VERSION 3 · Monounsaturated Fatty Acids (MUFAs) – Are liquid at room temperature and are found...
Transcript of VERSION 3 · Monounsaturated Fatty Acids (MUFAs) – Are liquid at room temperature and are found...
For Organizations Serving Children and Youth
252 Chapman RoadChristiana Building, Suite 200
Newark, DE 19702302-444-9100 n 888-494-5252
nemours.org/growuphealthy
©2013 The Nemours Foundataion. Nemours is a registered trademark of the Nemours Foundation.
VERSION 3
Best Practices for Healthy Eating
Authors
Michelle Boyle, MS, CHES
Gina Celano, MS, CHES
Erica Cooper, MPH, RD
Kate Dupont Phillips, MPH, CHES, PAPHS
Mary Trotter, MS, RD, LDN
Stefanie Van Stan, MS, CHES
Acknowledgements
The authors gratefully acknowledge the invaluable contributions of a wide variety of stakeholders committed to supporting children’s health and optimal development. The remarkable nutrition policy changes in Delaware, impacting 44,000 children in early care and education settings, would not have been possible without the knowledge, service, enthusiasm and support of many. We hope this guide assists providers in making those policies real in the lives of children. This is possible only through the collaborative efforts of many organizations and individuals, all dedicated to helping children grow up healthy!
We thank the following organizations and individuals for their guidance, support and feedback:
n David Bowman, Education Associate, Delaware Department of Education
n Elizabeth Walker, Director, Association of State and Territorial Health Officials
n Beth Weatherbee, formerly with the Delaware Department of Education
n Patricia Quinn, Administrator, Delaware Office of Child Care Licensing
For More Information
Please contact:
Nemours Health & Prevention Services252 Chapman Road, Christiana Building, Suite 200Newark, DE 197021-888-494-5252 or [email protected] www.nemours.org/growuphealthy
The content of this document is intended solely for educational non-commercial use and is strictly informational, information contained in this material is not intended as medical advice and is not a substitute for medical advice one receives or should receive from their health care provider.
Nemours is currently funded by the Centers for Disease Control and Prevention (CDC) under a five-year Cooperative Agreement (1U58DP004102-01). Funding for this publication was made possible by the CDC. The views expressed in this document do not necessarily reflect the official policies of the Department of Health and Human Services, nor does the mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.
VERSION 3
Copyright © 2013 The Nemours Foundation. All rights reserved.
Best Practices for Healthy Eating 1
Table of ContentsIntroduction 2
GlossaryofTerms 3
FeedingInfants&Children 5
Current CACFP Daily Meal Pattern for Infants 6Recommended CACFP Daily Meal Pattern for Infants 6Infant Feeding 7Recommendations, Rationale and Portion Sizes for Infants 8Current CACFP Daily Meal Pattern for Children 14Recommended CACFP Daily Meal Pattern for Children 15Comparison of Current and Recommended CACFP Requirements 16Recommendations, Rationale and Portion Sizes for Children 1–2 Years 17Recommendations, Rationale and Portion Sizes for Children 3–5 Years 22Recommendations, Rationale and Portion Sizes for Children 6 Years and Older 25
GeneralGuidance 29
Role Modeling 30Family-Style Dining 31Hungry or Full? 32Picky Eaters 33Choking Hazards and Food Allergies 34
MenuPlanningandMealPreparation 35
Transitioning Kids to Healthier Foods 36How to Read a Food Label 37Choosing Healthy Options 38Seasonal Fruits and Vegetables 39Healthy Food Substitutions 40Healthy Cooking Methods 42Engaging Children in the Kitchen 43
PolicySupport 45
For Program and Staff Handbooks 46For Family Handbooks 47
FamilyTipSheets 49
Healthy Eating for Infants Birth through 3 Months 50Healthy Eating for Infants 4 through 7 Months 52Healthy Eating for Infants 8 through 11 Months 56Healthy Eating for Children 1 through 2 Years 60Healthy Eating for Children 3 through 5 Years 63Healthy Eating for Children 6 Years and Older 66Division of Responsibility in Feeding 69Recommendations At-A-Glance 70Linkages to Home 71
References 72
2 Best Practices for Healthy Eating
IntroductionThisguideisintendedtoserveasapracticaltoolforimplementingfeedingbestpracticesforoptimalnutritioninearlycareandeducationsettings.Youandyourprogramplayanimportantpartinsupportingchildren’sdevelopmentofhealthyhabits,bothbyprovidingnutritiousfoodandbyteachingchildrenhowtomakehealthyfoodchoices.Childrenwholearnthesehabitswhenthey’reyoungaremorelikelytocontinuemakinghealthychoicesinadulthood.Bysharinginformationwithfamilies,youcanworkwiththemaspartnerstosupporthealthychildren.Inthisguideyouwillfind:
▪ Recommendationsforhealthyoptionsinthefollowingcategories:beverages,fruitsandvegetables,milk,meatsandmeatalternates,andgrainsandbreads
▪ Rationalefortherecommendations
▪ AppropriateportionsizesbyagethatarebasedontheCACFPreimbursablemealguidelines
▪ Ideasforengagingchildreninhealthyeating
▪ Tipsandtoolsforreadingnutritionlabels,motivatingpickyeaters,andmodelinghealthyhabits
▪ Tipsheetsforfamilies
▪ Samplepoliciesforuseinyourprogramandwithfamilies
Thistoolkitistheresultofextensiveresearch,collaborationandfeedbackfrommanyindividuals.Itisa“livingdocument.”Itwillcontinuetobeedited,updatedandimprovedovertime.Wewelcomeyourcomments,questionsandsuggestions.ItisYOUthatthistoolkitisintendedtoserve!Ifyouhavefeedback,pleasecontact:
NemoursHealth&PreventionServices252ChapmanRoad,ChristianaBuilding,Suite200
Newark,[email protected]
www.nemours.org/growuphealthy
Beforeyoubeginreadingthisguide,considertakingafewmomentstodoaself-assessmentofyourprogram’scurrentpracticesusingthetoolontheLet’s Move!ChildCarewebsitebelow.Itisimportanttoknowyourprogram’sstrengths,aswellasareasofopportunity.Thiswillhelpyoudeterminewhichsectionsofthisguidebestaddressyourspecificneeds.
Let’s Move! ChildCare
www.healthykidshealthyfuture.org
Best Practices for Healthy Eating 3
Glossary of Terms
Added Sugars–Sugarsandsyrupsthatareaddedtofoodsduringprocessingorpreparation.Addedsugarsdonotincludenaturally-occurringsugarssuchasthosefoundinmilkandfruits.
Basic Food Groups–IntheUSDAmealpattern,thebasicfoodgroupsaregrains;fruits;vegetables;milk,yogurt,andcheese(dairy);andmeat,poultry,fish,driedpeasandbeans,eggs,andnuts(protein).IntheCACFPmealpattern,thebasicfoodgroups(alsocalled“mealcomponents”)aregrainsandbreads;milk;meatsandmeatalternates;andfruitsandvegetables.1
Cardiovascular Disease–Referstodiseasesoftheheartanddiseasesofthebloodvessels(arteries,capillaries,veins)withinaperson’sentirebody,suchasthebrain,legsandlungs.1
Cheese Food–Aprocessedcheesepreparedbymixingoneormorecheeseingredientswithoneormoredairyingredientsintoahomogeneousplasticmass,whichreducestheamountofcheeseinthefinishedproduct.Itmustcontainatleast51%ofthecheeseingredientbyweight,haveamoisturecontentlessthan44%,andcontainatleast23%milkfat.2
Cheese Product–Aprocessedcheesethatdoesnotmeetthemaximummoisturecontentof43%and/orthe47%minimummilkfatstandardsofprocessedcheese.2
Cholesterol –Asterolpresentinallanimaltissuesthatwheningestedbyhumans,turnsintoasoft,fatty,wax-likesubstanceinthebloodstream.Itisnecessaryintheproductionofcellmembranesandsomehormones,buttoomuchcholesterolinthebloodisamajorriskforcoronaryheartdisease(whichleadstoheartattack)andforstroke.Thereisnoevidenceforadietaryrequirementforcholesterol.1,6
Chronic Diseases–suchasheartdisease,canceranddiabetes—aretheleadingcausesofdeathanddisabilityintheUnitedStates.Thesediseasesaccountforsevenofeverytendeathsandaffectthequalityoflifeof90millionAmericans.Althoughchronicdiseasesareamongthemostcommonandcostlyhealthproblems,theyarealsoamongthemostpreventable.Adoptinghealthybehaviorssuchaseatingnutritiousfoods,beingphysicallyactiveandavoidingtobaccousecanpreventorcontrolthedevastatingeffectsofthesediseases.1
Combination Food–Asingleservingofafooditemthatcontainstwoormoreoftherequiredmealcomponents(e.g.,pizza,chefsalad).
Dietary Fiber–Typicallyreferstonondigestablecarbohydratesfromplantfoodssuchaslegumes(e.g.,peasandbeans),oats,barley,somefruitsandfruitjuices(e.g.,prunes,plumsandapples),somevegetables(e.g.,broccoli,carrotsandcelery),nuts,seedsandwholegrains.1
Discretionary Calorie Allowance–Thecaloriesremaininginaperson’senergyallowanceafterhe/shehasconsumedadequatecaloriesfromhealthfulfoods,i.e.foodsinlow-fatornoaddedsugarforms.These“left-over”caloriescanbe“spent”onformsoffoodsthatarenotthemostnutrientdense(e.g.,wholemilkratherthanfat-freemilk)ormaybeadditionstofoods(e.g.,saladdressing,sugar,butter).1
Heart Disease–Anarrowingofthesmallbloodvesselsthatsupplybloodandoxygentotheheart(coronaryarteries).1
Monounsaturated Fatty Acids (MUFAs)–Areliquidatroomtemperatureandarefoundincanola,oliveandpeanutoils.MUFAslowertotalcholesterol,lowerbadcholesterol(LDL)andalsoraisegoodcholesterol(HDL).Thesearehealthyfats.4
Nutrient-Dense Foods–Foodsthatprovidesubstantialamountsofvitamins,mineralsandothernutrientsandrelativelyfewercalories.1Nutrient-densefoodsareformsoffoodsthatareleanorlowinsolidfatsandwithoutaddedsolidfats,sugars,starches,orsodiumandthatretainnaturally-occurringcomponentssuchasfiber.
4 Best Practices for Healthy Eating
Ounce Equivalent–Inthegrainsfoodgroup,theamountofafoodcountedasequaltoaoneouncesliceofbread;inthemeat,poultry,fish,drybeans,eggs,andnutsfoodgroup,theamountoffoodcountedasequaltooneounceofcookedmeat,poultry,orfish.1
Polyunsaturated Fatty Acids (PUFAs)–Areusuallyliquidatroomtemperature.Safflower,sunflower,cornandsoybeanoilscontainthehighestamountsofPUFAs.PUFAslowertotalcholesterolinthebloodandlowerthebadcholesterol.However,theyalsolowerthegoodcholesterol.Overall,theyarehealthyfats.4
Portion Size–Theamountofafoodconsumedinoneeatingoccasion;canconsistofmultipleservings.1
Processed Cheese–Foodpreparedbymixingoneormorecheeses,withtheaidofheat,formanufacturingwithanemulsifyingagent.Thecheeseisthenpouredintomoldstosolidifyintoahomogeneousplasticmassandislaterpackaged.Thefinalproductcanhaveamaximummoisturecontentof43%andmusthaveatleast47%milkfat.2
Processed Meat–Ameatproductcontainingatleast30%meat,wherethemeathasundergoneprocessingotherthanboning,slicing,dicing,mincingorfreezing,eitherasasinglemeatorincombinationwithotheringredientsoradditives.Processedmeatshavebeencured,smoked,dried,canned,dehydratedand/orcombinedwithchemicalsand/orenzymes.Examplesincludesausage,bacon,delimeats,hotdogs,bologna,salami,pepperoni,etc.3
Saturated Fats–Aresolidatroomtemperaturelikebutter,stickmargarine,shorteningandthefatincheeseandmeat.Somevegetableoils(e.g.,coconutandpalmoil)containmostlysaturatedfats.Theseareunhealthyfatsthatraisecholesterolintheblood,sousethemsparingly,ifatall.4
Serving Size–Astandardizedamountofafood,suchasacuporanounce,usedinprovidingdietaryguidanceorinmakingcomparisonsamongsimilarfoods.1
Sweet Grain–Agrainfoodthatcustomarilycontainsasignificantproportionofcaloriesfromsugar.Includes:doughnuts,Danishes,cakes,cupcakes,pies,cookies,brownies,toasterpastries,commercially-preparedmuffins/quickbreads,sweetrolls,granolabars,andgrainfruitbars.
Trans Fats–Arefoundnaturallyinsomefoodsbutmainlycomefrompartiallyhydrogenatedfatsincommercially-preparedbakedgoodslikecrackersandcookies.Transfatsraisecholesterolinthebloodjustlikesaturatedfatdoes,sotrytolimitoravoidthementirely.Theyareunhealthyfats.4
Whole Grains–Foodsmadefromtheentiregrainseed,usuallycalledthekernel,whichconsistsofthebran,germandendosperm.Ifthekernelhasbeencracked,crushedorflaked,itmustretainnearlythesamerelativeproportionsofbran,germandendospermastheoriginalgraininordertobecalledwholegrain.1
1. U.S.DepartmentofHealthandHumanServices,U.S.DepartmentofAgriculture.DietaryGuidelinesforAmericans,2005.http://www.health.gov/dietaryguidelines/dga2005/document/default.htm.AccessedMay28,2010.
2. ElectronicCodeofFederalRegulations.Title21,Part133.http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&tpl=/ecfrbrowse/Title21/21cfr133_main_02.tplAccessedAugust13,2010.
3. FoodStandardsNewZealandAustralia.FoodStandardsGuide,2001.http://www.foodstandards.gov.au/_srcfiles/Meat_0801.pdf.AccessedJune11,2010.
4. U.S.DepartmentofHealthandHumanServices.PhysicalActivityGuidelinesforAmericans,2008.http://www.health.gov/paguidelines/pdf/paguide.pdf.AccessedJune11,2010.
5. NemoursHealthandPreventionServices.PlanningHealthyMealsforChildCare,2009.
6. AmericanHeartAssociation.WhatisCholesterol?http://www.americanheart.org/presenter.jhtml?identifier=3046103AccessedJune30,2010.
Best Practices for Healthy Eating 5
Feeding Infants & Children
6 Best Practices for Healthy Eating
Recommended CACFP Daily Meal Pattern – InfantsThismealpatternwasnotreimbursablebyCACFPatthetimeofpublication.
Age Meal Breast Milk/Infant Formula Meats, vegetables, fruits, and infant cere-als (complementary foods)
0through5months Allfeedings 4–6oz.breastmilkorinfantformulaperfeeding Nosolidfoods
6through11months Breakfast 6–8oz.breastmilkorformula 1–4TBSPmeat,fish,poultry,oreggyolkOR1–4TBSPinfantcerealPLUS1–2TBSPvegetableOR1–2Tfruit*
Lunch/Sup-per
6–8oz.breastmilkorformula 1–4TBSPmeat,fish,poultryoreggyolkOR1–4TBSPinfantcerealPLUS1–2TBSPvegetableOR1–2TBSPfruit*
Snack 2–4oz.breastmilkorformula 1–2TBSPvegetableOR1–2TBSPfruit*PLUS½sliceofbreadOR2crackers
NOTES: n *Nofruitjuiceforinfantsunder12monthsofage.
n At6months,introducethesefoodsoneatatime,startingwithmeatorinfantcereal,followedbyvegetables,fruits,andbreadorcrackersinamountsandtypesthataredevelopmentally-appropriate.
n Donotserveanytypeofcow’smilk,foodsmixedwithmilk(suchasmilkwithcereal,milkinmashedpotatoes),ormilk-basedproducts(yogurt,milk,cottagecheese)until1yearofage.Begintransitioningtocow’smilkat1yearofage.
IOM(InstituteofMedicine).2011.Child and Adult Care Food Program: Aligning Dietary Guidance for All. Washington,DC:TheNationalAcademiesPress.
Current CACFP Daily Meal Pattern – Infants Meal Component Birth through 3 months 4 through 7 months 8 through 11 months
BREAKFAST – Serve the following 3 components:
Breast Milk or Formula 4–6floz. 4–8floz. 6–8floz.
Infant Cereal None 0–3Tbsp 2–4Tbsp
Fruit or Vegetable None None 1–4Tbsp
LUNCH or SUPPER – Serve the following 4 components:
Breast Milk or Formula 4–6floz. 4–8floz. 6–8floz.
Fruit or Vegetable None 0–3Tbsp 1–4Tbsp
Infant Cereal None 0–3Tbsp 2–4Tbsp
Meat or Meat Alternate (choose one)
Lean meat, poultry, fish, egg yolk, cooked beans or peas
None None 1–4Tbsp
Cheese None None ½–2oz.
Cottage cheese None None 1–4oz.
SNACK – Serve the following 2 components:
Breast Milk or Formula 4–6floz. 4–6floz. 2–4floz.
Grain or Bread (choose one)
Bread None None 0–½slice
Crackers None None 0–2crackers
IfyouparticipateinCACFP,youmustcomplywiththismealpatternforreimbursement.
Best Practices for Healthy Eating 7
Infant FeedingBreastfeedingBreastmilkistheidealfoodforinfants.Infact,theAmericanAcademyofPediatrics(AAP)recommendsexclusivebreastfeedingforthefirstsixmonthsofaninfant’slife.Duringthistime,nootherfoodsorbeveragesshouldbeserved.Atsixmonths,solidfoodscanbegraduallyintroducedtoaninfant’sdiet.However,breastfeedingshouldcontinueuntilatleast12months,andaslongasdesiredbymotherandbaby.Breastfeedinghasbeenshowntoreduceinfants’riskofdevelopingmanycommonillnessesandchronicconditionssuchasasthma,diabetes,earinfections,respiratorytractinfections,dermatitis,andceliacdisease.Infantswhoarebreastfedarealsolesslikelytobeoverweightorobese.1Additionally,breastfeedingpromotesbondingbetweenamotherandherinfant.
Asanearlycareandeducation(ECE)provider,youhaveaveryimportantroleinpromotingandfacilitatingbreastfeedingamongthefamiliesyouserve.Ifamotherwishestobreastfeed,workwithhertodevelopasystemtoensurethatanamplesupplyofbreastmilkisavailablewhiletheinfantisinyourcare.Thisincludeshavingarefrigerator/freezeravailableforbreastmilkstorageand/oradesignatedprivatespaceformotherstopumporbreastfeed.Breastmilkshouldbeclearlylabeledwitheachinfant’snameandthedateonwhichitwasexpressed.Thisensuresthataninfantreceivesonlyhis/herownmother’sbreastmilkandthatthebreastmilkissafeforconsumption.
Itisveryimportanttofamiliarizeyourselfwiththesafestorageandpreparationofbreastmilk.Belowaresomehelpfultipsandguidelines:
n Nevermicrowavebreastmilk!Itisbesttodefrostbreastmilkeitherintherefrigeratorovernight,byrunningunderwarmwater,orbysettingitinacontainerofwarmwater.Thawedbreastmilkshouldbeusedwithin24hours.Donotrefreezeunusedmilk.
n Ifaninfantdoesn’tfinishthebottleofbreastmilkwithinonehour,throwouttherest.Bacteriafromsalivacancontaminatethemilkandmaketheinfantsickifhe/shedrinksitlater.
n Atroomtemperature,abottleofbreastmilkcansafelystayoutfor3–4hours.
n Breastmilkcanbesafelystoredintherefrigeratorfor48–72hours.
n Breastmilkcanbesafelystoredinthefreezerforuptosixmonths.
n Alwaysstorebreastmilkinthebackoftherefrigeratororfreezer,asthisisthecoldestspot.
Infant FormulaIfbreastfeedingisnotpossibleordesired,iron-fortifiedinfantformulaisanacceptablealternative.Aswithbreastmilk,formulashouldbeclearlylabeledwiththeinfant’sname.Neverswitchaninfant’sformulawithoutconsultationwithhis/herparents/caregivers,asthiscouldcauseanadversereaction.Itisveryimportanttofamiliarizeyourselfwiththesafestorageandpreparationofinfantformula.Belowaresomehelpfultipsandguidelines:
n Alwaysfollowthedirectionsonthelabelcarefully.
n Ifaninfantdoesn’tfinishthebottleofformulawithinonehour,throwouttheremainder.Bacteriafromsalivacancontaminatetheformulaandmaketheinfantsickifhe/shedrinksitlater.
n Topreventwasteandsavetime,mixalargebatchofformulaanddivideitintobottlesthatyoucanrefrigerateandusethroughouttheday.
n Atroomtemperature,preparedinfantformulacansafelystayoutforuptotwohours.
n Ifwarmed,preparedinfantformulacansafelystayoutatroomtemperatureforuptoonehour.
n Preparedinfantformulacanbesafelystoredintherefrigeratorforupto24hours.
Solid/Complementary FoodsAtaroundsixmonths,infantsmaybeslowlyintroducedtosolidfoodsiftheyshowsignsthattheyaredevelopmentallyready.Theseinclude:
n Theabsenceoftonguethrustreflex(baby’stonguedoesn’tautomaticallypushfoodbackoutofhismouth)
n Goodheadandneckcontrol
n Openingtheirmouthswhenfoodcomestowardthem
n Doublingofbirthweight
n Anincreaseddemandforbreastmilkorformulathatcontinuesforseveraldays
Whensolidfoodsareintroduced,theAAPrecommendsthatsingle-ingredientfoodsbegivenoneatatime.Youshouldwaitatleasttwotothreedaysbetweenofferingnewfoods,sothatitwillbeeasiertoidentifythefoodiftheinfantexperiencesanadversereaction(i.e.,allergyorintolerance).Formostchildrenitdoesn’tmatterwhatthefirstfoodsare—wholegraincereals,orpureedvegetables,fruitsandmeats.Breastfedbabiesmaybenefitfrombabyfoodsmadewithmeat,astheseincreaseironandzincabsorption.
ECEprovidersshouldnotintroducenewsolidfoodswithoutfirstconsultinganinfant’sparents/caregivers.
1 AmericanAcademyofPediatrics(2012).PolicyStatement:BreastfeedingandtheUseofHumanMilk. Pediatrics,129(3):e827-e841.AccessedonJanuary7,2013athttp://pediatrics.aappublications.org/content/early/2012/02/22/peds.2011-3552.full.pdf+html
8 Best Practices for Healthy Eating
Infants:Beverages
Age Recommended Not RecommendedBirththrough3months n Breastmilk(preferred)
n Iron-fortifiedinfantformulan Anyotherfoodsorbeveragesatthisage
4through7months n Breastmilk(preferred)n Iron-fortifiedinfantformula
n Foodordrinkotherthanbreastmilkand/oriron-fortifiedinfantformulainabottleunlessmedicallynecessary
n Cow’smilkorlactose-freemilkornutritionally-equivalentbeverageslikesoyorricemilk
n 100%fruitandvegetablejuicen Softdrinksn Sports/energydrinksn Sugarybeveragesincludingfruit-baseddrinks
withaddedsweeteners,sweetenedicedteas,punch,etc.
n Artificiallysweetenedbeveragesincludingdietsoftdrinks,teas,lemonade,etc.
n Caffeinatedbeverages
8through11months n Breastmilk(preferred)n Iron-fortifiedinfantformulan Waterwithnoaddedsweeteners
Rationale
Why is juice not recommended for infants until 12 months of age or older?n Fruitsandvegetables,ratherthanjuice,arepreferable
becausetheyprovidenutrientsandfiberthatmaybelostintheprocessingofjuice.
Why should no food or drink other than breast milk or iron-fortified infant formula be served in a bottle?n Cerealsorotherfoodsaddedtoabottledonothelp
infantssleepthroughthenight.
n Additionofcerealsorotherfoodstoabottlecancausechoking.
n Thispracticedeprivesinfantsoftheopportunitytolearntoregulatetheirfoodintake.
Why are sugary beverages not recommended?n Sportsandsoftdrinksarehighincaloriesandsugar
andlowinkeynutrients.
n Breastmilkoriron-fortifiedformulaandwaterprovideallofthenutritionandhydrationthatinfantsneed.Infantsdonotneedtheaddedsugarinsugarybeverages.
n Consumptionofsugarybeveragesisassociatedwith:
• Overweightorobesity
• Calciumdeficiencybecausesugarybeveragesdisplacemilk
• Toothdecay
Best Practices for Healthy Eating 9
Portion SizeWatchforhungerandfullnesscues.Signsofhungerininfantsmaybesuckingnoisesorsuckingonfistorfingers,fussiness,orcrying.Signsoffullnessmaybesealingthelipstogether,decreasingtheamountofsucking,spittingoutorrefusingthenipple,orpushingorturningawayfromthebreastorbottle.
Age Item Meals SnacksBirththrough3months n Breastmilk(preferred)
n Iron-fortifiedinfantformula4-6oz.
4through7months n Breastmilk(preferred)n Iron-fortifiedinfantformula
Approximately4-8oz. 4-6oz.
n Waterwithnoaddedsweeteners Smallamountcanbegivenafterbreastmilkoriron-fortifiedinfantformula.Watercanbeusedforpracticingcupuse.
8through11months n Breastmilk(preferred)n Iron-fortifiedinfantformula
Approximately6-8oz. 2-4oz.
n Waterwithnoaddedsweeteners Smallamountcanbegivenafterbreastmilkoriron-fortifiedinfantformula.Watercanbeusedforpracticingcupuse.
10 Best Practices for Healthy Eating
Infants:Fruits & Vegetables
Age Recommended Not RecommendedBirththrough3months n Breastmilk(preferred)
n Iron-fortifiedinfantformulan Otherfoodsatthisage
4through7months n Avarietyoffruitsand/orvegetablesshouldbeoffered.Allshouldbemashed,strained,orpureedtopreventchoking.
n Fruitsandvegetablesshouldbeservedplain,withnoaddedfat,honey,sugar,orsalt.
n Someexamplesinclude:•Homemadepureedfruitsorvegetables•Commercially-preparedbabyfruits•Commercially-preparedbabyvegetables•Freshorfrozenfruit•Freshorfrozenvegetables•Cannedfruits(in100%juiceorwater)•Cannedvegetables,low-sodium
n Addedfat,honey,sugar,orsaltn 100%fruitandvegetablejuicesn Fruit-baseddrinkswithaddedsweeteners(e.g.,
cocktails,punches,etc.)n Foodordrinkotherthanbreastmilkand/or
iron-fortifiedformulainabottleunlessmedicallynecessary
n Pre-mixed,commercially-preparedfruitsorvegetableswithmorethanonefooditem(e.g.,fruitwithcereal,vegetableswithmeat.Mixturesoffruitsandvegetablesonlyarefine.)
n Pre-mixed,commercially-prepareddesserts(e.g.,infantsmoothies,puddings,etc.)
n Friedorpre-friedvegetablesandfruits
8through11months nAvarietyoffruitsand/orvegetablesshouldbeoffered.
nAllshouldbesoft,orcookeduntilsoft,andcutintobite-sizepiecestopreventchoking.
nCornshouldbecookedandpureedbeforeserving.
nFruitsandvegetablesshouldbeservedplain,withnoaddedfat,honey,sugar,orsalt.
nSomeexamplesinclude:•Freshorfrozenfruits•Freshorfrozenvegetables•Cannedfruits(in100%juiceorwater)•Cannedvegetables,low-sodium
IMPORTANT NOTE: The following are a choking hazard to children under 12 months:n Driedfruitandvegetables
n Rawvegetables
n Cookedorrawwholecornkernels
n Hardpiecesofrawfruitsuchasapple,pear,ormelon
n Wholegrapes,berries,cherries,melonballs,orcherryorgrapetomatoes
Best Practices for Healthy Eating 11
Rationale
Why serve fruits and vegetables?n TheDietaryGuidelinesforAmericans
encourageconsumptionofavarietyoffruitsandvegetablesweekly.
n Fruitsandvegetablesprovideessentialvitaminsandminerals,fiber,andothersubstancesthatmayprotectagainstmanychronicdiseases.
n Theyarehighinfiber.
n Theyhelpchildrenfeelfullerlonger.
n Theyprovidechildrenwiththeopportunitytolearnaboutdifferenttextures,colors,andtastes.
n Theyhelpchildrentodeveloplife-longhealthyeatinghabits.
Why no commercially-prepared mixtures of fruits or vegetables and another meal component?n Incommercially-preparedmixtures,itisdifficult
tofigureouthowmuchofeachmealcomponentthemixturecontains.Theremaynotbeenoughofarequiredcomponent;therefore;itcannotbereimbursedbytheCACFP.Mixturesofpeasand
chickencannotbereimbursed,forexample,butmixturesoffruitsand/orvegetablescanbecausetheyarecurrentlycountedasonemealcomponentinCACFP(e.g.,applesandsquash,orpearsandblueberries).
n Mixturesmaycontainanewfoodthatthechildhasnottriedandmaycauseanallergicreaction.Ifachildhasbeenintroducedtoallfoodsinthemixture,itisfinetoserve;however,itwillnotbereimbursedifitcontainstwoormoremealcomponents.
Portion SizeWatchforhungerandfullnesscues.
Age Item MealsBirththrough3months Fruitsand/orvegetables None
4through7months Fruitsand/orvegetables 0–3Tbsp
8through11months Fruitsand/orvegetables 1–4Tbsp
12 Best Practices for Healthy Eating
Portion Size Watchforhungerandfullnesscues.
Age Item Meals SnacksBirththrough3months n Grains None None
4through7months n Iron-fortifiedinfantcereal 0–3Tbsp —
8through11months n Iron-fortifiedinfantcereal 2–4Tbsp —
n Bread — ½slice
n Crackers — 2crackers
Infants:Grains & Breads
Age Recommended Not RecommendedBirththrough3months n Breastmilk(preferred)
n Iron-fortifiedinfantformulan Otherfoodsatthisage
4through7months n Iron-fortifiedinfantcerealsn Makeatleasthalfofgrainswholegrains(as
possible,giventhatinfantsarestillbeingintroducedtocereals).
n Commerciallypreparedcerealmixtures
8through11months n Iron-fortifiedinfantcerealsn Makeatleasthalfofgrainswholegrains.n Allfoodsshouldhavezerogramsoftransfatn Commercially-prepared,age-appropriatebaked
snacks(suchasteethingbiscuits)areallowedforsnacktimeonly.
n Trytoofferitems(cereals,crackers,bakedgoods,etc.)thathavenomorethan200mgofsodiumperserving
n Grainsandcerealsthathavemorethan6gramsofsugarperserving,aslabeled
n Commerciallypreparedcerealmixturesn Bakedgoodsthatarehighinsugarand/orfat
(suchascookies,granolabars,cupcakes,donuts,cinnamonbuns,etc.)
Rationale
Why serve whole grains?n TheDietaryGuidelinesforAmericansrecommend
makinghalfofgrainservingswholegrains.
n Wholegrainsaregoodsourcesofdietaryfiber,severalBvitaminsandminerals.
n Childrenandadultsshouldeatabout14goffiberforevery1,000caloriesconsumed.Dietshighinfiberhaveanumberofbeneficialeffects,includingloweringtheriskforheartdiseaseandpreventingconstipation.
n Choosingfoodsthatarefreeofaddedsugarshelpspeoplemeettheirnutrientneedswithouteatingtoomanycalories,sugarsandfats.Addedsugarssupplycaloriesbutfewornonutrients.
n Limitingcerealsto6gofsugar(1.5tsp)orfewerwillhelptokeepaddedsugarslowinchildren’sdiets.
Why no commercially-prepared cereal mixtures?n Mixturemaycontainanewfoodthatthechildhas
nottriedandmaycauseanallergicreaction.
n Portionsofthefoodcomponentsinthemixturearenotspecified.
Best Practices for Healthy Eating 13
Infants:Meats & Meat Alternates
Age Recommended Not RecommendedBirththrough3months n Breastmilk(preferred)
n Iron-fortifiedinfantformulan Otherfoodsatthisage
4through7months n Pureedmeatsorbeanswithnoaddedsugar,fatorsalt(notreimbursablebyCACFPuntil8monthsofage)
n Friedfoodsn Pre-friedbakedfoodssuchaschickennuggets
andfishsticksn Processedmeats,suchashotdogs,bologna,
baconandsausagen Nutsandseeds(chokinghazardforchildrenthis
age)*n Pre-mixed,commercially-preparedmealsn Addedfat,honey,sugarorsalt
8through11months n Leanmeats(beef,veal,and/orpork)n Skinlesspoultry(chicken,turkey)n Fishn Cookedbeansandpeas(legumes)n Eggyolkn Meatsandmeatalternatesshouldbesoft,
pureed,ground,mashedorfinelychoppedtopreventchoking
n Foodsshouldhavezerogramsoftransfat
*Ifusingnutsandseeds,servethemgroundorfinelychoppedinapreparedfood.
Rationale
Why are meats and meat alternates important?n Meats,beans,andeggsofferproteinandother
nutrientssuchaszinc,iron,andBvitamins.
n Proteinsuppliesaminoacidsthatbuild,repairandmaintainbodytissues.
n Nuts,nutbuttersandseedsaregoodsourcesofunsaturatedfat,whichpromotescardiovascularhealth.
n Minimizingtransfatconsumptionreducestheriskofcardiovasculardisease.
Portion Size
Age Item MealsBirththrough3months n Meats&meatalternates None
4through7months n Chicken,meat,egg,cookedbeansorpeas* 1–4Tbsp*
8through11months n Chicken,meat,egg,cookedbeansorpeas 1–4Tbsp
n Cottagecheese 1–4oz.
n Cheese ½oz.–2oz.
*NotreimbursablebyCACFPuntil8monthsofage
14 Best Practices for Healthy Eating
Current CACFP Daily Meal Pattern – ChildrenFood Component Ages 1 – 2 Ages 3 – 5 Ages 6 – 12
BREAKFAST – Serve all 3 components (meat/meat alternate is optional)
Milk, fluid ½cup ¾cup 1cup
Fruit or Vegetable ½cup ½cup ½cup
Grain or Bread
Bread ½slice ½slice 1slice
Cereal–cold,dry ¼cup ¹⁄3cup ¾cup
Cereal–hot,cooked ¼cup ¼cup ½cup
Pasta,noodlesorgrains ¼cup ¼cup ½cup
Meat or Meat Alternate (Best Practice—optional, not reimbursed by CACFP at the time of publication)
Leanmeat,poultryorfish ½oz. ½oz. 1oz.
Cheese ½oz. ½oz. 1oz.
Cottagecheese 2Tbsp 2Tbsp 2Tbsp
Largeegg ½egg ½egg ½egg
Peanutbutterorothernut/seedbutters 1Tbsp 1Tbsp 2Tbsp
Nutsorseeds ½oz. ½oz. 1oz.
Yogurt,plainorflavored ¼cup ¼cup ½cup
LUNCH or SUPPER – Serve all 4 components
Milk, fluid ½cup ¾cup 1cup
Fruit or Vegetable:Serve2ormoreseparateandidentifiablefruit/vegetabledishes.
¼cuptotal ½cuptotal ¾cuptotal
Grain or Bread(chooseone)
Bread ½slice ½slice 1slice
GrainorPasta ¼cup ¼cup ½cup
Cereal–cold,dry ¼cup ¹⁄3cup ¾cup
Cereal–hot,cooked ¼cup ¼cup ½cup
Meat or Meat Alternate(chooseone)
Leanmeat,poultryorfish 1oz. 1½oz. 2oz.
Alternateproteinproduct 1oz. 1½oz. 2oz.
Cheese 1oz. 1½oz. 2oz.
Cottagecheese ¼cup ³⁄8cup ½cup
Largeegg ½egg ¾egg 1egg
Cookeddrybeans/peas ¼cup ³⁄8cup ½cup
Peanutbutterorothernut/seedbutters 2Tbsp 3Tbsp 4Tbsp
Nutsorseeds ½oz. ¾oz. 1oz.
Yogurt,plainorflavored ½cup ¾cup 1cup
Best Practices for Healthy Eating 15
Food Component Ages 1 – 2 Ages 3 – 5 Ages 6 – 12 SNACK – Select 2 of the 4 components
Milk, fluid ½cup ½cup 1cup
Fruit or Vegetable ½cup ½cup ¾cup
Grain or Bread(chooseone)
Bread ½slice ½slice 1slice
Grainorpasta ¼cup ¼cup ½cup
Cereal–cold,dry ¼cup ¹⁄3cup ¾cup
Cereal–hot,cooked ¼cup ¼cup ½cup
Meat or Meat Alternate(chooseone)
Leanmeat,poultry,orfish ½oz. ½oz. 1oz.
Alternateproteinproduct ½oz. ½oz. 1oz.
Cheese ½oz. ½oz. 1oz.
Cottagecheese 2Tbsp 2Tbsp 2Tbsp
Largeegg ½egg ½egg ½egg
Cookeddrybeans/peas 2Tbsp 2Tbsp 4Tbsp
Peanutbutterorothernut/seedbutters 1Tbsp 1Tbsp 2Tbsp
Nutsorseeds ½oz. ½oz. 1oz.
Yogurt,plainorflavored ¼cup ¼cup ½cup
Recommended CACFP Daily Meal Pattern – ChildrenFood Group Serving Number Range of Serving Size (vary by
age group)Breakfast Fruitornon-starchyvegetable 1 ¼to½cup
Grain/bread 1 ½to3ounceequivalent
Leanmeat/meatalternate 1 ½to2ounceequivalent(3timesweekly)
Milk 1 ½to1cup
Lunch/Supper Fruit 1 ¼to½cup
Vegetable 2 ¹⁄8to½cup
Grain/bread 1 ½to2½ounceequivalent
Leanmeat/meatalternate 1 ½to2½ounceequivalent
Milk 1 ½to1cup
Snack (choose 2 food groups per snack)
Fruit 2perweek ½to1cup
Vegetable 2perweek ¹⁄8to1cup
Grain/bread 2perweek ½to2ounceequivalent
Leanmeat/meatalternate 2perweek ½to1ounceequivalent
Milk 2perweek ½cup
Pleasenotethattheshadedboxesarebestpracticerecommendations,butarenotreimbursedthroughtheCACFPasofthedateofthispublication.
InstituteofMedicine(2011).Report Brief: Child and Adult Care Food Program: Aligning Dietary Guidance for All.RetrievedonJanuary20,2013fromhttp://www.iom.edu/Reports/2010/Child-and-Adult-Care-Food-Program-Aligning-Dietary-Guidance-for-All.aspx
16 Best Practices for Healthy Eating
Comparison of Current and Recommended CACFP RequirementsYoucanmakeallofthesechangesnow!Reimbursementwillnotincreaseuntilthenewrulesareinplace.
Eating Occasion Current Requirements Recommended RequirementsAll Mustmeetdailypattern Mustmeetdailyandweeklypatterntoprovidemoreflexibilityandbetter
alignmentwiththeDietaryGuidelines
Breakfast 3mealcomponents 4or5mealcomponents
LunchorSupper 4mealcomponents 5mealcomponents
Snack Any2of4components Varietyspecifiedfortheweek.Choice between 2 small snacks or 1 enhanced snack.*
Meal ComponentFruit Fruitsandvegetablesarecombinedasa
categoryFruitsareaseparatecategory,andservingsareincreased;juiceisnotprovidedforinfantsandislimitedforchildren;fruitscontainingaddedsugarsarelimited.
Vegetable Vegetablesareaseparatecategoryfromfruit,andservingsareincreased;mustprovidevarietyincludingdarkgreenleafy,brightyellow/orange,legumes;sodiumcontentislimited;starchyvegetablesarelimited.
Grain/bread Enrichedorwholegrain,proportionsnotspecified
Atleasthalfmustbewholegrainrich,additionalwholegrainsareen-couraged,grainproductshighinsolidfatsandaddedsugarsarelimitedtocontrolcaloriesandsaturatedfat,highsodiumgrainsarealsolimited.
Meat/meatalternate Noneatbreakfast Includedinweeklybreakfastpatternthreetimesaweektoprovidebal-ancetomealbutflexibilitythroughtheweek;sometypesarelimitedtohelpcontrolcalories,solidfatandsodium.
Milk Anytypeoffluidmilk Mustbenon-fatorlow-fat(1%)forchildrenover2yearsofage.Flavoredmilkmustbenon-fatandisallowedonlyforat-riskafterschoolprograms.For children over 2 years of age and adults, non-fat or low-fat yogurt may be used as a substitute for milk or as a meat alternate no more than once per day.*
Food ComponentEnergy Norequirement Caloriesarecontrolledbylimitingfoodshighinsolidfatsandadded
sugars.
Micronutrients Nostandardspecifiedbyregulation Mealpatternsaredesignedtoachieve,forproteinandmostmicronutri-ents,DRItargetsconsistentwithalowprevalenceofinadequacy.
Fats Norestriction Labelmuststatezerotransfat(ifapplicable);foodspecificationslimithighlyprocessedandhigh-fatmeatsandfoods.
Sodium Norestriction Nosaltatthetable;encouragementtopreparefoodswithlesssalt.Foodspecificationslimitsomesourcesofsodium.
*This substitution (in italics) may not be made until the new CACFP rules are officially in place.
IOM(InstituteofMedicine).2011.Child and Adult Care Food Program: Aligning Dietary Guidance for All.Washington,DC:TheNationalAcademiesPress.
Best Practices for Healthy Eating 17
Children 1 through 2 Years:Beverages
Recommendedn12to23months:wholemilkorlactose-
freemilkornutritionally-equivalentnondairybeverageslikesoyorricemilk
n24+months:fat-freeor1%(low-fat)milkorlactose-freemilkornutritionally-equivalentnondairybeverageslikesoyorricemilk
nWaterwithnoaddedsweeteners
Limitn100%fruitandvegetablejuicestono
morethanoneage-appropriateservingperday.Juicemaybeeliminatedentirelyifdesired.
Not RecommendednSoftdrinksnSports/energydrinksnSugarybeveragesincludingfruit-based
drinkswithaddedsweeteners(i.e.juicedrinksorcocktails,punch,etc.)
nArtificially-sweetenedbeveragesincludingdietsodas,teas,lemonade,etc.
nCaffeinatedbeverages
Rationale
Portion Size
Age Item Meals Snacks12through23months Water Asmuchasdesired,anytime
Wholemilk ½cup(4oz.) ½cup(4oz.)
100%juice Nomorethan¼cup(oneserving)perday
24+months Water Asmuchasdesired,anytime
Fat-freeor1%(low-fat)milk ½cup(4oz.) ½cup(4oz.)
100%Juice Nomorethan½cup(oneserving)perday
Why whole milk for children aged 12 through 23 months?n Wholemilkprovidessomefatsthatarenecessaryfor
earlygrowthandbrainandspinalcorddevelopment.
Why fat-free or 1% (low-fat) milk for children aged 2 years and older?n TheAmericanAcademyofPediatrics(AAP)
recommendsservingfat-freeor1%(low-fat)milktochildrenaged2yearsandolder.
n Fat-freeand1%(low-fat)milkcontainasmuchcalciumandVitaminDas2%andwholemilkwithouttheextracaloriesandsaturatedfat.
Why limit juice?n TheAAPrecommendslimitingjuicetooneservingaday.
n Wholefruitsandvegetablesarepreferredbecausetheyprovidenutrientsandfiberthatmaybelostintheprocessingofjuice.
n Excessivejuiceconsumptionisassociatedwithoverweightorobesity,toothdecayanddiarrhea.
Why are sugary beverages not recommended?n Juicedrinks,sportsdrinksandsoftdrinksaregenerally
highincaloriesandsugarandlowinnutrients.
n Consumptionofsugarybeveragesisassociatedwithoverweightorobesity,calciumdeficiency(becausesugarybeveragesdisplacemilk),andtoothdecay.
Why no diet beverages or artificial sweeteners?n Whiledietandartificially-sweetenedbeverageshave
fewcalories,theymaydisplacetheintakeofmorenutritiousdrinkssuchas1%orfat-freemilkthatchildrenneedinordertogrow.
18 Best Practices for Healthy Eating
Children 1 through 2 Years:Fruits & Vegetables
Recommended Limit Not RecommendednAvarietyoffruitsand/orvegetables
shouldbeofferedateverymealnFreshorfrozenfruit(cutintobite-size
piecestopreventchoking)nFreshorfrozenvegetables(cutinto
bite-sizepiecesandcooktopreventchoking)
nCannedfruits(in100%juiceorwater)nCannedvegetables,no-orlow-sodium
n100%fruitand/orvegetablejuicestonomorethanoneage-appropriateservingperday.Juicemaybeeliminatedentirelyifdesired.
nAddedfat,sugar,orsalt
nDriedfruitorvegetablesforchildrenunderfour(chokinghazard)
nFruit-baseddrinkswithaddedsugars(i.e.juicedrinksorcocktails,punch,etc.)
nFriedorpre-friedvegetablesorfruits(e.g.Frenchfries,tatertots)
Rationale
Why serve fruits and vegetables?n TheDietaryGuidelinesforAmericansencourage
consumptionofavarietyoffruitsandvegetablesweekly.
n Fruitsandvegetablesprovideessentialvitaminsandminerals,fiber,andothersubstancesthatmayprotectagainstmanychronicdiseases.
n Theyarehighinfiber.
n Theyhelpchildrenfeelfullerlonger.
n Theyprovidechildrenwiththeopportunitytolearnaboutdifferenttextures,colors,andtastes.
n Theyhelpchildrentodeveloplife-longhealthyeatinghabits.
Portion Size
Item Meals SnacksFruitsandvegetables ½cup(breakfast)*
¼cup(lunch/supper)*½cup*
100%juice Nomorethan½cup(4oz.)perday
*Startwiththisage-appropriateserving.Ifchildrenarestillhungry,offeranotherage-appropriateservingoffruitsorvegetables.
Best Practices for Healthy Eating 19
Children 1 through 2 Years:Grains & Breads
Recommended Limit Not RecommendednMakehalfofgrainservingswhole
grains*nGrainfoodsthathavemorethan3
gramsoffiberperserving,aslabelednFoodsshouldhavezerogramsof
transfatnWholegrainpastanWholegrainbreadnWholegraincerealnBrownricenOatmealnBulgurnQuinoa
nAddedfat,sugarorsalt nCerealsorgrainswithmorethan6gramsofsugarperserving,aslabeled
nSweetgrains(cakes,cupcakes,donuts,Danishes,cinnamonrolls,toasterpastries,granolabars,cookies,commercially-preparedmuffins,etc.)
*Todetermineifaproductisawholegrain,lookontheingredientslist.Awholegrainshouldbethefirstingredientlisted,orthefirstingredientafterwater.Examplesincludewholewheatflour(notjust“wheatflour”),wholegraincorn,wholecornmeal,brownrice,oatsorwholeoats,etc.
Why serve whole grains?n TheDietaryGuidelinesforAmericansrecommend
makinghalfofgrainservingswholegrains.
n Wholegrainsaregoodsourcesofdietaryfiber,severalBvitaminsandminerals.
n Childrenandadultsshouldeatabout14goffiberforevery1,000caloriesconsumed.Dietshighinfiberhaveanumberofbeneficialeffects,includingloweringtheriskforheartdiseaseandpreventingconstipation.
n Choosingfoodsthatarefreeofaddedsugarshelpspeoplemeettheirnutrientneedswithouteatingtoomanycalories,sugarsandfats.
n Addedsugarssupplycaloriesbutfewornonutrients.
n Discretionarycalorieallowanceforchildren2–5yearsofageallowsforonly4–5tspofaddedsugarseachday.
n Limitingcerealsto6gofsugar(1.5tsp)orfewerwillhelptokeepaddedsugarslowinchildren’sdiets.
Portion Size
Item Meals SnacksBreaditems(bread,rolls,bagels,etc.) ½slice ½slice
Cereals,hotorcold ¼cup(2oz.) ¼cup(2oz.)
Pasta,noodlesorgrains ¼cup(2oz.) ¼cup(2oz.)
Rationale
20 Best Practices for Healthy Eating
Children 1 through 2 Years:Meat & Meat Alternates
Recommended Limit Not RecommendednLeanmeats(beef,veal,and/orpork)nSkinlesspoultry(chicken,turkey)nFishnCookedbeansandpeas(legumes)nNutbuttersnEggsnYogurt†
nCheese†
nCottagecheese†
nMeatsandmeatalternatesshouldbecutintobit-sizepiecestopreventchoking
nFoodsshouldhavezerogramsoftransfat
nAddedfat,sugarorsalt nFriedfoodsnPre-friedbakedfoodssuchaschicken
nuggetsandfishsticksnProcessedmeats,suchashotdogs,
bologna,baconandsausagenChickenorturkeywiththeskinnShark,swordfish,kingmackerel,tilefish,
albacoretuna(highinmercury)nProcessedcheesefoodorcheeseproductnNutsandseeds(chokinghazardfor
childrenunderfour)*
Why are meats and meat alternates important?n Meats,beans,andeggsofferproteinandother
nutrientssuchaszinc,iron,andBvitamins.
n Proteinsuppliesaminoacidsthatbuild,repairandmaintainbodytissues.
n Nuts,nutbuttersandseedsaregoodsourcesofunsaturatedfat,whichpromotescardiovascularhealth.
n Dairyfoods(e.g.,cheeseandyogurt)aregoodsourcesofproteinandcalcium.
n Minimizingtransfatconsumptionreducestheriskofcardiovasculardisease.
Portion Size
Item Meals SnacksLeanmeat,poultryorfish 1oz.(2Tbsp) ½oz.(1Tbsp)
Alternateproteinproduct 1oz.(2Tbsp) ½oz.(1Tbsp)
Cheese 1oz.(2Tbsp) ½oz.(1Tbsp)
Cottagecheese ¼cup(2oz.) 1oz.(2Tbsp)
Largeegg ½egg ½egg
Cooked,drybeansorpeas ¼cup(2oz.) 1oz.(2Tbsp)
Nutorseedbutters 2Tbsp 1Tbsp
Nutsandseeds ½oz.(1Tbsp) ½oz.(1Tbsp)
Yogurt ½cup(4oz.) ¼cup(2oz.)
*Ifusingnutsandseeds,servethemgroundorfinelychoppedinapreparedfood.†Fat-freeor1%low-fatforchildrentwoandolder
Rationale
Best Practices for Healthy Eating 21
Children 3 through 5 Years:Beverages
Recommended Limit Not RecommendednFat-freeor1%(low-fat)milkor
lactose-freemilkornutritionally-equivalentnondairybeverageslikesoyorricemilk
nWaterwithnoaddedsweeteners
n100%fruitandvegetablejuicestonomorethanoneage-appropriateservingperday.Juicemaybeeliminatedentirelyifdesired.
nSoftdrinksnSports/energydrinksnSugarybeveragesincludingfruit-based
drinkswithaddedsweeteners(i.e.juicedrinksorcocktails,punch,etc.)
nArtificially-sweetenedbeveragesincludingdietsodas,teas,lemonade,etc.
nCaffeinatedbeverages
Rationale
Why fat-free or 1% (low-fat) milk for children aged 2 years and older?• TheAmericanAcademyofPediatrics(AAP)
recommendsservingfat-freeor1%(low-fat)milktochildrenaged2yearsandolder.
• Fat-freeand1%(low-fat)milkcontainasmuchcalciumandVitaminDas2%andwholemilkwithouttheextracaloriesandsaturatedfat.
Why limit juice?• TheAAPrecommendslimitingjuicetooneservingaday.
• Wholefruitsandvegetablesarepreferredbecausetheyprovidenutrientsandfiberthatmaybelostintheprocessingofjuice.
• Excessivejuiceconsumptionisassociatedwithoverweightorobesity,toothdecay,anddiarrhea.
Why are sugary beverages not recommended?• Sportsandsoftdrinksaregenerallyhighincalories
andsugarandlowinnutrients.
• Consumptionofsugarybeveragesisassociatedwithoverweightorobesity,calciumdeficiency(becausesugarybeveragesdisplacemilk),toothdecay
Why no diet beverages or artificial sweeteners?• Whiledietandartificially-sweetenedbeverageshave
fewcalories,theymaydisplacetheintakeofmorenutritiousdrinkssuchasfat-freeor1%(low-fat)milkthatchildrenneedinordertogrow.
Portion Size
Item Meals SnacksWater Asmuchasdesired,anytime
Fat-freeor1%(low-fat)milk ¾cup(6oz.) ½cup(4oz.)
100%juice Nomorethan½cup(4oz.)perday
22 Best Practices for Healthy Eating
Children 3 through 5 Years:Fruits & Vegetables
Recommended Limit Not RecommendednAvarietyoffruitsand/orvegetables
shouldbeofferedateverymealnFreshorfrozenfruit*nFreshorfrozenvegetables*nCannedfruits(in100%juiceorwater)nCannedvegetables,no-orlow-sodiumnDriedfruitsandvegetablesforchildren
fourandolder
*For children under four, cut into bite-size pieces and/or cook to prevent choking
n100%fruitand/orvegetablejuicestonomorethanoneage-appropriateservingperday.Juicemaybeeliminatedentirelyifdesired.
nAddedfat,sugar,orsalt
nDriedfruitorvegetablesforchildrenunderfour(chokinghazard)
nFruit-baseddrinkswithaddedsugars(i.e.juicedrinksorcocktails,punch,etc.)
nFriedorpre-friedvegetablesorfruits(e.g.Frenchfries,tatertots)
Rationale
Why are fruits and vegetables important?n TheDietaryGuidelinesforAmericans
encourageconsumptionofavarietyoffruitsandvegetablesweekly.
n Fruitsandvegetablesprovideessentialvitaminsandminerals,fiber,andothersubstancesthatmayprotectagainstmanychronicdiseases.
n Theyarehighinfiber.
n Theyhelpchildrenfeelfullerlonger.
n Theyprovidechildrenwiththeopportunitytolearnaboutdifferenttextures,colors,andtastes.
n Theyhelpchildrentodeveloplife-longhealthyeatinghabits.
Portion Size
Item Meals SnacksFruitsandvegetables ½cup* ½cup*
100%juice Nomorethan½cup(4oz.)perday
*Startwiththisage-appropriateserving.Ifchildrenarestillhungry,offerthemanotherage-appropriateservingoffruitsorvegetables.
Best Practices for Healthy Eating 23
Children 3 through 5 Years:Grains & Breads
Recommended Limit Not RecommendednMakehalfofgrainservingswhole
grains*nGrainfoodsthathavemorethan
3gramsoffiberperserving,aslabeled
nFoodsshouldhavezerogramsoftransfat
nWholegrainpastanWholegrainbreadnWholegraincerealnBrownricenOatmealnBulgurnQuinoa
nAddedfat,sugarorsalt nCerealsorgrainswithmorethan6gramsofsugarperserving,aslabeled
nSweetgrains(cakes,cupcakes,donuts,Danishes,cinnamonrolls,toasterpastries,granolabars,cookies,commercially-preparedmuffins,etc.)
*Todetermineifaproductisawholegrain,lookontheingredientslist.Awholegrainshouldbethefirstingredientlisted,orthefirstingredientafterwater.Examplesincludewholewheatflour(notjust“wheatflour”),wholegraincorn,wholecornmeal,brownrice,oatsorwholeoats,etc.
Rationale
Why serve whole grains?n TheDietaryGuidelinesforAmericansrecommend
makinghalfofgrainservingswholegrains.
n Wholegrainsaregoodsourcesofdietaryfiber,severalBvitaminsandminerals.
n Childrenandadultsshouldeatabout14goffiberforevery1,000caloriesconsumed.Dietshighinfiberhaveanumberofbeneficialeffects,includingloweringtheriskforheartdiseaseandpreventingconstipation.
n Choosingfoodsthatarefreeofaddedsugarshelpspeoplemeettheirnutrientneedswithouteatingtoomanycalories,sugarsandfats.
n Addedsugarssupplycaloriesbutfewornonutrients.
n Discretionarycalorieallowanceforchildren2–5yearsofageallowsforonly4–5tspofaddedsugarseachday.
n Limitingcerealsto6gofsugar(1.5tsp)orfewerwillhelptokeepaddedsugarslowinchildren’sdiets.
n Minimizingtransfatconsumptionreducestheriskofcardiovasculardisease.
Portion Size
Item Meals SnacksBreaditems(bread,rolls,bagels,etc.) ½slice ½slice
Cereals,cold ¹⁄3cup(2.5oz.) ¹⁄3cup(2.5oz.)
Cereals,hot ¼cup(2oz.) ¼cup(2oz.)
Pasta,noodlesorgrains ¼cup(2oz.) ¼cup(2oz.)
24 Best Practices for Healthy Eating
Children 3 through 5 Years:Meats & Meat Alternates
Recommended Limit Not RecommendednLeanmeats(beef,veal,and/orpork)nSkinlesspoultry(chicken,turkey)nFishnCookedbeansandpeas(legumes)nNutbuttersnEggsnFat-freeorlow-fatyogurtnFat-freeorreduced-fatcheesenFat-freeorlow-fatcottagecheesenMeatsandmeatalternatesshouldbecut
intobite-sizepiecestopreventchokingnFoodsshouldhavezerogramsof
transfat
nAddedfat,sugarorsalt nFriedfoodsnPre-friedbakedfoodssuchaschicken
nuggetsandfishsticksnProcessedmeats,suchashotdogs,
bologna,baconandsausagenChickenorturkeywiththeskinnShark,swordfish,kingmackerel,tilefish,
albacoretuna(highinmercury)nProcessedcheesefoodorcheeseproductnNutsandseeds(chokinghazardfor
childrenunderfour)*
*Ifusingnutsandseedsforchildrenunderfour,servethemgroundorfinelychoppedinapreparedfood.
Rationale
Why are meats and meat alternates important?n Meats,beans,andeggsofferproteinandother
nutrientssuchaszinc,iron,andBvitamins.
n Proteinsuppliesaminoacidsthatbuild,repairandmaintainbodytissues.
n Nuts,nutbuttersandseedsaregoodsourcesofunsaturatedfat,whichpromotescardiovascularhealth.
n Dairyfoods(e.g.,cheeseandyogurt)aregoodsourcesofproteinandcalcium.
n Minimizingtransfatconsumptionreducestheriskofcardiovasculardisease.
Portion Size
Item Meals SnacksLeanmeat,poultryorfish 1½oz.(3Tbsp) ½oz.(1Tbsp)
Alternateproteinproduct 1½oz.(3Tbsp) ½oz.(1Tbsp)
Cheese 1½oz.(3Tbsp) ½oz.(1Tbsp)
Cottagecheese ³⁄8cup 1oz.(2Tbsp)
Largeegg ¾egg ½egg
Cooked,drybeansorpeas 3oz.(6Tbsp) 1oz.(2Tbsp)
Nutorseedbutters 3Tbsp 1Tbsp
Nutsandseeds ¾oz.(1½Tbsp) ½oz.(1Tbsp)
Yogurt ¾cup(6oz.) ¼cup(2oz.)
Best Practices for Healthy Eating 25
Children 6 Years and Older:Beverages
Recommended Limit Not RecommendednFat-freeor1%(low-fat)milkor
lactose-freemilkornutritionally-equivalentnondairybeverageslikesoyorricemilk
nWaterwithnoaddedsweeteners
n100% fruitandvegetablejuicestonomorethanoneage-appropriateservingperday.Juicemaybeeliminatedentirelyifdesired.
nSoftdrinksnSports/energydrinksnSugarybeveragesincludingfruit-based
drinkswithaddedsweeteners(i.e.juicedrinksorcocktails,punch,etc.)
nArtificially-sweetenedbeveragesincludingdietsodas,teas,lemonade,etc.
nCaffeinatedbeverages
Rationale
Why fat-free or 1% (low-fat) milk for children aged 2 years and older?• TheAmericanAcademyofPediatrics(AAP)
recommendsservingfat-freeor1%(low-fat)milktochildrenaged2yearsandolder.
• Fat-freeand1%(low-fat)milkcontainasmuchcalciumandVitaminDas2%andwholemilkwithouttheextracaloriesandsaturatedfat.
Why limit juice?• TheAAPrecommendslimitingjuicetoservingaday.
• Wholefruitsandvegetablesarepreferredbecausetheyprovidenutrientsandfiberthatmaybelostintheprocessingofjuice.
• Excessivejuiceconsumptionisassociatedwithoverweightorobesity,toothdecayanddiarrhea.
Why are sugary beverages not recommended?• Sportsandsoftdrinksaregenerallyhighincalories
andsugarandlowinnutrients.
• Consumptionofsugarybeveragesisassociatedwithoverweightorobesity,calciumdeficiency(becausesugarybeveragesdisplacemilk),andtoothdecay.
Why no diet beverages or artificial sweeteners?• Whiledietandartificially-sweetenedbeverageshave
fewcalories,theymaydisplacetheintakeofmorenutritiousdrinkssuchas1%orfat-freemilkthatchildrenneedinordertogrow.
Portion Size
Item Meals SnacksWater Asmuchasdesired,anytime
Fat-freeor1%(low-fat)milk 1cup(8oz.) 1cup(8oz.)
100%juice Nomorethan¾cup(6oz.)perday
26 Best Practices for Healthy Eating
Children 6 Years and Older:Fruits & Vegetables
Recommended Limit Not RecommendednAvarietyoffruitsand/orvegetables
shouldbeofferedateverymealnFreshorfrozenfruitnFreshorfrozenvegetablesnCannedfruits(in100%juiceor
water)nCannedvegetables,no-orlow-
sodiumnDriedfruitsandvegetables
n100%fruitandvegetablejuicestonomorethanoneage-appropriateservingperday.Juicemaybeeliminatedentirelyifdesired.
nAddedfat,sugar,orsalt
nFruit-baseddrinkswithaddedsugars(i.e.juicedrinksorcocktails,punch,etc.)
nFriedorpre-friedvegetablesorfruits
Rationale
Why are fruits and vegetables important?• TheDietaryGuidelinesforAmericansencourage
consumptionofavarietyoffruitsandvegetablesweekly.
• Fruitsandvegetablesprovideessentialvitaminsandminerals,fiber,andothersubstancesthatmayprotectagainstmanychronicdiseases.
• Theyarehighinfiber.
• Theyhelpchildrenfeelfullerlonger.
• Theyprovidechildrenwiththeopportunitytolearnaboutdifferenttextures,colors,andtastes.
• Theyhelpchildrentodeveloplife-longhealthyeatinghabits.
Portion Size
Item Meals SnacksFruitsandvegetables ¾cup* ¾cup*
100%juice Nomorethan¾cup(6oz.)perday 1cup(8oz.)
*Startwiththisage-appropriateserving.Ifchildrenarestillhungry,offerthemanotherage-appropriateservingoffruitsorvegetables.
Best Practices for Healthy Eating 27
Children 6 Years and Older:Grains & Breads
Recommended Limit Not RecommendednMakehalfofgrainservingswhole
grains*nGrainfoodsthathavemorethan3
gramsoffiberperserving,aslabelednFoodsshouldhavezerogramsof
transfatnWholegrainpastanWholegrainbreadnWholegraincerealnBrownricenOatmealnBulgurnQuinoa
nAddedfat,sugarorsalt nCerealsorgrainswithmorethan6gramsofsugarperserving,aslabeled
nSweetgrains(cakes,cupcakes,donuts,Danishes,cinnamonrolls,toasterpastries,granolabars,cookies,commercially-preparedmuffins,etc.)
* Todetermineifaproductisawholegrain,lookontheingredientslist.Awholegrainshouldbethefirstingredientlisted,orthefirstingredientafterwater.Examplesincludewholewheatflour(notjust“wheatflour”),wholegraincorn,wholecornmeal,brownrice,oatsorwholeoats,etc.
Rationale
Why serve whole grains?n TheDietaryGuidelinesforAmericansrecommend
makinghalfofgrainservingswholegrains.
n Wholegrainsaregoodsourcesofdietaryfiber,severalBvitaminsandminerals.
n Childrenandadultsshouldeatabout14goffiberforevery1,000caloriesconsumed.Dietshighinfiberhaveanumberofbeneficialeffects,includingloweringtheriskforheartdiseaseandpreventingconstipation.
n Choosingfoodsthatarefreeofaddedsugarshelpspeoplemeettheirnutrientneedswithouteatingtoomanycalories,sugarsandfats.
n Addedsugarssupplycaloriesbutfewornonutrients.
n Discretionarycalorieallowanceforchildren6yearsofageandolderallowsforonly4–6tspofaddedsugarseachday.
n Limitingcerealsto6gofsugar(1.5tsp)orfewerwillhelptokeepaddedsugarslowinchildren’sdiets.
n Minimizingtransfatconsumptionreducestheriskofcardiovasculardisease.
Portion Size
Item Meals SnacksBreaditems(bread,rolls,bagels,etc.) 1slice 1slice
Cereals,cold ¾cup(6oz.) ¾cup(6oz.)
Cereals,hot ½cup(4oz.) ½cup(4oz.)
Pasta,noodlesorgrains ½cup(4oz.) ½cup(4oz.)
28 Best Practices for Healthy Eating
Children 6 Years and Older:Meats & Meat Alternates
Recommended Limit Not RecommendednLeanmeats(beef,veal,and/orpork)nSkinlesspoultry(chicken,turkey)nFishnCookedbeansandpeas(legumes)nNutsandseedsnNutbuttersnEggsnFat-freeorlow-fatyogurtnFat-freeorreduced-fatcheesenFat-freeorlow-fatcottagecheesenMeatsandmeatalternatesshould
becutintobite-sizepiecestopreventchoking
nFoodsshouldhavezerogramsoftransfat
nAddedfat,sugarorsalt nFriedfoodsnPre-friedbakedfoodssuchaschicken
nuggetsandfishsticksnProcessedmeats,suchashotdogs,
bologna,baconandsausagenChickenorturkeywiththeskinnShark,swordfish,kingmackerel,tile
fish,albacoretuna(highinmercury)nProcessedcheesefoodorcheese
product
Rationale
Why are meats and meat alternates important?n Meats,beans,andeggsofferproteinandother
nutrientssuchaszinc,iron,andBvitamins.
n Proteinsuppliesaminoacidsthatbuild,repairandmaintainbodytissues.
n Nuts,nutbuttersandseedsaregoodsourcesofunsaturatedfat,whichpromotescardiovascularhealth.
n Dairyfoods(e.g.,cheeseandyogurt)aregoodsourcesofproteinandcalcium.
n Minimizingtransfatconsumptionreducestheriskofcardiovasculardisease.
Portion Size
Item Meals SnacksLeanmeat,poultryorfish ¼cup(2oz.) 1oz.(2Tbsp)
Alternateproteinproduct ¼cup(2oz.) 1oz.(2Tbsp)
Cheese ¼cup(2oz.) 1oz.(2Tbsp)
Cottagecheese ½cup(4oz.) 1oz.(2Tbsp)
Largeegg 1egg ½egg
Cooked,drybeansorpeas ½cup(4oz.) ¼cup(2oz.)
Nutorseedbutters ¼cup(4Tbsp) 2Tbsp
Nutsandseeds 1oz.(2Tbsp) 1oz.(2Tbsp)
Yogurt 1cup(8oz.) ½cup(4oz.)
General Guidance
Best Practices for Healthy Eating 29
Role Modeling
30 Best Practices for Healthy Eating
Fromearliestinfancy,childrenlearnthroughtheirinteractionswithparents/guardiansandearlycareandeducationproviders.Youngchildrennaturallywanttodowhatyoudo.Workingwithchildrenandfamilieseverydaygivesyouauniqueopportunitytoinfluencepositivehealthbehaviors.Youcandomanythingstohelpchildrendevelophealthyeatingandphysicalactivityhabits,andbeingagoodrolemodeliswhereitbegins.Rememberthatchildrenpickuponattitudesandbehaviors.Theywilllearnfromyouwhichfoodstoeatandwhichtoreject,somakesureyourcommentsaboutthefoodservedarepositive.Mealtime isagreatwaytohelpchildrendeveloppositiveattitudesabouthealthyfoods,learnappropriatemealtimebehavior,andimprovecommunicationskills.Usethefollowingtipstohelpyoumodelhealthyhabits:
n Eathealthyfoodstogether.Letchildrenseeyouenjoyingfruits,vegetablesandwholegrainsatmealsandsnacktime.
n Bewillingtotrynewfoodswiththechildren.Childrenwillbemoreinclinedtotasteanunfamiliarfoodifatrustedadultiseatingitalso.Compareexperiencesandtalkabouthowthefoodlooks,smells,andtastes.
n Makepositivecommentsabouthealthyeating—encouragechildrentotasteallfoods,especiallynewones!
n Alwayspraisechildrenwhentheyeattheirfruitsandvegetablesoratleastgivethematry.Praiseservesaspositivereinforcementandmakesitmorelikelythatkidswillrepeatthisbehavioragaininthefuture.
n Adoptfamily-style dining,inwhichallfoodisplacedinservingbowlsonthetableandchildrenareencouragedtoservethemselvesaloneorwithhelpfromanadult.Thishelpschildrenthinkabouttheirownhungerandfullnesscuesandlearnhowtomakehealthychoices.It’salsoagreattimetoteachchildrenaboutappropriateservingsizesandencouragethemtotryunfamiliarfoods.
n Makemealsandsnacktimepositive,cheerfulandunhurriedevents.Childrenshouldlearntochewtheirfoodcompletely.Ourbodiesneedtimetorealizethatthey’vehadenoughtoeat,andthisisespeciallytrueforchildren’sgrowingbodies.Modelingthesebehaviorsandtakingtimetoenjoyaleisurelymealteacheschildrentheimportanceofmealtimeandpropernutrition.
n Wheneatingwithchildren,makesureyou’reconsistentinyourmessagesbyeatingonlywhatthey’realsoallowedtoeat.Childrenarequicktopickupwhensomethingisn’t“fair,”sodon’tcreateadoublestandard.
n Seizetheteachablemomentsduringmealsandsnacktime.InsteadofwatchingTVwhileeating,engagechildreninconversationabouthealthyhabits.Discusswherethefoodsyou’reeatingcomefromandwhythey’regoodforbothadultsandkids.
n Allowchildrentoobserveyouchoosinghealthyfoodsoverlessnutritiousalternatives(e.g.,sweetsandhigh-fatsnacks).Thentellthemwhyyouchosetheappleoverthecookieorbrownie.
UnitedStatesDepartmentofAgriculture.Set a good example- they take their lead from you.http://www.mypyramid.gov/preschoolers/HealthyHabits/goodexample.html.AccessedJune22,2010.
Family-Style Meals
Best Practices for Healthy Eating 31
Usingfamily-styledininginyourearlycareandeducationprogramsupportsindependence,socialskills,healthyeatingandmore.Childrenwhoaregiventheopportunitytoactivelyparticipateinmealtimelearnandpracticeimportantskillslikepassingandservingfoodanddrinks,tablemanners,preparingformealsandcleaningup.Theyareencouragedtotrynewfoodsandtoservethemselvesappropriateportions.Usethebelowguidancetoplanforfamily-styledininginyourprogram.
Mealtime Routine Sample1. Callforhelpers—childrenwithdailyjobs
2. Transitionactivity—song
3. Bathroomandhandwashbreak
4. Childrensitatthetableasthefoodisplacedonthetable
5. Teacherssitandeatwithchildren
6. Childrenandteacherscleanup
7. Transition—childrenchoosequietbooksorpuzzlesasothersfinisheating
Family-Style Mealtime ChecklistMealtime routine Teachers’routinesallowforfoodtobepreparedand
readyatthedesignatedmealtime.
Appropriately sized bowls and serving utensils Foodisservedinbowlsofappropriatesizethat
childrencanliftandpass.
Servingbowlsareofappropriatematerialsotheydonotconductheatandarenottoohottopass.
Smallsizescoops,one-pieceplastictongs,andshort-handledhardplasticservingspoonsareused.Servingutensilsshouldalignwithservingsizerecommendationsforageandfoodgroup.
Mealtime expectations to review with children Weeattogetheratthetable.
Weallcometothetableatthesametime.
Wewaituntileveryoneisreadybeforewebeginourmeal.
Weserveourselvesandpassfoodtoeachother.
Weuseinsidevoices.
Passing food practice for children Passwithbothhands.
Keepfoodoverthetablewhenpassingit.
Holdthebowlbythesidetokeepfingersoutoffood.
Serving utensils practice for children: try this for a small group activity or set up a learning center in classroom Practicewithscoops,tongs,andshort-handledhard
plasticservingspoons.
Pouring practice for children: set up water table or learning center for practice in classroom Pretendpractice.
Practicewithdryliquidsuchassandorbeans.
Practicewithwater.
Practicewithwaterandpouringintochild-sizecups.
Cleanup practice for children: try this in dramatic play or as a small group activity Pretendcleanupwithspongeorcloth.
Pretendfloorcleanupwithmini-moporcloth.
Practicecleanupoftableandfloorwithwater.
NationalFoodServiceManagementInstitute.(2011).Happy mealtimes for healthy kids. University,MS:Author.
32 Best Practices for Healthy Eating
Hungry or Full?Mostinfantsandyoungchildrencanfigureoutwhentheyarefullandwillstopeatingifpermitted.Followthedivisionofresponsibilitywhenfeeding:“It’syourjobtoprovide,andchildren’sjobtodecide.”Overthecourseoftheweek,infantsandchildrenwilleatasmuchastheyneedtogrow.Youcanhelpthemeatjusttherightamountbyfollowingtheseeasystrategies:
For infantsn Lookforhungercues.Infantshavedifferentwaysof
showingtheyarehungry,butcommonhungercuesincluderooting,makingsuckingnoises,ortryingtoputafistintheirmouth.
n Whentheinfantcries,looktoseewhatelsecouldbebotheringherbeforeimmediatelyfeeding.Aninfantwhocriesmaynotbehungry.Aneedforsleep,affectionoradiaperchangemayalsobethecause.
n Whentheinfantbecomesdistracted,andsuckingstopsorbecomeslessfrequent,takethebottleoutandseeifhestillrootsforit.Theinfantcouldjustbeusingthebottleasapacifierafterhehasfulfilledhishungerneeds.
n Lookformilkrunningoutoftheinfant’smouth.Aninfantmayletthebottlestayinhermouthevenaftersheisfull.
n Itisnotnecessarytofinishoffabottle,containeroffoodorfoodontheplate.Evenwhenthereisanounceleft,ifaninfantisfull,lethimstopeating.Ifyouareworriedaboutwastingbreastmilkoriron-fortifiedinfantformula,startwithsmalleramountsandaddmoreiftheinfantisstillhungry.
For toddlers and older childrenn Littletummiesneedlittleportions.Justlikeadults,
whenthereisalargeamountoffoodontheplate,childrenwilleatit.Therefore,startsmallandaskthemiftheyarehungrybeforeservingorallowingsecondservings.Thiswillalsoreducefoodwasteandsavemoney!
n Servefamily-style—childrenwilllearntoputtherightamountontheirplatesfromthestart.
n Createapositiveeatingenvironmentbylisteningwhenachildsayssheisfull.Discouragethe“cleanyourplate”habit.Atoddlermaynotsaysheisfull,butshemaystartplaying,becomedistracted,shakeherhead“no,”closehermouth,orrefusetofinishthefoodonherplate.
n Sitwiththechildrenandletthemseeyoueatwhenyouarehungryandstopeatingwhenyouarefull,evenifthereisfoodonyourplate.Explainwhatyouaredoing.
n Complaintsofbeinghungry,especiallywhenachildhasjusteaten,maybeduetoothertriggerssuchasboredom,TVadvertisingorseeinganotherpersoneating.Helpthechildmoveontoadifferentfunactivity.
Best Practices for Healthy Eating 33
Picky EatersItisnatural forchildrentobecautiouswithnewfoods.Itcantakeupto10–15tries—actuallyputtingthefoodintheirmouths—beforetheymaycometolikeit.Somechildrenareespeciallycautiousabouttryingnewfoods,whileothersusefoodasawaytobeincontrol.
Usethesestrategiestocreateapositiveenvironmentandminimizestruggleswhentryingnewfoods:
For infantsn Don’tbediscouragedbyafrown.Infantsnaturally
prefersaltyandsweettastes,soforsomefruitsandvegetablesitmaytakeupto10–15triesforababytoacceptthenewfood.Don’tgiveup.
n Whenofferinganewfood,servetheinfantafoodhe/sheisfamiliarwithandlikes.Youcouldtryalternatingbitesbetweenthenewfoodandthefamiliarfood.
For toddlers and older childrenn Createaroutinethateveryoneshouldtryandtaste
newfoodsofferedatyourprogram.Encourageallchildrentotakeatleastonebiteofnewfoods.Ifachildisadamantlyagainstit,don’tforcetheissue.
n Putaverysmallportionontheplatetotry(liketwopeas).Youngchildrenmaybeconcernedthattheywon’tlikethenewfood,sohelpthembyputtingonlyasmallamountontheirplates—itlookslessoverwhelming.
n Alwaysofferhealthyfoodsorcreateapolicythatrequiresparentstoprovidewell-balancedmealsthatalignwithMyPlateand/orCACFPrecommendations.
n Avoidrewardinggoodbehaviororacleanplatewithfoodsofanykind.Especiallyavoidforcingachildtofinishthe“healthyfoods”togettohisdessertorsweets—thiscanmakethehealthyfoodseemlikepunishmentandforcethechildtoeatwhenheisfull.
n Offerdessertsrarelysochildrendonotexpectthemateverymeal.Whenchildrencometoexpectdessert,theymaynoteatthehealthierfoodsortheymayseedessertsasarewardforeatinghealthyfood.Bynothavingdessertasaregularoption,youminimizethisstruggle.
n Whenintroducinganewfood,makeitagameorlesson.Remember,itcantake10to15triesforachildtoacceptanewfood.Tryofferingthenewfoodoutsidethemealtime.Youcanmakeitaclassroomlessonandthenhavechildrenwhoareinterestedintryingthenewfoodtakeatasteandsharetheirperceptions.Thiscreatesadesirabilitytotrythenewfood.
34 Best Practices for Healthy Eating
Choking Hazards and Allergy WarningThefollowingfoodsareconsideredchokinghazardsforchildrenunder four years of ageifservedwholeorinchunks.Usethesesimplechangestomakethemsafeoptions.Somefoodscannotbesafelyaltered,soit’srecommendedtheynotbeservedatall.
Choking Hazard Make It Safe By…Nutsandseeds Choppingfinely;servingchoppedorgroundinpreparedfoods
Hotdogs Cuttinginquarterslengthwise,thencutintosmallerpieces
Wholegrapes Cuttinginhalflengthwise
Raisins Cookinginfood
Chunksofmeatorcheese Choppingfinely
Hardfruitchunks(likeapples) Choppingfinely,cuttingintothinstrips,steaming,mashing,orpureeing
Rawvegetables Choppingfinely,cuttingintothinstrips,steaming,mashing,orpureeing
Peanutbutter Spreadthinlyoncrackersormixwithapplesauceandcinnamonandspreadthinlyonbread
Choking Hazard DO NOT SERVEDriedfruitsorvegetables Donotserve
Popcorn* Donotserve*Foodsthatarenotreimbursable
ACTIONSTEP:Besureallfoodsarecutintobite-sizepieces,steamedormashed.Encouragechewingcompletelybeforeswallowingtoensuresafety.
Food AllergiesBecausefoodallergiesarecommoninchildren,itisimportanttobeawareoftheingredientsinallfoodsbeforeserving.
Theeightmostcommonallergensare
n Milk
n Eggs
n Peanuts*
n Treenuts*
n Fish
n Shellfish
n Soy
n Wheat
*Note:Treenuts,peanutsandnutbuttersareexcellentsourcesofproteinandhealthyfatsforgrowingchildren,arereimbursablemeatalternateoptionsandarestronglyencouragediffeasibleforyourprogram.
ACTIONSTEP:Ifachildhasafoodallergy,adoctor’snotemustbekeptonfilestatingtheallergyandanyappropriatesubstitutions.Besuretospeakwithallparents/guardiansaboutchildren’sfoodallergies.Ifallergiesaresevere,askforalistoffoodstheirchildispermittedtoeat.
Menu Planning & Meal Preparation
Best Practices for Healthy Eating 35
36 Best Practices for Healthy Eating
Tips for Transitioning Kids to Healthier FoodsManyyoungchildrenarepickyeatersandprefertoeatsimple,familiarfoods.However,childhoodisanimportanttimethatshapesfoodpreferencesandlifelonghealthhabits.Asanearlycareandeducationprovider,youhavetheuniqueopportunitytointroducechildrentoavarietyofnutritiousfoodstomakesuretheygrowupstrongandhealthy.Whileyoumayencountersmallchallengesalongtheway,thetipsbelowfortransitioningkidstohealthierfoodsaresuretomakethetasklessdaunting.
n Transitionfoodsafterasummer,winterorspringbreak.Childrenarelesslikelytonoticeadifferenceifthey’vebeenawayforawhile.
n Transitiontonewfoodsoringredientsslowlyandgradually.Insteadofgoingdirectlyfromwholemilktofat-free,firstserve2%forafewweeks,then1%(low-fat),beforefinallyarrivingatfat-freemilk.Youcanalsotrymixingwholeandfat-freeandgraduallyreducingtheamountofwholemilkaskidsadjusttothetaste.
n Besuretointroduceonlyonenewfoodatatimeandallowkidstoadjusttothechange.
n Encourageallkidstotastefoodeverytimeit’sserved,butletthemknowthattheydon’thavetoeatawholeservingiftheydon’tlikeit.Theycanjust“tryit.”Makeitagroupevent.
n Introducenewfoodsinfunandcreativeways.Forexample,freezesmallbatchesofmixedchoppedfruitinsmallcupsoricecubetrays,addastick,andvoilà–adeliciousfrozentreatthatkidsaresuretoenjoy!
n Involvechildreninpreparingmealsandsnackscreatedfromnewfoodstheyarelearningabout.Childrenaremorelikelytotryandenjoyfoodthattheyhavehelpedprepare.
n Teachchildrenwherethefoodthey’reeatingcomesfrom.Thismaybecomfortingforpickyeatersandallowsthemtolearnabouthowfoodismadeorgrown.Talkaboutthefoodwithchildrenduringmealtime,andencouragethemtosharehowtheylikeit.
n Alwaysprovideplentyofpraiseandencouragementwhenkidstrynewfoodstoreinforcethispositivebehavior.Praisingchildrenatthetablewhoaretryingthenewfoodmayencouragethemorehesitantchildrenaswell.
n “Sneakin”healthieringredients.Forexample,cauliflowercangoundetectedwhenpureedandmixedinwithmashedpotatoes.Askidsadjusttothetaste,youcanservecaulifloweronitsown.
Best Practices for Healthy Eating 37
How to Read a Food Label
2-100
110
Serving Size:
18
12g0g
0g0mg
Calories per gram:Fat 8 • Carbohydrate 4 • Protein 4
210mg22g
1g3g
3%0%
9%7%
6%
0%
1 (1 cup, 30 grams)
12%3g
How to Read a Food Label
Serving Size and Servings Per Container• Look at the serving size and how
many servings you are actually eating. If you are eating more than one serving, you need to multiply the calories by the number of servings.
Sodium• Important to look for less sodium
(<5% is low, and >20% is high) in order to reduce the risk of high blood pressure.
• Snack items should have no more than 200mg of sodium per serving.
Fats • Look for foods low in saturated and
trans fat, and cholesterol. Most fats should be poly or monounsaturated.
• Food should have no more than 35% of its calories from fat and no more than 10% of its calories from saturated fat excluding nuts, seeds, peanut butter, and other nut butters.
• All foods should have less than 0.5g of trans fat.
Calories Per Serving• Low - 40 calories or
less per serving• High - 400 or more
calories per serving • First check the calories and then
check the nutrients to see what you will be getting from the foods you are eating.
Sugars • Look for foods low in added sugars.
Read the ingredient list and make sure that sugar is not one of the first three items on the list.
• Names for added sugars include: sucrose, glucose, high fructose corn syrup, corn syrup, maple syrup, molasses, and fructose.
• A food should have no more than 35% of its calories from total sugars.
38 Best Practices for Healthy Eating
Planningamenucanbehard.Tryingtofindfoodsthatmeetrecommendationsandyourbudgetisachallengingtask!Usethesuggestionsbelowtochoosehealthyoptionsfromeachfoodgroupwhenplanningmenus:
Food Component Healthy OptionsGrainsandBreads nWholegrainbread(rolls,breadsticks)
nWholegrainpitanWholegrainmini-bagelsnWholegrainEnglishmuffinsnWholegrainpancakeorwafflemixnWholegrainorcorntortillasnBrownricenWholegraincouscousnOatmealnLowsugarcereal(lessthan6gramsofsugarperserving)nRicecakesnWholegraincrackersnGrahamcrackersnBakedtortillaorcornchipsnPretzels
MeatAlternates nLeanandveryleangroundmeats(80–95%lean)nLeanandveryleangroundchickenorturkey(80–95%lean)nLeancutsofbeef,ham,lamb,porkorvealnBoneless,skinlesschickenandturkeynFish(e.g.,salmon,trout,flounder,tilapia,tunaorcod)nCannedtunapackedinwaternRealcheeses(e.g.,cheddar,provolone,parmesan,Gouda,mozzarella,Swissorricotta)nLow-fatrealcheeses(e.g.,cheddar,provolone,parmesan,Gouda,mozzarella,Swissorricotta)nCottagecheese(low-fatorfat-free)nYogurt(low-fatorfat-free,plainorflavored)nNutsandseedsnBeansnHummusnEggs
FruitsandVegetables nFresh—Seethe“SeasonalFruitsandVegetablesList”forfreshsuggestionsnCannedfruitin100%juiceorwater(ifinsyrup,drainedandrinsed)nCannedvegetableswithoutaddedsaltorfatnFrozenfruitsandvegetableswithoutaddedsalt,sugarorfatnUnsweetenedornosugaraddedapplesaucenSalsa
Milk n1%(low-fat)nFat-free
Choosing Healthy Options in Each Food Group
} Forchildrenagetwoandolder
Best Practices for Healthy Eating 39
Seasonal Fruits & VegetablesFreshfruitsandvegetablesareadelicious,healthypartofmealsand snacks.Whilemostproduceisavailableyear-round,itcanbeexpensivewhenitisnotpurchasedinseason.Fruitsandvegetablesalsotastebetterwhenpurchasedduringtheirnaturalgrowingseason.Thechartbelowshowswhichfruitsandvegetablesgrowbestinthefall,winter,spring,andsummer.Whenpreparingfoodatyourprogram,keepthislistinmindanduseseasonally-appropriateingredientstosavemoney.Ifarecipecallsfora vegetablethatisnotinseason,replaceitwithonefromthischartthatis.Youcanalsousethischarttoteachchildrenaboutdifferentfruitsandveggies!
Fall Winter Spring SummerSeptember, October, November December, January, February March, April, May June, July, August
ApplesBroccoliBrusselssproutsCabbageChinesecabbageCauliflowerCeleryRootChicoryCranberriesCucumbersDatesEggplantFennelGrapesGreensLettuce:headoricebergLeaflettuceMushroomsNutsOkraMandarinorangesPearsChilipeppersSweetpeppersPersimmonsPomegranatesPumpkinQuinceShallotsSpinachWintersquashStarFruitSweetpotatoesTurnips
AvocadosBroccoliBrusselssproutsCabbageChinesecabbageCauliflowerCeleryrootChicoryDatesFennelGrapefruitGreensLemonsWildmushroomsMandarinorangesSweetorangesPearsSpinachSweetpotatoesTangerinesTurnips
AsparagusAvocadosBasilBeansBeetsBerriesBroccoliCabbageChinesecabbageCucumbersLettuce:headoricebergMangoesOkraSweetorangesPapayasPeasChilipeppersSweetpeppersRadishesRhubarbShallotsSpinachSummersquashTurnips
ApricotsBasilBeansBeetsBlackberriesBlueberriesBoysenberriesCarrotsCherriesCollardsCornCucumbersDatesFigsGrapesGreenbeansLimesMangoesMelonsNectarinesOkraPeachesPearsChilipeppersSweetpeppersPlumsRaspberriesSummersquashTomatoesWatermelon
Source:UnitedStatesDepartmentofAgriculture(USDA).AccessedAugust10,2010http://healthymeals.nal.usda.gov
40 Best Practices for Healthy Eating
Healthy Food SubstitutionsMakingyourmenuhealthierdoesn’talwaysrequirebigchanges.Itcan beeasy!Adjustingjustoneortwoingredientscanreducethefatandsugarcontentofmostmealsandsnacks.Moreimportantly,manysubstitutionsaresosubtlethatchildrenwon’tevennoticeadifference!Changingthewayfoodisprepared,likeswitchingfromfryingtobaking,isalsoaneffectiveandsimplewaytocutcaloriesandfat(seeHealthy Cooking Methods).
Usethechartbelowforideasonhealthysubstitutions.ItorganizesfoodsintocategoriesbyCACFPfoodgroups(whichmaynotbehowyou’reusedtoseeingfoodsgrouped).Pleasenotethatmanyofthefoodsinthefirstcolumnarenotreimbursableand/ordonotmeetrecommendations.Whilemostfoodsinthesecondcolumnarereimbursable,some—suchasthoseinthe“Condiments”section—arenot.Youmayevenfindthatsomehealthieroptionsarelessexpensivethantheirlesshealthycounterparts.Eitherway,switchingtohealthieringredientswillgreatlybenefitthehealthandwell-beingofthechildreninyourcare!
Instead of this… Try this healthier option!MILK
Wholemilkor2%milk nFat-freeor1%(low-fat)milk[forcooking/bakingandchildrenagedtwoandolder]
GRAINS & BREADS
Whitebread nWholegrainbread,pita,roll,etc.
Whiterice nBrownrice
Bagel nWholegrainminibagel
Flourtortilla nCornorwholegraintortilla
Pasta nWholegrainpasta
Croissant nWholegrainroll,Englishmuffinormini-bagel
Sugaryboxedcereal nWholegrainboxedcerealwithatleast3gramsoffiberandnomorethan6gramsofsugarperserving
Instantsweetenedoatmeal nPlaininstantoatswithfruitand/ornuts
FRUITS & VEGETABLES
Addingsalttoflavorcookedvegetables nAmixtureofherbsorspiceslikegarlicpowder,onionpowder,oregano,basil,lemonpepper,etc.*
Creamysauces nLemonjuice
Fruitpie nBakedfruitwithraisins
Fruitcannedinheavysyrup nFruitcannedin100%juiceorwater(ifcannedinsyrup,drainedandrinsed)
Driedfruit,sweetened nDriedfruit,unsweetenednFreshfruit,fruitcannedin100%juiceorwater(ifcannedinsyrup,drainedandrinsed)
Frenchfries nOvenbakedpotatoorsweetpotatowedgeswithskinintact
Best Practices for Healthy Eating 41
Instead of this… Try this healthier option!MEATS & MEAT ALTERNATES
Groundbeef nLeanandveryleangroundbeef(90%leanorgreater)nLeangroundturkeyorchickennTexturedvegetableprotein*
Bacon nBakedturkey,chickenorporkstripsnTurkeybaconCN
nSpiralham
Sausage nLeangroundturkeyn95%fat-freesausageCNnLeanturkeysausageCNnSoysausagelinksorpatties*
Chickennuggets nBakedchickenbreast
Fishsticks nBakedfishfillets
Cheese nReduced-fat,part-skim,low-fat,orfat-freecheese
Yogurt nLow-fatorfat-freeyogurt
Icecream nLow-fatorfat-freefrozenyogurtnLow-fatorfat-freeicecream*nFrozenfruitjuiceproducts*orsorbet*
Creamcheese nLow-fatorfat-freecreamcheese*
CONDIMENTS * Please note that most condiments are not reimbursable
Whippedcream nChilled,whippedevaporatedskimmilk*nNondairy,fat-freeorlow-fatwhippedtoppingmadefrompolyunsaturatedfat*nLow-fatorfat-freeyogurt
Mayonnaise nFat-freeorlow-fatmayonnaise*nFat-freeorlow-fatsaladdressing,whipped*nFat-freeorlow-fatyogurt,plain
Saladdressing nFat-freeorlow-fatcommercialdressings*n Homemadedressingmadewithunsaturatedoils,water,andvinegar,honeyorlemonjuice*
Sourcream nFat-freeorlow-fatsourcream*nFat-freeorlow-fatyogurt,plainn½cupfat-freeorlow-fatcottagecheeseblendedwith1½tsplemonjuice
Vegetabledips,commercial nHummus;low-fatorfat-freeplainyogurt
SOUPS
Creamsoups,commercial nBroth-basedorskimmilk-basedsoups,commercialn Fat-freeorlow-fatcreamsoups,commercial
Creamorwholemilkinsoupsorcasseroles nPureedvegetablesnEvaporatedskimmilk*
BAKING & COOKING
Evaporatedmilk nEvaporatedskimmilk*
Butter,margarineoroiltogreasepan nCookingsprayoratinyamountofvegetableoilrubbedinwithapapertowel*
Butteroroilinbakedgoods nNaturalapplesauceforhalfofbutter,oilorshortening
Refined,all-purposeflour nHalfwholewheatflour,halfall-purposeflour
Sugar nReducetheamountbyhalfandaddspiceslikecinnamon,cloves,all-spiceornutmeg*
Salt nReducetheamountbyhalf(unlessit’sabakedgoodthatrequiresyeast)nHerbs,spices,fruitjuicesorsalt-freeseasoningmixes*
*FoodsthatarenotreimbursableCNFoodsthatrequireaChildNutritionlabel
42 Best Practices for Healthy Eating
Healthy Cooking Methods2
Preparationandcookingmethodsmakeabigdifferenceindeterminingthenutritionalvalueofarecipe.Usethefollowingeasycookingmethodstomakeeverydaydisheshealthier.
1. Baking–Bakingcanbeusedforalmostanytypeoffoodincludingmeat,fruitsandvegetables,mixeddishes(i.e.,casseroles)andbakedgoodssuchasbreadorpies.Placethefoodinadish,eithercoveredoruncovered,andallowthehotairfromtheovencookit.
2. Braising–Cookingslowlyinacoveredcontainerwithasmallamountofliquidorwater.Thecookingliquidmaybeusedforasauce.3
3. Broiling–Cookingmeats,poultry,seafood,orvegetablesbyplacingonabroilerrackinovenbelowtheheat,allowingfattodripaway.
4. Grilling–Cookingfoodsoverdirectheatonagrill,griddleorpan.Fatcanberemovedasitaccumulates.
5. Microwaving–Microwavingcanbeafastandeasywaytocookfoodifitisdonecorrectly.Coverthefoodwithalidorplasticwrap.Loosenthelidorwrapsothatsteamcanescape.Stirorrotatethefoodmid-waythroughcooktimesothatitisevenlycooked.4
6. Poaching–Cookingdelicatefoodslikeeggsorfisheitherpartiallyorcompletelyinliquid(suchaswaterorbroth)attemperaturebetween140°and180°F.
7. Roasting–Cookingmeat,poultry,andseafoodlargerthansingleportionsbydryheat,uncoveredinanoven.Itisagreatwaytousemarinades,herbsandspices.
8. Sautéing–Sautéingisagoodmethodforvegetablesthataretenderandhighinmoisturesuchasmushrooms,tomatoesandzucchini.Theingredientsarecookedinasmallamountofoilormargarineataveryhighheatuntiltender.
9. Steaming–Agreat,healthywaytocookvegetablesthatproduceslittletonolossinflavorormoisture.Cutintosmall,even-sizepieces.Fillapotorpanwith1–2inchesofwaterorbroth,settomedium-highheat,andwaituntilliquidbeginstoproducesteam.Addthevegetables,cover,andletthesteamsurroundandcookthevegetables.Generally,vegetablesaredonesteamingwhentheybecomeslightlysoft(yetstillcrunchy)andvibrantincolor.Toenhancetaste,seasoning(e.g.,herbs,chickenstock)canbeaddedtothewater.2
10.Stir frying–Cookingquicklyoververyhighheatinawokorskillet.Cutallingredientsthesamesizesothattheycookevenly.Withasmallamountofvegetableorcanolaoil,keepthefoodinconstantmotionbystirringandtossing.Greatforlargeorsmallbatchesofmeats,seafood,vegetables(fresh,frozen,orprecooked)combinations.
2UnitedStatesDepartmentofAgriculture(USDA)FoodandNutritionService.(June2009).USDA Recipes for Child Care.
3UnitedStatesDepartmentofAgriculture(USDA)FoodandNutritionService.AccessedAugust12,2010.Cooking A World of New Tastes.http://www.fns.usda.gov/tn/Resources/worldtastes03Seg2.pdf.
4UnitedStatesDepartmentofAgriculture(USDA).AccessedAugust12,2010.Cooking Safely in the Microwave Oven.Retrievedfromhttp://www.fsis.usda.gov/PDF/Cooking_Safely_in_the_Microwave.pdf.
Best Practices for Healthy Eating 43
Engaging Children in the KitchenInvolvingchildreninpreparingmealsisaneasywaytoencouragetheirgrowingindependenceandhelpthemgetexcitedabouttryingnewfoods!Childrenaremorelikelytotryaneworunusualfoodiftheyhelpedprepareit.Theywillalsotakeprideintheirculinaryskillsandmayencourageotherstotastewhattheyhavemade.Seethelistbelowforsuggestionsonage-appropriateactivities.5,6
2 year oldsn Rinsingvegetablesandfruits
n Tearinglettuceorgreens
n Snappinggreenbeans
n Making“faces”outofpiecesofvegetablesandfruit
n Handingitemstoadulttoputaway(e.g.,aftergroceryshopping)
n Throwingwasteinthetrash
n Wipingofftables,chairsandcounters
3 year olds:All of the 2 year old activities plus:n Addingingredients
n Stirring
n Scoopingormashingpotatoes
n Spreadingpeanutbutterorotherspreads
n Kneadingandshapingdough
n Helpingassemblefoods(e.g.,pizza)
n Namingandcountingfoods
4 year olds:All of the 2 and 3 year old activities plus:n Peelingeggsandsomefruitsandvegetables(e.g.,
orangesandbananas)
n Settingthetable
n Measuringdryingredients
n Helpingmakesandwichesandsalads
n Mashingsoftfruits,vegetablesandbeans
5 year olds:All of the 2, 3, and 4 year old activities plus:n Measuringliquids
n Cuttingsoftfruitswithaplasticknife
n Crackingeggs
n Usinganeggbeater
n Readingarecipeoutloud
5UnitedStatesDepartmentofAgriculture,Mypyramid.gov.Http://www.mypyramid.gov/preschoolers/HealthyHabits/PickyEaters/kitchenactivities.html.AccessedJune9,2010.
6UnitedStatesDepartmentofAgricultureandNutritionService.Maximizing the message: Helping moms and kids make healthier food choices.http://www.fns.usda.gov/fns/corenutritionmessages/Files/Guidebook.pdf#xml=http://65.216.150.153/texis/search/pdfhi.txt?query=role+modeling&pr=FNS&prox=page&rorder=500&rprox=500&rdfreq=500&rwfreq=500&rlead=500&rdepth=0&sufs=0&order=r&cq=&id=4bc8cea611.AccessedJune9,2010.
44 BestPracticesforHealthyEating
Policy Support
Best Practices for Healthy Eating 45
46 Best Practices for Healthy Eating
Sample PoliciesHavingwrittenpoliciescansupportyourworktoimprovechildren’snutritionandhealthyhabitsinyourearlycareandeducationprogram,andhelptomakepositivechangessustainable.Policiesshouldbecommunicatedtostaffandfamiliesonanannualbasis.Seebelowforsomesamplepolicies.
For Program and Staff HandbooksBreastfeeding1 At(name of program),wesupportbreastfeedingmothersandbabiesby:
n Providingaprivate,cleanandcomfortableplaceformotherstobreastfeedorexpressmilk.Mothersarealsowelcometobreastfeedinclassroomsorotherpublicspaces.
n Providingrefrigeratorstorageofbreastmilkandensuringthateachchild’sbottlesarelabeledwithhis/hername,thedate,andthecontentsofthecontainer.
n Trainingstafftoappropriatelyhandleandstorebreastmilk.
n Feedingbasedoneachbaby’sscheduleaswellashungerandfullnesscues.
n Timingfeedingstoaccommodatebreastfeedingmothers.Forexample,iftheywanttobreastfeedbabyatpick-up,wewillnotofferabottledirectlybeforehand.
n Refrainingfromsupplementingwithformulaorsolidfoodswithoutparentalpermission.
n Displayingvisualsupportofbreastfeedingfamilies.
n Connectingfamilieswithcommunitysupport,iftheydesireit.
n Providingreasonableandflexiblebreaktimetoaccommodateassociateswhoarebreastfeedingorexpressingmilk.
General2
At(name of program),wesupportchildren’shealthyeatingby:
n Role-modelingpositivebehaviorsbyeatingonlyhealthyfoodsinthepresenceofthechildren.
n Providingnutritioneducationatleastthreetimesperyear,toteachchildrenhowtomakehealthychoices.
n Gentlyencouragingchildrentotryhealthyfoodsandgivingpositivereinforcementwhentheydo.
n Observingandsupportinghungerandfullnesscues.
n Servingonlyhealthyfoodsandbeveragesthatmeetbestpracticerecommendations.
n Makingwaterclearlyvisibleandavailabletochildrenatalltimes,indoorsandoutdoors.
n Followinghealthycelebrationguidelines.
n Providingnutritioneducationforourstaffatleastonetimeperyear.
n Refrainingfromusingfoodasarewardorpunishment.
n Sittingwithchildrenatthetableandeatingthesamemealsandsnacks.
n Encouraging,butnotforcing,childrentoeathealthyfoods.
At(name of program),wesupportourassociates’healthby:
n Servingonlyhealthyfoodsthatmeetbestpracticerecommendationsatmeetingsandforstaffmeals.
n Limitinglesshealthytreatstooneortwooptionsatstaffcelebrations.
n Ensuringthatourenvironment(vendingmachines,etc.)supportshealthyeating.
n Connectingstafftocommunityresourcestosupporthealthyeating.
Best Practices for Healthy Eating 47
For Family HandbooksAt(name of program),wesupportbreastfeedingmothersandbabiesby:1
n Providingaprivate,cleanandcomfortableplaceforyoutobreastfeedorexpressmilk.Youarealsowelcometobreastfeedyourbabyinhis/herclassroomorotherpublicspace.
n Providingrefrigeratorstorageofbreastmilk.Pleasebesuretolabelyourchild’sbottleswithhis/hername,thedate,andthecontentsofthecontainer.
n Trainingstafftoappropriatelyhandleandstorebreastmilk.
n Feedingbasedonyourbaby’sscheduleaswellashungerandfullnesscues.
n Timingfeedingsbasedonyourpreference.Forexample,ifyouwanttobreastfeedyourbabyatpick-up,wewillnotofferabottledirectlybeforehand.
n Refrainingfromsupplementingwithformulaorsolidfoodswithoutyourpermission.
n Displayingvisualsupportofbreastfeedingfamilies.
n Connectingyouwithcommunitysupport,ifyoudesireit.
At(name of program),wesupportyourchild’shealthyfoodchoicesby:2
n Role-modelingpositivebehaviorsbyeatingonlyhealthyfoodsinthepresenceofthechildren.
n Providingnutritioneducationatleastthreetimesperyear,toteachchildrenhowtomakehealthychoices.
n Gentlyencouragingchildrentotryhealthyfoodsandgivingpositivereinforcementwhentheydo.
n Observingandsupportinghungerandfullnesscues.
n Servingonlyhealthyfoodsandbeveragesthatmeetbestpracticerecommendations.
n Makingwaterclearlyvisibleandavailabletochildrenatalltimes,indoorsandoutdoors.
n Followinghealthycelebrationguidelines.
n Providingnutritioneducationforourstaffatleastonetimeperyear.
n Refrainingfromusingfoodasarewardorpunishment.
n Sittingwithchildrenatthetableandeatingthesamemealsandsnacks.
n Encouraging,butnotforcing,childrentoeathealthyfoods.
Providinggoodnutritionforyourchildisapartnership.Weat(name of program)askforyoursupport:
n Forpackedmealsfromhome,pleaseprovide:
• Fruitsandvegetables
• Wholegraincereals,crackers,breads,pasta,etc.
• Proteinsuchasleanmeat,skinlesspoultry,fish,cookedbeansorpeas,nutbutters,eggs,yogurtorcheese.
• Milk
n Pleaserefrainfromsending:
• Pre-friedandhighlyprocessedmeats(e.g.,chickennuggets,hotdogs,etc.)
• Chipsandsimilarhigh-fatsnacks
• Cookies,candyandsimilarsugarydesserts
• Sugarydrinks(e.g.,sodas,fruitdrinks,sportsdrinks,etc.)
n Forcelebrationsandholidayparties,pleaseprovidehealthyfoods(especiallyfruitsandvegetables).Alistofrecommendedage-appropriatefoodswillbeprovided.
1 WisconsinDepartmentofHealthServices.TenStepstoBreastfeedingFriendlyChildCareCentersResourceKit.RetrievedonMay7,2013fromhttp://www.dhs.wisconsin.gov/physical-activity/Childcare/BFFChildCare.pdf
2 Benjamin,Sara.PreventingObesityintheChildcareSetting:EvaluatingStateRegulations.RetrievedonMay9,2013fromhttp://cfm.mc.duke.edu/wysiwyg/downloads/State_Reports_FInal.pdf
48 BestPracticesforHealthyEating
Family Tip Sheets
Best Practices for Healthy Eating 49
Tip Sheet: Healthy Eating for Infants from Birth through 3 Months
50 Best Practices for Healthy Eating
What to Feed Your Babyn Feedyourbabyeitherbreastmilkoriron-fortified
formulaonlyforthefirst6monthsoflife.Evenafterstartingsolidfoods,breastfeedingandformulafeedingshouldcontinueuntil12monthsofage.Unlessbreastfeedingcontinues,wholemilkshouldbeservedafter12monthsofage.
n Startingandcontinuingtobreastfeedcanbechallenging.Don’tgiveup!Ifyouneedsupportorhavequestions,callalocallactationconsultantortheSpecialSupplementalNutritionProgramforWomen,InfantsandChildren(WIC)inyourarea.Formoreinformationonbreastfeedingcontact:
• WICtoll-freeat1-800-222-2189
• Toll-freeNationalWomen’sHealthHelplineat1-800-994-9662
• Yourstatebreastfeedingcoalition.Finditat:http://www.usbreastfeeding.org/Coalitions/CoalitionsDirectory/tabid/74/Default.aspx
n ManyinfantswillneedtoreceiveadailyVitaminDsupplement,whichisnecessarytoensurehealthybonegrowthanddevelopment.AskyourhealthcareproviderabouttheamountofVitaminDneededforyourinfant.
Signs of HungerBabiesshouldbefedwhenevertheyshowyoutheyarehungry.Lookforthesesigns:
n Rooting:areflexinnewbornsthatmakesthemturntheirheadtowardabreastorbottletofeed
n Suckingonfingersorafist
n Moving,lickingorsmackingoflips
n Fussingorcrying
n Excitedarmandlegmovements
Signs of FullnessIt’snotnecessaryforyourbabytofinishabottleorcontaineroffood.Ifsheshowssignsthatsheisfullandthereisfoodleft,allowhertostopeating.Lookforthesesigns:
n Sealinglipstogether,decreasingsucking,spittingoutorrefusingthenipple,orpushingorturningawayfromthebreastorbottle
n Milkbeginstorunoutofthebaby’smouth
Safety and Storage of Breast Milkn Itisbesttodefrostbreastmilkeitherinthe
refrigeratorovernight,byrunningunderwarmwater,orbysettinginacontainerofwarmwater.Thawedbreastmilkshouldbeusedwithin24hours.Donotrefreezeunusedmilk.
n Ifyourbabydoesn’tfinishthebottleofbreastmilkwithinonehour,throwouttherest.Bacteriafromsalivacancontaminatethemilkandmakeyourinfantsickifhedrinksitlater.
Breast Milk Storage GuidelinesLocation of Storage Maximum Recommended Storage Time
RoomTemperature 3-4hours
Refrigerator 48-72hours
Freezer 6months
Safety and Storage of Formulan Alwaysfollowlabeldirectionscarefully.
n Ifyourbabydoesn’tfinishthebottleofformulawithin1hour,throwouttheremainder.Bacteriafromsalivacancontaminatetheformulaandmakeyourinfantsickifshedrinksitlater.
n Topreventwasteandsavetime,mixalargebatchofformulaanddivideitintobottlesthatyoucanrefrigerateandusethroughouttheday.
Formula Storage GuidelinesLocation of Storage Maximum Recommended Storage Time
RoomTemperature 2hours
RoomTemperature 1hourifwarmed
Refrigerator 24hours
How Much to Feed Your BabyUnderstandyourroleandyourbaby’sroleatmealtimes.Yourjobistoofferbreastmilkorformulaatregulartimes;yourbaby’sjobistodecidehowmuchtoeat.
Ask your healthcare provider if you have any questions about feeding your baby.
How Much to Feed Your BabyIfbreastfeeding Ondemand
Ifiron-fortifiedinfantformula* 4–6fluidouncesperfeed
Daily Formula Feeding Amounts by Age*1month 14–20fluidouncesperday
2months 20–28fluidouncesperday
3months 26–32fluidouncesperday
* Formulaintakeshouldbeadequatetosupportappropriateweightgainasdeterminedbyyourinfant’sdoctor.
Best Practices for Healthy Eating 51
Tip Sheet: Healthy Eating for Infants from Birth through 3 Months
Reminder: Never use a microwave to
heat a bottle of breast milk or formula.
5ozservingshown
52 Best Practices for Healthy Eating
Tip Sheet: Healthy Eating for Infants Ages 4 through 7 Months
Breast Milk and Formulan Feedyourbabyeitherbreastmilkoriron-fortified
formulaonlyforthefirst6monthsoflife.Evenafterstartingsolidfoods,breastfeedingandformulafeedingshouldcontinueuntil12monthsofage.Unlessbreastfeedingcontinues,wholemilkshouldbeservedafter12monthsofage.
n Startingandcontinuingtobreastfeedcanbechallenging.Don’tgiveup!Ifyouneedsupportorhavequestions,callalocallactationconsultantortheSpecialSupplementalNutritionProgramforWomen,InfantsandChildren(WIC)inyourarea.Formoreinformationonbreastfeedingcontact:
• WICtoll-freeat1-800-222-2189
• Toll-freeNationalWomen’sHealthHelplineat1-800-994-9662
• Yourstatebreastfeedingcoalition.Finditat:http://www.usbreastfeeding.org/Coalitions/CoalitionsDirectory/tabid/74/Default.aspx
n ManyinfantswillneedtoreceiveadailyVitaminDsupplement,whichisnecessarytoensurehealthybonegrowthanddevelopment.AskyourhealthcareproviderabouttheamountofVitaminDneededforyourinfant.
Solid Foodsn Around6monthsyourbabywillbegintoshowsigns
thatheisreadyforsolidfoods.Signsinclude:
• Absenceoftonguethrustreflex
• Goodneckandheadcontrol
• Increaseddemandforbreastmilkorformulathatcontinuesforafewdays
n Offersingle-ingredientfoodsfirstandwait2–3daysbetweeneachnewfood.Thismakesiteasiertoidentifytheoffendingfoodifheexperiencesabadreaction(i.e.,allergy).
n Introduceiron-fortifiedricecerealfirst,followedbyiron-fortifiedoatorbarleycereal.
n Offerdifferentfruitsandvegetables.Theyshouldbe:
• Puréed,mashedorstrainedtopreventchoking
• Servedplainwithoutaddedfat,sugar,honeyorsalt
n Itmaytakemultipletries(5–20)beforeyourbabyacceptsanewfood.Don’tgetdiscouraged!
Choking Hazards Donotfeedchildrenyoungerthanfouryearsofageround,firmfoodunlessitischoppedcompletely.
The following foods are choking hazards:
nNutsandseedsnLargechunksofcheeseormeat(e.g.,hotdogs)nWholegrapes,chunksofhardfruit(e.g.,apples)andraw
vegetablesnPeanutbutternIcecubesnRaisinsnPopcornnHard,gooey,orstickycandy,chewinggum
*Neverleaveaninfantunattendedwhileshe/heiseating.
Best Practices for Healthy Eating 53
Signs of HungerBabiesshouldbefedwhenevertheyshowyoutheyarehungry.Lookforthesesigns:
n Rooting:areflexinnewbornsthatmakesthemturntheirheadtowardabreastorbottletofeed
n Suckingonfingersorafist
n Moving,lickingorsmackingoflips
n Fussingorcrying
n Excitedarmandlegmovements
Signs of FullnessIt’snotnecessaryforyourbabytofinishabottleorcontaineroffood.Ifsheshowssignsthatsheisfullandthereisfoodleft,allowhertostopeating.Whenmakinga meal,offerthecorrectamountoffoodforherageandoffermoreonlyifsheisstillhungryandengagedineating.Lookforthesesignsoffullness:
n Sealinglipstogether,decreasingsucking,spittingoutorrefusingthenipple,orpushingorturningawayfromthebreastorbottle
n Milkbeginstorunoutofthebaby’smouth
Safety and Storage of Breast Milkn Itisbesttodefrostbreastmilkeitherinthe
refrigeratorovernight,byrunningunderwarmwater,orbysettinginacontainerofwarmwater.Thawedbreastmilkshouldbeusedwithin24hours.Donotrefreezeunusedmilk.
n Ifyourbabydoesn’tfinishthebottleofbreastmilkwithinonehour,throwouttherest.Bacteriafromsalivacancontaminatethemilkandmakeyourinfantsickifhedrinksitlater.
Breast Milk Storage GuidelinesLocation of Storage Maximum Recommended Storage Time
RoomTemperature 3-4hours
Refrigerator 48-72hours
Freezer 6months
Safety and Storage of Formula• Alwaysfollowlabeldirectionscarefully.
• Ifyourbabydoesn’tfinishthebottleofformulawithin1hour,throwouttheremainder.Bacteriafromsalivacancontaminatetheformulaandmakeyourinfantsickifshedrinksitlater.
• To prevent wasteandsavetime,mixalargebatchofformulaanddivideitintobottlesthatyoucanrefrigerateandusethroughouttheday.
Formula Storage GuidelinesLocation of Storage Maximum Recommended Storage Time
RoomTemperature 2hours
RoomTemperature 1hourifwarmed
Refrigerator 24hours
Tip Sheet: Healthy Eating for Infants Ages 4 through 7 Months
How Much to Feed Your Child Understandyourroleandyourchild’sroleatmealtimes.Yourjobistoofferhealthyfoodsatregulartimes;yourchild’sjobistodecidewhetherandhowmuchtoeat.
BREAKFASTLUNCH/ SUPPER
SNACK
Serve both components
Serve all 3 components
1.BreastMilkorFormula 4–8floz 4–8floz 4–6floz
2.FruitorVegetable None 0–3Tbsp None
3.GrainorBreadInfantCerealBreadCrackers
0–3Tbsp
NoneNone
0–3Tbsp
NoneNone
NoneNoneNone
How Much to Feed Your BabyIfbreastfeeding Ondemand
Ifiron-fortifiedinfantformula* 4–8fluidouncesperfeed
Waterwithnoaddedsweeteners Ifdesired,smallamountscanbegivenafterbreastmilkoriron-fortifiedformula
Daily Formula Feeding Amounts by Age*4through7months 26–32fluidouncesperday
* Formulaintakeshouldbeadequatetosupportappropriateweightgainasdeterminedbytheinfant’sdoctor.
54 Best Practices for Healthy Eating
Reminder: Never use a microwave to
heat a bottle of breast milk or formula.
6ozservingshown
Tip Sheet: Healthy Eating for Infants Ages 4 through 7 Months
Age-Appropriate Servings for Lunch/Supper:Infants Ages 4 through 7 Months
Best Practices for Healthy Eating 55
Tip Sheet: Healthy Eating for Infants Ages 4 through 7 Months
Lunch/Suppershownon8”plate.Addbreastmilkor
formulatocompletethemealrequirements.
Grain/Bread InfantCereal–
1.5Tbspservingshown
Fruit/Vegetable 1.5Tbspservingshown,puréed
Breast Milk and Formulan Feedyourbabyeitherbreastmilkoriron-fortified
formulaonlyforthefirst6monthsoflife.Evenafterstartingsolidfoods,breastfeedingandformulafeedingshouldcontinueuntil12monthsofage.Unlessbreastfeedingcontinues,wholemilkshouldbeservedafter12monthsofage.
n Startingandcontinuingtobreastfeedcanbechallenging.Don’tgiveup!Ifyouneedsupportorhavequestions,callalocallactationconsultantortheSpecialSupplementalNutritionProgramforWomen,InfantsandChildren(WIC)inyourarea.Formoreinformationonbreastfeedingcontact:
• WICtoll-freeat1-800-222-2189
• Toll-freeNationalWomen’sHealthHelplineat1-800-994-9662
• Yourstatebreastfeedingcoalition.Finditat:http://www.usbreastfeeding.org/Coalitions/CoalitionsDirectory/tabid/74/Default.aspx
n ManyinfantswillneedtoreceiveadailyVitaminDsupplement,whichisnecessarytoensurehealthybonegrowthanddevelopment.AskyourhealthcareproviderabouttheamountofVitaminDneededforyourinfant.
Solid Foodsn Encourageyourbabytobeginfeedingherselfsimple
fingerfoodsduringmealsandsnacks(e.g.,smallpiecesofbanana;cooked,cutcarrots;softcheese,etc.).
n Offersingle-ingredientfoodsfirstandwait2–3daysbetweeneachnewfood.Thismakesiteasiertoidentifytheoffendingfoodifsheexperiencesabadreaction(i.e.,allergy).
n Itmaytakemultipletries(5–20)beforeyourbabyacceptsanewfood.Don’tgetdiscouraged!
n Ifsheseemsinterested,beginusingacup(i.e.,“sippy”cup)aroundeightmonthsofage.
• Startwithwater(withnoaddedsweeteners)
n Offerdifferentfruitsandvegetables.Theyshouldbe:
• Cookedand/orcutintobite-sizepiecestopreventchoking
• Servedplainwithoutaddedfat,sugar,honeyorsalt
n Youcanalsointroduce:
• Iron-fortifiedinfantcereal
• Leanbeef,veal,and/orpork*
• Skinlesschickenand/orturkey*
• Cookedbeansandpeas* Forchildrenunderagefour,meats,beansandpeasshouldbesoft,puréed,ground,
mashedorfinelychoppedtopreventchoking.
Choking Hazards Donotfeedchildrenyoungerthanfouryearsofageround,firmfoodunlessitischoppedcompletely.
The following foods are choking hazards:
nNutsandseedsnLargechunksofcheeseormeat(e.g.,hotdogs)nWholegrapes,chunksofhardfruit(e.g.,apples)andraw
vegetablesnPeanutbutternIcecubesnRaisinsnPopcornnHard,gooey,orstickycandy,chewinggum
*Neverleaveaninfantunattendedwhileshe/heiseating.
Signs of HungerBabiesshouldbefedwhenevertheyshowyoutheyarehungry.Lookforthesesigns:
n Rooting:areflexinnewbornsthatmakesthemturntheirheadtowardabreastorbottletofeed
n Suckingonfingersorafist
n Moving,lickingorsmackingoflips
n Fussingorcrying
n Excitedarmandlegmovements
Signs of FullnessIt’snotnecessaryforyourbabytofinishabottleorcontaineroffood.Ifheshowssignsthatheisfullandthereisfoodleft,allowhimtostopeating.Whenmakingameal,offerthecorrectamountoffoodforhisageandoffermoreonlyifheisstillhungryandengagedineating.Lookforthesesignsoffullness:
n Sealinglipstogether,decreasingsucking,spittingoutorrefusingthenipple,orpushingorturningawayfromthebreastorbottle
n Milkbeginstorunoutofthebaby’smouth
56 Best Practices for Healthy Eating
Tip Sheet: Healthy Eating for Infants Ages 8 through 11 Months
Safety and Storage of Breast Milkn Itisbesttodefrostbreastmilkeitherinthe
refrigeratorovernight,byrunningunderwarmwater,orbysettinginacontainerofwarmwater.Thawedbreastmilkshouldbeusedwithin24hours.Donotrefreezeunusedmilk.
n Ifyourbabydoesn’tfinishthebottleofbreastmilkwithinonehour,throwouttherest.Bacteriafromsalivacancontaminatethemilkandmakeyourinfantsickifhedrinksitlater.
Breast Milk Storage GuidelinesLocation of Storage Maximum Recommended Storage Time
RoomTemperature 3-4hours
Refrigerator 48-72hours
Freezer 6months
Safety and Storage of Formulan Alwaysfollowlabeldirectionscarefully.
n Ifyourbabydoesn’tfinishthebottleofformulawithin1hour,throwouttheremainder.Bacteriafromsalivacancontaminatetheformulaandmakeyourinfantsickifshedrinksitlater.
n To prevent wasteandsavetime,mixalargebatchofformulaanddivideitintobottlesthatyoucanrefrigerateandusethroughouttheday.
Formula Storage GuidelinesLocation of Storage Maximum Recommended Storage Time
RoomTemperature 2hours
RoomTemperature 1hourifwarmed
Refrigerator 24hours
BestPracticesforHealthyEating 57
Tip Sheet: Healthy Eating for Infants Ages 8 through 11 Months
How Much to Feed Your BabyUnderstandyourroleandyourbaby’sroleatmealtimes.Yourjobistoofferbreastmilkorformulaatregulartimes;yourbaby’sjobistodecidehowmuchtoeat.
Ask your healthcare provider if you have any questions about feeding your baby.
BREAKFAST LUNCH/SUPPER SNACKServe all 3 components Serve all 4 components Serve both components
1.BreastMilkorFormula 6–8fluidoz 6–8fluidoz 2–4fluidoz
2.FruitorVegetable 1–4Tbsp 1–4Tbsp None
3.GrainorBreadInfantCerealBreadCrackers
2–4TbspNoneNone
2–4TbspNoneNone
None0–1/2slice0–2crackers
4.MeatorMeatAlternate(proteinsource)Leanmeat,poultry/fish,eggyolk,cookedbeansorpeasCheeseCottagecheese
None
NoneNone
1–4Tbsp
1/2–2oz1–4oz
None
NoneNone
58 Best Practices for Healthy Eating
How Much to Feed Your BabyIfbreastfeeding Ondemand
Ifiron-fortifiedinfantformula* 6–8fluidouncesperfeed
Waterwithnoaddedsweeteners Ifdesired,smallamountscanbegivenafterbreastmilkoriron-fortifiedformula
Daily Formula Feeding Amounts by Age*8through11months 26–32fluidouncesperday
* Formulaintakeshouldbeadequatetosupportappropriateweightgainasdeterminedbytheinfant’sdoctor.
Reminder: Never use a microwave to
heat a bottle of breast milk or formula.
7ozservingshown
7ozservingshownina7ozcup
Tip Sheet: Healthy Eating for Infants Ages 8 through 11 Months
Best Practices for Healthy Eating 59
Age-Appropriate Servings for Lunch/Supper for Ages 8 through 11 Months
Tip Sheet: Healthy Eating for Infants Ages 8 through 11 Months
Lunch/Suppershownon8”plate.Addbreastmilkor
formulatocompletethemealrequirements.
Grain/Bread InfantCereal–
3Tbspservingshown
Fruit/Vegetable 2Tbspservingshown–
puréed,mashedorfinelychopped
Meat/Meat Alternate 2Tbspservingshown–
puréed,mashedorfinelychopped
60 Best Practices for Healthy Eating
Tip Sheet: Healthy Eating for Toddlers Ages 1 through 2 Years
Developing Healthy Eating Habits • Startwithage-appropriateservings,aslistedinthe
chartonthenextpage.
• Teachhertoeatslowly.Askifsheisstillhungrybeforeallowinghertoserveherselfmorefood.Takingthetimetodecideifsheishungryorfullwillhelpherpayattentiontoimportantcuesfromherbody.
• Avoidrequiringyourchildtocleanhisplate.Helphimlearntoeatbasedonhowhungryheis,notonhowmuchfoodisstillonhisplate.
• Understandyourroleandyourchild’s.Yourjobistoofferavarietyofhealthyfoodsatregularmealtimes;herjobistodecidewhatandhowmuchtoeat.
• Beapositiverolemodel.Sitwithyourchildandlethimobserveyoueatahealthy,balanceddiet.Serveyourselfappropriateportionsandtry“new”foods.Explainwhatyouaredoing.
• Payattentiontoyourtoddler’shungercues.Shemaynotsaythatsheisfull,butmaystartplaying,becomedistracted,shakeherhead“no,”closehermouthorrefusetofinishthefoodonherplate.
• Complaintsofbeinghungry,especiallywhenachildhasjusteaten,maybeduetoothertriggerssuchasboredom,TVadvertisingorseeinganotherpersoneating.
• Givenhealthyservings,mosttoddlerssensewhentheyarefullandwillstopeatingifyouletthem.Theamountoffoodatoddlereatsmaychangefromdaytoday,butahealthychildwillgenerallyconsumejusttherightamountoffoodtonourishhisbody.
Trying New FoodsItisnaturalforyourtoddlertobecautiouswithnewfoods.Itmaytake5–20triesbeforehewillcometolikeit.Minimizethestrugglesofintroducingnewfoodsby:
• Alternatingbitesbetweenanewfoodandafoodyourchildisfamiliarwithandlikes.
• Encouragingchildrentotrynewfoods.Beginbyputtingaverysmallportiononyourchild’splate(e.g.,twopeas).However,donotforcehertofinishmorethanshewants.
• Avoidingrewardinggoodbehaviororacleanplatewithfood.Especiallyavoidforcingachildtofinishthe“healthyfoods”togetdessertorsweets—thiscanmakethehealthyfoodseemlikepunishmentandcausehimtoeatwhenheisfull.
How Much to Feed Your Child Understandyourroleandyourchild’sroleatmealtimes.Yourjobistoofferhealthyfoodsatregulartimes;yourchild’sjobistodecidewhetherandhowmuchtoeat.
Ask your healthcare provider if you have any questions about feeding your toddler.
Choking Hazards Donotfeedchildrenyoungerthanfouryearsofageround,firmfoodunlessitischoppedcompletely.
The following foods are choking hazards:
nNutsandseedsnLargechunksofcheeseormeat(e.g.,hotdogs)nWholegrapes,chunksofhardfruit(e.g.,apples)andraw
vegetablesnPeanutbutternIcecubesnRaisinsnPopcornnHard,gooey,orstickycandy,chewinggum
*Neverleaveayoungchildunattendedwhileshe/heiseating.
Best Practices for Healthy Eating 61
Tip Sheet: Healthy Eating for Toddlers Ages 1 through 2 Years
BREAKFASTLUNCH/ SUPPER
SNACK
Serve first 3 components Serve all 4 components Select 2 of the 4 components
1.Milk,fluid(Age1,whole;Age2,fat-freeor1%low-fat)
1/2cup 1/2cup 1/2cup
2.FruitorVegetable 1/4cup Serve2ormoreseparatefruit/vegetabledishes:1/4
cuptotal(2Tbspeach)
1/2cup
3.GrainorBreadBreadGrainorPastaCereal–DryCereal–Hot
1/2slice—
1/4cup1/4cup
1/2slice1/4cup1/4cup1/4cup
1/2slice1/4cup1/4cup1/4cup
4.MeatorMeatAlternate(proteinsource)Leanmeat,poultry/fishCheeseCottagecheeseLargeeggCookeddrybeans/peasPeanutbutter/othernut/seedbuttersNutsorseedsYogurt,plainorflavored
1/2oz1/2oz2Tbsp1/2egg
—1Tbsp1/2oz
1/4cup
1oz1oz
1/4cup1/2egg1/4cup2Tbsp1/2oz
1/2cup
1/2oz1/2oz2Tbsp1/2egg2Tbsp1Tbsp1/2oz
1/4cup
Milk4oz(1/2cup)servingshownina9ozcup:•Wholemilkforage1•Fat-freeor1%(low-fat)forage2
Juice4oz(1/2cup)servingshown
ina9ozcup–100%juice
Age-Appropriate Drink Servings for Toddlers Ages 1 through 2 Years
62 Best Practices for Healthy Eating
Age-Appropriate Servings for Lunch/Supper for Toddlers Ages 1 through 2 Years
Tip Sheet: Healthy Eating for Toddlers Ages 1 through 2 Years
Grain/Bread1/4cupservingshown
Fruit/Vegetable 1/4cuptotal(2Tbspeach)
Meat/Meat Alternate 1ozservingshown
Lunch/Suppershownon8”plate.
Addmilktocompletethemealrequirements.
Best Practices for Healthy Eating 63
Encouraging Healthy Eating Habits• Startwithage-appropriateservings,aslistedinthe
chartonthenextpage.
• Teachhimtoeatslowly.Askifheisstillhungrybeforeallowinghimtoservehimselfmorefood.Takingthetimetodecideifheishungryorfullwillhelphimpayattentiontoimportantcuesfromhisbody.
• Avoidrequiringyourchildtocleanherplate.Helpherlearntoeatbasedonhowhungrysheis,notonhowmuchfoodisstillonherplate.
• Understandyourroleandyourchild’s.Yourjobistoofferavarietyofhealthyfoodsatregularmealtimes;hisjobistodecidewhatandhowmuchtoeat.
• Beapositiverolemodel.Sitwithyourchildandletherobserveyoueatahealthy,balanceddiet.Serveyourselfappropriateportionsandtry“new”foods.Eatwhenyouarehungryandstopwhenyouarefull,evenifthereisfoodleftonyourplate.Talkaboutwhatyouaredoing.
• Payattentiontoyourpreschooler’scues.Hemaynotsaythatheisfull,butmayshowitbystartingtoplay,becomingdistracted,shakinghishead“no,”pushingfoodaroundonhisplateorsimplyrefusingtoeat.
• Complaintsofbeinghungry,especiallywhenachildhasjusteaten,maybeduetoothertriggerssuchasboredom,TVadvertisingorseeinganotherpersoneating.
• Givenhealthyservings,mostchildrencansensewhentheyarefullandwillstopeatingifyouletthem.Theamountoffoodapreschoolereatsmaychangefromdaytoday,butahealthychildwillgenerallyconsumejusttherightamountoffoodtonourishherbody.
Trying New FoodsItisnaturalforpreschoolerstobecautiousabouttryingnewfoods;butrememberthatbyandlarge,theyshouldeatwhattherestofthefamilyiseating.Ifyouareeatingandenjoyingavarietyofhealthyfoods,theywon’twanttobeleftout.
• Whenofferinganewfood,feedafamiliarfoodwiththenewone,alternatingbitesbetweeneach.
• Somechildrenarelesslikelythanotherstotrynewthings.Itmaytakeher5–20timesoftryinganewfoodbeforeshewilllikeit.Don’tgiveup!
• Encourageyourchildtotrynewfoods—atleastonebite.Beginbyputtingasmallamountonhisplate(e.g.,twopeas).However,donotforcehimtofinishmorethanhefeelscomfortableeating.
• Modeltryingnewfoods.Tryanewfruitorvegetableandtalkabouthowitlooks,smellsandtastes.
• Avoidrewardinggoodbehaviororacleanplatewithfoodsofanykind.Especiallyavoidforcingyourchildtofinishthe“healthyfoods”togetdessertorsweets—thiscanmakethehealthyfoodseemlikepunishmentandforcehertoeatwhensheisfull.
• Offerdessertsrarelysohedoesnotexpectoneateverymeal.
How Much to Feed Your Child Understandyourroleandyourchild’sroleatmealtimes.Yourjobistoofferhealthyfoodsatregulartimes;yourchild’sjobistodecidewhetherandhowmuchtoeat.
Ask your healthcare provider if you have any questions about feeding your child.
Tip Sheet: Healthy Eating for Toddlers Ages 3 through 5 Years
Choking Hazards Donotfeedchildrenyoungerthanfouryearsofageround,firmfoodunlessitischoppedcompletely.
The following foods are choking hazards:
nNutsandseedsnLargechunksofcheeseormeat(e.g.,hotdogs)nWholegrapes,chunksofhardfruit(e.g.,apples)andraw
vegetablesnPeanutbutternIcecubesnRaisinsnPopcornnHard,gooey,orstickycandy,chewinggum
*Neverleaveayoungchildunattendedwhileshe/heiseating.
64 Best Practices for Healthy Eating
BREAKFASTLUNCH/ SUPPER
SNACK
Serve first 3 components Serve all 4 components Select 2 of the 4 components
1.Milk,fluid(Fat-freeor1%low-fat) 3/4cup 3/4cup 1/2cup
2.FruitorVegetable 1/2cup Serve2ormoreseparatefruit/vegetabledishes:
1/2cuptotal(1/4cupforeach)
1/2cup
3.GrainorBreadBreadGrainorPastaCereal–DryCereal–Hot
1/2slice—
1/3cup1/4cup
1/2slice1/4cup1/3cup1/4cup
1/2slice1/4cup1/3cup1/4cup
4.MeatorMeatAlternate(proteinsource)Leanmeat,poultry/fishCheeseCottagecheeseLargeeggCookeddrybeans/peasPeanutbutter/othernut/seedbuttersNutsorseedsYogurt,plainorflavored
1/2oz1/2oz2Tbsp1/2egg
—1Tbsp1/2oz
1/4cup
11/2oz11/2oz
3/8cup(1/4cup+2Tbsp)3/4egg
3/8cup(1/4cup+2Tbsp)3Tbsp3/4oz
3/4cup
1/2oz1/2oz2Tbsp1/2egg2Tbsp1Tbsp1/2oz
1/4cup
Tip Sheet: Healthy Eating for Toddlers Ages 3 through 5 Years
Milk6oz(3/4cup)servingshownina9ozcup:
•Fat-freeor1%(low-fat)milk
Juice4oz(1/2cup)servingina
9ozcup–100%juice
Best Practices for Healthy Eating 65
Age-Appropriate Servings for Lunch/Supper for Preschoolers Ages 3 through 5 Years
Tip Sheet: Healthy Eating for Toddlers Ages 3 through 5 Years
Grain/Bread 1/4cupservingshown
Fruit/Vegetable 1/2cuptotal
(1/4cupeach)
Meat/Meat Alternate 1-1/2ozservingshown
Lunch/Suppershownon8”plate.
Addmilktocompletethemealrequirements.
66 Best Practices for Healthy Eating
Encouraging Healthy Eating Habits• Startwithage-appropriateservings,aslistedonthe
chartbelow.
• Teachhimtoeatslowly.Askifheisstillhungrybeforeallowinghimtoservehimselfmorefood.Takingthetimetodecideifheishungrywillhelphimpayattentiontoimportantcuesfromhisbody.
• Createapositiveeatingenvironmentbymakingmealtimesrelaxed,funandfreeofpowerstruggles.
• Avoidrequiringyourchildtocleanherplate.Helpherlearntoeatbasedonhowhungrysheis,notbyhowmuchfoodisstillonherplate.
• Understandyourroleandyourchild’s.Yourjobistoofferavarietyofhealthyfoodsatregularmealtimes;hisjobistodecidewhatandhowmuchtoeat.
• Beapositiverolemodel.Sitwithyourchildandletherobserveyoueatingahealthy,balanceddiet.Serveyourselfappropriateportionsandtry“new”foods.Eatwhenyouarehungryandstopwhenyouarefull,evenifthereisfoodleftonyourplate.Talkaboutwhatyouaredoing.
• Complaintsofbeinghungry,especiallywhenachildhasjusteaten,maybeduetoothertriggerssuchasboredom,TVadvertising,orseeinganotherpersoneating.
• DiscourageeatingmealsinfrontoftheTVorcomputer.Eatingduringscreentimeisadistractionandcankeepachildfromnoticingheisfull.Thismaycausehimtoeatmorethanhenormallywould.
• Whenofferinganewfood,feedafamiliarfoodwiththenewone,alternatingbitesbetweeneach.
• Avoidrewardinggoodbehaviororacleanplatewithfoodsofanykind.Especiallyavoidforcinghertofinishthe“healthyfoods”togetdessertorsweets—thiscanmakethehealthyfoodseemlikepunishmentandcausehertoeatwhensheisfull.
• Offerdessertsrarelysohedoesnotexpectoneateverymeal.
How Much to Feed Your Child Understandyourroleandyourchild’sroleatmealtimes.Yourjobistoofferhealthyfoodsatregulartimes;yourchild’sjobistodecidewhetherandhowmuchtoeat.
Tip Sheet: Healthy Eating for Children Ages 6 through 12 Years
BREAKFAST LUNCH/ SUPPER SNACK
Serve first 3 components Serve all 4 components Select 2 of the 4 components
1.Milk,fluid(Fat-freeor1%low-fat) 1cup 1cup 1cup
2.FruitorVegetable 1/2cup Serve2ormoreseparatefruit/vegetabledishes:
3/4cuptotal(1/4cup+2Tbspeach)
3/4cup
3.GrainorBreadBreadGrainorPastaCereal–DryCereal–Hot
1slice—
3/4cup1/2cup
1slice1/2cup3/4cup1/2cup
1slice1/2cup3/4cup1/2cup
4.MeatorMeatAlternate(proteinsource)Leanmeat,poultry/fishCheeseCottagecheeseLargeeggCookeddrybeans/peasPeanutbutter/othernut/seedbuttersNutsorseedsYogurt,plainorflavored
1oz1oz
2Tbsp1/2egg
—2Tbsp
1oz1/2cup
2oz2oz
1/2cup1egg
1/2cup4Tbsp
1oz1cup
1oz1oz
2Tbsp1/2egg1/4cup2Tbsp
1oz1/2cup
Age-Appropriate Drink Servings for Children Ages 6 through 12 Years
Best Practices for Healthy Eating 67
Tip Sheet: Healthy Eating for Children Ages 6 through 12 Years
Milk8oz(1cup)servingshownina9ozcup:
•Fat-freeor1%(low-fat)milk
Juice6oz(3/4cup)serving
ina9ozcup–100%juice
68 Best Practices for Healthy Eating
Age-Appropriate Servings for Lunch/Supper for Children Ages 6 through 12 Years.
Tip Sheet: Healthy Eating for Children Ages 6 through 12 Years
Grain/Bread 1/2cupservingshown
Fruit/Vegetable 3/4cuptotal
(1/4cup+2Tbspeach)
Meat/Meat Alternate 2ozservingshown
Lunch/Suppershownon8”plate.
Addmilktocompletethemealrequirements
Best Practices for Healthy Eating 69
Ellyn Satter’s Division of Responsibility in FeedingParentsprovidestructure, support andopportunities.Childrenchoosehow muchandwhethertoeatfromwhattheparentsprovide.
The Division of Responsibility for Infants:• Theparentisresponsibleforwhat
• Thechildisresponsibleforhow much(andeverythingelse)
Theparenthelpstheinfanttobecalmandorganizedandfeedssmoothly,payingattentiontoinformationcomingfromthebabyabouttiming,tempo,frequencyandamounts.
The Division of Responsibility for Toddlers through Adolescents• Theparentisresponsibleforwhat, when, where
• Thechildisresponsibleforhow muchandwhether
Parents’ Feeding Jobs:• Chooseandpreparethefood
• Provideregularmealsandsnacks
• Makeeatingtimespleasant
• Showchildrenwhattheyhavetolearnaboutfoodandmealtimebehavior
• Notletchildrengrazeforfoodorbeveragesbetweenmealandsnacktimes
Fundamentaltoparents’jobsistotrustchildrentodecidehow muchandwhethertoeat.Ifparentsdotheirjobswithfeeding,childrenwilldotheirjobswitheating.
Children’s Eating Jobs:• Childrenwilleat.
• Theywilleattheamounttheyneedovertime.Somedaysmaybemore—somedaysless.
• Theywilllearntoeatthefoodtheirparentseat.
• Theywillgrowpredictably.
• Theywilllearntobehavewellatthetable.
©2007EllynSatter.Forafurtherexplanationofthedivisionofresponsibility,seeanyofEllynSatter’sfourbooks;Your Child’s Weight: Helping Without Harming, Child of Mine: Feeding With Love and Good Sense, Secrets of Feeding a Healthy Family,orHow To Get Your Kid To Eat... But Not Too Much.Maybereproducedforfreedistributiononly.Maynotbemodifiedinanyway.Creditandfurtherinformationlinesmustappearoneachcopy.ForinformationonEllynSatter’smaterialsandprograms,seewww.EllynSatter.comorcall800-808-7976.
70 Best Practices for Healthy Eating
Recommendations At-A-Glance
Recommended Limit Not RecommendedBeverages n Waterwithoutflavoringoradditives
n Fat-freeand1%(low-fat)milk,plainn 100%fruitjuicen 2%milk,plainn Fat-freeor1%flavoredmilk
n Wholemilk,plainorflavoredn 2%milk,flavoredn Regularordietsodasn Sweetenedteas,lemonadeandfruit
drinkswithlessthan100%juicen Sportsdrinksandenergydrinks
Vegetables n Fresh,frozen,andcannedvegetableswithoutaddedfat,sugarorsalt
n Vegetableswithaddedfat,sugarorsalt
n Friedvegetables(e.g.,Frenchfries)
Fruits n Fresh,frozen,andcannedfruitspackedin100%juiceorwater
n 100%fruitjuicen Fruitswithaddedfat,sugaror
saltn Driedfruits
n Fruitscannedinheavysyrupn Friedfruits
Dairy n Fat-freeorlow-fatyogurtn Fat-freeorlow-fatcottagecheesen Fat-freeorpart-skimrealcheesen Fat-freeorlow-fatcreamcheese
n Reduced-fatyogurtorcottagecheese
n Reduced-fatrealcheesen Reduced-fatcreamcheese
n Wholemilkn Full-fatyogurtn Full-fatcottagecheesen Full-fatrealcheesen Full-fatcreamcheesen Cheesefoodorcheeseproduct
Grains and Breads
n Whole-grainbreads,pitasandtortillas
n Whole-grainpastan Brownricen Cerealsandgrainswith6orfewer
gramsofsugarand3ormoregramsoffiberperserving
n Whitebreadandpastan Tacoshellsn Frenchtoast,waffles,and
pancakesn Biscuitsn Low-fatgranolan Wholegrain,low-fatmuffinsand
crackers
n Doughnuts,muffins,croissants,andsweetrolls
n Biscuitsn Full-fatgranolan Sweetened,low-fibercerealsn Crackersmadewithhydrogenated
oils(transfats)
Meats and Meat Alternates
n Extra-leangroundbeefn Beeforporkthathasbeentrimmed
offatn Chickenandturkeywithoutskinn Tunacannedinwatern Fishandshellfishn Beans,splitpeas,andlentilsn Tofuandsoyproductsn Nuts(forchildrenover4)n Eggwhitesandeggsubstitutes
n Leangroundbeefn Turkeyandchickenwithskinn Broiledhamburgersn Ham,Canadianbaconn Low-fathotdogsn Tunacannedinoiln Wholeeggscookedwithoutadded
fatn Peanut-buttern Nuts
n Fried/pre-friedmeats(e.g.friedchicken,chickennuggets,fishsticks)
n Hotdogs,bolognaandotherlunchmeats,bacon,pepperoni,andsausage
n Beefandporkthathasnotbeentrimmedofitsfat
n Ribs,baconn Friedfishandshellfishn Wholeeggscookedwithaddedfat
Sweets and Snacks
n Air-poppedorlow-fatpopcorn(forchildrenover4)
n Wholegrainpretzelsn Wholegraincrackers
n Frozen100%juicebarsn Fat-free,low-fatorlightfrozen
yogurtoricecreamn Wholegrainfigbarsn Animalandgrahamcrackersn Bakedchips
n Cookies,cakes,andpiesn Candyn Chipsn Butteredpopcornn Full-faticecreamn Watericeandpopsicles
Condiments n Ketchupn Mustardn Fat-freesaladdressingn Fat-freemayonnaisen Fat-freesourcreamn Vinegarn Herbsandspices
n Oilsn Low-fat/lightsaladdressingsn Low-fat/lightmayonnaisen Low-fat/lightsourcream
n Butter,lard,andmargarinen Saltn Porkgravyn Creamysaladdressing(full-fat)n Mayonnaiseortartarsauce
(full-fat)n Sourcream(full-fat)n Cheeseorcreamsaucesanddips
Best Practices for Healthy Eating 71
Dear Parent(s)/Guardian(s), Tosupportyourchildinmakinghealthyeatingchoices,weareteachinghim/heraboutwherefoodcomesfrom,howitisprepared,andencouraginghim/hertotrynewfoods.
Today your child:
Learnedsomethingnewaboutafood.Itwas____________________________________________________________
______________________________________________________________________________________________________
Participatedinpreparingfoodforamealorsnackby______________________________________________________
______________________________________________________________________________________________________
Tastedanewfood.Itwas____________________________________________________________________________
______________________________________________________________________________________________________
Youcanreinforcetheselessonsathomebyaskingyourchildwhathe/shelearnedandhowyoucanmakehealthychoicesasafamily;lettinghim/herhelpinmeal preparationandpickoutnewfruitsandvegetablestotryasafamily.Rememberitmaytakeanywherefrom10–15triesofafoodbeforeyourchilddecidestoeatit!Encourageyourchildtoparticipateinmealplanningandpreparationtohelphim/herestablishhealthyhabitsthatwilllastalifetime.
Thankyou!
Dear Parent(s)/Guardian(s), Tosupportyourchildinmakinghealthyeatingchoicesweareteachinghim/heraboutwherefoodcomesfrom,howitisprepared,andencouraginghim/hertotrynewfoods.
Today your child:
Learnedsomethingnewaboutafood.Itwas____________________________________________________________
______________________________________________________________________________________________________
Participatedinpreparingfoodforamealorsnackby______________________________________________________
______________________________________________________________________________________________________
Tastedanewfood.Itwas____________________________________________________________________________
______________________________________________________________________________________________________
Youcanreinforcetheselessonsathomebyaskingyourchildwhathe/shelearnedandhowyoucanmakehealthychoicesasafamily;lettinghim/herhelpinmeal preparationandpickoutnewfruitsandvegetablestotryasafamily.Rememberitmaytakeanywherefrom10–15triesofafoodbeforeyourchilddecidestoeatit!Encourageyourchildtoparticipateinmealplanningandpreparationtohelphim/herestablishhealthyhabitsthatwilllastalifetime.
Thankyou!
72 Best Practices for Healthy Eating
ReferencesAmericanAcademyofPediatrics,AmericanPublicHealthAssociation,andNationalResourceCenterforHealthandSafetyinChildCareandEarlyEducation.2012.Preventing Childhood Obesity in Early Care and Education: Selected Standards from Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs,3rd Edition.http://nrckids.org/CFOC3/PDFVersion/preventing_obesity.pdf
AmericanAcademyofPediatrics.PolicyStatement:BreastfeedingandtheUseofHumanMilk.Pediatrics,2012;129(3):e827–e841.http://pediatrics.aappublications.org/content/early/2012/02/22/peds.2011–3552.full.pdf+html
AmericanAcademyofPediatrics.TheUseandMisuseofFruitJuiceinPediatrics.Pediatrics,2001;107(5):1210–1213.
IOM(InstituteofMedicine).2011.Child and Adult Care Food Program: Aligning Dietary Guidance for All. Washington,DC:TheNationalAcademiesPress.
OgdenCL,CarrollMD,KitBK,etal.PrevalenceofobesityandtrendsinbodymassindexamongUSchildrenandadolescents,1999-2010.JAMA.2012;307:483–490
UnitedStatesDepartmentofAgriculture,CenterforNutritionPolicyandPromotion.DietaryGuidelinesforAmericans2010.http://www.cnpp.usda.gov/Publications/DietaryGuidelines/2010/PolicyDoc/PolicyDoc.pdf
UnitedStatesDepartmentofAgriculture,FoodandNutritionService.ChildandAdultCareFoodProgramMealPatterns;2007.http://www.fns.usda.gov/cnd/care/ProgramBasics/Meals/Meal_Patterns.htm
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Best Practices for Healthy Eating