Feeding Infants in the CACFP
October 19, 2017
Infant feeding can be a challenge. This memo seeks to clarify the new meal patterns as related to infant feeding, including breastmilk/formula and the introduction of solid foods. It also includes an extensive Question & Answers section in the second half of the memo to assist in providing the best nutritional start possible for the youngest in our care. Remember, infants do not eat on a set meal schedule, so you must not disallow infant meals for not following the typical meal schedule. Further clarification is below:
Creditable Infant Formulas
- Must be iron-fortified. To ensure that the formula is creditable, follow these guidelines:
- Double-check that the formula is not on the FDA Exempt Infant Formula list.
- Look on label for “Infant Formula with Iron” or a similar statement.
- Use the Nutrition Facts label to ensure that the formula has at least 1 mg of iron per 100 calories.
- A medical statement is necessary for the creditable use of an FDA Exempt Infant formula.
Provided breastmilk or formula
- Parents may decline the provider’s formula and bring their own creditable formula or expressed breastmilk.
- Breastmilk is creditable when provided as expressed milk or breastfed on site.
- Both formula and breastmilk are creditable even when it is the sole meal component.
- While you must document that breastmilk or formula were received, you do not have to specify whether on-site or expressed.
- Providers are responsible for making sure the other food components are offered when they begin solid foods.
Expressed breastmilk storage
- May be stored up to 72 hours after being expressed in a refrigerator at 40F or below.
Solid Foods (Complementary Foods)
- Two infant age groups: 0-5 months and 6-11 months.
- Delay the introduction of solids until 6 months or developmental readiness (typically 6 to 8 months)
- Meals must not be disallowed as infants begin to try new foods. Meal offerings must follow the infant’s feeding patterns. Do not disallow a meal because one day you offered a food and the next you didn’t.
- Be sure to offer foods that are appropriate for the age of the infant in texture and consistency.
- As a best practice, centers and homes should ask the parent or guardian to approve in writing when they should begin serving solid foods to their infant. The American Academy of Pediatrics (AAP) recommends these signs:
- When an infant has good head control and can sit in a high chair or seat.
- When an infant opens their mouth for food, watches others eat with interest, and/or seem excited to participate in the meal.
- When an infant has less of a gag reflex and can move food from spoon to mouth.
- When the infant has doubled their birth weight and weighs 13 pounds or more.
Vegetables and Fruits
- Juice is no longer allowed for infants.
- Vegetables and/or fruits are already required at breakfast, lunch, and supper for infants who are developmentally ready. Additionally, fruits and vegetables are now required at snack for the same developmentally ready infants.
- Ready-to-eat cereals allowed for developmentally ready infants.
- Must meet sugar limits (no more than 6 grams per dry ounce).
Meat and Meat Alternates
- Older infants may have yogurt as a meat alternate as long as it contains no more than 23 grams of sugar per 6 ounces.
- Whole eggs allowed as a meat alternate as well.
- No cheese spread or cheese food products are reimbursable. Regular cheese is still allowed.
DHA enriched foods
- DHA-containing credible infant food items are now reimbursable.
- Must keep records of menus.
- State Agencies are allowed to request other forms of documentation. However, State Agencies are encouraged not to impose additional paperwork burdens.
Please be sure to refer to the extensive Question and Answer portion of the full text memo.
Why It Matters
Taking care of infants is a joy for many providers across the nation. However, sometimes feeding them can be challenging and confusing. The new meal patterns may seem overwhelming at first, but broken down into food components can help us understand the most recent nutritional science when crafting our menus and introducing foods to those who are ready. The increased flexibility for breastfeeding mothers (both expressed milk and feeding on-site) supports both mothers and strengthens our program. We know the first years of life are vitally important to a lifetime of positive health and these changes help us support healthier infants as they grow into children.
For more information, check out Feeding Infants and Meal Pattern Requirements in the Child and Adult Care Food Program; Questions and Answers (CACFP 02-2018).