Attachment T: Stimulus: Sample illustrations for use in Nutrition and Wellness Tips for Young Children: Provider Handbook for th

OMB BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995, an
agency may not conduct or sponsor, and a person is not required to respond to, a
collection of information unless it displays a valid OMB control number. The valid OMB
control number for this information collection is 0584-0524. The time required to complete
this information collection is estimated to average 1 hour per response, including the time
for reviewing instructions, searching existing data sources, gathering and maintaining the
data needed, and completing and reviewing the collection of information.

A-1

Nutrition and Wellness Tips
for Young Children
Provider Handbook for the Child and Adult Care Food Program

A-2

Build a Healthy Plate With Vegetables

Activities
How can I put this information into practice?
Take a look at your current weekly or cycle menu. Circle the menu items to which you can
add more vegetables.
What other ways will you try to
promote vegetables?

How will you offer vegetables next month?
As part of a:

Put a check mark next to actions
you will try next month. Next
month, I will:
Promote a different “vegetable
of the week” every week.
Next month, I will promote:

Salad
Sandwich
Veggie Roll-Up (veggies wrapped in
a whole-grain tortilla
with ranch dressing)

Veggie Burrito or Quesadilla
Stir-Fry
Purchase and serve vegetables
in season to save money. For
example, asparagus in the
spring, green peppers in the
summer, sweet potatoes and
Brussels sprouts in the fall,
and cabbage and acorn
squash in the winter.

Pasta Dish or Lasagna Meal
Pasta Salad
Snack
Veggie Sticks With Dip Snack
Veggie Bake (vegetables roasted in the oven)

CHOKING!

For children younger than 4 years,
offer cooked or soft vegetables to
prevent choking.

Soup, Chili, or Stew
Pizza

✓
12

CACFP Crediting Tip:

Two different vegetables can be served in
place of a fruit and vegetable at lunch and
supper. Prepackaged vegetable mixes,
such as succotash or peas and carrots
count as one type of vegetable.

Egg Dish

more 'Activities' on next page ...

Nutrition and Wellness Tips for Young Children: Provider Handbook for the Child and Adult Care Food Program
Build a Healthy Plate With Vegetables • http://teamnutrition.usda.gov

Encourage Active Play and Participate With Children

A-3

Activities
What are some specific ways I can encourage
active play every day in my child care program?
Use every opportunity to show the children that you believe physical activity is important.

Which of these ideas will you try next week? Mark your choices.
Encourage active play by offering children a
variety of options such as hula hoops, balls, and
jump ropes and letting them choose what they
want to do.

Make a chart for tracking physical activity with
children’s and child care providers’ names.
Have children place a sticker or a stamp by
their name every time they participate in
active play. Send ideas home to families so
they can continue to encourage active play at
home.
Let families know that physical activity is an
important part of the day when children are in
your care. Add physical activity messages to
newsletters, posters, and posted schedules.
http://www.teamnutrition.usda.gov/resources/
Nibbles/Nibbles_Newsletter_36.pdf

Display posters and pictures of children and
adults being physically active. Read books that
promote physical activity as part of the story.
Make activity cards and use them for a game by
having children select a card and then
demonstrate the activity. Activity cards are
easy to make – use index cards or square
sheets of paper. On one side of the card, paste
a picture of a physical activity movement. The
child who chooses the card will show
everyone else how to do the movement.

Request that families dress children in clothing,
shoes, and outerwear that allow movement
and play outside, or bring clothes to change
into for playing outdoors.
See the Provide Opportunities for Active Play
tip sheet on page 63 for instructions and
other ideas.
List other ideas to show children that physical
activity is fun:

Include physical activity in your special events
and family events. Lead children and their
families in playing Octopus Tag or Musical
Hoops. Add fun by using pool noodles, beach
balls, and hula hoops.
Be a good role model. Participate with children
in activities and show them through your
actions that active play is an important and fun
part of the day. Make positive comments about
physical activity.
68
U.S. Department of Agriculture • U.S. Department of Health and Human Services
Food and Nutrition Service • FNS-440 • June 2013
USDA and HHS are equal opportunity providers and employers.

A-4

Limit Screen Time

Why do we need to limit screen time use?
Limiting screen time can help children maintain a healthy weight as they grow. Screen time can
take away from activities that help brain development, imagination, and social skills, such as
talking, playing, singing, and reading.
► It is important to limit TV and DVD time because:
●

●

►

Having the TV on can disturb children’s sleep
and play, even if it is on in the background.
TV and some DVDs include advertisements for
unhealthy foods. Young children cannot tell the
difference between programs and advertisements.

It is important to limit video game* playing because:
●

●

●

●

*

Video games include
those played using a
video game console and
a TV, a hand-held device
such as a cell phone, or
a computer.

The more time children spend playing video
games, the more likely they are to have difficulty
concentrating in school.
Many video games contain violence.
We know from research that, at least for boys, the
more time they spend playing video games and
watching TV, the less active they are.
Even video games requiring children to be active
while playing the game (called exergames)
should be limited. Children might not reach a
high level of physical activity when playing
these games.
► It is important to limit recreational computer use, even for educational
games, because:
●

Many Web sites promote less healthy foods.

●

Many Web sites include on-screen computer or video games.

●

Computer games can impair children’s sleep at night, possibly
causing them to spend less time in deep sleep. Sleep is
important for children’s health and development.

TIP: Limit screen time by removing the TV or other equipment from the areas where children spend
time, or keep it out of sight by covering it with a cloth. This keeps children from expecting screen
time and helps them focus on developing relationships and social skills while they learn.
74

Nutrition and Wellness Tips for Young Children: Provider Handbook for the Child and Adult Care Food Program
Limit Screen Time • http://www.teamnutrition.usda.gov/library.html

Build a Healthy Plate With Milk
Build a Healthy
Plate With Milk

B-1

Nutrition and Wellness Tips for Young Children:
Provider Handbook for the Child and Adult Care Food Program
Children who consume dairy products such as milk, milk substitutes, yogurt, and cheese get many
important nutrients and have healthier diets than those who don’t. Offer unflavored fat-free and low-fat
milk during the day to:

●

●

●

Provide children with nutrients such as protein,
calcium, vitamin D, and potassium.
Help build strong bones, teeth, and muscles in
growing children.
Increase the chance that children will drink milk when
they are older.

NOTE: “Milk” refers to pasteurized fluid types

such as unflavored or flavored whole milk,
low-fat milk, fat-free (skim) milk, or cultured
buttermilk that meet State and local standards for
such milk. All milk should contain vitamins A
and D at levels specified by the Food and Drug
Administration and must be consistent with
State and local standards for such milk. Only
unflavored milk is creditable for 0 to 5 year olds
in CACFP.

✓

Fat-Free = Skim Milk
Low-Fat = 1% Fat Milk
Reduced-Fat = 2% Fat Milk
Full-Fat = Whole Milk
What types of milk should I offer children over

CACFP Crediting Tips:
•

Yogurt and cheese credit as a meat
alternate, and not as a part of the
fluid milk requirement of the CACFP
meal pattern. See the Meat and Meat
Alternate tip sheet on page 19 for
more information.

•

Remember, cream cheese, whipped
cream, and butter are not part of
the milk component and are not
creditable in CACFP. They are high
in solid fats and have little or
no calcium.

2 years old?

Fat-free and low-fat (1%) milk options have the same amount of calcium and other important nutrients
as whole and reduced-fat (2%) milks, but much less fat. Starting at age 2, children should drink only:
►
►

Fat-free or low-fat (1%) milk, or
Fat-free, or low-fat, lactose-free or lactose-reduced milk.

Whole and reduced-fat milks (2%) contain high amounts of saturated fat and may not, under USDA’s
CACFP requirements, be served to children over 2 years of age. While dietary fats are needed for
children’s growth and development, children 2 years and older generally consume enough fats in their
diet without consuming fat from milk.
Nutrition and Wellness Tips for Young Children: Provider Handbook for the Child and Adult Care Food Program
Build a Healthy Plate With Milk • http://teamnutrition.usda.gov

33

B-2

Build a Healthy Plate With Milk

How can I serve fat-free and low-fat milk?
►

►

Offer unflavored, fat-free, and low-fat milks. They
have less added sugar and fewer calories than
flavored, whole, or reduced-fat milk. (See the
Added Sugars tip sheet on page 47 for more
information.)
Offer lactose-reduced or lactose-free milk to children
who are lactose-intolerant or, upon a parent’s
written request, a preapproved nondairy milk (for
example, soy) to children who can’t consume cow’s
milk. Handle milk substitutions on a case-by-case
basis and contact your State agency or sponsoring
organization if additional guidance is needed.

ALLERGY!

• Some children in your care may
be allergic to milk, soy, nuts, and
seeds.
Actively supervise children when
serving milk and milk substitutes.
Handle food allergies on a caseby-case basis, have a medical
statement on file, and contact
your State agency or sponsoring
organization if additional
guidance is needed.
• See Supplement B on page 81
for more information on food
allergies.

How can I encourage children to choose fat-free and low-fat milk?

Enjoy milk often.
The children in your
care are looking at the
choices you make.

►

Make food fun. Make up a song that is associated with
drinking milk, and sing it when milk is being served.

►

Do a milk taste-test. Let kids sample low-fat (1%) milk
and fat-free milk and pick their favorite. Low-fat milk
and fat-free milk have less calories and saturated fat than
reduced-fat (2%) milk and whole milk but do not reduce
calcium or other important nutrients.

►

Create your own Milk Mustache Event! Take pictures of
children drinking low-fat milk and post them on a bulletin
board. For more fun, include adults and parents.

Choose fat-free or
low-fat milk as your
beverage of choice
during meal and snack
times. http://www.

choosemyplate.gov/foodgroups/dairy-tips.html

34

more 'encourage choosing fat-free and low-fat milk tips' on next page ...
Nutrition and Wellness Tips for Young Children: Provider Handbook for the Child and Adult Care Food Program
Build a Healthy Plate With Milk • http://teamnutrition.usda.gov

Practice the Basics of Food Safety To Prevent Foodborne Illness

B-3

... more 'clean' tips

Keep It Clean
►

Always start preparing food with clean cutting boards, pots, pans, utensils, and counter tops.

►

Wash your cutting boards, dishes, utensils, and counter tops with hot soapy water after preparing each
food item and before you go on to the next. This is especially important before and after preparing
raw meat, poultry, seafood, and eggs.

►

Use clean towels or paper towels to wipe kitchen surfaces, counter tops, sinks, and tables. Dirty
towels and sponges often collect and spread bacteria, instead of removing them. TIP: To kill germs,
put damp sponges in the microwave for 1 minute on full power or through a full wash-dry cycle in the
dishwasher. Use new sponges frequently.

►

After washing and drying, you may choose to sanitize the food preparation surfaces with a solution of
1 tablespoon of unscented, liquid chlorine bleach per gallon of water. Spray surfaces or immerse
cutting boards and utensils with the bleach solution, and let surfaces air dry.

►

Do not allow books, backpacks, or other items to be placed on tables or counters where food will be
prepared or served. Keep pets and other animals off of tables and counters too.

Clean and Prepare
►

Rinse all fresh fruits and vegetables just before peeling, eating, cutting, or cooking.
Under running water, rub produce briskly with your hands and scrub
firm-skinned fruits and vegetables with a clean produce brush to remove dirt
and germs. Some vegetables, like lettuce, celery, and broccoli, should be
broken apart before rinsing to remove dirt between the different layers.

►

Before opening cans of food, wash the top of the can under clean running water. Then, dry the can with
a clean cloth or paper towel.

►

Do not rinse raw fish, seafood, meat, and poultry. Bacteria in these raw juices can splash and spread to
other foods and surfaces. Cooking foods thoroughly will kill harmful bacteria.

SEPARATE
Separate foods that are ready to eat from those that are raw or that might contain harmful germs. Be
sure to separate foods at each step of food handling. Keep fruits and vegetables away from raw meat,
poultry, and seafood while buying, storing, or preparing them.

Purchase and Store

56

►

Place raw meat, poultry, and seafood in plastic bags when food shopping to prevent juices from leaking
or dripping. Separate them from other foods in your grocery cart and bags. Throw away these
plastic bags; do not reuse them.

►

Store raw meat, poultry, and seafood on a plate, or in a container or sealed plastic bag on the bottom
shelf of the refrigerator, so juices don’t drip onto other foods.
more 'separate' tips on next page ...
Nutrition and Wellness Tips for Young Children: Provider Handbook for the Child and Adult Care Food Program
Practice the Basics of Food Safety To Prevent Foodborne Illness • http://teamnutrition.usda.gov

Make Water Available Throughout the Day

C-1

How can I keep drinking water safe?
►

Keep drinking fountains clean, sanitized, and maintained to provide adequate
drainage. Teach children to drink water from a cup and to drink from a
fountain without putting their mouths to the spout.

►

Provide single-use paper cups by the kitchen sink or a water pitcher for children to
use when they feel thirsty.

►

Purchasing water for children may be considered a reasonable and allowable cost
for CACFP programs only if safe drinking water is not available in the facility.

►

Ice cubes pose a choking hazard to children under 4 years old. (See Supplement A
on page 77 for more information.)

Activities
How can I put this information into practice?
Locate safe water sources inside and outside the child care facility or home. They are located:

How will you make water available throughout the day, both indoors and outdoors?
Make sure that water is freely accessible to children, with clean cups to drink from when appropriate.
Put a check mark next to the ideas you will try next month.
Small pitchers of water
Kitchen sink faucet
Water fountain
Water jugs on the playground
Other ideas:

53
U.S. Department of Agriculture • U.S. Department of Health and Human Services
Food and Nutrition Service • FNS-440 • June 2013
USDA and HHS are equal opportunity providers and employers.

C-2

Practice the Basics of Food Safety To Prevent Foodborne Illness
... more 'questions'
●

●

Immediately before leaving, use a cooler to pack food right from the refrigerator. Add enough
ice or gel packs to keep food cold. Single-serving boxed juice drinks could be partially frozen
as a cold source for food, but might not defrost by lunchtime. Food and leftover food are only
safe if the cooler still has ice in it. If the ice or cooling source has melted or thawed, discard
the food.
In the summer, eat foods shortly after they are prepared.

Q: How do I select safe food and keep it safe while traveling from the grocery store to my child care program?
A: There are many ways you can choose safe foods and keep them safe until you return to your
child care program.
●

●

In the store, select cold foods last.
Do not buy foods that are past the “sell by,” “use by,” or
any other expiration dates.

●

Place meat, poultry, and seafood in plastic bags.

●

Separate foods in your shopping cart.
●

●

2013
C 15

E
BY D
SELL

Keep a cooler in your car to transport perishable foods, and go straight to your
child care program to put cold foods in the refrigerator quickly.
Always refrigerate perishable foods within 2 hours, except if the
temperature outside is 90 °F or more, which reduces this time to
within 1 hour.

Q: What should I do if I suspect a child in my care has a foodborne illness?
A: Follow your State agency or sponsoring organization’s standard policies and procedures for getting
medical care for children who become sick for any reason, and follow any State or local policies on
preparing for and reporting a suspected foodborne illness.
●

●

It is important to preserve up to 3 days of samples of all food served to children, as well as
the packaging the food came in. This way, it can be determined if food caused the illness and
which food it was. Also be sure to note what the symptoms were and when they began.
Read more information on common foodborne illnesses, their symptoms, and causes.
http://fightbac.org/about-foodborne-illness/causes-a-symptoms and http://www.foodsafety.
gov/poisoning/index.html

Q: How do I get more information about child care involvement in food safety?
A: Go to the Additional Resources section on page 100 to find more information on food safety, and ways
you can educate children and involve them in handling food safely.

Nutrition and Wellness Tips for Young Children: Provider Handbook for the Child and Adult Care Food Program
Practice the Basics of Food Safety To Prevent Foodborne Illness • http://teamnutrition.usda.gov

59

C-3

Limit Screen Time

Why do we need to limit screen time use?
Limiting screen time can help children maintain a healthy weight as they grow. Screen time can
take away from activities that help brain development, imagination, and social skills, such as
talking, playing, singing, and reading.
► It is important to limit TV and DVD time because:
●

●

►

Having the TV on can disturb children’s sleep
and play, even if it is on in the background.
TV and some DVDs include advertisements for
unhealthy foods. Young children cannot tell the
difference between programs and advertisements.

It is important to limit video game* playing because:
●

●

●

●

*

Video games include
those played using a
video game console and
a TV, a hand-held device
such as a cell phone, or
a computer.

The more time children spend playing video
games, the more likely they are to have difficulty
concentrating in school.
Many video games contain violence.
We know from research that, at least for boys, the
more time they spend playing video games and
watching TV, the less active they are.
Even video games requiring children to be active
while playing the game (called exergames)
should be limited. Children might not reach a
high level of physical activity when playing
these games.
► It is important to limit recreational computer use, even for educational
games, because:
●

Many Web sites promote less healthy foods.

●

Many Web sites include on-screen computer or video games.

●

Computer games can impair children’s sleep at night, possibly
causing them to spend less time in deep sleep. Sleep is
important for children’s health and development.

TIP: Limit screen time by removing the TV or other equipment from the areas where children spend
time, or keep it out of sight by covering it with a cloth. This keeps children from expecting screen
time and helps them focus on developing relationships and social skills while they learn.
74

Nutrition and Wellness Tips for Young Children: Provider Handbook for the Child and Adult Care Food Program
Limit Screen Time • http://teamnutrition.usda.gov