Nutrition Basics:

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Nutrition Basics
Infants to Age Three
Presented by Nevada Department of
Education Office of Child Nutrition and School
Health
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Goals

• Participants will have a better understanding of
  how to feed infants and young children well by
  learning about feeding stages and developmental
  needs.
• Participants will learn how children grow and
  develop, how that affects eating habits and what
  nutrients are needed to support that growth and
  development.
• Participants will review the CACFP meal pattern
  requirements, the creditable, non-creditable, and
  non-reimbursable foods list and the proper method
  of filling out infant and child menu records.

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A Closer Look at Infants

• CACFP Meal Pattern
• Creditable, Non-Creditable, and Non-Reimbursable
  Foods
• Growth and Development

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CACFP Meal Pattern Requirements for Infants
1 Infant formula and dry infant cereal must be
iron-fortified. 2 It is recommended that breast
milk be served in place of formula from birth
through 11 months. 3 For some breastfed infants
who regularly consume less than the minimum
amount of breast milk per feeding, a serving of
less than the minimum amount of breast milk may
be offered, with additional breast milk
offered if the infant is still hungry. 4 A
serving of this component is required when the
infant is developmentally ready to accept it. 5
Fruit juice must be full-strength. 6 Bread and
bread alternates must be made from whole-grain or
enriched meal or flour.
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Creditable, Non-Creditable Non-Reimbursable

• Creditable Foods for Infants
• Foods that meet the meal pattern components and
  are found in the USDA Food Buying Guide
• Examples
• Iron fortified formula and cereal, plain
  vegetables, fruits and crackers

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Creditable, Non-Creditable Non-Reimbursable

• Non-Creditable Foods for Infants
• Foods that do not meet the USDA requirement for
  any component in the meal pattern.
• Examples yogurt, baby food fruit or vegetables
  with water is the first ingredient, baby food
  desserts, peanut butter,

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Creditable, Non-Creditable Non-Reimbursable

• Non-Reimbursable Foods for Infants
• Foods that may not be served, even as an extra.
  Examples
• Whole milk, baby food desserts, baby cookies
  (with sugar as the first ingredient) and meat
  sticks.

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Developmental Skills

• Birth through 5 months
• Suck/swallow reflex
• Tongue thrust reflex
• Rooting reflex
• Gag reflex
• Poor control of head, neck, trunk

• SERVE LIQUIDS ONLY
• Breastmilk
• Infant formula with iron

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Developmental Skills, continued

• 4 months through 7 months
• Tongue thrust and rooting reflexes begin to
  disappear
• Gag reflex diminishes
• Can transfer food from front to back of tongue
  to swallow
• Begin to see an up-and-down munching movement
  of the jaw
• Sits with support
• Has good head control

• ADD SEMISOLID FOODS
• Infant cereal with iron
• Strained vegetables
• Strained fruit
• Progress to thicker texture and add in meats
• may be started later in the age range

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Developmental Skills, continued

• 8 months through 11 months
• Moves food from side-to side in mouth
• Begins to curve lips around rim of cup
• Begins to chew in rotary pattern (diagonal
  movement of the jaw as food is moved to the side
  or center of the mouth)

• ADD MODIFIED TABLE FOODS
• Mashed or diced soft fruit or soft-cooked
  vegetables
• Strained meat/poultry or mashed egg yolk
• Mashed cooked beans or peas
• Cottage cheese, yogurt, or cheese strips
• Crackers or pieces of soft bread
• Breastmilk, iron-fortified formula or fruit juice
  in a cup

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Eating and FoodBehaviors of Infants

• Caregivers and Parents
• Provide the right foods to promote good health.
• Decide what to serve and when to introduce new
  foods.
• Determine the kinds and types of food and
  textures to introduce.
• Offer older infants appropriate finger foods when
  they can enjoy and manage them.

• Tips
• Feed infants the foods you want them to love when
  they get older.
• Provide a variety of nutritious foods.
• Make mealtime relaxed and enjoyable.

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Feeding the Baby for the First Year
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Food Safety and Infant Feeding

• Infants are particularly sensitive to food borne
  disease. Their immature digestive system cannot
  fight bacteria as well as adults.
• Common symptoms of food borne illness (nausea,
  vomiting, and diarrhea) can be deadly for the
  infant.
• To keep it safe, remember the following Infant
  Food Safety tips . . .

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Infant Food Safety Tips

• Wash hands before preparing or feeding foods.
• Use clean utensils.
• Transfer baby food to a dish dont serve baby
  from the jar and discard leftovers from the
  dish.
• Refrigerate leftover food in the jar label with
  the date and discard 2 days after opening.

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Infant Food Safety Tips, continued

• Check that the safety button tin the lid of a
  baby food jar is down and pops when opened.
• Discard formula or breastmilk left in a bottle
  after feeding.
• Avoid honey for the first year.

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Breast Fed Babies in Childcare

• Breastfeeding is the best source of food for a
  babys first year of life.
• Supporting a breastfeeding mother helps to
  sustain the duration of breastfeeding.
• Safe and sanitary handling is important for
  breastmilk as well as formula, so . . .
• Handle it with care!

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Feeding Infants-Resources-

• On the World Wide Web
• Feeding Infants A Guide for Use in the Child
  Nutrition Programs (FNS-258), is available on the
  Team Nutrition Home Page at
• www.fns.usda.gov/cnd/tn/Resources/feeding_infants
  .html

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A Closer Look at Toddlers

• CACFP Meal Pattern
• Creditable, Non-Creditable, and Non-Reimbursable
  Foods
• Growth and Development

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CACFP Meal PatternBreakfast
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CACFP Meal Pattern Lunch and Supper
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CACFP Meal Pattern Snack
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Creditable, Non-Creditable Non-Reimbursable

• Creditable Foods for Children
• Foods that meet the meal pattern components and
  are found in the USDA Food Buying Guide
• Examples
• Fruits, vegetables, meats, cheese, milk, and
  bread, cereals and grain items

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Creditable, Non-Creditable Non-Reimbursable

• Non-Creditable Foods for Children
• Foods that do not meet the USDA requirement for
  any component in the meal pattern.
• Examples cream cheese, jam, jelly, pudding,
  gelatin, whipped cream, desserts such as cake and
  ice cream, salad dressing, ketchup, condiments
  and seasonings, etc.

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Creditable, Non-Creditable Non-Reimbursable

• Non-Reimbursable Foods for Children
• Foods that may not be served, even as an extra.
  Examples
• Hot dogs, beef jerky, Spam, processed luncheon
  meats, imitation cheese, cake, brownies, candy,
  etc.

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Developmental Skills

• ONE-YEAR-OLD CHILDREN
• They may grow less quickly than during infancy.
• They may eat less, but they tend to eat
  frequently throughout the day.
• They get better at feeding themselves, although
  spills should still be expected.
• They drink from a cup with help.

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How Children Grow and Develop

• At 1 year old
• Teething occurs
• Playing consists of imitating others
• One-year-olds use and understand the words me,
  mine, and no
• They recognize their names
• They can make two to three word sentences

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Developmental Skills, continued

• Two-year olds canFold napkinsScrub fruits and
  vegetablesWipe tablesSnap fresh beansTear
  lettuce and salad greensBreak bread for stuffing

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How Children Grow and Develop

• At 2 years old
• Two-year-olds have a high energy level
• They develop skills including walking, running,
  and eye-hand coordination
• They are curious and want to do things for
  themselves
• 2-year-olds still use sucking, mouthing,
  and tasting to explore
• Children can speak in two to five
  word sentences

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Developmental Skills, continued

• Three-year olds canPour liquids into a
  batterMix muffin batterShake a milk
  drinkSpread peanut butter on breadCrack hard
  cooked eggs

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Eating and Food Behaviors of Toddlers

• Caregivers and Parents
• Know that appetite ups and downs are normal and
  usually relate to growth.
• Allow children to stop eating when they indicate
  they are full
• Know that now is the time when food preferences
  are being firmly established.
• Realize that children are usually willing to try
  new foods.

• Tips
• Dont serve large amounts of juice.
• Offer sweet and sugary foods only rarely.

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Feeding Responsibility Caregivers Parents

• Select and buy foods, including new foods
• Choose meal and snack times
• Prepare present the food attractively
• Expect a standard of behavior at the table
• Make mealtime pleasant
• Set a good example

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Feeding Responsibility Child

• Decides what foods they will eat
• Determines how much they will eat
• Chooses whether or not they will eat

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Transitional Feeding/Eating

• How do you handle the transition between infant
  and toddler on the CACFP meal pattern?

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What DO You Do?Small Group Activity

• Read the scenario.
• Is the child at risk for poor nutrition? Why
  or why not.
• What are some things that you, the child care
  provider, can do to help?
• What discussions, if any, will you have with the
  parent?

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Serving Meals Family-Style

• Introducing Family-Style Meals
• Provide a table and play dinnerware so the
  children can practice.
• Show the children the proper way to set the
  table.

• Practice proper table etiquette emphasize using
  please and thank you.
• Keep food safety in mind (if the cup falls on
  the floor, it must be washed).

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Family Style Meals

• Remember these tips
• Children enjoy helping with "grown up"
  activities. Let them assist with each of the four
  components of family-style meals as it will boost
  their self-esteem. The four components are
• Table setting
• Self-serve
• Food preparation
• Cleanup
• Begin with something simple like table setting.
  Then allow children to help with a small snack,
  and always encourage them to clean up after
  themselves.

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Family Style Meals

• Goals Today
• Discuss Family Style Meal Service
• Review program requirements
• Share ideas

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Family Style Meals
Food Safety
Nutrition
Child Development
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FOOD SAFETY

• Handwashing
• Keep Foods Safe to Eat
• Hot Foods HOT/Cold Foods COLD

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Introducing New Foods
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Introducing New Foods

• Think about timing
• Be positive
• Keep trying

Tip Did you know that children may need to
encounter a new food 12 times before they
actually eat it?
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Family Style Meals
Child Development
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How Children Grow and Develop

• Between 3 and 5 years of age
• Preschoolers enjoy art, pretend and music and
  dramatic play.
• Children begin to use a fork or spoon well.
• As they get older, sharing toys and belongings
  becomes easier.
• Attention spans continue to
  grow with the childs age.

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Eating and Food Behaviorsof Preschoolers

• Tips
• Preschoolers enjoy learning abut food.
• With proper supervision, they can help prepare
  simple meals and snacks.
• Books, videos, storytelling and discussion groups
  are excellent ways to teach good nutrition!
• Allow input on what is served.

• Caregivers and Parents
• Realize that erratic eating habits are normal.
• Provide healthy meals and snacks in order to
  build a strong foundation for a lifetime of good
  eating habits.

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A Closer Look at Eating Habits

• Childcare Providers Support Positive Eating
  Habits by
• Successful introduction of new foods.
• Encouraging favorable attitudes toward food.
• Encouraging good eating habits.

• Eating Habits are formed in early childhood.
• Good eating habits do not just happen, they must
  be learned.

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Encouraging Favorable Food Attitudes and Good
Eating Habits

• Be sensitive to childrens needs.
• Help children feel ready to eat.
• Get children interested and involved.
• Make eating a pleasure.
• Foster positive feelings.

Check out the Mealtime Memo on Feeding Toddlers
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Food Matching GameActivity
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Nutrients are Needed for Growth and Development

• Nutrition is the process by which our bodies take
  in and use food.
• The best way to ensure good nutrition is to
  choose a variety of foods.

Check out the Mealtime Memo on Nutrition
Cognitive Development!
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Nutrients Needed for Growth and Development

• Carbohydrates
• Supply energy 4 kcal per gram
• Provide fiber if whole grain
• Made up of 2 types
• Complex
• Simple

• Proteins
• Supply 4 kcal per gram
• Build and repair body tissue
• Help antibodies fight infection

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Nutrients Needed for Growth and Development

• Fats
• Supply 9 kcal per gram
• Carry fat-soluble vitamins A, D, E, and K
• Provide a feeling of fullness since fats take
  longer to digest
• Tips About Fat
• Serve reduced- or low-fat milk to preschoolers,
  ages 2 and older.
• Do not restrict all fats in childrens diets.

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Nutrients Needed for Growth and Development

• Vitamins
• Needed by body in small amounts
• Help release energy from nutrients
• Minerals
• Needed in small amounts
• Help in making strong bones and teeth healthy
  red blood cells

• Water
• Essential for life
• Is part of every living cell
• Helps maintain body temperature
• Is the medium for metabolism
• Transports nutrients and body substances
• Acts as a lubricant

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Dietary Guidelines for Americans

• Aim for Fitness
• Build a Healthy Base
• Choose Sensibly

Check out the Mealtime Memo on Dietary Guidelines!
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What is a Portion Size?
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Nutrient Contributions from MyPyramid
Protein, Iron, Phosphorous, and Zinc
Complex Carbohydrates, Fiber, Iron, Thiamin, and
Niacin
Calcium, Protein, some B-vitamins, and Vitamins
AD
Fiber, Potassium, and Vitamins AC
Empty Calories
Fiber, Potassium, and Vitamins AC
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Keeping a Daily Record of Meals
TIP Be sure to record menu components in your log
each day!
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Nutrition Education

• Why?
• To get children involved in activities with food
  and eating.
• To encourage them to try new food.
• To help them establish a lifetime of good eating
  behavior.

Check out the Mealtime Memo on Preventing Obesity
Part I!
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Nutrition Education

• How?
• Plan activities that match childrens abilities
  and interests (developmentally appropriate).
• Build on what a child already knows.
• When?
• Plan simple activities before trying harder ones.

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Food Activity
Check out the Mealtime Memos on Healthy Snacks
and Serving Meals Family-Style
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The Parent Factor
Establish regular communication with parents on
activities, progress, and how they can support
healthy eating concepts at home.
Take a look at the Mealtime Memo on Preventing
Obesity Part II!
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Scenarios

• Sylvia refuses to eat breakfast. She is in first
  grade. Her teacher says that she is falling
  asleep in class.
• Jared is 4. He will eat three servings of meat
  at lunch, but wont touch his vegetables.
• Allie is 8 and weighs a lot more than the other
  children in her class. She refuses to play
  outside and wants to watch TV and snack after
  school every day.

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Scenarios
4. Sally is 2. She only wants to drink milk.
She doesnt eat much solid food at
all. 5. Joey refuses to drink any milk. He is
3 years old. His mom says it makes him sick.
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Child Development

• DEVELOPMENTALLY APPROPRIATE!
• For all Ages and Stages

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Child Development

• Children make decisions
• Children socialize
• Learn to listen to internal cues
• Practice daily living skills

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What you say (and do!) really matters

• Does it help or hurt childrens independence and
  decision making abilities when the adult says.

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Family Style Meals
Nutrition
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Nutrition

• Must follow the meal pattern
• Must put all foods on the table
• Children can try new foods
• Children learn to enjoy a variety of foods

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Skills for Serving Self
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SKILLS FOR SERVING SELF

• Hold and physically pass bowls or pitchers
• Make sure someone receives them.
• Judge space for bowls or pitchers.
• Efficiently use serving utensils.

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SKILLS FOR SERVING SELF

• Teachers direct table conversations and model
  behavior.
• Children wait their turn.
• Children balance serving containers
• Children spoon food from a serving dish without
  using fingers.

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The Baby Food Is Right Activity

• INSTRUCTIONS
• Look at the baby food item nearest you. Note the
  name of the item.
• Check the ingredient list.
• Determine if the item is creditable on CACFP.
• Do you have any comments about this item?

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The Baby Food Is Right Activity

• Food Item Creditable?
• 1. Rice Cereal Box Yes
• Graduates Veg Beef Stew NO
• 3. Peaches Yes
• 4. Spinach Potatoes NO
• 5. Peach Cobbler NO

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The Baby Food Is Right Activity

• Food Item Creditable?
• 6. Parents Choice Soy Formula Yes
• 7. Apple Carrot Juice Yes
• 8. Fruit Wagon Wheels NO
• 9. Applesauce Yes
• 10. Pasta Primavera NO
• 11. Banana Yogurt Dessert NO

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The Baby Food Is Right Activity

• Food Item
  Creditable?
• 12. Pears and Winter Squash Yes
• 13. Sweet Potatoes Yes
• 14. Graduates Diced Green Beans Yes
• 15. Macaroni and Cheese Dinner NO
• 16. Carnation Follow Up Formula Yes
• 17. Veal and Veal Gravy Yes

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Discussion Group Activity

• Read the following scenarios and answer the
  following questions
• Is this child at risk for poor nutrition and
  /or health? Why or why not?
• What are some things that you, the child care
  provider, can do to help improve the nutrition or
  eating behavior of this infant?
• What discussions, if any, will you have with the
  parent?

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Discussion Group Activity, continuedScenarios

• Rickie is 4 months old. His mom is breast
  feeding him. Now she has to go back to work, and
  she is trying to get him to drink from a bottle.
  He doesnt like it. Can you offer her some tips
  on what to do? What happens if you are watching
  him and you run out of breastmilk?
• Alessandra is 20 months old. Her mom does not
  allow her to feed herself at home because she is
  such a messy eater. Her mom tells you that she
  is also very picky and gives you a long list of
  the foods she refuses to eat.
• Sidney is 3 months old. He is very small for his
  age, and is not growing well. He looks like a
  newborn. You know that his parents are having
  problems financially and with drug abuse. His
  mom is starting a job and wants you to care for
  him.
• Elena is 6 months old. Her family is feeding her
  bean juice, carrots, orange juice, and infant
  formula. He has had a sore bottom for the last
  week and she is very cranky.

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Discussion Group Activity, continuedScenarios

• Jessica is 10 months old. She loves to sit in
  her high chair. She is very feisty and excitable
  and has a tendency to throw things. One morning
  she throws her iron fortified infant oatmeal on
  the floor and starts screaming.
• Johnny is only 6 weeks old. He is a big baby,
  but he cannot sit up or hold up his head yet.
  His mother tells you that you should be putting
  infant cereal into his bottle.
• Carlos is 11 months old. He will eat everything
  from the table, but his parents want him to have
  baby food because it is easier.
• Tiffany is 16 months old. You have just started
  caring for her. Her Aunt brings her to you for
  care with her bottle of kool aide. She says
  that she has to have it with her in order to get
  to sleep.

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Thank You! Any Questions?