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Chapter 9. Menu Planning Knowledge of menu planning is essential to providing appropriate nutrition to young children. Early care and education programs must have staff who plan and prepare food that are aware of individual preferences, including vegetarianism, and cultural and religious differences in food choice, preparation, and service. To protect children’s health, proper hygiene and sanitation processes must be followed closely. Only safe food should be purchased. And how that food is stored, prepared, and served must follow proper protocol to prevent foodborne illness.

Learning Objectives

At the end of this chapter, you should be able to: ● Outline the meal patterns for infants and children. ● Create nutritious menus that follow the meal patterns. ● Describe factors to consider when menu planning. ● Identify a variety of sources of food for each food group. ● Examine individual and cultural food preferences. ● Discuss the benefits of family style meal service. ● Relate ways to support families in providing well-balanced foods from home.

Nutrition in Early Care and Education Programs The Child and Adult Care Food Program (CACFP) is a federal program that provides reimbursements for nutritious meals and snacks to eligible children and adults who are enrolled for care at participating child care centers, day care homes, and adult day care centers. Eligible public or private nonprofit child care centers, outside-school-hours care centers, Head Start programs, and other institutions which are licensed or approved to provide day care services may participate in CACFP, independently or as sponsored centers.1 Over 2 billion meals are served in the CACFP.2

Even if a program chooses not to participate in (or is ineligible for) the CACFP, they are required by licensing to follow its meal plan requirements.3 The CACFP nutrition standards for meals and snacks served in the CACFP are based on the Dietary Guidelines for Americans, science-based

3 California Childcare Health Program. (2018). Preventive Health and Safety in the Child Care Setting: A Curriculum for the Training of Child Care Providers (3rd ed.). University of California, San Francisco.

2 Child and Adult Care Food Program (PDF) by the USDA Food and Nutrition Service is in the public domain

1 Child and Adult Care Food Program by the USDA Food and Nutrition Serviceis in the public domain

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recommendations made by the National Academy of Medicine, cost and practical considerations, and stakeholder’s input. Under these standards, meals and snacks served include a greater variety of vegetables and fruit, more whole grains, and less added sugar and saturated fat.4

Meal or Snack 0-5 Months 6-11 Months

Breakfast 4-6 fl oz breastmilk or formula 6-8 fl oz breastmilk or formula 0-4 tbsp infant cereal, meat, fish, poultry, whole eggs, cooked dry beans or peas; or 0-2 oz cheese; or 0-4 oz (volume) cottage cheese; or 0-4 oz yogurt; or a combination* 0-2 tbsp vegetable, fruit or both*

Lunch or Supper 4-6 fl oz breastmilk or formula 6-8 fl oz breastmilk or formula 0-4 tbsp infant cereal, meat, fish, poultry, whole eggs, cooked dry beans or peas; or 0-2 oz cheese; or 0-4 oz (volume) cottage cheese; or 0-4 oz yogurt; or a combination* 0-2 tbsp vegetable, fruit or both*

Snack 4-6 fl oz breastmilk or formula 2-4 fl oz breastmilk or formula 0-½ bread slice; or 0-2 crackers; or 0-4 tbsp infant cereal or ready-to-eat cereal* 0-2 tbsp vegetable, fruit or both*

Table 9.1. Infant Meal Patterns. Source: Updated Child and Adult Care Food Program Meal Patterns: Infant Meals by the USDA Food and Nutrition Service is in the public domain.

Solid foods are required when an infant is ready. All serving sizes are minimum quantities of the food components that are required to be served.

Breakfast

Food Item 1-2 Years 3-5 Years 6-18 Years

Milk ½ cup whole ¾ cup low-fat or fat-free 1 cup low-fat or fat-free

Vegetables, fruit, or both ¼ cup ½ cup ½ cup

Grains ½ ounce equivalent ½ ounce equivalent 1 ounce equivalent

Table 9.2. Meal Pattern for Children. Source: Updated Child and Adult Care Food Program Meal Patterns: Child and Adult Meals by the USDA Food and Nutrition Service is in the public domain.

4 Nutrition Standards for CACFP Meals and Snacks by the USDA Food and Nutrition Service is in the public domain

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Figure 9.1 – A healthy breakfast for 3- to 5-year-olds. Image by the USDA Food and Nutrition Service is in the public domain

Figure 9.2 – A healthy breakfast for 6- to 18-year-olds. Image by the USDA Food and Nutrition Service is in the public domain

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Lunch

Food Item 1-2 Years 3-5 Years 6-18 Years

Milk ½ cup whole ¾ cup low-fat or fat-free 1 cup low-fat or fat-free

Meat and meat alternative 1 ounce 1½ ounces 2 ounces

Vegetables ⅛ cup ¼ cup ½ cup

Fruits ⅛ cup ¼ cup ¼ cup

Grains ½ ounce equivalent ½ ounce equivalent 1 ounce equivalent

Table 9.3. Meal Pattern for Children. Source: Updated Child and Adult Care Food Program Meal Patterns: Child and Adult Meals by the USDA Food and Nutrition Service is in the public domain.

Figure 9.3 – A healthy lunch for 1- to 2-year-olds. Image by the USDA Food and Nutrition Service is in the public domain.

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Figure 9.4 – A healthy lunch for 6- to 18-year-olds. Image by the USDA Food and Nutrition Service is in the public domain.

Snack Choose 2 of the options. Best practice: Make at least 1 of the 2 required components of a snack, a vegetable or a fruit.

Food Item 1-2 Years 3-5 Years 6-18 Years

Milk ½ cup whole ½ cup low-fat or fat-free 1 cup low-fat or fat-free

Meat and meat alternative 1 ounce ½ ounce 1 ounce

Vegetables ½ cup ½ cup ¾ cup

Fruits ½ cup ½ cup ¾ cup

Grains ½ ounce equivalent ½ ounce equivalent 1 ounce equivalent

Table 9.4. Meal Pattern for Children. Source: Updated Child and Adult Care Food Program Meal Patterns: Child and Adult Meals by the USDA Food and Nutrition Service is in the public domain.

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Figure 9.5 – A healthy snack for 1- to 2-year-olds. Image by the USDA Food and Nutrition Service is in the public domain.

Figure 9.6 – A healthy snack for 3- to 5-year-olds. Image by the USDA Food and Nutrition Service is in the public domain.

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Figure 9.7 – A healthy snack for 6- to 18-year-olds. Image by the USDA Food and Nutrition Service is in the public domain.

Category Best Practices

Vegetables and Fruit ● Make at least one of the two required components of snack a vegetable or fruit ● Serve a variety of fruit and choose whole fruits ● Juice is limited to once a day ● Provide at least one serving each of dark green leafy vegetables, red and

orange vegetables, beans and peas (legumes), starchy vegetables, and other vegetables each week

Grains ● Provide at least two servings of whole grains per day (at least one is required)

Meat and Meat Alternatives

● Serve only lean meats, nuts, and legumes. ● Limit serving processed meats to no more than one serving per week. ● Serve only natural cheeses and choose low-fat or reduced fat-cheeses.

Milk ● Serve only unflavored milk ● Nondairy milk substitutes that are nutritionally equivalent to milk may be

served in place of milk to children with medical or special dietary needs

Sugar ● Yogurt must contain no more than 23 grams per 6 ounces ● Breakfast cereals must contain no more than 6 grams of sugar per dry ounce ● Avoid serving non-creditable foods that are sources of added sugars, such as

sweet toppings (honey, jam, syrup), mix-in ingredients sold with yogurt, and sugar sweetened beverages

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Miscellaneous ● Frying is not allowed as a way of preparing foods on-site ● Limit serving purchased pre-fired foods to no more than one serving per week ● Incorporate seasonal and local produced foods into meals

Table 9.5. CACFP Best Practices. Source: Child and Adult Care Food Program: Best Practices by the USDA Food and Nutrition Service is in the public domain. Updated Child and Adult Care Food Program Meal Patterns: Child and Adult Meals by the USDA Food and Nutrition Service is in the public domain.

Healthy Beverages in Child Care Act “And all licensed child care providers…must follow the Healthy Beverages in Child Care Act. The four key messages in the Healthy Beverages in Child Care Act are:

1. Only unflavored, unsweetened, non-fat (fat free, skim, 0%) or low fat (1%) milk can be served to children 2 years of age or older.

2. No beverages with added sweeteners, natural or artificial, can be served, including sports drinks, sweet teas, juice drinks with added sugars, flavored milk, soda, and diet drinks.

3. A maximum of one serving of 100% juice is allowed per day. 4. Clean and safe drinking water must be readily available at all times; indoors and

outdoors and with meals and snacks.”5

Child Nutrition Programs for Schools

The federal government provides federal assistance to schools to provide nutritious meals to children. With the exception of the Special Milk Program, early care and education programs will not qualify for these programs. But they are included in this chapter as they are important sources of nutrition for many children in the U.S., for reference for those that may work within the school system, and they may provide resources that early care and education programs may find useful when planning healthy meals and snacks and purchasing foods.

National School Lunch Program

The National School Lunch Program (NSLP) is a federally assisted meal program operating in public and nonprofit private schools and residential child care institutions. It provides nutritionally balanced, low-cost or no-cost lunches to children each school day. The program was established under the Richard B. Russell National School Lunch Act, signed into law by President Harry Truman in 1946. 30.4 million children participated in the program in 2016.6

6 National School Lunch Program (NSLP) Fact Sheet by the USDA Food and Nutrition Service is in the public domain.

5 California Childcare Health Program. (2018). Preventive Health and Safety in the Child Care Setting: A Curriculum for the Training of Child Care Providers (3rd ed.). University of California, San Francisco.

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Figure 9.1. Children eating lunch together at school. Image by the USDA is in the public domain

School Breakfast Program

The School Breakfast Program (SBP) is a federally assisted meal program operating in public and non-profit private schools and residential child care institutions. The SBP started in 1966 as a pilot project, and was made a permanent entitlement program by Congress in 1975. Participation in the SBP has slowly but steadily grown over the years and in 2016, 14.57 million children participated in the program.7

Special Milk Program

The Special Milk Program provides milk to children in schools, child care program and eligible camps that do not participate in other federal child nutrition meal service programs. The program reimburses schools and institutions for the milk they serve. In 2011, 3,848 schools and r