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Understanding Special Dietary Needs. Lisa Calderone Nutrition Program Consultant Community Nutrition Programs WI Dept of Public Instruction. Objectives of this Session. Understand the CACFP requirements for disabilities and non-disabilities relating to special dietary needs
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Understanding Special Dietary Needs Lisa Calderone Nutrition Program Consultant Community Nutrition Programs WI Dept of Public Instruction
Objectives of this Session • Understand the CACFP requirements for disabilities and non-disabilities relating to special dietary needs • Address lifestyle preferences and parental choices relating to food • Follow CACFP requirements for claiming meals that accommodate special dietary needs • Differentiate between a food allergy and intolerance • Plan meals to accommodate special dietary needs
The CACFP Role Provides reimbursement for serving nutritious meals that are in compliance with the CACFP Meal Pattern
The CACFP Role The CACFP Meal Pattern is based on average nutritional needs of a healthy child
The CACFP Role Requires medical documentation for meals that do not meet the CACFP Meal Pattern and/or have parent supplied items (for 1 year – 12+ years)
Your Child Care’s Role • Serves each child a meal/snack that is in compliance with the CACFP Meal Pattern Accommodates special dietary need requests when they are the result of a disability
Your Child Care’s Role May accommodate special dietary need requests when they are not the result of a disability Claims meals with special dietary needs only when CACFP requirements are met
The Challenge More children have food allergies and intolerances than ever before FARE – Food Allergy Research and Education http://www.foodallergy.org/
Disability or Not? Medical Statement Flow Chart
What is a Disability? • Americans with Disabilities Act (ADA) of 1990 • A mental or physical impairment that substantially limits a major life activity.
Food Related Disabilities • Metabolic Diseases such as Diabetes and PKU • Food Anaphylaxis • Heart Disease • Cancer • Muscular dystrophy • Sometimes Celiac Disease
Child Care’s Responsibilities • Must offer to purchase and supply the required substitution based on the special dietary need • Physician prescribed supplements that are in addition the standard CACFP meal pattern requirements do not have to be supplied by child care.
Suspected but not Documented… If a food allergy or intolerance is suspected by the parents, but… there is no medical statement The child care cannot claim meal unless it supplies the substitute and no required components are excluded from the meal
Lifestyle Preferences Ramadan Diet The full meal pattern must be supplied by the child care in order to claim meals for reimbursement unless justified by a medical statement
Non-Dairy Milk Substitutes Medical Statement Flow Chart
Same Component Substitutions When the special dietary need does not omit an entire meal component and foods are not supplied by parent (1-12+ olds), Examples? a medical statement is not required for claiming meals
Resources Found at: http://fns.dpi.wi.gov/fns_guidememos • Guidance Memorandum 12C or L • Claiming Meals with Special Dietary Needs Flow Chart • Medical Statement Flow Chart • Fluid Milk Substitution for Child Nutrition Programs
Case Studies What should the child care do? Samantha Lilliana Dillon Tyler
What is a food allergy? harmless food protein = threatening substance (allergen)
Allergens Stimulate the immune system to make Immunoglobulin E (IgE) antibodies to attack that food protein
Antibodies Circulate in the blood and enter body tissues Cells release histamine, prostaglandins and leukotrienes = allergic reaction
Allergic Reaction Inhaling Direct Food Consumption Cross Contact Touching
Food Allergy Symptoms Skin Onset - Immediate to a few hours Respiratory GI Tract
! Anaphylaxis • A severe allergic reaction – happens quickly and may cause death • Stop breathing • Dangerous drop in blood pressure
Allergens What are some non-food sources of allergens?
What is a Food Intolerance? Inadequate digestion due to the inability to fully metabolize certain foods Metabolic Intolerances
Most Common Food Intolerances Lactose Intolerance Gluten Intolerance (Non-Celiac and Celiac) Cannot metabolize milk sugar because of deficiency of the enzyme lactase in the intestine Negative intestinal reaction to gluten protein within wheat, rye, and barley