1. Feeding Infants in the Child and Adult Care Food Program (CACFP) Bureau of Nutrition Programs & Services New Hampshire State Department of Education March 23, 2015

2. Infant Feeding Evolves USDA issues a clarifying memorandum May 17, 2002 CCC’s and FDCH’s participating in CACFP must offer program meals to all eligible children who are enrolled. Infants must be provided with access to meals. USDA issues a rule update April 28, 2003 Non-food related costs associated with feeding infants are recognized by USDA. Reimbursement for meals containing only infant formula is allowed, whether supplied by caregiver or by the parent.

3. Obligation to Offer Infant Meals CACFP centers and homes must offer program meals to all eligible enrolled* children *“a child whose parent or guardian has submitted to an institution a signed document which indicates that the child is enrolled for child care” Must offer the infant a meal that complies with program requirements Parent/guardian may decline what is offered and supply the infant’s meals instead Key factor: infant provided access to meals Section 226.2 of CACFP regulations Page 3-5

4. Shows types and amounts of foods which meet CACFP requirements Three age groups – each 4 months Meals are specified as a guideline only – babies should be fed when they are hungry Infant Meal Pattern Page 3-6

5. Page 3-8 Age of Baby by Month Birth123456789101112 Age Grouping in Infant Meal Pattern Birth through 3 months 4 through 7 months 8 through 11 months Sequence of Introducing Foods in the Infant Meal Pattern Breast Milk or Formula Infant Cereal Vegetables and/or Fruits Meat or Meat Alternates Crackers or Bread Fruit Juice (only in a cup) Texture of Solid Foods Strained/Pureed (thin consistency for cereal) Mashed Ground/Finely Chopped Chopped Feeding Style Breastfeeding or Bottle Feeding Spoon Feeding Cup Feeding Self Feeding/Finger Food

6. Birth through 3 months 4 months through 7 months 8 months through 11 months Breakfast 4–6 fluid ounces (fl. oz.) breast milk 1, 2 or iron- fortified formula 3, 4 4–8 fl. oz. breast milk 1, 2 or iron- fortified formula 3, 4 0–3 tablespoons (Tbsp.) iron- fortified dry infant cereal (optional) 5 6–8 fl. oz. breast milk 1, 2 or iron- fortified formula 3 2–4 Tbsp. iron- fortified dry infant cereal 6 1–4 Tbsp. fruit and/or vegetable 6 Infant Meal Pattern: Breakfast Page 3-7

7. Birth through 3 months 4 months through 7 months 8 months through 11 months Lunch or Supper 4–6 fluid ounces (fl. oz.) breast milk 1, 2 or iron- fortified formula 3, 4 4–8 fl. oz. breast milk 1, 2 or iron- fortified formula 3, 4 0–3 Tbsp. iron- fortified dry infant cereal (optional) 5 0-3 Tbsp. fruit and/or vegetable (optional) 5 6–8 fl. oz. breast milk 1, 2 or iron-fortified formula 3 2–4 Tbsp. iron-fortified dry infant cereal and/or 1–4 Tbsp. meat, fish, poultry, egg yolk or cooked dry beans or peas or ½–2 oz. cheese or 1–4 oz. cottage cheese, cheese food or cheese spread 6 1–4 Tbsp. fruit and/or vegetable 6 Infant Meal Pattern: Lunch Page 3-7

8. Birth through 3 months 4 months through 7 months 8 months through 11 months Snack 4–6 fluid ounces (fl. oz.) breast milk 1, 2 or iron- fortified formula 3, 4 4–8 fl. oz. breast milk 1, 2 or iron- fortified formula 3, 4 0–3 Tbsp. iron- fortified dry infant cereal (optional) 5 0-3 Tbsp. fruit and/or vegetable (optional) 5 2–4 fl. oz. breast milk 1, 2 or iron-fortified formula 3 or fruit juice 7 0–½ slice bread or 0–2 crackers 8 (optional) 6 Infant Meal Pattern: Snack Page 3-7

9. Meeting Infant Meal Pattern Requirements Birth through 7 months: breast milk or iron- fortified infant formula is only required component at breakfast, lunch/supper and snack Page 3-9

10. Ages 4 through 7 months: iron-fortified infant cereal is an optional component at breakfast both iron-fortified infant cereal and fruit/vegetable are optional components at lunch/supper Page 3-9 Meeting Infant Meal Pattern Requirements

11. Ages 8 through 11 months: Breakfast must contain iron-fortified infant cereal fruit/vegetable breast milk or iron-fortified infant formula Lunch/supper must contain 3 components breast milk or iron-fortified infant formula vegetable/fruit iron-fortified infant cereal and/or one of the specified meat or meat alternates Snack must include breast milk or iron-fortified infant formula or 100% fruit juice may include bread or crackers as optional component Page 3-9 Meeting Infant Meal Pattern Requirements

12. Optional components become required (and must be served by the center/home) when the infant is developmentally ready to accept them When optional components are required: 1.the center/home must provide at least one component 2.a complete meal (all components the infant is developmentally ready to accept) must be supplied between parent-provided and facility-provided components Optional Components

13. Documentation Requirements CACFP Infant Menu Forms Must keep posted menu simple or cycle Must keep daily dated records of all meals served to each infant enrolled in the CACFP Helps develop POS meal counts (in addition to enrollment & attendance records) Page 3-10

14. Posted Menu All centers and homes must develop a written infant menu Tool to communicate types of meals provided to: Parents, Sponsors, State Agency Cycle or Simple –As elaborate as a 4 week cycle –As simple as identifying a house formula, house cereal, and other foods served.

15. Daily Dated Records of Meals Served Must keep dated daily records of all meals served to each infant enrolled in CACFP Provides record of meal components and meal counts for infants Sample menu form (not required, may choose to use or adapt)

16. 0 through 3 months 4 through 7 months 8 through 11 months Month and Day Year MondayTuesdayWednesdayThursdayFriday Breakfast 4-6 oz. breast milk 1, 2 or IFIF 3, 4 4-8 oz. breast milk 1, 2 or IFIF 3,5 6-8 oz. breast milk 1,2 or IFIF 3, 7 0-3 Tbsp. iron-fortified dry infant cereal (optional) 6 2-4 Tbsp. iron-fortified dry infant cereal 7 1-4 Tbsp. fruit/vegetable 7 AM Snack 4-6 oz. breast milk 1, 2 or IFIF 3, 4 2-4 oz. breast milk 1, 2 or IFIF 3, 5 or fruit juice 8 0-½ slice bread or 0-2 crackers 9 (optional) 6 Lunch 4-6 oz. breast milk 1, 2 or IFIF 3, 4 4-8 oz. breast milk 1, 2 or IFIF 3,5 6-8 oz. breast milk 1,2 or IFIF 3, 7 0-3 Tbsp. iron-fortified dry infant cereal (optional) 6 2-4 Tbsp. iron-fortified dry infant cereal 7 and/or 1-4 Tbsp. meat/meat alternate 7,10 0-3 Tbsp. fruit/vegetable (optional) 6 1-4 Tbsp. fruit/vegetable 7 PM Snack 4-6 oz. breast milk 1, 2 or IFIF 3, 4 2-4 oz. breast milk 1, 2 or IFIF 3, 5 or fruit juice 8 0-½ slice bread or 0-2 crackers 9 (optional) 6 Supper 4-6 oz. breast milk 1, 2 or IFIF 3, 4 4-8 oz. breast milk 1, 2 or IFIF 3,5 6-8 oz. breast milk 1,2 or IFIF 3, 7 0-3 Tbsp. iron-fortified dry infant cereal (optional) 6 2-4 Tbsp. iron-fortified dry infant cereal 7 and/or 1-4 Tbsp. meat/meat alternate 7,10 0-3 Tbsp. fruit/vegetable (optional) 6 1-4 Tbsp. fruit/vegetable 7 Child and Adult Care Food Program Weekly Menu for Infants Infant’s Name: Age: Parent Provided foods: ________________________________________________Parent Signature____________________

17. In Obligation to Offer Infant Meals: Key factor: consistent polices & equal access CACFP centers and homes must offer program meals to all eligible enrolled children Must offer the infant a meal that complies with program requirements Parent/guardian may decline what is offered and supply the infant’s meals instead Section 226.2 of CACFP regulations Page 3-5

18. Breast Milk Optimal food for babies USDA recommends breast milk in place of formula from birth through 11 months Minimum Quantities May initially offer less than the minimum required serving if 1)infant does not regularly consume the specified amount and 2)additional breast milk is offered if the infant is still hungry Page 3-13

19. Reimbursement for Meals Containing Only Breast Milk May claim reimbursement of meals in which breast milk is the only required component –Breakfast, lunch or supper and snack for ages birth through 7 months –Snack for ages 8 through 11 months Page 3-13

20. Transitioning from Breast Milk to Formula (Infants under 12 months of age) Meals containing both breast milk and formula are reimbursable as long as the total number of ounces offered meets or exceeds the minimum required amount All other components must be provided Page 3-14

21. Use of Breast Milk for Babies Over 12 Months of Age Centers and day care homes may continue to serve babies their mother’s milk as long as the mother is able and wishes to provide it Mothers can continue to provide breast milk for babies older than 12 months Breast milk is a substitute for cow’s milk in the CACFP Meal Pattern for Children Page 3-14

22. Mothers Breastfeeding in the Center or Day Care Home Birth through 3 months: not reimbursable Page 3-15

23. Mothers Breastfeeding in the Center or Day Care Home Breakfast and lunch/supper: Mother breastfeeds 4 through 7 month old who is developmentally ready for solid foods Meal is reimbursable if: 1.at least one other component is provided (paid for) by the center or day care home 2.the infant receives a complete meal (all of the components that the child is developmentally ready to accept) between parent-provided and facility-provided components Page 3-15

24. Mothers Breastfeeding in the Center or Day Care Home Breakfast and lunch/supper: Mother breastfeeds 8 through 11 month old who is developmentally ready for solid foods Meal is reimbursable if: 1.the center or day care home pays for at least one component 2.the infant receives a complete meal (all three components), between parent-provided and facility-provided components Page 3-15

25. Mothers Breastfeeding in the Center or Day Care Home Snack: Mother breastfeeds 8 through 11 month old who is developmentally ready for solid foods Meal is only reimbursable if: 1.Infant is developmentally ready for bread or crackers 2.the center or day care home serves bread or crackers Page 3-15

26. Breastfeeding Scenarios Page 3-16 A mother comes in at lunch to breastfeed her 3-month-old infant. Meal Pattern Lunch (Birth through 3 months) Parent Provides Center/Home Provides Reimbursable Meal? 4–6 fl. oz. breast milk or iron-fortified formula breast milk (mother breastfeeds the child) * Breast milk or iron-fortified formula is the only required component for birth through 3 months, so the center/day care home has not incurred any expense for which reimbursement can be claimed No*

27. Breastfeeding Scenarios Page 3-16 A 5-month-old infant is eating iron-fortified dry infant cereal but is not yet eating baby food fruits and vegetables. The mother comes in at lunch to breastfeed and the center/day care home supplies a serving of iron-fortified dry infant cereal. Meal Pattern Lunch (4 through 7 months) Parent Provides Center/Home Provides Reimbursable Meal? 4–8 fl. oz. breast milk or iron- fortified formula breast milk (mother breastfeeds the child) 0–3 Tbsp. iron-fortified dry infant cereal (optional) iron-fortified dry infant cereal 0-3 Tbsp. fruit and/or vegetable (optional) Yes*

28. Breastfeeding Scenarios Page 3-16 * Center/day care home has provided at least one component (iron-fortified dry infant cereal) * A complete meal has been served since the other required component (breast milk or iron-fortified infant formula) has been provided by the parent/guardian (optional components become required if infant is developmentally ready to accept them) * Fruit/vegetable is still optional, since the infant is not yet developmentally ready A 5-month-old infant is eating iron-fortified dry infant cereal but is not yet eating baby food fruits and vegetables. The mother comes in at lunch to breastfeed and the center/day care home supplies a serving of iron-fortified dry infant cereal.

29. Breastfeeding Scenarios Page 3-17 A 6-month-old infant is eating iron-fortified dry infant cereal and baby food fruits and vegetables. The mother comes in at lunch to breastfeed and the center/day care home supplies a serving of iron-fortified dry infant cereal. Meal Pattern Lunch (4 through 7 months) Parent Provides Center/Home Provides Reimbursable Meal? 4–8 fl. oz. breast milk or iron- fortified formula breast milk (mother breastfeeds the child) 0–3 Tbsp. iron-fortified dry infant cereal (optional) iron-fortified dry infant cereal 0-3 Tbsp. fruit and/or vegetable (optional) No*

30. Breastfeeding Scenarios Page 3-17 * A complete meal (all three components) has not been served to the infant * Since the infant is developmentally ready for both optional components, they are now required * In order for this meal to be reimbursable, a fruit or vegetable must be provided by the center/day care home or, if they choose to, by the parents/guardians A 6-month-old infant is eating iron-fortified dry infant cereal and baby food fruits and vegetables. The mother comes in at lunch to breastfeed and the center/day care home supplies a serving of iron-fortified dry infant cereal.

31. Breastfeeding Scenarios Page 3-18 A mother comes in at lunch to breastfeed her 10-month-old infant. She also supplies baby food peaches, because she prefers a different brand than the one purchased by the center/day care home. The center/day care home supplies a serving of cheese. Meal Pattern Lunch (8 through 11 months) Parent Provides Center/Home Provides Reimbursable Meal? 6–8 fl. oz. breast milk or iron- fortified formula breast milk (mother breastfeeds the child) 2–4 Tbsp. iron-fortified dry infant cereal and/or 1–4 Tbsp. meat, fish, poultry, egg yolk or cooked dry beans or peas or ½–2 oz. cheese or 1 /8–½ cup cottage cheese or 1–4 oz. cheese food or cheese spread cheese 1–4 Tbsp. fruit and/or vegetablepeaches Yes*

32. Breastfeeding Scenarios Page 3-8 * Center/day care home has paid for at least one component (cheese) * Infant has received a complete meal (all three required components), between parent-provided and facility-provided components A mother comes in at lunch to breastfeed her 10-month-old infant. She also supplies baby food peaches, because she prefers a different brand than the one purchased by the center/day care home. The center/day care home supplies a serving of cheese.

33. To claim meals served to the provider’s own child, the infant must be 1.eligible for free and reduced price meals 2.enrolled in the day care program 3.participating in the program during the time of meal service At least one other nonresident child must also be enrolled in the day care program and participating in the meal service Day Care Home Providers Breastfeeding their Own Infant Page 3-19

34. Reimbursement may be claimed for meals when a center employee breastfeeds her own infant if: 1.mother is employee of child care center, e.g., teacher, aide, administrative staff, food service worker, etc. 2.mother has infant who is enrolled in the center Center Staff Breastfeeding Their Own Infant Page 3-19

35. Infant formula must always be offered in order to obtain CACFP reimbursement, unless infant’s mother provides breast milk Must offer at least one infant formula that meets CACFP requirements Strongly encouraged to select infant formula(s) which satisfies the needs of one or more infants Decision to decline the infant formula offered by the center or day care home rests with the parents or guardian Obligation to Offer Infant Formula Page 3-23

36. Any iron-fortified infant formula intended for dietary use solely as a source of food for normal, healthy infants served in liquid state at manufacturer’s recommended dilution OR A formula which does not meet the regulatory definition of infant formula but for which a medical statement has been provided CACFP Regulatory Definition of Infant Formula Page 3-26

37. Low-Iron Infant Formulas Follow-Up Formulas Exempt Infant Formulas Other Milks (not for babies less than 12 months) cow’s milk evaporated cow’s milk or home-prepared evaporated cow’s milk formula sweetened condensed milk; goat’s milk soy milk (usually called soy beverage imitation milks, including those made from rice or nuts (such as almonds) or nondairy creamer Infant Formula Page 3-24

38. Cow’s milk is not a creditable component of CACFP infant meal pattern Meals containing whole cow’s milk in place of breast milk or iron-fortified formula are only reimbursable if authorized in writing by the infant’s doctor (medical statement) Cow’s Milk for Infants 11 Months and Younger Page 3-25

39. Do not serve to babies or young children less than 2 years old: fat-free (skim) milk reconstituted nonfat dry milk low-fat (1%) milk reduced-fat (2%)

40. Crediting of Infant Formula Provided by Parents Page 3-31 Meals containing parent-provided infant formula may be claimed for reimbursement when: 1.a formula meeting CACFP requirements was offered 2.the decision to decline the offered infant formula was made by the parents/guardian 3.the center/day care home provides (pays for) at least one component of the infant meal when other components are required 4.the infant receives a complete meal (all of the components that the child is developmentally ready to accept) between parent-provided and facility-provided components

41. A signed statement must be obtained from the parent/guardian if offered formula is declined Page 3-31 4Must be maintained on file 4Will be reviewed by Bureau of Nutrition Programs & Services 4Day care home sponsors must maintain this documentation with day care home provider’s menu records Crediting of Infant Formula Provided by Parents

42. Meals containing only parent-provided infant formula may be claimed for reimbursement when: 1.a formula meeting CACFP requirements was offered 2.the decision to decline the offered infant formula was made by the parents/guardian 3.the infant is not yet developmentally ready for any optional meal component(s) 4.the meal is fed to the infant by center staff/day care provider Page 3-32 Reimbursement for Meals Containing Only Parent-Provided Formula

43. Page 3-33 Accepting/Rejecting Infant Formula in the Child and Adult Care Food Program (CACFP) This section to be competed by the center or day care provider. Name of Center/Provider: Infant formula served by center/provider: This section to be completed by parent/guardian. Name of Infant:Name of Parent/Guardian:  YES, I would like my child to receive the formula indicated above.  NO, I do not want my child to receive the formula indicated above. I am providing my own formula. Formula provided by parent/guardian**:___ **The infant formula provided must be one of the formulas indicated on the Child Nutrition Programs list. If another formula is provided, a medical statement documenting the child’s required formula must be given to the center/provider. Signature of Parent/Guardian:Date:

44. Feeding Infant Formula to Children 12 Months and Older Over Age 1: CACFP Meal Pattern for Children Reimbursable during one month transition period 13 months of age and older: meals containing infant formula are only reimbursable with medical statement Use only whole milk for transitioning infants Page 3-38 Whole

45. Center or day care home provider is responsible for purchasing solid foods and serving them to the infant if 1.infant is developmentally ready 2.parent/guardian requests that solid foods are served Page 3-48 Responsibility to Provide Solid Foods

46. Once a child is dev ready to eat solid foods there are two KEY POINTS. Meal is reimbursable if the baby is offered the minimum serving size of the required meal components The food does not have to be totally consumed by the baby for the meal to be reimbursable Meal is reimbursable if required meal components are offered to baby during course of day while baby is in child care If baby is not hungry for a meal component required at lunch, it can be offered as a snack when baby is hungry Page 3-48

47. Readiness for Solid Foods Baby only requires breast milk for iron- fortified infant formula for first 4 to 6 months Decision to introduce solid foods in consultation with parents Page 3-49

48. Readiness for Solid Foods Feeding Solids Too Early Avoid feeding solids before infant is developmentally ready Risk of choking Can develop food allergies or intolerance May consume less breast milk or formula and not get enough calories and other nutrients for proper growth and development Babies should never be fed bottles with added infant cereal Page 3-49

49. Readiness for Solid Foods Feeding Solids Too Late Delaying introduction of solid foods beyond the time when a baby is developmentally ready for them increases the risk that babies will not learn to eat solid foods properly become malnourished develop iron-deficiency anemia not grow normally Page 3-49

50. Foods That Should Not Be Served Page 3-51 to 3-52 Cow’s milk Common allergens: chocolate, egg whites, whole eggs, honey and shellfish (shrimp, lobster, crab, crawfish, scallops, oysters, clams) Citrus fruits (e.g., orange, tangerine, grapefruit), pineapple or tomato juices or foods Shark, swordfish, king mackerel or tilefish Peanut butter, other nut or seed butters (e.g., soy nut, almond, cashew or sunflower seed butter), nuts and seeds Honey Raw milk (e.g., raw cow’s or goat’s milk) Raw or undercooked eggs, meat, poultry or fish Home-canned foods Sweeteners (e.g., sugars, syrups) Sugar and fat Frankfurter rounds, popcorn, grapes, peanut butter or nuts Hard pieces of raw vegetables and fruits (except mashed ripe bananas) Home-prepared high-nitrate vegetables such as beets, carrots, collard greens, spinach and turnips Large amounts of high fiber foods, e.g., bran and raw vegetables, Artificially sweetened foods or beverages

51. Introducing Solid Foods Start with infant rice cereal, then —Oat and barley (one-week intervals) —Single food strained vegetables and fruits —Meats —Breads Introduce one food at a time Communicate closely with parents —Recommended that centers/homes obtain written instructions on introduction and feeding of foods from parent/guardian and baby’s doctor —Centers/homes should provide daily information to parent/guardian on what and how much is eaten Page 3-53

52. Claiming Reimbursement for Meals with Parent-Provided Components Page 3-55 Two Criteria: 1.Center/day care home must provide (pay for) at least one component of the infant meal - Exceptions: center/home feeds expressed breast milk to an infant center/day care home feeds parent- provided formula to an infant who is not yet developmentally ready for any optional meal components

53. Page 3-56 Two Criteria: 2.Infant must receive complete meal (all components the infant is developmentally ready to accept) between parent-provided and facility-provided components When optional components are listed, the number of other components that must be provided depends on what the infant is developmentally ready to accept Claiming Reimbursement for Meals with Parent-Provided Components

54. Page 3-56 Claiming Reimbursement for Meals with Parent-Provided Components For infants 8 through 11 months, breakfast and lunch/supper do not contain any optional components – all 3 must be served If center/home provides at least one component and parent/guardian provides (by choice) all other required components, meal is reimbursable Food items provided by parent/guardian must meet criteria for creditable foods

55. Page 3-56 A 7-month-old infant is eating infant cereal and baby food fruits and vegetables. The parent has chosen to decline the center/day care home formula and provide her own. In addition, the parent provides commercial baby food strained peas for lunch. The center/day care home supplies the iron-fortified infant cereal. Meal Pattern Lunch (4 through 7 months) Parent Provides Center/Home Provides Reimbursable Meal? 4–8 fl. oz. breast milk or iron- fortified formula Iron-fortified formula 0–3 Tbsp. iron-fortified dry infant cereal (optional) iron-fortified dry infant cereal 0-3 Tbsp. fruit and/or vegetable (optional) strained peas * Center/day care home has supplied at least one component * Complete meal has been served since other required components have been provided by the parent Yes* Parent-Provided Components Scenarios

56. Page 3-57 A 4-month-old infant consumes formula and has begun to eat infant cereal, but is not yet ready for fruits and vegetables. The infant’s parents choose to provide both the iron-fortified infant formula and the infant cereal. Meal Pattern Lunch (4 through 7 months) Parent Provides Center/Home Provides Reimbursable Meal? 4–8 fl. oz. breast milk or iron- fortified formula Iron-fortified formula 0–3 Tbsp. iron-fortified dry infant cereal (optional) iron-fortified dry infant cereal 0-3 Tbsp. fruit and/or vegetable (optional) * Center/day care home has not supplied at least one component * Parents have supplied both components that the infant is developmentally ready to eat No* Parent Provided Components Scenario

57. Parent-Provided Components Scenarios Page 3-57 The parents of an 11-month-old infant provide commercial baby food prunes and strained chicken for lunch. The center/day care home supplies the iron-fortified infant formula. Meal Pattern Lunch (8 through 11 months) Parent Provides Center/Home Provides Reimbursable Meal? 6–8 fl. oz. breast milk or iron- fortified formula iron-fortified formula 2–4 Tbsp. iron-fortified dry infant cereal and/or 1–4 Tbsp. meat, fish, poultry, egg yolk or cooked dry beans or peas or ½–2 oz. cheese or 1 /8–½ cup cottage cheese or 1–4 oz. cheese food or cheese spread strained chicken 1–4 Tbsp. fruit and/or vegetable pureed prunes Yes* * Center/day care home has supplied at least one component * Parents have supplied other required components

58. Parent-Provided Components Scenarios Page 3-58 The parent of an 8-month-old infant provides a commercial baby food combination dinner for lunch. The center/day care home supplies the iron-fortified infant formula and baby applesauce. Meal Pattern Lunch (8 through 11 months) Parent Provides Center/Home Provides Reimbursable Meal? 6–8 fl. oz. breast milk or iron- fortified formula iron-fortified formula 2–4 Tbsp. iron-fortified dry infant cereal and/or 1–4 Tbsp. meat, fish, poultry, egg yolk or cooked dry beans or peas or ½–2 oz. cheese or 1 /8–½ cup cottage cheese or 1–4 oz. cheese food or cheese spread strained chicken 1–4 Tbsp. fruit and/or vegetable applesauce No* * Parent has provided a food item (baby food combination dinner) that does not meet criteria for meat or meat alternate * A complete meal has not been provided since only 2 of the 3 items are creditable foods

59. Infant Cereal “Any iron-fortified dry cereal specially formulated for and generally recognized as cereal for infants that is routinely mixed with breast milk or iron-fortified infant formula prior to consumption” Page 3-59

60. Infant Cereal Ages 4 through 7 months can be served as an optional component at breakfast and lunch/supper Ages 8 through 11 months: must be served at breakfast can be served in addition to or instead of meat/meat alternate foods at lunch/supper Page 3-59

61. Infant Cereal, continued Cereal in bottles Adult cereal –Not recommended before 8-9 months –Can be fed to older babies as additional foods (not creditable) Page 3-61

62. Crediting Infant Cereal Infant Cereal CreditableNoncreditable 1 Mixed grain cereals should not be served until the baby has successfully tolerated each single grain cereal. Wheat cereal should not be served until babies are 8 or 9 months old, due to potential intolerances. Page 3-61 “ Any iron-fortified dry cereal specially formulated for and generally recognized as cereal for infants that is routinely mixed with breast milk or iron- fortified infant formula prior to consumption,” including: rice cereal, barley cereal, oat cereal 1 Iron-fortified dry infant cereals containing fruit Commercial jarred baby food cereals (wet not dry) Ready-to-eat breakfast cereal (cold dry) and breakfast cereals (cooked, e.g., oatmeal, farina, Wheatina, etc.)

63. Crediting Commercial Baby Food Fruits and Vegetables Fruits and Vegetables CreditableNoncreditable Page 3-63 Commercial baby food fruits and vegetables which list fruit or vegetable as the first ingredient Commercial baby food fruits and vegetables which contain multiple fruits or multiple vegetables, and list fruit or vegetable as the first ingredient Baby food fruits and vegetables with modified food starch if water is not the first ingredient Full strength fruit juice (regular or infant), only at snack for infants 8 through 11 months of age Commercial baby food dinners which list fruit or vegetable as the first ingredient Commercial baby foods in the “jarred cereal with fruit” category Commercial baby foods in the dessert category (these generally have “dessert” or “pudding” as part of the product name on the front of the label) which list a fruit as the first ingredient Baby food fruits and vegetables with modified food starch if water is the first ingredient Vegetable juices Fruit juices with yogurt Baby food fruits and vegetables containing Docosahexaenoic Acid (DHA)

64. Fruit Juice Must be full-strength fruit juice (regular or infant juice) May only be creditable at snack for infants ages 8 through 11 months When purchasing fruit juice for infants Choose fruit juice containing or fortified with Vitamin C Choose only pasteurized fruit juice Avoid orange juice and grapefruit juice Page 3-65

65. Crediting Commercial Baby Food Meats and Meat Alternates Meat and Meat Alternates CreditableNoncreditable Page 3-69 Commercial plain strained baby food meats (including those with beef, chicken, turkey, lamb, veal and ham) Gerber’s “2nd Foods  Meats” baby food meat products, including Beef and Beef Gravy, Chicken and Chicken Gravy, Ham and Ham Gravy, Lamb and Lamb Gravy, Turkey and Turkey Gravy, and Veal and Veal Gravy. (May include additional ingredients such as corn starch and lemon juice concentrate) Commercial baby food combination dinners 1 Meat sticks or “finger sticks” Home-canned meats Commercial fish sticks, other commercial breaded or battered fish or seafood products, canned fish with bones, hot dogs, and sausages Yogurt Nuts, seeds and nut and/or seed butters

66. Crediting Commercial Bread and Crackers Bread and Crackers CreditableNoncreditable Page 3-71 Bread Breads (white, wheat, whole wheat, French, Italian, and similar breads, all without nuts, seeds or hard pieces of whole-grain kernels) Biscuits Bagels (made without nuts, seeds or hard pieces of whole-grain kernels) English Muffins Pita bread (white, wheat, whole wheat) Rolls (white, wheat, whole wheat, potato, all without nuts, seeds or hard pieces of whole-grain kernels) Soft tortillas (wheat or corn) Pancakes, waffles, or muffins made with whole eggs Hard pretzels, certain cookies, bread sticks, tortilla chips, granola bars, rice cakes Croutons, pieces of crunchy waffles, and many ready-to-eat breakfast cereals Doughnuts, cake and brownies

67. Bread and Crackers CreditableNoncreditable Page 3-71 Cracker-Type Products Crackers: saltines or snack crackers without nuts, seeds or hard pieces of whole- grain kernels matzo crackers animal crackers graham crackers made without honey (honey, even possibly in baked goods, could contain Clostridium botulinum spores which can cause a type of serious foodborne illness in infants) Teething biscuits Zwieback Crediting Commercial Bread and Crackers

68. Crediting Guide for Infant Foods Feeding Infants: A Guide for Use in the Child Nutrition Program Assists sponsors in determining whether or not a food item is creditable Page 3-78

69. Key Resources Special thanks to Susan Fiore, MS, RD and the Conneticutt State Department of Education, Bureau of Early Childhood, Family and Student Services for their assistance with this presentation. Feeding Infants: A Guide for Use in the Child Nutrition Programs. USDA, Revised December 2001 www.fns.usda.gov/tn/Resources/feeding_infants.html Bright Futures for Babies: Three Appropriate Feeding Practices in Early Infancy. Susan Miller. 2000 www.nal.usda.gov/wicworks/Learning_Center/BF_babies.pdf Infant Nutrition and Feeding Resource List. Food and Nutrition Information Center, National Agricultural Library, U.S Department of Agriculture, September 2001. www.nal.usda.gov/fnic/pubs/bibs/topics/pregnancy/infnut.html www.nal.usda.gov/fnic/pubs/bibs/topics/pregnancy/infnut.html

70. Team Nutrition: http://www.fns.usda.gov/tn/ The Child Care Nutrition Resource System: http://www.nal.usda.gov/childcare/ WIC Works Resource System: http://www.nal.usda.gov/wicworks/ National Food Service Management Institute (NFSMI): http://www.nal.usda.gov/fnic/ Food and Nutrition Information Center (FNIC): http://www.nal.usda.gov/fnic http://www.nal.usda.gov/fnic Key Resources, continued

71. Questions?????

72. For more information… Carole Dennis Program Specialist II Bureau of Nutrition Programs & Services New Hampshire State Department of Education (603) 271-3883 Resources Questions Help