/2 slice | 1/2 slice |
| OR | |||
| Enriched Dry Cereal | 1/4 c. OR 1/3oz. | 1/3 c. OR 1/2 oz. | 3/4 c. OR 1oz. |
| OR | 1/4 c. | 1/3 c. | 1/2 c. |
| Enriched Hot Cereal | |||
| OR | 1/4 c. | 1/3 c. | 1/2 c. |
| Enriched, Whole Grain Pasta, | |||
| Noodles, Rice | |||
| Water | 1/2 c. | 3/4 c. | 1 c. |
Milk:
Milk shall be served at Breakfast. The milk shall be pasteurized fluid milk, fortified with vitamin A and D. Whole milk is served to infants and toddlers less than 2 years of age. After age two, skim/fat free milk shall be served
Soymilk may be served when indicated with dietary restrictions.
Bread and Bread Alternates:
Use enriched whole-grain breads and bread alternatives. Dry cereals need to be of high fiber and not sugar coated. Hot cereals cannot be instant. Whole grain pasta, noodles, or brown rice may be used occasionally for the breakfast meal.
Breakfast breads may include muffins, biscuit, toast, breakfast bread, no more than weekly pancake or waffle (with no syrup). Crust used as part of the main dish (i.e., for quiche) is allowed as a bread alternate. These items may not be served: doughnuts, honey buns, breakfast tarts, pastries, packaged snack cakes, and other high fat/sugar foods.
Fruits and Vegetables:
Use fresh, canned, dried, or frozen fruit for breakfast. 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, such as tomatoes, may be used occasionally for the breakfast meal. Cultural differences may also dictate that items such as tomatoes, peppers, onions, or salsas may be served with brown rice for the vegetable and bread component at breakfast.
Water:
Water is to be made available with all meals and snacks. Tap or bottled water may used. Facilities may have water fountains in the classroom or dining area. This water source should be encouraged before and after all meals and snacks and takes the place of water served at the table.
Meat and Meat Alternates:
The Meat component is not required for the breakfast meal. IF the facility desires to serve a meat item with the breakfast, that would be allowed. 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.
MEAL PATTERNS FOR CHILDREN IN CHILDCARE FACILITIES:
LUNCH/SUPPER/DINNER
| LUNCH/SUPPER/DINNER | AGES 1 YR 2 YR | AGES3 YR - 5 YR | AGES6 YR - 12 YR |
| Meat/Meat Alternate | |||
| Cooked Meat, No Bone | 1 oz. | 1 1/2 oz. | 2 oz. |
| Cooked Dry Beans/Peas | 1/4 c. | 3/8 c. | 1/2 c. |
| Low Fat Cheese | 1 oz. | 1 1/2 oz. | 2 oz. |
| Egg | 1 small | 1 medium | 1 medium |
| Peanut Butter | 2 Tbsp. | 3 Tbsp. | 4 Tbsp. |
| Fat Free Yogurt/Cottage Cheese | 4 oz/1/2 c. | 6 oz./3/4 c. | 8 oz./1 c. |
| Fruit or Vegetable: Must include 2 different foods- 1 vegetable/1 fruit OR 2 vegetable OR 2 fruit | 1/4 c. total 1/8 c. of 2 foods | 1/2 c. total 1/4 c. of 2 | 3/4 c. total 3/8 c. of 2 foods foods |
| Grains/Breads | |||
| Enriched, Whole Grain Bread | 1/2 slice | 1/2 slice | 1/2 slice |
| OR | |||
| Enriched Dry Cereal | 1/4 c. OR 1/3oz. | 1/3 c. OR 1/2 oz. | 3/4 c. OR 1oz. |
| OR | 1/4 c. | 1/3 c. | 1/2 c. |
| Enriched Hot Cereal | |||
| OR | 1/4 c. | 1/3 c. | 1/2 c. |
| Enriched, Whole Grain Pasta, | |||
| Noodles, Rice | |||
| Milk (Must be fluid, skim/fat free) | 1/2 c. | 3/4 c. | 1 c. |
| Water | 1/2 c. | 3/4 c. | 1 c. |
Meat and Meat Alternates:
It is recommended to have at least one meatless meal a week. An alternate for meat could be cooked, dried beans, or peas. Cooked dried beans and peas cannot count for a vegetable and meat alternate in the same meal. Canned beans and peas will include the canned kidney, black bean, garbanzo, etc. Note: Canned beans are much higher in sodium/salt.
Edible portion for meats and meat alternates is used. Bone and skin shall not be counted as servings. No bones may be served. Note: 1 ounce of cooked meat is equal to one medium cooked chicken leg wtih bone removed.
Processed, pre-fried meats are not allowed due to the sodium/salt and fat content. Meats not allowed include hot dogs, 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 would be a meat alternate that is allowed.
For menu variety, use meat, and low fat cheese in combination to equal a full serving portion.
It is not recommended serving nuts and seeds due to nut/seed allergies prevalent in the youth today.
Bread and Bread Alternates:
Use enriched whole-grain breads and bread alternatives. Whole grain pasta, noodles, brown rice, wheat rolls, and cornbread are encouraged for the lunch/supper/dinner meals.
Bread alternates may include crust used as part of the main dish (i.e. pizza or quiche), Dry oatmeal used in a fruit crisp.
Pre-fried items, such as hash browns, French fries, and tater tots are not recommended due to the fat and sodium content Any pre-fried item served is limited to once a week.
Cookies, pastries, packaged snack cakes, and other high fat/sugar foods cannot be counted for any bread serving at the lunch/supper/dinner meal.
Fruits and Vegetables:
Must serve a Vitamin C source daily and must serve a Vitamin A source every other day, three times a week refer to the guidelines. Fruits and vegetables supply these nutrients. More than once vitamin source a day is also encouraged.
Use a different combination of two or more servings for the meal service. Use fresh, canned, dried, or frozen vegetables and fruits for lunch/supper/dinner. 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 and fruits may be served as combination dishes (i.e., beef stew with meat, potatoes, carrots, English peas, OR shredded carrot salad with diced pineapple).
Avoid serving two forms of the same fruit or vegetable in the same day. Example: an orange and orange juice or an apple and applesauce are combinations that should not be used. Serve a variety of vegetables and fruits to ensure a nutritionally well-balanced meal.
It is highly recommended to either serve at least one raw vegetable and two raw fruits per week, for a meal or snack
Limit serving starchy vegetables to once per meal. Starchy vegetables include white/sweet potatoes, lima beans, butter beans, English peas, black-eye peas, field peas, Crowder peas, cream and whole kernel corn, any dried bean/pea (unless counted for a meat alternate).
Vegetables shall be seasoned with powders, spices, and herbs. The use of high sodium/salt and high fat seasonings should be restricted as much as possible.
Small amounts (less than 1/8 cup) of lettuce, tomatoes, onions, relish, catsup, salsa, jams, jellies, or other condiments may be added for flavor or garnish as "other foods," but do not count as a fruit or vegetable.
Milk:
Milk shall be served at Lunch/Supper/Dinner. The milk shall be pasteurized fluid milk, fortified with vitamin A and D. Whole milk is served to infants and toddlers less than 2 years of age. After age two, skim/fat free milk shall be served. Flavored milk may be served no more than once a week, using flavoring added to whole/skim/fat free milk.
Soymilk 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, etc.
All milk equivalent used as a meat alternate must be low in fat.
Water:
Water is to be made available at all meals and snacks. Tap or bottled water may used. Facilities may have water fountains in the classroom or dining area. This water source should be encouraged before and after all meals and snacks and takes the place of water served at the table.
MEAL PATTERNS FOR CHILDREN IN CHILDCARE FACILITIES: SNACK
| SNACK MUST SELECT TWO OF THE FOUR COMPONENTS, PLUS WATER | AGES 1YR-2YR | AGES 3 YR-5 YR | AGES6 YR12 YR |
| Meat/Meat Alternate | |||
| Cooked Meat, No Bone | 1/2 oz. | 1/2 OZ. | 1 oz. |
| Cooked Dry Beans/Peas | 1/8 c. | 1/8 c. | 1/4 c. |
| Low Fat Cheese | 1/2 oz. | 1/2 oz. | 1 oz. |
| Egg | 1 small | 1 medium | 1 medium |
| Peanut Butter | 1 Tbsp. | 1 Tbsp. | 2 Tbsp. |
| Fat Free Yogurt/Cottage Cheese | 2 oz/1/4 c. | 2 oz./1/4 c. | 4 oz./1/2 c. |
| Fruit or Vegetable | 1/2 c. | 1/2 c. | 3/4 c. |
| Grains/Breads | |||
| Enriched, Whole Grain Bread | 1/2 slice | 1/2 slice | 1/2 slice |
| OR | |||
| Enriched Dry Cereal | 1/4 c. OR 1/3oz. | 1/3 c. OR 1/2 oz . | 3/4 c. OR 1oz. |
| OR | 1/4 c. | 1/3 c. | 1/2 c. |
| Enriched Hot Cereal | |||
| OR | 1/4 c. | 1/3 c. | 1/2 c. |
| Enriched, Whole Grain Pasta, Noodles, Rice | |||
| Milk (Must be fluid, skim/fat free) | 1/2 c. | 1/2 c. | 1 c. |
| Water | 1/2 c. | 1 c. | 1 c. |
Meat and Meat Alternates:
It is recommended to have at least one meatless meal a week. An alternate for meat could be cooked, dried beans or peas. Cooked dried beans and peas cannot count for a vegetable and meat alternate in the same meal. Canned beans and peas will include the canned kidney, black bean, garbanzo, etc. Note: Canned beans are much higher in sodium/salt.
Edible portion for meats and meat alternates is used. Bone and skin shall not be counted as servings. No bones may be served. Note: 1 ounce of cooked meat is equal to one medium cooked chicken leg with bone removed.
Processed, pre-fried meats are not allowed due to the sodium/salt and fat content. Meats not allowed include hot dogs, 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 would be a meat alternate that is allowed.
For menu variety, use meat, and low fat cheese in combination to equal a full serving portion.
Nuts or seeds may be used as a meat alternate for snack time, but is not recommended due to nut/seed allergies prevalent in the youth today.
Bread and Bread Alternates:
Use enriched whole-grain breads and bread alternatives. Whole grain pasta, noodles, brown rice, wheat rolls, and cornbread are encouraged for the lunch/supper/dinner meals.
Bread alternates may include crust used as part of the main dish (i.e. pizza or quiche), dry oatmeal used in a fruit crisp.
Pre-fried items, such as hash browns, French fries, tater tots are not recommended due to the fat and sodium content Any pre-fried item served is limited to once a week. Fresh, "homemade" oven baked fries or wedges would be allowed.
Plain, low sugar type cookies may be served occasionally for a snack component. These cookies may include animal crackers, graham crackers, vanilla wafers, oatmeal, oatmeal raisin, peanut butter, and ginger snaps. Items that may not be served include chocolate chip, most packaged cookies/cakes.
Low fat granola bars, cereal bars, whole grain fruit bars, rice krispie treats may be used for a snack bread component. Packaged crackers with cheese/peanut butter filling are discouraged due to the fat/sodium content. The cheese/peanut butter filling cannot count as a meat serving.
Baked chips, chips, popcorn, hard pretzels, and other low-moisture, high sodium foods cannot meet the bread requirement for a snack. Crackers, cheese and vegetable flavored crackers are allowed. Trail mixes made of various dry, no sugar coated cereals, dried fruits, and small marshmallows are a suggested snack item to meet a bread component.
Fruits and Vegetables:
Use fresh, canned, dried, or frozen vegetables and fruits for snack. 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 and fruits may be served as combination dishes (i.e., shredded carrot salad with diced pineapple, fat free yogurt parfait with fresh fruit).
Avoid serving two forms of the same fruit or vegetable in the same day. Example: an orange and orange juice or an apple and applesauce are combinations that should not be used. Serve a variety of vegetables and fruits to ensure a nutritionally well-balanced meal.
It is highly recommended to either serve at least one raw vegetable and two raw fruits per week, for a meal or snack. Younger children may have an appropriate substitution due to the choking hazard or the item may be cooked first.
Small amounts (less than 1/8 cup) of lettuce, tomatoes, onions, relish, catsup, salsa, jams, jellies, or other condiments may be added for flavor or garnish as "other foods," but do not count as a fruit or vegetable.
Juice should not be served as part of the snack when milk is the only other component. It is poor menu planning to offer such a combination since it provides too much liquid for children.
100%Fruit juice is allowed once a day. Vitamin fortified fruit juices, such as apple juice, with extra Vitamin C, will not be recognized as a good vitamin source.
The best time to serve this juice would be at the late 4:30/5:30 p.m., snack period.
Milk:
The milk shall be pasteurized fluid milk, fortified with vitamin A and D. Whole milk is served to infants and toddlers less than 2 years or age. After age two, skim/fat free milk shall be served.
Flavored milk may be served no more than once a week, using flavoring added to whole/skim/fat free milk.
Soymilk 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, etc.
All milk equivalents used as a meat alternate must be low in fat.
Water:
Water is to be made available with all meals and snacks. Tap or bottled water may used. Facilities may have water fountains in the classroom or dining area. This water source should be encouraged before and after all meals and snacks and takes the place of water served at the table.
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 | 1/4 c. | # | Asparagus | 1/4 c. | * |
| Blueberries | 1/4 c. | # | Artichoke | 1/4 medium | * |
| Cantaloupe | 1/4 c | ** | Bok Choy | 1/4 c. | * |
| Grapefruit | 1/4 medium | ** | Broccoli | 1/4 c. | ** |
| Grapefruit Juice | 1/2 c | ** | Brussel Sprouts | 1/4 c. | ** |
| Grapefruit-Orange Juice | 1/2 c. | ** | Cabbage | 1/4 c. | * |
| Guava | 1/4 c. | ** | Cauliflower | 1/4 c. | * |
| Honeydew Melon | 1/2 c. | * | Chicory | 1/4 c. | * |
| Kiwi | 1/2 medium | ** | Collard Greens | 1/4 c. | * |
| Mandarin Orange Sections | 1/4 c. | * | Kale | 1/4 c. | # |
| Mango | 1/4 medium | * | Kohlrabi | 1/4 c. | ** |
| Melon balls | 1/4 c. | * | |||
| Orange | 1/2 medium | ** | Mustard Greens | 1/4 c. | # |
| Orange Juice | 1/4 c. | ** | Okra, not fried | 1/4 c. | # |
| Papaya | 1/4 c. | * | Peppers, green & red | 1/4 c. | ** |
| Peach, frozen only | 1/4 c. | ** | Potato, White, or Red Skinned Baked only-no instant/fries/tots | 1/2 medium | * |
| Pineapple | 1/4 c. | # | Rutabagas | 1/4c. | # |
| Pineapple Juice | 1/4 c. | * | Snow Peas | 1/4 c. | # |
| Pineapple-grapefruit or orange juice | 1/4c. | ** | Spinach | 1/4 c. | # |
| Raspberries | 1/4 c. | * | Sweet Potato | 1/2 medium | * |
| Starfruit | 1/4 c. | # | Tomato | 1/2 medium | * |
| Strawberries | 1/4 c. | ** | Tomato or V-8 Juice | 1/4 c. | ** |
| Tangelo | 1/2 medium | ** | Turnip Greens | 1/4 c. | * |
| Tangerine | 1/2 medium | ** | Miscellaneous | ||
| Tropical fruit mix | 1/4 c. | * | |||
| Watermelon | 1/2 c. | # | Liver, beef | 1 oz. | ** |
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 | 1/4 medium | # | Asparagus | 1/4 c. | # |
| Apricot | 2 halves | * | Artichoke | 1/2 medium | # |
| Cantaloupe | 1/4 c. | * | Bok Choy | 1/4 c. | * |
| Cherries, red sour | 1/4 c. | * | Broccoli | 1/4 c. | * |
| Mandarin Orange Segments | 1/4 c. | * | Brussels Sprouts | 1/4 c. | * |
| Mango | 1/4 medium | ** | Carrots | 1/4 c. | ** |
| Melon Balls | 1/4 c. | * | Collard Greens | 1/4 c. | ** |
| Nectarine | 1/4 medium | # | |||
| Papaya | 1/4 c. | * | Kale | 1/4 c. | ** |
| Peaches | 1/4 c. | # | Lettuce, Green, Romaine, or Red NOT Iceberg (Iceberg is not high in vitamins) | 1/2 c. | # |
| Plantain | 1/4 c. | # | Mixed Vegetables | 1/4 c. | ** |
| Prunes | 1/4 c. | * | Mustard Greens | 1/4 c. | ** |
| Tangerine | 1/2 medium | * | Okra, not fried | 1/4 c. | # |
| Peas & Carrots | 1/4 c. | ** | |||
| Peppers, red | 1/4 c. | ** | |||
| Miscellaneous | Pumpkin | 1/4 c. | ** | ||
| Egg | 1 medium | * | Rutabagas | 1/4 c. | # |
| Liver, beef | 1 oz. | ** | Spinach | 1/4 c. | ** |
| Liver, chicken | 1 oz. | ** | Sweet Potato | 1/2 medium | ** |
| Tomato or V-8 Juice | 1/4 c. | ** | |||
| Turnip Greens | 1/4 c. | ** | |||
| Winter Squash, Butternut or Hubbard | 1/4 c. | ** |
DENTAL CARE
Dental care is encouraged after each meal service. Parents shall supply toothbrushes and tooth powders or pastes for the child's individual use. Recommendations include replacing the brush every three months or when bristles are bent.
Each toothbrush and powder or paste must be:
* Labeled with the child's full name
* Stored out of children's reach when not in use
* Stored in a manner that prevents the toothbrushes from touching each other during storage
Staff is encouraged to attend trainings on dental care that includes:
* Proper tooth brushing technique as appropriate for the child's age and skills.
*Education to train parents about proper oral healthcare techniques.
* Education for staff and parents to learn the appropriate techniques to feed infants and children that minimize damage to teeth and facial development.
Children must have adult supervision during tooth brushing activities.
GARDENING AND FRESH PRODUCE
Gardening is an excellent opportunity to incorporate physical activity with nutrition education. Facilities are encouraged to have gardening projects with the children. Produce that is grown in the gardens may be washed and handled properly to allow the items to be served for a snack time or education activity.
Purchasing local produce from Mississippi farmers is one way to offer fresh items to the children. This also helps the local economy and raising families' awareness of food sources. The child care center must ensure the safety of foods served. Steps must be taken to demonstrate reasonable care has been taken to ensure the safety of foods purchased. Steps include: Investigating the local farm and production practices, communicating with the local farmer on the needs of the facility including packaging, delivery, and payment procedures, and promoting the use of local produce with families and the community. There are several resources available to use as a safety checklist, such as the Iowa State University Checklist for Retail Purchasing of Local Produce. The checklist is on thewww.Healthyms.comwebsite under Nutrition and Farm to School and Preschool.
REFERENCES
Dietary Guidelines for Americans, 2005. http://www.health.gov/dietaryguidelines/dga2005/document/
United States Department of Agriculture; Food and Nutrition Service; Child and Adult Care Food Program: Nutrition Guidance for Child Care Centers. http://www.fns.usda.gov/cnd/care/ProgramBasics/Meals/Meal_Patterns .
Dietary Reference Intakes, (DRIs), Food and Nutrition board, Institute of Medicine, National Academies
USDA National Nutrient Database for Standard Reference, Release 18.
Promoting good Nutrition and Physical Activity in Child-Care Settings, A Research Brief, May 2007, Robert Wood Johnson Foundation.
Position of the American Dietetic Association: Benchmarks for Nutrition Programs in Child Care Settings, Journal of the American Dietetic Association, June 2005.
Nemours, Health and Prevention Services, Best Practices for Health Eating: A Guide to Help Children Grow Up Healthy, Version 2, 2008
The Wellness Child Care Assessment Tool: A Measure to Assess the Quality of Written Nutrition and Physical Activity Policies, The American Dietetic Associations, December 2011
Institute of Medicine, Child and Adult Care Food Programs: Aligning Dietary Guidance for All, November 4, 2011
Miss. Code. tit. 15, pt. 11, subpt. 55, ch. 4, app 15-11-55-4-C