Infant Meals Component of the Child and Adult Care Food Program -CACFP

1. Infant Meals Component of the Child and Adult Care Food Program -CACFP Ann-Marie Martin CACFP Coordinator Alaska Department of Education & Early Development

2. Definition of Infant in the CACFP Birth through 11 Months Up to the child’s first birthday

3. Infant Meals • CACFP Centers/Providers caring for infants must offer meals to them All centers/providers must offer iron-fortified formula to infants under one year of age

4. 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

7. 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.

8. USDA Infant Meal Pattern Meal pattern is grouped into three age categories: birth-3 mo 4-7 mo 8-11 mo

9. 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

10. Must provide at least one infant formula • Parents may decline infant formula • Bring their own iron-fortified infant formula • Bring their own pumped breast milk

11. When parents provide non-creditable infant formulas • Provide a Specialty Formula • That does not meet CACFP Requirements • Need: • Signed Medical Statement • Diagnosis must be identified and authorized Example: Low-iron formulas <1 mg iron per 100 kcals

12. Breast Milk • Credited the same as formula • Chapter 3 provides information on handling breast milk

13. CACFP Infant Meal Pattern

14. 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

15. 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)

16. 4 through 7 months Required at all meals and snacks: • Iron-fortified formula and/or • Breast milk Solid foods when developmentally ready

17. 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

18. 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.

19. 8 through 11 months

20. Reimbursable meals for 8 through 11 month olds • Center must offer meal components with either breast milk or formula

21. 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)

22. 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

23. 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

24. 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

25. 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

26. 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

27. 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

28. 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 calories of formula

29. 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)

30. 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.

31. 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.

32. 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

33. Is this infant meal reimbursable?

34. Is this infant meal reimbursable?

35. 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

36. Individual Infant Menu/Meal Count Pont of service (POS) – write food offered at time of service & include count

38. 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.

39. Common MenuDocumentation Errors • Non-creditable foods • Missing required components • Breast fed infants are included in the meal counts (and no other component supplied by the site).

40. Common MenuDocumentation Errors • Not moving to next set of meal pattern requirements at start of their 4th and 8th months. • Infants are moved to the Toddler Room and their meals are no longer recorded on individual daily infant meal records or are fed the child meal pattern. • Children over age 1 are still in the infant room and fed infant meal pattern.

41. Transitional Period After the 1st Birthday • Between the 12th and 13th month Transition from IFIF to cows milk • Offer as a mixture

42. 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

43. Medical Statements Also required for serving: • Cows milk to children under 1 year • Formula to children over 13 months • An alternate meal pattern

44. 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

45. 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

46. Iron Fortified Infant Cereal Not creditable: • Cereal in jars • Infant Cereal with fruit flakes • Regular family breakfast cereals (hot or cold)

47. Vegetables and Fruits • Commercially Prepared • Center Prepared

48. Commercially Prepared Infant Food

49. Commercial Fruits and Vegetables • Vegetable or fruit must be listed as first ingredient (no sugar) • Plain vegetables and fruits are preferred

50. Not Creditable Cereals with fruit not creditable. Not Creditable - Water 1st ingredient. - Has 2 food components, making it a dinner. Pasta Vegetable Medley 4 oz. Vegetables 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.