A proposed federal rule accepting comments until April 15, 2015 proposes changes to meal pattern requirements for young children served by the Child and Adult Care Food Program (CACFP) to better align with updated nutrition guidelines. Several proposed revisions would extend to affect the National School Lunch Program, School Breakfast Program, and Special Milk Program to be more consistent across all Child Nutrition programs, as well as move toward more nutritious meals for children in day care. 

Amendments made by the Healthy, Hunger-Free Kids Act of 2010 (HHFKA) require the Department of Agriculture (USDA) through its CACFP to promote health and wellness in child care settings by guidance and technical assistance in promoting nutrition and physical activity and limiting of electronic media use. Amendments also require the USDA to review and update CACFP meal patterns no less than every 10 years to reflect most recent nutrition guidelines.

Unfortunately, CACFP meal patterns have not been significantly updated since the program was started, since which nutritional concerns have shifted from malnutrition to overconsumption of calories including unhealthy fats, added sugar, and sodium, with underconsumption of fiber and other nutritional needs.

Some of the proposed revisions include:

• Introduce solid foods to infants beginning at 6 months of age
• Eliminate the service of fruit juice to infants of any age
• Allow reimbursement for infant meals when the mother directly breastfeeds her child at the child care facility
• Require a fruit or vegetable serving in the snack meal pattern for the 6 to 11 month infant age group
• Allow additional grain options for infant snacks
• Separate the fruit and vegetable component for children and adults
• Require that at least one grain serving per day, across all eating occasions, be whole grain or whole grain-rich
• Require breakfast cereals to conform to WIC requirements
• Prevent grain-based desserts from counting towards the grains component
• Allow an optional meat or meat alternate to be served at breakfast in lieu of some grains
• Allow tofu to be counted as a meat alternate
• Disallow frying as an onsite preparation method for day care institutions and facilities

In 2012 alone, the CACFP provided over 1.9 billion meals and snacks to adults and over 3.4 million children daily in child care centers, family care homes, and after school programs. Supporting the proposed rule would allow this influential program to help address the epidemic of obesity and new health concerns that affect American adults, adolescents, children, and now young children as well.

For more information and to make a comment:

http://www.regulations.gov/#!documentDetail;D=FNS-2011-0029-0001

https://brightfutures.aap.org/pdfs/Guidelines_PDF/6-Promoting_Healthy_Nutrition.pdf

http://frac.org/federal-foodnutrition-programs/child-and-adult-care-program/

Grace Kim, MD