Introduction

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.

Menu Planning

Let’s examine several factors that are important for menu planning, including the meal patterns, licensed programs must follow, the importance of variety and balance, and aesthetics.

Meal Patterns

In the state of Washington, licensing requires programs to follow the meal plan requirements of the Child and Adult Care Food Program and the Healthy Beverages in Child Care Act. Both of these were introduced in Chapter 12. To review, here are the breakfast meal patterns for infants and children.

Breakfast

Table 15.1 – Infant Breakfast Meal Patterns^[1]

Infants	Birth through 5 months	6 through 11 months
Breakfast	4-6 fluid ounces breast milk or formula	6-8 fluid ounces breast milk or formula; and 0-½ ounce equivalent infant cereal; or 0-4 tablespoons: meat, fish, poultry, whole egg, cooked dry beans, peas, and lentils; or 0-2 ounces of cheese; or 0-4 ounces (volume) of cottage cheese; or 0-4 ounces or ½ cup of yogurt; or a combination of the above; and 0-2 tablespoons vegetable or fruit, or a combination of both.

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

Table 15.2 – Breakfast Meal Pattern for Children^[2]

Meal components and food items	Ages 1-2	Ages 3-5	Ages 6-12
Fluid Milk	4 fluid ounces	6 fluid ounces	8 fluid ounces
Vegetables, fruits, or portions of both	¼ cup	½ cup	½ cup
Grains	½ ounce equivalent	½ ounce equivalent	1 ounce equivalent

Here is what breakfasts that follow the meal pattern might look like:

Lunch

And here are the lunch meal patterns for infants and children:

Table 15.3 – Infant Lunch Meal Patterns^[3]

Infants	Birth through 5 months	6 through 11 months
Breakfast	4-6 fluid ounces breast milk or formula	6-8 fluid ounces breast milk or formula; and 0-½ ounce equivalent infant cereal; or 0-4 tablespoons: meat, fish, poultry, whole egg, cooked dry beans, peas, and lentils; or 0-2 ounces of cheese; or 0-4 ounces (volume) of cottage cheese; or 0-4 ounces or ½ cup of yogurt; or a combination of the above; and 0-2 tablespoons vegetable or fruit, or a combination of both.

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

Table 15.4 – Lunch Meal Pattern for Children^[4]

Meal Components and Food Items	Ages 1-2	Ages 3-5	Ages 6-12
Fluid Milk	4 fluid ounces	6 fluid ounces	8 fluid ounces
Meats/meat alternates	1 ounce equivalent	1½ ounce equivalents	2-ounce equivalent
Vegetables	⅛ cup	¼ cup	½ cup
Fruits	⅛ cup	¼ cup	¼ cup
Grains	½ ounce equivalent	½ ounce equivalent	1 ounce equivalent

Here is what breakfasts that follow the meal pattern might look like:

Snacks

And finally, here are the meal patterns for snacks for infants and children:

Table 15.5 – Infant Snack Meal Patterns^[5]

Infants	Birth through 5 months	6 through 11 months
Snack	4-6 fluid ounces breast milk or formula	2-4 fluid ounces breast milk or formula; and 0-½ ounce equivalent bread; or 0-¼ ounce equivalent crackers; or 0-½ ounce equivalent infant cereal; or 0-¼ ounce equivalent ready-to-eat breakfast cereal; and 0-2 tablespoons vegetable or fruit, or a combination of both.

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

Table 15.6 – Snack Meal Pattern for Children^[6]

Meal Components and Food Items	Ages 1-2	Ages 3-5	Ages 6-12
Fluid Milk	4 fluid ounces	4 fluid ounces	8 fluid ounces
Meats/meat alternates	½ ounce equivalent	½ ounce equivalent	1 ounce equivalent
Vegetables	½ cup	½ cup	3⁄4 cup
Fruits	½ cup	½ cup	3⁄4 cup
Grains	½ ounce equivalent	½ ounce equivalent	1 ounce equivalent

Best practice: Make at least 1 of the 2 required components of a snack a vegetable or a fruit.^[7]

Here are some snacks that follow the meal pattern:

 

Factors to consider

Menu planning principles include aesthetics, and variety, including color, texture, flavors, shapes, and sizes of food, cost, balance, and nutritional quality, The availability of equipment and staff knowledge and skill to prepare the foods on menus are also important considerations in planning the menu. Along with all of these, an effective menu also considers cost.^[8]

Aesthetics and Variety

How our food is presented, along with texture, consistency, color, shape, and the preparation method, influences how we feel and what we think about a menu. It can even influence our appetite and our interest in eating.^[9]

Select nutritious foods that are contrasting colors and textures. This adds to the visual and chewing appeal. Try to vary the colors of the foods being served. Avoid serving foods that are all one color. For example, select a green, soft vegetable (spinach), a red, crunchy fruit (an apple), and colorful, chewy wild rice to go along with a piece of chicken and a glass of milk. This lends visual and chewing appeal as the children can see different colors and feel different textures as they chew.^[10]

Cost

While well-balanced nutrition should never be sacrificed to save money, early care and education programs must also consider the costs of the menus they plan. One way to save costs is to use cycle menus. A cycle menu follows a particular pattern and repeats on a regular basis. The length of the cycle can vary, but may be 4-6 weeks long and can be different lengths for different meals/snacks (for instance, with breakfast repeating more often than lunches). And they can be updated as needed to include new foods or make other accommodations.^[11]

Cycle menus allow a program to forecast costs, order in bulk, and reduce waste (with tried and tested menus). Cycle menus are often planned seasonally so an operation might have a spring, summer, and fall/winter cycle.⁶⁶¹ And buying produce seasonally is often more affordable.

Nutrition and Balance

The most important consideration for menu planning is that it meets children’s nutritional needs. The meals and snacks provided by full-day early care and education program should provide a substantial portion of a child’s daily nutrition. All programs should be supporting children’s well–balanced diet, in which all the nutrients the body needs for proper functioning and energy are taken in. A well-balanced diet contains a variety of foods from all the food groups, as well as all the necessary vitamins and minerals we need. It also means taking in an adequate supply of water for adequate health. A well-balanced diet can be planned by selecting healthy foods from each of the food groups.^[12]

Food Groups

Let’s look at each of the food groups a bit more closely and identify sources for each.

Dairy Group

All fluid milk products and many foods made from milk are considered part of this food group. Foods made from milk that retain their calcium content are part of the group. Foods made from milk that have little to no calcium, such as cream cheese, cream, and butter, are not. Calcium-fortified soymilk (soy beverage) is also part of the Dairy Group. When choosing dairy, fat-free and low-fat dairy are good options for children.^[13]

Sources of dairy include:

• Milk (low fat, fat-free, whole)
• Lactose-free and lactose-reduced milk
• Yogurt
• Pudding
• Ice cream
• Frozen yogurt
• Calcium-fortified soy milk
• Hard cheeses (cheddar, mozzarella, swiss, parmesan)
• Soft cheeses (ricotta, cottage cheese)
• Calcium-fortified juices and cereals^[14]

TIPS FOR SERVING THE DAIRY GROUP FOR CHILDREN Serve unflavored, fat-free, and low-fat milks most often. They have less added sugar and fewer calories than flavored, whole, or reduced-fat milk. Low-fat milk, yogurt, and cheese provide much needed calcium. Try making a dip for fruits or vegetables from yogurt. Blend dairy into smoothies. Combine low-fat or fat-free yogurt with bananas and cocoa powder for a smoothie, or try milk, ice cubes, and frozen berries.[15]

Protein Group

All foods made from meat, poultry, seafood, beans and peas, eggs, processed soy products, nuts, and seeds are considered part of the Protein Foods Group. Select a variety of protein foods to improve nutrient intake and health benefits, including cooked seafood. Meat and poultry choices should be lean or low-fat.^[16]

Sources of protein include:

• Beef
• Pork (ham, pork chops)
• Lamb
• Veal
• Poultry (chicken, turkey)
• Beans (black, kidney, chickpeas, lentils, navy, pinto, white, soy beans, split peas)
• Eggs
• Canned fish (sardines, salmon, tuna, anchovies, clams)
• Fish (cod, tuna, sea bass, catfish, flounder, halibut, swordfish, trout, mackerel)
• Nuts (almonds, walnuts, hazelnuts, pistachios, peanuts, pecans)
• Seeds (sesame, pumpkin, squash, sunflower)^[17]

TIPS FOR SERVING THE PROTEIN GROUP FOR CHILDREN Choose a variety of protein foods such as seafood, beans, lean meats, poultry, and eggs. Limit highly processed poultry, fish, or meat (like hotdogs, chicken nuggets, and fish sticks). Even some “reduced-fat” meats and cold cuts, like sausage, bologna, and salami, may be high in saturated fat and sodium. Add beans to children’s favorite foods. Add beans and peas to tacos, casseroles, stews, pastas, and side dishes.[18]

Fruit Group

Any fruit or 100% fruit juice counts as part of the Fruit Group. Fruits may be fresh, canned, frozen, or dried, and may be whole, cut-up, or pureed.^[19] Intake of fruit juice should be limited to no more than once a day.

Sources of fruit include:

• Apples
• Apricots
• Bananas
• Blueberries
• Cantaloupe
• Cherries
• Fruit juices (100% fruit juice, all varieties)
• Grapefruit
• Grapes
• Kiwi
• Lemons
• Limes
• Mangoes
• Nectarines
• Oranges
• Papayas
• Peaches
• Pears
• Pineapples
• Plums
• Raisins
• Raspberries
• Strawberries
• Watermelon^[20]

TIPS FOR SERVING THE FRUIT GROUP FOR CHILDREN Focus on whole fruits Serve a rainbow of choices. Fruit can be a quick and easy way to make meals and snacks healthier and more colorful. Choose from fresh, frozen, canned, and dried fruits. Purchase canned fruit in water or 100% fruit juice instead of syrup. Limit fruit juice. While 100% fruit juice can be part of a healthy diet, it does not contain the dietary fiber found in other forms of fruit. Offer raisins or other unsweetened dried fruit instead of chewy fruit snacks or strips, which usually contain very little fruit.[21]

Vegetable Group

Any vegetable or 100% vegetable juice counts as a member of the Vegetable Group. Vegetables may be raw or cooked; fresh, frozen, canned, or dried/dehydrated; and may be whole, cut-up, or mashed. Based on their nutrient content, vegetables are organized into 5 subgroups: dark-green vegetables, starchy vegetables, red and orange vegetables, beans and peas, and other vegetables. While it is not necessary to eat vegetables from each subgroup daily, over the course of a week, vegetables from each subgroup should be eaten to reach ensure the daily intake recommendation of the different vitamins is met.^[22]

Sources of vegetables include:

• Artichokes
• Asparagus
• Bok choy
• Broccoli
• Celery
• Collard greens
• Corn
• Cucumbers
• Green lima beans
• Green peas
• Lettuce
• Kale
• Mushrooms
• Mustard greens
• Onions
• Peppers (green, red, orange, yellow)
• Potatoes
• Spinach
• Squash (all varieties)
• Sweet potatoes
• Taro
• Tomatoes
• Turnip greens
• Water chestnuts^[23]

TIPS FOR SERVING THE VEGETABLE GROUP FOR CHILDREN  Serve a variety of colorful choices. Brighten children’s plates with red, orange, and dark-green vegetables. Choose from fresh, frozen, or canned vegetables. Prepare and serve vegetables without added salt or solid fat. Try a dip. Kids love to dip their foods. Whip up a quick dip for veggies with yogurt and seasonings such as herbs or garlic. Serve with raw vegetables like broccoli, carrots, or cauliflower.682 Provide at least one serving each of dark green vegetables, red and orange vegetables, beans and peas (legumes), starchy vegetables, and other vegetables once per week.[24]

Grain Group

Any food made from wheat, rice, oats, cornmeal, barley, or another cereal grain is a grain product. Bread, pasta, breakfast cereals, grits, and tortillas are examples of grain products. Foods such as popcorn, rice, and oatmeal are also included in the Grains Group.

Grains are divided into 2 subgroups: Whole Grains and Refined Grains. Whole grains contain the entire grain kernel ― the bran, germ, and endosperm. Examples of whole grains include whole-wheat flour, bulgur (cracked wheat), oatmeal, whole cornmeal, and brown rice. Refined grains have been milled, a process that removes the bran and germ. This is done to give grains a finer texture and improve their shelf life, but it also removes dietary fiber, iron, and many B vitamins. Some examples of refined grain products are white flour, de-germed cornmeal, white bread, and white rice.

Most refined grains are enriched. This means certain B vitamins (thiamin, riboflavin, niacin, folic acid) and iron are added back after processing. Fiber is not added back to enriched grains. Check the ingredient list on refined grain products to make sure that the word “enriched” is included in the grain name. Some food products are made from mixtures of whole grains and refined grains.^[25]

Source of grain include:

• Barley
• Bread (all kinds)
• Bulgur
• Cereals (all kinds)
• Cornbread
• Cornmeal
• Couscous
• Crackers
• Millet
• Muesli
• Oatmeal
• Rice
• Pasta (including whole wheat)
• Popcorn
• Pretzels
• Tortillas^[26]

TIPS FOR SERVING THE GRAIN GROUP FOR CHILDREN Make at least half their grains whole grains by offering 100% whole-grain cereals, breads, and pasta. Vary the choices for whole grains. Rolled oats, oatmeal, brown rice, wild rice, buckwheat, quinoa, wheat berries, and millet are whole-grain foods. Choose toppings wisely for toast, hot cereals, pasta, and rice. Instead of adding butter, stick margarine, and regular full-fat cheese, use vegetable oils, low-fat cheeses, or marinara sauce as toppings.687 Provide at least two servings of whole grain-rich grains per day.[27]

Oils

Oils are NOT a food group, although they provide essential nutrients. Oils include items such as butter, oils, margarine, mayonnaise, salad dressings. These food items should be used sparingly. Foods such as fish, nuts, and avocados are good choices of fats. Many foods we eat, especially those that are processed, often are high in fat. This should be considered when planning meals.^[28]

Individual and Cultural Preferences

What families eat, how those foods are prepared and served, and the routines surrounding meals and snacks are going to vary in every family. For some children, those will be similar to what they encounter in early care and education programs. And some children will easily adapt to new foods and routines. But gathering information from families on these is one way to have an understanding of the food experiences and preferences children have. Menus can be planned that include familiar foods.

Cultural and Religious Considerations

Some people do not eat various specific foods and beverages in conformity with various religious, cultural, legal, or other societal prohibitions. Many of these prohibitions constitute taboos. Many food taboos and other prohibitions forbid the meat of a particular animal. Some food prohibitions can be defined as rules, codified by religion or otherwise, about which foods, or combinations of foods, may not be eaten and how animals are to be slaughtered or prepared. Some foods may be prohibited during certain religious periods (e.g., Lent), at certain stages of life (e.g., pregnancy), or to certain classes of people (e.g., priests), even though the food is otherwise permitted.^[29]

Families and children may choose to exclude, include, or prepare foods in a particular way according to their religious faith and beliefs. The guidance given in Table 15.7 on food choices for specific religious groups is very general (and does not include prohibited items, such as alcohol that do not apply to children in early care and education programs). There will be individual differences and varying levels of adherence to guidelines which should be discussed for each child with their family. Some people within some of the faith groups identified may not observe the dietary guidelines listed. Prohibitions and restrictions even within a particular faith may change between denominations or branches.^[30]

Table 15.7 – General Guidance for Religious Food Choices^[31]

Religious Affiliation	General Guidelines
Buddhist	Many are vegetarian or vegan Some may eat fish or eggs May participate in fasting
Catholic	May avoid certain meats and fish products May fast during specific dates
Hindu	Most are vegetarian Dairy is usually acceptable Those who eat meat, poultry, and fish will exclude beef May fast during specific dates
Jainism	Many are vegetarian or vegan Some may not eat roots Fermented foods are also excluded
Jewish	Pork and pork products are excluded Kosher beef, lamb, poultry, and fish (with fins and scales) are eaten Shellfish are excluded Meat and dairy are never eaten at same meal; dairy may not be eaten until 3 hours after meat or poultry Will also exclude gelatin, fats, emulsifiers, stabilizers, and additives from animal origin that Is not kosher May fast during specific dates
Muslim	Pork and pork products are excluded Halal beef, lamb, poultry, fish are eaten Dairy products are eaten by most Will also exclude gelatin, fats, emulsifiers, stabilizers, and additives from animal origin that Is not halal May fast during specific dates
Sikh	Many are vegetarian Those who eat meat, poultry and fish will exclude beef and possibly pork Halal and kosher meat are not eaten
Rastafarian	Pork and pork products are excluded Many will be vegetarian Some may be vegan Prefer to eat a pure and natural diet so may exclude: canned or non-organic foods
Seventh Day Adventist[32]	Those who eat meat typically do not eat meat from pigs, certain fish, and other animals that the Bible names as unclean Many are vegetarian or vegan Encourage drinking a lot of water
Mormon[33]	Hot drinks containing caffeine are excluded

FOOD ALLERGIES, INTOLERENCES, AND MEDICAL ISSUES   As discussed in Chapter 13, some allergic reactions can be life-threatening and some foods can cause major health issues for children, it is vitally important that everyone in the early care and education program that prepares or serves food is aware of these and protects children from consuming food that can hurt them.

Vegetarian Menu Planning

A vegetarian diet does not include any meat, poultry, or seafood. It is a meal plan made up of foods that come mostly from plants. These include:

• Vegetables
• Fruits
• Whole grains
• Legumes
• Seeds
• Nuts
• May include eggs and/or milk if ovo-lacto vegetarian

A vegetarian diet contains no animal proteins. A semi-vegetarian diet is a meal plan that contains little animal protein, but mostly plant-based foods. Vegetarians DO NOT eat:

• Fowl
• Seafood
• Beef
• Pork
• Lamb
• Other animal meats, such as bison, or exotic meats like ostrich or alligator

Vegetarians also do not eat products containing gelatin or rennin (an enzyme found in calf’s stomachs that is used to produce many cheeses).

Here are the different types of vegetarian diets:

• Vegan: Includes only plant-based foods. No animal proteins or animal by-products such as eggs, milk, or honey.
• Lacto-vegetarian: Includes plant foods plus some or all dairy products.
• Lacto-ovo vegetarian: Includes plant foods, dairy products, and eggs.
• Semi- or partial vegetarian: Includes plant foods and may include chicken or fish, dairy products, and eggs. It does not include red meat.
• Pescatarian: Includes plant foods and seafood.

Vegetarian diets that include some dairy products and eggs have all the nutrition needed. But the more restrictive the diet, the harder it can be to get certain nutrients.

When a vegetarian’s diet avoids most or all animal foods, close attention is required to make sure there is adequate intake of all of the following nutrients.

Vitamin B12: This vitamin is needed to help prevent anemia. Eggs and dairy foods have the most B12, so vegans may have a hard time getting enough. Sources of B12 include:

• Eggs
• Milk, yogurt, low-fat cheese, cottage cheese, and other dairy products
• Foods that have B12 added to them (fortified), such as cereal and soy products
• Nutritional yeast
• Seafood such as clams, salmon, and tuna (this only applies to pescetarians and semi-vegetarians)

Vitamin D: This vitamin is needed for bone health. Vitamin D can be produced from sun exposure, but sun exposure should be limited due to skin cancer concerns. So vegetarians most likely will not be able to get enough from sun exposure. Sources of vitamin D include:

• Fatty fish, such as sardines, salmon, and mackerel (this only applies to pescatarians and semi-vegetarians)
• Egg yolks
• Foods that are fortified with vitamin D, such as orange juice, cow’s milk, soy milk, rice milk, and cereals

Zinc: Zinc is important for the immune system and cell growth, especially in teens. The body does not absorb zinc from plant foods as well as from meat and other animal foods. Sources of zinc include:

• Beans and legumes, such as chickpeas, kidney beans, and baked beans
• Nuts and seeds, such as almonds, peanuts, and cashews
• Seafood, such as oysters, crab, and lobster (this only applies to pescatarians and semi-vegetarians)
• Yogurt and cheese
• Foods fortified with zinc, such as milk and cereals

Iron: Iron is needed for red blood cells. The body does not absorb the type of iron found from plant foods as well as from the type found in meat and other animal foods. Sources of iron include:

• Beans and legumes, such as white beans, lentils, and kidney beans
• Green vegetables, such as broccoli, spinach, kale, and collard greens
• Dried fruit, such as prunes, raisins, and apricots
• Whole grains
• Foods fortified with iron, such as cereals and breads

Eating foods that are high in vitamin C at the same meal as iron-rich foods increase iron absorption. Vitamin C helps the body absorb iron. Foods high in vitamin C include tomatoes, potatoes, citrus fruits, bell peppers, and strawberries.

Calcium: Foods high in calcium help keep bones strong. Dairy products have the highest amount of calcium. If a vegetarian does not eat dairy, it can be hard to get enough. Oxalates, a substance found in plant foods inhibits calcium absorption. Foods that are high in both oxalates and calcium are not good sources of calcium. Examples include spinach, Swiss chard, and beet greens. Good sources of calcium include:

• Sardines and canned salmon with bones (this only applies to pescatarians and semi-vegetarians)
• Dairy products, such as milk, yogurt, cottage cheese, and cheese
• Green vegetables, such as collard greens, kale, bok choy, and broccoli
• Oranges and figs
• Tofu
• Almonds, Brazil nuts, sunflower seeds, tahini, and white beans
• Foods fortified with calcium, such as cereal, orange juice, and soy, almond and rice milk

Omega-3 fatty acids: Omega-3s are important for heart and brain health. Sources of omega-3s include:

• Fatty fish, such as halibut, mackerel, salmon, herring, and sardines (this only applies to pescatarians and semi-vegetarians)
• Nuts and seeds, such as walnuts, pumpkin seeds, ground flaxseed, canola oil, chia seeds
• Soybeans and soy oil
• Foods fortified with omega-3s, such as bread, eggs, juice, and milk

Protein: If you eat fish and/or eggs and dairy getting enough protein will not be a concern for most people. Protein sources also include:

• Soy foods, such as soy nuts, soy milk, tempeh and tofu.
• Seitan (made of gluten).
• Vegetarian meat substitutes. Just watch for products that are high in sodium.
• Legumes, beans, and lentils.
• Nuts, nut butters, seeds, and whole grains.
• Dairy products such as milk, yogurt, and cottage cheese.

These foods do not need to be combined in the same meal to get enough protein.^[34]

The Dietary Guidelines 2015-2020 includes a Healthy Vegetarian Pattern that was adapted from the Healthy U.S.-Style Pattern, modifying amounts recommended from some food groups. The current Healthy Vegetarian Pattern includes changes in food group composition and amounts, based on assessing the food choices of vegetarians.^[35]

TIPS FOR MENU PLANNING FOR CHILDREN WITH VEGETARIAN DIETS   When following a vegetarian diet, keep in mind the following: Provide different kinds of foods, including vegetables, fruits, beans, nuts, seeds, whole grains, and low-fat or fat-free dairy and eggs if their diet includes these. Choose fortified foods, such as cereals, breads, soy or almond milk, and fruits juices to get a full range of nutrients. Limit foods that are high in sugar, salt (sodium), and fat. Include a protein source with all meals. Learn to read the Nutrition Facts Label on food packages. The label tells you the ingredients and nutrition contents of the food product. If you follow a more restrictive diet, you may want to work with a dietitian to make sure you are getting enough nutrients.   Note: Vegetarian children may need to take supplements at home if their diet lacks certain vitamins and minerals.[36]

Family Style Meal Service

Currently, traditional family style meal service is the recommended approach to serving meals in preschool settings. Using this approach, all foods on the menu are served at the same time in serving bowls that are passed around the table, and children self-serve the amounts they desire. There are a number of potential advantages to traditional family-style meal service including allowing children the opportunity to self-regulate consumption (match food selection with hunger level).^[37]

This approach to mealtime creates a number of healthy habits that are important to the growth and development of children at any age. Children tend to eat more healthy foods if they see their friends try it. They learn skills such as taking turns, sharing, and teamwork.

Family style dining opens up opportunities for conversation, which increases vocabulary, promotes proper use of language and interaction with friends.

There are even more benefits that support healthy growth. Children learn:

• portion sizes for each food group
• to recognize when they are hungry or satisfied
• how to identify healthy foods and where they come from
• to improve fine motor skills

Children are not the only ones who benefit. Providers get a better grasp of food costs, get help with mealtime service and, with less food being wasted, they save money.^[38]

TIPS FOR FAMILY STYLE DINING Start with the right equipment. When purchasing serving dishes, utensils and other place settings, keep in mind that they need to be kid-friendly and sized for little hands to maneuver Remember each child’s skill level when choosing your menu. Finger foods and foods that are easy to navigate with a child-size fork or spoon are easiest to self-serve for younger children. Have multiple sets of utensils and serving spoons in case someone drops one on the floor. Give each child a task to help set the table. One child can set the plates, one can place the cups and so on. Children have a sense of pride and belonging when they have a contributing role. Offer a variety of familiar foods and don’t forget to introduce new foods. Children are more willing to try something new when they serve themselves. Reserve extra servings for second helpings or in case the bowl of food gets contaminated. Provide a trash can for children in which to dispose napkins and uneaten food. Provide a tub for them to place dirty dishes after they scrape them off. Keep cleaning supplies nearby. Spills will happen. Be patient and use this opportunity as a teaching moment on how to clean-up. Most importantly, eat with the children. Children learn from good role models. Sitting with them while everyone eats also allows you to start positive mealtime conversations.[39]

Food from Home

Some early care and education programs depend on families to provide some or all of children’s meals and snacks. According to Sweitzer et al (2011), “[o]bservations of lunches of three to five year old children attending fulltime childcare support the need for parent education about packing healthy lunches.” They site several studies that show inadequate servings of fruit and vegetables and foods that fail to meet the Daily Reference Intakes for essential nutrients in foods brought from home. They also site several studies that demonstrated that knowledge and attitudes about nutrition were positively linked to serving fruits and vegetables to children. As they stated, parents report barriers to supporting their young children’s healthy eating. “Common barriers for consumption of fruits and vegetables are the child’s preferences, preparation time involved, and higher cost of those items.”^[40]

Food brought from home, should be labeled with the child’s name and date and stored in the refrigerator when needed. When prepared and served to children it is important to follow food safety practices (discussed in the next section of the book). Foods for one child should never be given to another child.^[41]

Food Safety

Even the most nutritious, visually appealing, affordable, delicious food won’t keep children healthy if it isn’t stored, prepared, and served safely. Let’s look at recommendations for food safety in early care and education programs based on the King County Safe Food Handling Practices for Food Establishments.

Safe Shopping

When purchasing food for an early care and education program:

• All foods served in a food service establishment must come from an approved source. Food service establishments should work with their suppliers to ensure the foods they are using meet the food safety standards.
• Temperature and time are the two most important factors to control. Foods need to be received and stored as soon as possible. The staff of the food service establishment should be checking for temperatures and conditions of incoming foods.
• All refrigerated foods should be put away quickly to prevent time and temperature abuse. Frozen foods should not have large ice crystals, be discolored or dried-out. Canned goods should have labels, no swelling and flawed seams, rust or dents. Never accept home-canned foods because of the risk of botulism.^[42]

Storage Before Preparation

To keep foods safe from spoilage and contamination before you prepare them:

• All canned foods and dry ingredients are stored in a designated area. Foods should not be stored in areas such as restrooms, furnace rooms, stairwells or hallways. Foods should be stored off the floor and in closed containers.
• Storage areas should be well ventilated and pest free. Dry storage areas can become a food source for rodent and insects. Keeping containers closed, in sound condition and off the floor help to keep the storage area pest free. Stock rotation is a good management practice.
• Foods and chemicals need to be stored separately. Chemicals should be stored below and away from foods to prevent chemical contamination.
• Cold holding is storing food under refrigeration at 41°F or below. Refrigeration prevents food from becoming a hazard by slowing the growth of most microbes. Some organisms like Listeria monocytogenes are significantly slowed but not stopped by refrigeration.
• The walk-in refrigerator is the major cold storage area in a food service establishment. The temperature of a walk-in refrigerator must be sufficient to adequately hold the food temperature at 41°F or below. The temperature of a walk-in refrigerator is usually colder than 41°F to compensate the opening and closing of doors and demands of adding additional foods for storage and cooling.
• Foods need to be stored to prevent contamination. All cooked foods and foods that will receive no further cooking should be stored above other foods. Foods need to be stored to allow enough space for air to circulate around them.
• Temperature is one of the prime factors that control the growth of bacteria in food. Many types of pathogens and spoilage bacteria are prevented from multiplying to significant levels that cause foodborne illness with proper holding practices. All TCS foods* need to be stored cold 41°F and below, or hot 135°F or above.
• Preparation procedures should have built in barriers to limit the time TCS foods are in the temperature danger zone (41°F to 135°F). Active preparation of TCS food at room temperature must be limited to 2 hours or less.^[43]

Preparing

Safe food preparation practices include:

• Keep all kitchen equipment, dishes, and utensils clean and in safe condition.
• Wash dishes and eating and serving utensils in a dishwasher (reach a temperature of 165° F during the washing or drying cycle) or by hand with a sanitizing agent.
• Keep the food preparation area separate from the eating, napping, play, toilet and bathroom areas, and from areas where animals are kept. Never use the food preparation area as a passageway while food is being prepared.
• Make sure that all staff wash their hands before preparing food, serving and eating meals and snacks, and after toileting, diapering, and outdoor activities. The best way to combat the spread of communicable disease or germs is by careful handwashing with liquid soap, rinsing under running water, and drying with paper towels.
• Do not wash hands in food preparation sinks to prevent contamination of food.
• Keep all surfaces that come in contact with food (including tables and countertops), floors, and shelving in good repair. Use smooth and nonporous materials that are easily cleaned and sanitized.

• 

  Use cutting boards that can be disinfected (such as glass, Formica, or plastic). Always clean them with soap and hot water after each use.

• Do not use cutting boards with crevices and cuts because they can hide food material that can grow bacteria and contaminate the next food cut on the surface.

• Always clean and sanitize cutting boards, knives, and other utensils after they come in contact with raw meat, poultry, and seafood. Use one cutting board for raw meat products and another for salads and ready-to-eat foods to prevent cross-contamination of bacteria from one food to another.
• Air-dry hand-washed dishes to eliminate recontamination from hands or towels.
• Use dishes with smooth, hard-glazed surfaces that do not have cracks or chips.
• Clean and sanitize table surfaces before and after use.
• Sanitize kitchen dishcloths and sponges often because these materials can hide bacteria and promote their growth.
• Wash kitchen towels and cloths often in hot water in the washing machine.
• Clean the can opener blade after each use.
• Keep garbage in a covered container, away from children. Empty the garbage every day to reduce odors, control insects and rodents, and protect children and the child care center from contamination.
• Occasionally sanitize the kitchen sink, drain, disposal, and connecting pipe by pouring a solution of one teaspoon of chlorine bleach in one quart of water or a commercial cleaning solution down the drain.
• Wash fresh fruits and vegetables with water, and soap and scrub brush when needed, to reduce or eliminate any pesticides or residues.
• Do not allow infants and toddlers in the food preparation area to protect them from kitchen hazards.^[44]

Thawing

To protect against foodborne illness, follow the following practices when thawing frozen foods

• Thawing foods may take several hours or days depending on the size of the food item being thawed. Thawing must be done so that the risk of cross-contamination is reduced, and the time that Time/Temperature Control for Safety Food* is in the temperature danger zone (41°F to 135°F) is kept to minimum.
• To thaw food safely:
  • Thaw under refrigeration (41°F or below)
  • Under cold running potable water (safe to drink) of 70ºF or less.
  • In a microwave, then transferred to conventional cooking equipment with no interruption in the process.^[45]

Cooking

Foods must be cooked at high enough temperatures and for long enough to kill any possible microorganisms they may be contaminated with. Here are some general guidelines

• Cooking is the thermal heating of foods at sufficient temperature over time to kill microorganisms in the food.
• Food characteristics also contribute to the lethality of cooking temperatures. Heat penetrates different foods at different rates. High fat content reduces the lethality of heat. High humidity in the cooking container or the moisture content of the food aid the lethality of heat.
• To effectively eliminate pathogens, there are a number of factors to consider: the level of pathogens in the raw product and the initial temperature of the food and the bulk of the food. Another factor to consider, to kill the pathogenic organisms in food, cooking must heat all parts of the food to the required temperatures.
• Use a meat thermometer to determine the temperature in the thickest part of the meat.^[46]

Table 15.8 – Safe Minimum Internal Temperature Chart^[47]

Food Product	Minimum Internal Temperature (Fahrenheit)
Beef, fish, seafood, pork, and eggs	145° (hold this temperature for 15 seconds)
Restructured meat, ground or fabricated meat	158°
Poultry, food containing poultry, stuffed meats or stuffing containing meat, casseroles containing Time/Temperature Control for Safety (TCS) foods	165°
Reheating food	165° for 15 seconds before being hot held at 135° or above

Food Service

To continue to protect against foodborne illness and prevent injury, food must be served following food safety guidelines, including:

• Once a food is heated or cooked, the food must be maintained at a temperature to limit the growth of bacteria. The correct hot holding temperature is 135°F.
• Bare hand contact is not allowed with ready-to-eat foods. Equipment, utensils and food contact surfaces must be washed, rinsed and sanitized.
• Temperature is one of the prime factors that control the growth of bacteria in food. Many types of pathogens and spoilage bacteria are prevented from multiplying to significant levels that cause foodborne illness with proper holding practices. All TCS foods* need to be stored cold 41°F and below, or hot 135°F or above.
• Preparation procedures should have built in barriers to limit the time TCS foods are in the temperature danger zone (41°F to 135°F). Active preparation of TCS food at room temperature must be limited to 2 hours or less.
• Do not re-serve unwrapped bread, rolls, crackers, salad dressings, or relish trays.⁷¹⁰
• Carry perishable picnic food in a cooler with a cold pack or ice. Store the cooler in the shade and open it as little as possible.
• Do not leave cooked, perishable foods, including hot foods such as soups or sauces, out for more than two hours after cooking (one hour in temperatures over 90° F). The bacteria that cause foodborne illness grow rapidly at room temperature.
• Never offer foods that are round, hard, small, thick and sticky, smooth, or slippery to children under four years of age because they can cause choking. Hot dogs (sliced into rounds), whole grapes, hard candy, nuts, seeds, raw peas, dried fruit, pretzels, chips, peanuts, popcorn, marshmallows, spoonfuls of peanut butter, and chunks of meat, which are larger than can be swallowed whole are examples of foods that can cause choking.
• Cut food into small pieces for infants (¼ inch) and toddlers (½ inch).
• Do not use microwave ovens for warming infant bottles and infant food because the microwave can heat liquids or food unevenly and to scalding temperatures. The milk or formula in a microwaved bottle may reach a higher temperature than the outside of the bottle.^[48]

Handling Leftovers

• Refrigerated leftover food must be stored and then served again within forty-eight hours of originally being prepared; or
• Frozen leftover food must be promptly served after thawing and being cooked.^[49]

Summary

When staff in early care and education programs have an understanding of the CACFP meal patterns and health sources for all of the food groups, they have the foundation to plan menus that consider cost, variety, aesthetics, and balance. They can also support families in providing healthy food to their children. And with a solid grounding in food safety policies and practices they can buy, store, prepare, cook, and serve food to children safely.

RESOURCES FOR FURTHER EXPLORATION Institute of Child Nutrition: https://theicn.org/ California Department of Education CACFP Meal Patterns Resources: https://www.cde.ca.gov/ls/nu/he/cacfpresource.asp Virtual Lab School Menu Planning for Success: https://www.virtuallabschool.org/focused-topics/food-service/lesson-1 CACFP Menu Planning Guide: https://healthymeals.fns.usda.gov/hsmrs/Wisconsin/cacfp-menu-planning.pdf Crediting Handbook for the Child and Adult Care Food Program: https://www.cacfp.org/files/9914/4240/2457/CACFP_creditinghandbook.pdf Cultural and Ethnic Food and Nutrition Education Materials: A Resource List for Educators: www.nal.usda.gov/sites/default/files/fnic_uploads/ethnic.pdf Guidance on Foods for Religious Faiths: https://www.publichealth.hscni.net/sites/default/files/FaithsPosterA2.pdf Vegetarianism and Children: https://www.nal.usda.gov/fnic/vegetarianism-and-children Virtual Lab School Family-Style Dining in Child Care Settings: https://www.virtuallabschool.org/focused-topics/food-service/lesson-2 Federal Food Safety Gateway: www.foodsafety.gov CDC Food Safety: https://www.cdc.gov/foodsafety/ Food Buying Guide for Child Nutrition Programs Interactive Web-Based Tool: https://foodbuyingguide.fns.usda.gov/ Safe Food Handling Practices for Food Establishments – King County: https://kingcounty.gov/en/dept/dph/health-safety/food-safety/safe-food-handling