1. Infant Meals and the CACFP Ann-Marie Martin CACFP Specialist Alaska Department of Education & Early Development

2. Claiming infants on CACFP Infant meal pattern Creditable foods Recordkeeping requirements Infant resources Infant Meals

3. Claiming Infants on CACFP To claim infants, you must 1. Include infants in your study month enrollment roster (for centers or Early HS). 2. Have a parent complete the Infant Formula Offer form for each infant. 3. Follow the CACFP Infant Meal Pattern. 4. Maintain Infant Menus/Production records. 5. Take point of service meal counts.

4. Parent Provided Food & Formula A parent may choose to provide food and/or formula for their own child. Must be an approved iron-fortified infant formula. Maintain documentation that the parent declined offered food and/or formula.

5. 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, in order to claim the meal for reimbursement.

6. Food Provided by Parents When mom comes to the site and nurses… the meal is not reimbursable… UNLESS the center or provider supplies an additional required component.

7. Day Care Homes Only A provider who nurses her own child may claim meals and snacks for reimbursement, as long as: -she is eligible to claim her own children, -the infant is enrolled and participating in the CACFP, and -at least one other enrolled child is present during the meal service.

8. USDA Infant Meal Pattern USDA defines infants as ages birth through the 11 th month. Amounts and types of food required to offer changes as infants get older. 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. AgeBreakfastLunch and SupperSnack Birth through 3 months 4-6 fluid ounces formula 1 and/or breast milk 4 through 7 months 4-8 fluid ounces formula 1 and/or breast milk 0-3 Tbsp infant cereal 2 (optional) 4-8 fluid ounces formula 1 and/or breast milk 0-3 Tbsp infant cereal 2 (optional) 0-3 Tbsp fruit and/or vegetable (optional) 4-6 fluid ounces formula 1 and/or breast milk 8 through 11 months 6-8 fluid ounces formula 1 and/or breast milk and 2-4 Tbsp infant cereal 2 and 1-4 Tbsp fruit and/or vegetable 6-8 fluid ounces formula 1 and/or breast milk and 2-4 Tbsp infant cereal 2 and/or 1-4 Tbsp lean meat, fish, poultry, egg yolk, cooked dry beans or cooked dry peas 5 or ½-2 ounces (weight) cheese or 1-4 ounces (volume) cottage cheese or 1-4 ounces (weight) of cheese food or cheese spread and 1-4 Tbsp fruit and/or vegetable 2-4 fluid ounces formula 1 and/or breast milk or fruit juice 3 0 to ½ slice of crusty bread 4 (optional) or 0 to 2 crackers 4 (optional) Refer to page 63 in the Creditable Foods Guide (Revised March 2007) for the footnotes 1, 2, 3, 4, 5. CACFP Infant Meal Pattern

11. 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 AgeBreakfastLunch and SupperSnack Birth through 3 months 4-6 fluid ounces formula and/or breast milk

12. 4 through 7 months Required at all meals and snacks: Iron-fortified formula and/or Breast milk Solid foods when developmentally ready AgeBreakfastLunch and SupperSnack 4 through 7 months 4-8 fluid ounces formula 1 and/or breast milk 0-3 Tbsp infant cereal 2 (optional) 4-8 fluid ounces formula 1 and/or breast milk 0-3 Tbsp infant cereal 2 (optional) 0-3 Tbsp fruit and/or vegetable (optional) 4-6 fluid ounces formula 1 and/or breast milk

13. 8 through 11 months Required at all meals and snacks: Only Iron-fortified formula or breast milk is required to be offered. OK to offer less than the minimum amount of breast milk AgeBreakfastLunch and SupperSnack 8 through 11 months 6-8 fluid ounces formula 1 and/or breast milk and 2-4 Tbsp infant cereal 2 and 1-4 Tbsp fruit and/or vegetable 6-8 fluid ounces formula 1 and/or breast milk and 2-4 Tbsp infant cereal 2 and/or 1-4 Tbsp lean meat, fish, poultry, egg yolk, cooked dry beans or cooked dry peas 5 or ½-2 ounces (weight) cheese or 1-4 ounces (volume) cottage cheese or 1-4 ounces (weight) of cheese food or cheese spread and 1-4 Tbsp fruit and/or vegetable 2-4 fluid ounces formula 1 and/or breast milk or fruit juice 3 0 to ½ slice of crusty bread 4 (optional) or 0 to 2 crackers 4 (optional)

14. 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)

15. 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

16. 8 through 11 months Required at Snacks: Iron-fortified formula and/or Breast milk or Fruit Juice (full strength) Optional at Snacks: Crusty bread or Crackers

17. 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.

18. Infant Formula Center/Provider must supply at least one creditable infant formula. Must be iron-fortified To view the list of approved iron-fortified formulas, go online to: This list is not comprehensive-- contact your State agency if you have questions. www.fns.usda.gov/cnd/Care/Regs-Policy/InfantMeals/FormulaList.htm

19. Medical Statement A signed statement by a recognized medical authority is required to support the use of: Low-iron infant formulas. Follow-up formulas when served to infants less than the specified age. Exempt infant formulas.

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

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

22. Happy 1 st Birthday! After the 1 st Birthday Serve off of the 1-2 year old meal pattern Medical statements required: Infants not ready to transition to cows milk after their 13 th month Infants not ready to be served the1-2 year old meal pattern

23. 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.

24. Iron-fortified Infant Cereal Creditable Infant cereals Iron-fortified Can be mixed with breast milk or formula Non-Creditable Adult cereals Not iron-fortified infant cereals Infant cereals containing fruit Jarred infant cereals

25. Commercially Prepared Infant Food Fruits and Vegetables Creditable The fruit or vegetable is the first ingredient. Contain multiple fruits or vegetables ingredient. Water is not the first ingredient. Non-Creditable Baby dinners. Jarred cereal with fruit. Desserts. Water is the first ingredient. Containing DHA.

26. 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. Rice Cereal with Apples Beech-Nut Naturals First Advantage 4 oz. Cereals Ingredients: apples, apple juice from concentrate (water and apple juice concentrate), water, dried egg yolks, rice flour, cinnamon, ascorbic acid (vitamin c), ferrous sulfate (source of iron), citric acid, zinc sulfate (source of zinc), niacinamide, calcium pantothenate, thiamine mononitrate (vitamin b1), riboflavin (vitamin b2), pyridoxine hydrochloride (vitamin b6), vitamin b12 and folic acid. Not Creditable - Water 1 st ingredient. - Has 2 food components, making it a dinner. Not Creditable Cereals with fruit not creditable.

27. Green Beans Corn & Rice Beech-Nut Naturals Stage 3 4 oz. Vegetables Ingredients: Green beans, corn, water and rice flour. Mixed Vegetables Beech-Nut Naturals Stage 2 4 oz. Vegetables Ingredients: vegetables (carrots, green beans, peas) and water necessary for preparation. Creditable - Vegetable 1 st ingredient. - Water okay. - No other food components. Not Creditable - Vegetable 1 st ingredient. - Water okay. - Has rice flour, another food components, making it a dinner.

28. Commercially Prepared Infant Food Meat & Meat Alternates Creditable Plain strained baby food meats - Including those with beef, chicken, turkey, lamb, veal, and ham. Non-Creditable Combination dinners. Meat sticks. Breaded/battered seafood and canned fish with bones. Yogurt. Nuts, seeds, and nut/seed butters.

29. Chicken Lasagna Beech-Nut Naturals Stage 3 6 oz Dinners Ingredients: water, tomato paste, finely ground chicken, carrots, pear puree concentrate, enriched macaroni product (durum wheat semolina, niacin, ferrous sulfate, thiamine mononitrate, riboflavin and folic acid) and romano cheese (made from partially skimmed cow's milk, cheese cultures, salt and enzymes). Vegetables & Beef Beech-Nut Naturals Stage 2 4 oz. Dinners Ingredients: vegetables (carrots, rehydrated potatoes, peas), water and beef Not Creditable - Has more than 1 food component. - Considered a Dinner. Not Creditable - Water 1 st ingredient - More than 1 food component. Making it a dinner.

30. Chicken & Chicken Broth Beech-Nut Naturals Stage 1 2.5 oz. Meats Ingredients: Chicken, finely ground chicken, and chicken broth. Creditable - Chicken is the only ingredient.

31. 8 through 11 months Optional at Snacks: Crusty bread or Crackers Whole grain or enriched meal or flour Not Bread Alternates Not all grain and bread alternates are appropriate for infants!

32. Non-Creditable Breads and Crackers for Infants Allergies (whole eggs): pancakes waffles muffins Calories: brownies cakes doughnuts Choking: hard pretzels breadsticks tortilla chips granola bars some ready to eat cereals

33. Creditable Breads for Infants Breads (without seeds, nuts, or hard pieces of grain kernels): white wheat whole wheat French Italian other similar breads

34. Creditable Breads and Crackers for Infants Other Foods: biscuits bagels English muffins pita bread rolls soft tortillas Crackers: saltines snack crackers animal crackers graham crackers (without honey)* *clostridium botulinum spores = serious food borne illness

35. Creditable Foods for Infants -- Fruit Juice Creditable Full strength juice Only at snack for 8-11 month olds Non-Creditable Unpasteurized fruit juice Vegetable juice Fruit juices with yogurt

36. Exempt Infant Formulas i.e. Nutramigen, Pregestimil, Alimentum Specialty formulas required for: inborn errors of metabolism low birth weight unusual medical or dietary problems www.fda.gov www.fda.gov and search exempt infant formula

37. Meal Times for Infants No specified meal time May offer meal at more than one sitting Complete one meal before serving the next

38. Meal Times for Infants On-Demand Infant Feeding Feed when hungry Only approved meal types can be claimed

39. Infant menus must contain the following information: Food components offered. Names of infant. Infants age and date of birth. Meal type. Date of meal service.

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

43. Not moving to next set of meal pattern requirements at start of their 4 th and 8 th 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. Common Menu Documentation Errors

44. Want more on infant feeding? www.fns.usda.gov/tn/Resources/feeding_infants.html

45. Thank You Infant Training PowerPoint: http://www.eed.state.ak.us/tls/cns/CACFP3.html Infant Forms: http://www.eed.state.ak.us/tls/cns/CACFP2.html http://www.eed.state.ak.us/tls/cns/CACFP2.html