Questions About Claiming Infants

Questions
About Claiming
Infants
Introduction
The Infant Menu Form was designed to make your job and ours a little easier. The
Infant Menu Form lists each requirement. You are not expected to record quantities. It is necessary that you record the kind of meats, fruits and vegetables. You
can record IFIF on the menu form. The infant menu form is to record menus
only! Infants must be recorded on your meal count form if you are to be
reimbursed. Remember, record your menus and meal counts daily, by the
end of the day. If you do not have records up-to-date at the time of your
home visit, federal regulations require that you be deducted for all meals
not recorded through the day prior to your home visit.
Some questions regarding infant requirements seem to come up more often than
others. The answers to these questions appear on the following pages. Remember,
you are welcome to call your Field Representative or our nutritionist with your
questions.
How much will I be paid for infant meals?
You are reimbursed at the same rates as you are for children over one year.
Do I have to use commercial baby food?
No, you do not. From a nutritional viewpoint, home-prepared food of appropriate
consistency offers these advantages: you can control the quality, cooking time, additives and consistency.
To prepare baby food, use fresh or frozen fruits and vegetables. Cook them only if
necessary and then, only until tender. Over-cooking destroys valuable nutrients.
Do not add salt or sugar. Mash, blend or grind foods to appropriate consistency.
Most commercial baby foods have water listed as the first ingredient. This means
there is more water than any other ingredient in the product. Many home prepared
baby foods do not require any water, thorough blending, grinding or mashing is acceptable. If liquid is needed to get an appropriate consistency, use liquid leftover
from cooking.
Home-prepared baby food is less expensive. Packaging and advertising cost you
food dollars. At home, when the foods that you are serving the older children are
appropriate, you can fix the baby’s food at the same time or prepare ahead and
freeze. Vegetables and meats can be frozen in ice cube trays.
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Can I serve fruit instead of juice to an infant for snacks?
No. A beverage must be provided. Infants need the fluid that juice or breastmilk or
IFIF provides.
Are commercial baby desserts creditable?
No. Read the label carefully. Pudding desserts, custards and cobblers are not creditable.
Fruits which contain tapioca starch as a thickener are not creditable. Consider serving
fresh, canned or frozen fruits of appropriate consistency.
How long do I use an infant menu?
Infant menus should be used up until the day the infant turns one year old. An
infant should be switched to the children’s menu form the day of their first birthday, even if it’s in the middle of the month. Remember breastmilk or IFIF must be
served until the day the infant turns 1 year of age.
If I am income eligible can I claim my breast fed infant?
Yes, you may claim your breast-fed infant for meals as long as other day care children are present during the time of the meal service.
Can an infant who is old enough to eat table food be served a
regular cereal such as Cream of Wheat or Cheerios instead of
the IFIC?
No, adult cereal will not meet the meal pattern requirement. The iron in regular
cereal is in a form that is not as easily digested by the child. IFIC must be offered
to infants until their first birthday. To allow the older infant to feel part of the
whole day care group some regular cereal may also be offered as an additional food.
Overeating, however, should not result.
Can I serve juice instead of fruit and vegetables at meals?
No, juice is creditable ONLY at snack for infants 8 through 11 months of age. Juice
cannot be substituted for a fruit/vegetable at meals, nor can it be served at snacks
to infants under the age of 8 months.
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USDA Rationale For Specific Infant Requirements
1. Solid foods should be introduced one at a time, when the infant is
developmentally ready, usually sometime between 4 and 7 months.
Consult the infant’s parent to determine appropriate time to introduce
solid food.
2. Infant cereals and fruits or vegetables are required at 8 months
of age. Since the infant's iron supply is usually used up by 6 months,
adequate iron must be included in the diet.
3. Meat or meat alternates can be substituted for infant cereal at lunch
or supper in the 8 through 11 month age group. Formula or breastmilk
alone does not provide enough protein and iron to meet the child’s needs
at this age.
4. Iron-fortified infant cereal is required until 12 months because of its
higher level of iron and because the form the iron is in is more readily
absorbed by the body.
5. Table Foods (carefully chosen and prepared to an appropriate consistency) can be started somewhere between 9 through 11 months when
the child is eager to try new foods. The continued use of commercial baby
foods past one year of age can result in a child having difficulty in accepting textures and tastes of table food later on. Again the actual age for
switching to table food depends on the child’s developmental readiness.
Consult the parents on timing.
6. Fruit juice can be introduced to infants in the 8 through 11 months
age category. It is recommended that juice be introduced to the infant
at an age when infant can begin to drink from a cup. Use only 100%
fruit juice.
7. Cooked dry beans and dry peas may be served as a meat alternate.
You may use any cooked dry beans or dry peas such as kidney beans,
lima beans, or chick peas. Mash or puree the beans with cooking liquid
or formula. Green sweet peas are creditable as a vegetable not as a meat
alternate.
8. A crusty dry bread or cracker may be served in addition to the breastmilk, IFIF or fruit juice at snacks for infants in the 8 - 11 month age
category. Adult cereals (i.e. Cheerios) are not considered to be a crusty,
dry bread.
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Infant
Feeding
Guidelines
Good nutrition is essential during the first year when babies are growing and
developing rapidly. Providing the right foods for infants will promote good health
and provide them with an opportunity to enjoy new tastes and textures as they
mature.
Formula Feeding
During the first four to six months the breast milk or formula provides all of the
nutrients and calories required by the infant for proper growth. The Child and
Adult Food Program (CACFP) meal pattern guidelines require iron-fortified infant
formula for babies that are not breast fed. The iron stored in a baby's body is soon
depleted and must be replaced. Serving iron-fortified formula is the easiest way to
ensure adequate intake of iron.
Low iron formulas do not meet the CACFP requirements. They may only be served
if recommended by the infant's physician. A special diet statement signed by the
physician or health care provider must be on file in our office to reimburse meals
containing low iron formulas.
Meals containing only breast milk are reimbursable for infants from birth through 7
months of age. For infants 8 - 11 months of age the other required meal components
(i.e. infant cereal, fruit/vegetable and meat) must be served for the meal to be
reimbursable. Be sure to discuss starting solid foods with the parents when the
baby is developmentally ready.
Creditable Infant Formulas
Alimentum*
Enfamil w/iron
Parent's Choice
Alsoy
Enfamil Lipil
Parent's Choice Soy
Bright Beginnings
Healthy Baby
Pregestimil*
Bright Beginnings Soy
Healthy Baby Soy ProSoBee
Good Start
Isomil
Enfamil AR
Nutramigen*
Similac w/iron
Similac Lactose Free
Nestle Follow Up/Follow up Soy (only for 4 - 11 month olds)
Healthy Baby for Older Infants ( only for 4 - 11 month olds)
Similac Advance (only for 6 - 11 month olds)
Next Step Toddler Formula (only for 6-11 month olds)
Next Step Soy Toddler Formula (only for 6-11 month olds)
* Requires a special diet statement.
Babies drinking formula usually want to be fed every 3-4 hours. The amount of
formula consumed can vary day to day as well as from meal to meal. When the baby
stops nursing and turns her head away or closes her mouth tightly, she is signaling
that she has had enough. Babies may want to eat less if they are teething or not
feeling well and more if they are going through a growth spurt.
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Feeding Solid Foods
Most babies are ready to progress to solid foods sometime between 4 and 7 months
of age. A baby is ready to add solid foods when he sits up, opens his mouth when
something is approaching, and draws in his lower lips as a spoon is removed from
his mouth.
It's essential to discuss the baby's readiness for solid foods with his parents. Continue
to consult with each baby's parents concerning which foods they have introduced.
This allows you to follow the parents' schedule as well as more easily identify food
allergies or intolerances.
Iron-fortified infant rice cereal is a good choice for baby's first solid food because it's
bland, easily digested, and is least likely to cause an allergic reaction. The CACFP
meal patterns require dry-pack infant cereals rather than dry or "wet" cereal and
fruit combinations or adult cereals.
Creditable Infant Cereals
BarleyMixed
Brown Rice
Rice
Oatmeal
It's important to start new foods one at a time, waiting 5-7 days before starting the
new next food. If a reaction occurs, discontinue the food. Wheezing, rash, vomiting
or diarrhea should be reported to the baby's doctor.
Fruits and vegetables may be introduced when the baby is readily accepting 2-3
tablespoons of infant cereal at each meal. Talk to the parents to see which fruits
and vegetables are being consumed at home so you can serve the same food at the
same time. The CACFP does not reimburse for infant fruit desserts, fruits with
tapioca and creamed vegetables. (A list of creditable and non-creditable foods is
included.)
Older infants may be served any soft-cooked fruit or vegetable of appropriate
consistency. Choose canned fruits in juice and low sodium canned vegetables. Frozen
and fresh cooked vegetables are also good choices. As babies' mouth skills progress,
gradually increase the thickness and lumpiness of fruits and vegetables.
Avoid foods such as corn, raw unpeeled apples, raw carrots, celery, lettuce, raisins,
and grapes because they may cause choking. Raw fruits (except ripe bananas) should
also be avoided as they may be difficult for the baby to digest.
Meat and meat alternates can be offered to babies starting at 8 months of age. By
that time most babies will be ready to replace some of the protein and iron from
formula or breast milk with meat.
Appropriate table foods to offer include well-cooked strained or pureed meats and
poultry, boneless fish, egg yolk, pureed dry beans and dry peas, diced or grated
cheese, or cottage cheese. If you are using commercial baby food, choose plain meats
rather than the mixed meat and vegetables or noodle combination dinners, which
are not reimbursable. You may mix the plain meats with vegetables after measuring
to encourage meat acceptance by the baby.
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Additional Foods
Additional foods may be offered to the baby as they grow older and continue to
learn the skills of eating. Fruit juice may be served to babies when they are ready
to drink from a cup. The CACFP reimburses for snacks containing juice beginning
at 8 months of age. Choose a juice that is fortified with Vitamin C. Citrus juices
(oranges and grapefruit) should be avoided as they are more likely to cause an allergic reaction.
Enriched crackers, bread, dry cereal, rice and macaroni are examples of additional
foods not included in the CACFP infant meal patterns which may be served to infants. These foods are appropriate finger foods which can help the baby to develop
the muscle and hand/eye coordination necessary for self-feeding.
Menu Recording Tips
* Record the infant's name and date of birth on the top left-hand corner of the
menu in the appropriate age group. Advance the infant to the next category the
day of their birthday. For example, if Megan was born on 7/13/06 she will turn
4 months on 11/13/06 and 8 months on 3/13/07. You must begin serving the foods
required for the new age group on that day even if it's the middle of the month.
* Record the type of IFIF served below the infant’s date of birth.
* Record infant menus daily by the end of the day. NOTE: The infant's name
and meals must also be recorded on the meal count form with your
other day care children to be reimbursed.
* Infant menus must be used until the infant turns one year of age. Transfer the
infant to the children’s menu the day he/she turns one year of age, even if it's
the middle of the month.
* Specify the type of meat, fruit and vegetable served. For example: record
peaches instead of fruit, beef instead of meat and sweet potatoes instead of
vegetable.
* Designate table foods by recording H.M. for homemade or reg. for regular.
For example H.M. chicken and rice, or reg. bananas.
* Fruit juice cannot be served in place of a fruit or vegetable for infants. Fruit
juice is creditable only at snack for 8-11 month infants.
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Infant Foods Crediting Update
Formula
Grains/Breads
Creditable
†† Breast Milk
†† Iron-fortified Infant Formula intended
for dietary use as a sole source of food for
normal, healthy infants served in liquid
state at manufacturer’s recommended
dilution
†† Follow Up Infant Formulas
(Creditable according to the information
on the can some are 4 months and older,
some are 6 months and older)
The following foods, which must be made
from whole-grain or enriched meal or flour,
are creditable in the bread and cracker
categories at snack for 8 – 11 month infants.
Bread (Crusty and dry or toasted)
†† Breads: white, wheat, whole wheat,
French, Italian and similar breads, all
without nuts, seeds or hard pieces of
whole grain kernels.
†† Biscuits
†† Bagels: made without nuts, seeds or hard
pieces of whole grain kernels
Non-Creditable (requires Diet Statement)
†† English muffins
†† Cow’s milk
†† Pita bread: white, wheat, whole wheat
†† Predigested formulas (Nutramigin,
Alimentum)
†† Premature infant formulas (Neocate, etc.)
†† Rolls: white, wheat, whole wheat, potato
all without nuts, seeds, or hard pieces of
whole grain kernels.
†† Goat’s milk
†† Soft tortillas: wheat or corn
†† Low-iron infant formula
†† Rice milk
Cracker-type products
Cereal
Creditable
†† Iron-fortified dry cereal for infants with
“Cereal for Baby” on label.
†† Crackers: saltines or snack crackers
without nuts, seeds or hard pieces of
whole grain kernels; matzo crackers;
animal crackers; graham crackers without
honey
†† Zwieback
Non-Creditable
†† Iron-fortified dry infant cereals containing †† Teething biscuits
fruit and/or infant formula
†† Commercial Jarred baby food cereals
which are wet
†† Cooked breakfast cereals not for baby’s
such as Quaker Oats or Cream of Rice
†† Cold, ready to eat cereal
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Infant Foods Crediting Update
Fruit/Vegetable Group
Meat/Meat Alternate Group
Commercial Baby Foods
Creditable
†† Fruits and vegetables with fruit or vegetable listed as the first ingredient in the
ingredient listing on the label
†† Fruits and vegetables which contain multiple fruits or multiple vegetables and list
fruit or vegetable as the first ingredient in
the ingredient listing on the label
Creditable
†† Commercial plain strained baby food
meats
†† Gerber “2nd Foods” baby food meat products (Beef and Beef Gravy, etc.) with additional ingredients of corn starch or lemon
juice concentrate
†† Egg Yolks
†† Full-strength fruit juice (regular or infant
juice). Juice is creditable only at snack for †† Soft cooked or mashed table food meats
without seasoning such as chicken or beef.
8-11 month infants.
†† Cooked dry beans
†† Cheese, cottage cheese, cheese spreads
and cheese foods
Non-Creditable
Non-Creditable
†† Jarred cereal with fruit
†† Meat sticks or “finger sticks” (which look
like miniature hot dogs)
†† Dinners which list fruit or vegetable as
the first ingredient
†† Products with “dessert” or “pudding”
or “yogurt” as part of the product name
which list fruit as the first ingredient
†† Products with water as the first
ingredient
†† Vegetable Juice
†† Fruit Juices with Yogurt
†† Commercial baby food combinations dinners
†† Commercial fish sticks or other commercial breaded or battered fish or seafood
products
†† Canned fish with bones (salmon, sardines)
†† Hot dogs, sausages, bologna (any meat in
a casing)
†† Yogurt/Yo-J
†† Nuts, seeds and nut or seed butters such
as peanut butter
†† Egg whites
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You Can Help
Prevent
Choking
Babies and young children are at the highest
risk for choking on food and remain at high
risk until they can chew better. Choking kills
more young children than any other home
accident. How can you make eating safer for
young children?
Watch Babies and Children During
Meals and Snacks to Make Sure They:
• Sit quietly for all feedings.
• Eat slowly.
• Chew food well before swallowing.
• Eat small portions and only one bite at a
time.
Fix Table Foods So They are Easy to
Chew:
• Grind up tough foods.
• Cut soft food into small pieces or thin
slices.
• Cut soft round foods, like cooked carrots,
into short strips rather than round pieces.
• Remove all bones from fish, chicken, and
meat before cooking.
• Cook food until it is soft.
• Remove seeds and pits from fruit.
Foods That Can Cause Choking and
Should Not be Fed to Babies and
Young Children:
Firm, smooth, or slippery foods that slide
down the throat before chewing, such as:
• hot dogs, sausages, or toddler hot dogs
(even when cut into round slices)
• peanuts and other nuts
• hard candy, jelly beans
• whole beans
• whole grapes, berries, cherries, melon
balls, or cherry and grape tomatoes
• whole pieces of canned fruit
Small dry, or hard foods that are difficult to
chew and easily to swallow whole, such as:
• popcorn
• peanuts, nuts and seeds
• small pieces of raw carrots or hard vegetables
• pretzels
• potato chips
Sticky or tough foods that do not break apart
easily and are hard to remove from the airway,
such as:
•
•
•
•
•
•
peanut butter
raisins
dried fruit
large chunks of meat
marshmallows
chewy candy such as caramel
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Recipes
for
Infants
Iron-fortified infant cereal (IFIC) is required at breakfast until the infant turns one year of age. It is an
important source of iron which is easily digested by the infant. Often it can be a challenge to feed the infant who is interested in self-feeding. The following are some suggestions for sneaking the cereal into the
infant's meals.
IFIC Muffins
IFIC Scrambled Eggs
1 egg*
1/2 cup enriched flour
1 cup milk 1/4 cup sugar
1/4 cup oil
1 Tbsp. baking powder
1 1/2 cups infant rice cereal
1 egg*
2 Tbsp. infant rice cereal
1 Tbsp. water
Heat oven to 400°. Grease bottom of 12 medium
muffin cups. Beat egg, stir in milk and oil.
Mix remaining ingredients just until flour is
moistened. Batter should be lumpy. Fill muffin
cups 2/3 full. Bake about 20 minutes. Yield: 12
muffins
IFIC Pancakes
Mix with fork, pour into oiled skillet and cook
until thickened. Use egg yolk only for younger
infants who haven’t had whole eggs.
Homemade Teething Biscuits
2 large eggs*
1/2 cup sugar (white or brown)
2 1/2 cups enriched flour
1 egg*
1 Tbsp. sugar
1 cup milk 1 tsp. baking powder
2 Tbsp. oil 1/4 tsp. salt
1/2 tsp. soda
3/4 cup infant rice cereal
1/2 cup enriched flour
Beat egg, add remaining ingredients. Beat with
spoon until only small lumps remain. Grease
griddle if necessary; pour batter onto hot griddle.
Turn pancakes as soon as they are puffed and
full of bubbles.
In large bowl, break eggs and stir until creamy.
Add sugar and continue to stir. Gradually add
enough flour to make a stiff dough. Roll between
two sheets of lightly floured wax paper to 3/4
inch thickness. Cut round shapes. Place on
lightly greased cookie sheet. Let it stand over
night (10-12 hours). Bake at 350° for 20 minutes
until browned and hard. Yield: 12 durable and
almost crumb free teething biscuits.
*USDA recommends that only egg yolks be served to infants. Three egg yolks beaten with a
teaspoon of water can be used in place of 1 whole egg.
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Infant Formula
Must I Provide?
The USDA guidance for the Child and Adult Care Food Program requires providers
participating on the food program to offer at least one type of iron-fortified infant
formula to the families of infants in their care. Providers are encouraged to select
a creditable infant formula which meets the needs of one or more of the infants in
their care.
Parents may choose to accept the offered infant formula or decline and bring another
type of formula. Parents choosing to decline the offered formula will need to sign a
form stating their intentions. A copy of this form must be on file in the Providers
Choice office.
You will be reimbursed for infant meals when the following criteria are met:
1. During the first three months, you will be reimbursed for an infant's meal
as long as you are serving the meal whether you provide the formula or
the parents provide the formula.
2. You will be reimbursed for meals served to infants in the 4 - 7 month
category whether you or the parents provide the formula. When the infant
is developmentally ready for solid foods you must supply the optional
meal components (infant cereal, fruits and vegetables) in addition to the
infant formula.
3. Beginning at 8 months, since additional food components are required
at meals, you must provide these foods in addition to the infant formula,
whether you or the parents supply the infant formula.
* The infant formula served must meet CACFP requirements. Iron-fortified infant
formula is the requirement unless a Special Diet Statement is on file.
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