On Friday, April 22, 2016, the USDA announced that it has finalized meal pattern revisions to the Child and Adult Care Food Program (CACFP). This rule updates the meal pattern requirements to better align with the Dietary Guidelines for Americans, which was required by the Healthy, Hunger-Free Kids Act of 2010.  Changes are as follows:

Infant Meal Pattern

• Requires whole vegetables and fruits to be served at snack for infants 6-11 months of age.
• Eliminates fruit juice from the infant meal pattern.
• Allows ready-to-eat cereals to be served as a grain at snack for infants 6-11 months of age.
• Allows cheese, cottage cheese, and yogurt as allowable meat alternates for infants 6 – 11 months of age.

Child and Adult Meal Pattern

• Establishes the child and adult age groups as 1-2 year olds, 3-5 year olds, 6-12 year olds, 13-18 year olds.
• Requires breakfast cereals to contain no more than 6 grams of sugar per dry ounce. Starting October 1, 2019, ounce equivalents are used to determine the quantity of credible grain.
• Allows meat and meat alternates to be served in place of the entire grains requirement at breakfast a maximum of three times per week.
• Requires yogurt to contain no more than 23 grams of sugar per 6 ounces.
• Prohibits flavored milk for children 2-5.
• Allows yogurt to meet the fluid milk requirement once per day for adults only.
• Recommends as a best practice that flavored milk contain no more than 22 grams of sugar per 8 fluid ounces for children 6 years old and older, and adults.
• Requires potable drinking water to be offered to children throughout the day and available to children upon their request throughout the day.
• Reimburses providers for meals when the mother directly breastfeeds her infant at the center or daycare home, for infants birth through 11 months of age.
• Establishes a separate vegetable component and a separate fruit component at lunch, supper, and snack.
• Limits the service of fruit juice or vegetable juice to one serving per day for children 1 year old and older.
• Requires at least one serving of grains per day be whole grain-rich.
• Disallows grain-based desserts from counting towards the grains requirement.
• Allows tofu as a meat alternate.
• Allows non-dairy beverages that are nutritionally equivalent to milk and meet the nutritional standards for fortification of calcium, protein, vitamin A, vitamin D, and other nutrients to levels found in cow’s milk.
• Prohibits frying as a way of preparing food on-site, as defined as deep fat frying.
• Restricts the use of food as a punishment or reward.
• Allows reimbursement for meals that contain one component that is provided by a parent or guardian, or by, or on behalf of, an adult participant.
• Codifies proposed practices that must be followed when a provider or center chooses to serve meals family style.

The meal pattern also offers “best practice” guidelines, which (while not mandatory) will be addressed in policy guidance rather than through regulatory language. These best-practices include, among others, supporting breastfeeding mothers, including making one of the two snack components a fruit or vegetable, providing at least two servings of whole grain-rich grains per day, serving only lean meats and limiting processed meats, and serving only natural cheeses that are low-fat or reduced-fat.

Some state child care license regulations have nutrition standards that are linked to CACFP requirements. Depending on how the state regulation was written, the regulation may not automatically adopt the new meal patterns. This means that some child care regulations may have state standards lower than the new meal patterns. These states may need to reopen regulations if they want the state licensure regulations to meet the new CACFP meal patterns.

The meal pattern and best practices were developed using research and reports from the National Academy of Medicine (NAM, formerly the Institute of Medicine of National Academies) report, issued in November 2010. The rule is a balance of the findings in this reports as well as stakeholder input and cost and practicality for providers. The Food Research and Action Center (FRAC) supports the meal pattern changes, stating that they “make a good program even better.”

In the public comment period, USDA received support for the rules on breastfeeding, vegetable and fruit requirements, the increase of whole grains, and the reduction in sugars. USDA also received comments expressing concern over the cost of the changes and the timeline for implementation. These changes would come at a significant cost—both in terms of food costs borne by providers and the training and support costs to ensure that all providers have the information and supports to properly implement the new requirements.

In preparation for the meal pattern revisions, FRAC, the USDA, and the National CACFP Sponsors Association are great sources for information and support:

• New Spanish (language) Nutrition and Wellness Resources: CACFP Creating Healthier Child Care Environments
• National CACFP Sponsors Association: Tools for Providers & Centers
• USDA’s ChooseMyPlate.Gov

Although the rule does not go into effect until October 1, 2017, participating programs will need ample time and resources in order to make changes to their menus and procurement systems. Cooks, center directors, family child care providers, and teachers will all need training and technical assistance.