North CarolinaDepartment of Health and Human Services
Division of Public Health; Women's & Children's Health Section
1914 Mail Service Center; Raleigh, North Carolina 27699-1914
Tel 919-733-2973 Fax 919-733-1384
Michael F. Easley, Governor
Carmen Hooker Buell, Secretary
August 22, 2000
CACFP 00-18
TO: All Child and Adult Care Food Program Sponsors

Arnette Cowan, MS, RD, LDN
Head, Special Nutrition Programs Unit

SUBJECT: All CACFP Sponsors Please Read: Clarifications on the Infant Meal Pattern

Recently you have received several memos concerning the changes in the infant meal pattern, which includes the provision of iron fortified infant formula. The State Agency has received several questions concerning these changes. This memo is provided to clarify several issues concerning the infant meal pattern and provision of iron fortified infant formula.

Child care facilities must offer infants program meals if you are participating on the CACFP. All providers must offer at least one iron-fortified formula to infants, however, the parent may decline the sponsor's/facility's choice. All facilities must have a completed, signed "Provision of Infant-Formula or Breastmilk and Provision of Baby Food" form (attachment A) or an equivalent form on file for each infant. Providers must not solicit (request or require) the parent or guardian to provide the meal components or infant formula.

Previously, child care facilities had the option of providing or not providing infant formula to infants enrolled in their facilities. This policy was revised to ensure that (1) child care facilities offer infants a meal which meets the infant meal pattern; and (2) the decision to decline the infant formula offered by the child care facility rests with the parent or guardian. This does not mean that the child care facility is required to satisfy the unique formula needs of every infant. Therefore, all facilities who have infants enrolled and participate on the CACFP must offer at least one infant formula which meets the definition of infant formula. Child care facilities that did not previously offer formula to infants must now offer infant formula.

The decision regarding which infant formula to feed a baby is one for the infant's doctor and parents/guardian to make together. A parent or guardian may elect to decline the offered infant formula and supply another formula. However, a child care facility may not claim reimbursement for meals containing parent-provided formula as the only component.

If an infant's parent decides not to use the formula offered by the facility and supply their own formula, the facility may claim reimbursement for meals served to infants if the following statements are true:

  • The facility has documentation on file that the parent declined the offered formula. Attachment A should be completed and signed by the parent/guardian for each infant.
  • The infant is 4 through 7 months of age and at least one other meal component is supplied by the child care facility and served to infants 4 through 7 months of age (Additional meal components are shown as optional for infants 4 thorough 7 months in the attached table for breakfast, lunch and supper. However, if an infant is developmentally ready for one or more solid food items and the parent or guardian requests that the infant be served solid foods, the facility is responsible for purchasing and serving them to the infant. The decision to offer an infant one other meal component should be made by the infant's doctor and parents/guardian).
  • The infant is 8 through 11 months of age and the required meal components are offered by the facility. (At least one of the components must be provided by the facility and the decision to bring other components must be that of the parents and be unsolicited by the facility.)

There have also been questions concerning the preparation of infant formula at the facility. According to 15A NCAC18A.2804, "formula provided by the child care center shall be commercially pre-packaged, ready-to-feed, fully prepared, and packaged in single use containers. However, formula that does not meet these requirements may be provided by the child care center as prescribed by the child's physician or instructed by the parent or guardian in writing." Therefore, the child care facility must have a doctor's prescription or written permission from the parents. If the parent/guardian uses the formula offered by the facility and completes and signs attachment A, permission is given for the child care center to prepare the formula at the center. For those facilities that do not meet the sanitation requirements, you may consider contracting out the preparation of the infant formula and/or meals with a School Food Authority or Food Service Management Company.

Also included with this memo is the infant meal pattern (Attachment B) and summary of regulations for claiming infants. (Attachment C).

If you have any questions, please contact me at (919) 715-1926 or your regional special nutrition programs consultant.

cc: SNP Staff
SNP Auditors

[Recycle Symbol]  Location: 1330 St. Mary's Street Raleigh, NC 27605An Equal Opportunity / Affirmative Action Employer

Attachment A [PDF]
Attachment B [PDF]
Attachment C [PDF]

([PDF] in .pdf format -- requires the FREE Acrobat Reader.)