Download Feeding Young Children with Special Food Needs

Feeding Young Children with Special Food Needs in Child Care Settings
Section 1: Welcome
SLIDE # 1: Welcome to this course, Feeding Young Children with Special Food Needs in Child Care
Settings, which is a Texas AgriLife Extension Service professional development training program. The
course is intended for child care providers, parents, families, teachers, and other professionals.
This module is approximately 2 hours in length. Take time to review the reference section, and visit the
different websites related to special food needs for medical conditions.
This course will be presented in a voice-narrated format, which allows you to follow along with a
PowerPoint slide presentation. A high-speed Internet connection is required to complete the module.
Content is divided into multiple sections (see menu bar on the left for the course outline), enabling you
to complete and/or review content at your own pace. Printable handouts, if applicable, will be
presented prior to the section in which they are referenced.
In the next section, you will be directed to complete a brief, multiple-choice pre-learning assessment.
Once you have completed the pre-learning assessment, you will be free to advance to the course
content by checking the “Next Section” button at the bottom of the page. At the conclusion of this
module, you will be directed to complete a post-learning assessment that will determine if you
successfully pass the course.
If at any time you wish to take a break from the module, simple log out and return to the course when
you are ready to continue. When you sign back in to the module, you will be taken directly to the
section where you left off. To review a section you have already completed, click on the desired section
on the left menu bar.
Section 2: Learning Objectives
Participants will be able to:
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Recognize certain special dietary needs for common special medical conditions (food
allergies/intolerances, hyperactivity, iron-deficient anemia, choking, diabetes, and
developmental disability) of children;
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Describe food planning, preparation, safety, and service;
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Use the dietary guidelines and nutritional resources for this age group;
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Obtain special dietary requests, via the parents, that have been ordered by the physician and
dietitian;
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Utilize the listing of allowed meals/snacks for treatment of the child’s condition;
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Provide any special feedings or medications that the child must be given; and,
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Locate and use research-based resources that are available to assist caregivers in feeding all
children in child care settings.
Section 3: Food Service
SLIDE # 2: Two specific questions that need to be addressed as a care giver may include:
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What about young children who have special concerns related to nutrition? and
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Should we be the ones to put them on a special meal plan?
The answer is that any child in your care who needs and requires a special food meal plan should have
a special dietary pattern that has been ordered by the child’s physician. The parents should provide
you with the special meal plan, which has been given to them by a dietitian.
Answering these questions will help to ensure that child care workers are equipped to handle the
children’s care as it relates to their meals and snacks.
SLIDE # 3: It’s become more common to see millions of preschool children in daycare facilities. Twice as
many million school-age youth are in after-school care programs. Many of these children have special
food need requirements for their medical conditions.
Besides knowing how to prepare and cook foods, do you really know about foods and nutrition? When
you’re asked about food safety, do you know what that really means?
Your role is to help preschoolers in your care to practice good food habits early. Doing so gives you the
chance to be an important part of America’s future.
During this course, you’ll become acquainted with some excellent government resources. The USDA
website shown on the slide for Child Care and After-School Programs
(http://www.csrees.usda.gov/childcareafterschoolprograms.cfm) can help you learn how to plan
menus and prepare foods, help picky eaters learn about new foods, and much more.
SLIDE # 4: It can be challenging to feed young children who have special food need issues. So, what are
some general rules to follow when planning food service for the preschool child?
The best way to know how to plan is by the number of hours the children spend in your facility.
Specifically:
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If the children are there for 4 hours, then 1 snack is sufficient.
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If they spend 4 to 7 hours in your care, 1 meal plus 1 snack should be provided.
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For children who are there for 8 hours, 1 meal plus 2 snacks are required.
SLIDE # 5: Organization and pleasant surroundings are important when feeding children. When it
comes to preparing food and the physical food service environment, pay particular attention to:
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arranging the furniture well,
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providing the children with utensils that are appropriate and developmentally suited for eating,
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providing a pleasant emotional environment,
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providing foods that are interesting and inviting; and,
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having conversations about the food the children are eating.
SLIDE # 6: Always follow these food preparation tips.
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Consider the nutritional needs of all children in your care. Pay special attention to those who
are on special meal plans.
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It’s important to cut the fat, salt, and sugar in the foods being served.
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Increase the fiber and nutrients by serving fresh fruit and vegetables that are in season, and
whole-grain products such as cereals, breads, pasta, and brown rice.
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Plan all menus to include healthful food choices, using the USDA Food Guidance System for
preschool children. Be sure to include food choices from each food group.
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Plan for enough foods to balance the energy and nutrients with children’s small appetites and
abilities to eat foods.
SLIDE # 7: Especially since you’ll be preparing foods for children with special food needs, know and
follow these six simple steps in your food preparation and service to reduce your risk of foodborne
illness. Foodborne illness is what our mothers and fathers referred to as food poisoning.
This formula, “4C’s + S + T,” will help you remember the food safety rules. Let’s learn the meaning of
the formula so you can remember it well.
1. The first “C” stands for “Check.” Check fresh produce to be sure it’s free from damage, such as
bruising. Keep packaged produce and pre-cut fruits refrigerated.
2. The second “C” stands for “Clean.” Start clean and keep things clean when you’re preparing
food. Wash your hands, utensils, and cutting boards before and after they are in contact with
raw meat, poultry, seafood, and eggs.
3. The third “C” stands for “Cook.” Use a food thermometer to be sure foods reach a safe
temperature. Using the thermometer ensures that the food is thoroughly and appropriately
cooked.
4. The fourth “C” stands for “Chill.” When shopping for food, buy cold food last, and refrigerate it
quickly. Chill leftovers and take-out foods in a refrigerator within 2 hours, with a temperature
that is less than or equal to 40°F.
5. Next is the “S” in the formula. That stands for “Separate.” What we really mean here is: don’t
cross contaminate food. Keep raw meat, poultry, and seafood apart from foods that will not be
cooked. Don’t use the same cutting board for cooked foods that you just used for raw foods.
6. Last in the formula is the “T,” which stands for “Throw away.” If you’re in doubt as to whether
or not a food is good, throw it out! If food smells or appears to be questionable to serve, play it
safe and throw it out.
Section 4: Requirements for Feeding Young Children with Special Food Needs
SLIDE # 8: It’s important to ensure that all meals are based on the Daily Recommended Intakes for
Children. At the ChooseMyPlate.gov website, go to the “Daily Food Plan for Preschoolers” information
to see a general guide that will help you plan what and how much to offer a child to meet his or her
needs.
Also at this website, you can use and follow the recommended amounts from the USDA Dietary
Guidance System. This system ensures variety and moderation, with plenty of fruits and vegetables.
If you have questions concerning meal planning for preschoolers, don’t hesitate to ask a local dietitian.
This is especially important when children have special food needs!
SLIDE # 9: MyPlate provides guidelines for eating healthfully. For preschoolers, use a small plate of 7 to
9 inches. The amounts of food will vary for preschoolers because their activity levels vary. Using
MyPlate as a guide, offer one serving of each food at each meal that is served.
Let’s examine the MyPlate guide. The larger middle plate on this slide represents the 5 food groups
that should be served at each meal. You can see where each of the single servings fit on the plate. If
you use MyPlate as a guide, you’ll automatically get enough fiber each day by eating from the grains,
fruits, and vegetables groups. The dairy and protein foods groups contribute many nutrients, but they
contribute very little fiber. Let’s take a minute to look at each serving size for the main groups:
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First, let’s examine the Grains group. Have 5-6 servings each day of grains, cereals, and starchy
vegetables, such as potatoes, sweet potatoes, winter squash, corn, and green peas.
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Next, let’s look at the Fruits group. Have 3-4 servings of fruit each day, such as citrus fruit,
strawberries, bananas, melons, plums, and peaches.
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For the Vegetables group, have 4-5 servings each day, such as green beans, carrots, celery,
lettuce, spinach, summer squash, turnip greens, and tomatoes.
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In the Dairy group, all children over 2 years of age should have 2-3 servings of low-fat milk each
day. Children younger than 2 should be served whole milk.
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Protein foods are our last food group to discuss. Each day, have two 2-3 ounce servings of
protein foods, such as meat, chicken, fish, cheese, and eggs.
SLIDE # 10: Toward the top of this slide is the website address for the “Health and Nutrition
Information for Preschoolers” page on ChooseMyPlate.gov. It has many resources for child care
providers. (http://www.choosemyplate.gov/preschoolers.html)
On this website, you’ll find topics such as: Daily Food Plan for Preschoolers, Develop Healthy Eating
Habits, and some suggested physical activities. You’ll also see information on how to deal with certain
issues, such as picky eaters.
SLIDE # 11: It’s important for all of us, and especially for those with any disease, to learn about food
labels and how to use them when you’re shopping for food and planning meals.
Food labels give us clues about the content of the food. The Ingredients List on the label gives
information about all foods that are used in the food product, and they’re listed in order from the most
to least quantity used. In the example on the screen, the first four ingredients on the Ingredients List
are corn flour, sugar, brown sugar, and graham cracker crumbs. Those are ingredients in the largest
amount of foods in that container. If a person needs to restrict their carbohydrates, they might want to
choose another food product that doesn’t have 4 carbohydrates as the first four ingredients.
Nutrition labels reflect how the foods we eat relate to health and what its role is in reducing the risks
of some diseases, such as diabetes, heart disease, food allergies, and osteoporosis. They also provide
nutrition facts about the calories, carbohydrates, total and saturated fat, cholesterol, and sodium.
All food labels give us specific information about the product that’s inside: its brand name, product
name, manufacturer’s address, and the amount of food in the package or the net weight of the
ingredients.
By looking at the Nutrition Facts and the Ingredients Listing, the following information will help you
make your decision about whether or not a food choice will fit into your meal plan:
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serving size;
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calories;
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total fat, saturated fat, and trans fat;
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cholesterol;
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sodium;
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total carbohydrates, fiber, sugars, and sugar alcohols; and
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protein.
SLIDE # 12: The USDA website, ChooseMyPlate.gov, can provide you with healthy eating and snack
suggestions for young children. Be sure to download and review our Handout 1, Healthy Eating and
Snack Ideas for Preschoolers.
Here are some tips to follow when feeding young children:
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Set a good example! Child “pick up” on your attitudes and behaviors, including your eating
habits!
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Provide a variety of healthy foods for the children in your care.
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Start with small portions. Offer preschoolers small, easy-to-eat amounts to make eating easy
and more enjoyable.
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Don’t insist that children finish all of the food on their plate. Let the child know that it’s okay to
only eat as much as he or she wants at that time.
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Help the children know when they've had enough to eat. Babies know when they have eaten
enough. Help your children keep listening to their bodies as they grow.
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Regularly scheduled meals and snack times help preschoolers learn structure.
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Picky eating is a typical behavior for many preschoolers. It’s just another step in the process of
growing up and becoming independent. Provide preschoolers with a chance to try new foods.
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Get creative in the kitchen. Make some fun faces on sandwiches that are cut in circles. Or, let
the children help in making their own pizzas by using simple ingredients such as rolled out
canned biscuits, tomato sauce, and grated cheese. Have some vegetables and prepared sausage
ready for them to add to their pizza.
Section 5: Special Medical Conditions: Food Allergies and Intolerances
SLIDE # 13: Some children have special conditions, such as allergies. They may complain that they can’t
breathe very well or don’t feel like going outside or doing activities. Allergies don’t just affect the nose
or eyes or skin, but they can affect different parts of the body. Try to keep the children as free from
stress as possible since stress increases the allergy’s effects and makes the child feel worse. Be aware
that some allergies can be life-threatening.
SLIDE # 14: People often are curious if their child has food allergies or food intolerances. Are they the
same thing? Let’s take a look.
A food allergy occurs when a food is eaten and body’s defense or immune system mistakes the food,
which is usually a protein, as harmful. This reaction causes the body’s own antibodies to fight the
offending food. An allergic reaction affects the immune system.
Food intolerance is a digestive system, rather than an immune system, response. Food irritates the
digestive system so person can’t properly digest the food.
Some problems that may occur if there are allergies from different foods include:
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The child has aversions to certain foods and rejects foods for no reason that you are aware of.
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The child has a highly restrictive meal plan where the child is essentially eating the same foods
all of the time, and it’s boring.
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Forbidden foods can be used by the child to manipulate parents or care givers.
Some foods cause sensitivities or intolerances.
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Lactose intolerance is due to the lack of lactase, which is an enzyme in the small intestine that is
needed to digest lactose.
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MSG, or monosodium glutamate, is often used in Asian food and can cause some allergic types
of reactions, such as flushing face, lightheadedness, headache, and other symptoms.
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Gluten is harmful to those who have Celiac Disease, and it damages the small intestine when
they eat wheat products containing gluten.
SLIDE # 15: Gluten is present in the proteins in wheat and grains. Examples of gluten products include:
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Durum, semolina, spelt, kamut (kah-MOOT), einkorn, and faro, and
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Rye, barley, and triticale.
Gluten is harmful to people with Celiac Disease, and it must be removed from all foods for children
with this disease.
SLIDE # 16: Dietary management guidelines for children with allergies or intolerances include:
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Avoid feeding the problem foods.
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Follow the physician’s or dietitian’s order that is provided through parents.
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Parents should provide the care giver with a listing of the foods that are allowed or to be
omitted.
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If the child is subject to life-threatening reactions, the care giver should obtain authorization
from the physician, via the parents, to administer the appropriate medications.
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Read food labels to see that foods are free from allergens or food intolerances.
SLIDE # 17: The Food and Drug Administration’s Food Allergen Labeling and Consumer Protection Act
of 2004 requires that the label of a food product that is or contains an ingredient that bears or contains
a “major food allergen” declare the presence of the allergen.
A “major food allergen” is one of eight common foods or food groups, and includes: milk, egg, fish,
crustacean shellfish, tree nuts, wheat, peanuts, and soybeans. Or it can be a food ingredient that
contains protein that is derived from one of those foods.
Other food ingredients that contain protein from these foods must also be declared on the label and
include: beef; pork; chicken; corn; rice; legumes, which are dried peas and beans; oranges; chocolate;
celery; mustard; grains of sesame; and sulfites.
SLIDE # 18: On this slide, you see the different options that can be used with the food allergen labeling
law. Food manufacturers have to label food products that contain an ingredient that is or contains
protein from a major food allergen in one of two ways. The ingredients you see in bold are the ones
that can cause food allergies.
Option 1 shows the food source in parentheses, following the common or usual name of the major
food allergen in the list of ingredients in instances when the name of the food source of the major
allergen does not appear elsewhere in the ingredient statement.
Option 2 uses the word “Contains,” followed by the name of the food source from which the major
food allergen comes, just after or next to the list of ingredients. It is in a type size that is no smaller
than the type size used for the list of ingredients.
Section 6: Special Medical Conditions: Hyperactivity or Food Sensitivity
SLIDE # 19: Some questions need to be addressed regarding hyperactivity and food sensitivity.
Is hyperactivity caused by food additives, such as salicylates? Or is it a behavioral problem in children?
Hyperactivity isn’t a contagious health problem. It’s considered a behavioral problem, and hyperactive
children may at times try to manipulate their parents and/or care givers.
SLIDE # 20: Hyperactivity isn’t linked to food additives.
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A physician, Dr. Feingold, MD, in California, proposed that food additives, such as salicylates,
cause hyperactivity in children.
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Salicylates are common in foods such as candy, pies, soft drinks, and sweet rolls. Eliminating
these foods and replacing them with better nutritional foods contributes to the overall
nutritional status of the child and can contribute to better behavior.
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The evidence that was shown was only from testimonials of parents who claimed that removing
all salicylates from their children’s meal plans solved the problem.
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However, research finds that there is no evidence to support the claim that these food
additives cause hyperactivity in children. (http://www.nncc.org/Nutrition/hyper.html)
SLIDE # 21: Is there a special dietary plan for hyperactivity? No, you should plan a meal based on the
2010 USDA Dietary Guidelines for Americans’ Food Guidance System recommendations for preschool
children. Here are some other tips to follow:
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Avoid making a “big deal” over the child with this condition.
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Replace sugars, desserts, and less nutrient-filled foods with more vegetables, fruits, and whole
grain breads and cereals that will contribute to better health and possibly better behavior by
the child.
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Enlist a buddy.
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Encourage exercise.
Section 7: Special Medical Conditions: Anemia and Iron Deficiency
SLIDE # 22: Exactly what is the cause of anemia and iron deficiency in children?
In anemia, oxygen, which is carried by the hemoglobin in red blood cells, is low.
This is may be one of the most common nutritional problems affecting children aged 12-36 months,
teenage boys, and women of childbearing age.
Anemia is common in all children, but it’s more prevalent in children from poorer families.
The symptoms in infants are that they appear to be:
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fearful of new people and noises;
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tense;
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unresponsive to those examining them, such as doctors or nurses; and
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unhappy much of the time.
SLIDE # 23: Symptoms of iron-deficiency anemia in older children include:
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a shortened attention span;
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irritability;
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fatigue;
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inability to concentrate;
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poor performance on vocabulary, reading, math, problem-solving and psychological tests; and
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lowered resistance to infection.
SLIDE # 24: One of the best solutions to iron deficiency anemia is to provide a dietary plan in which
iron-rich foods are provided. Let’s take a look at some of the better sources of iron-rich foods.
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Muscle meats, such as beef, pork, lamb, and poultry, are the best sources for iron. Organ meats
and shellfish are, too, but they’re rarely eaten by very young children.
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Nuts, green vegetables, whole grains, egg yolks, enriched bread and fortified cereals, and dried
fruits are good sources of iron.
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If you serve meat or other animal foods that contain the most absorbable form of iron with less
absorbable iron sources, such as whole grains and dried peas and beans, the combination will
provide better absorption of iron in the foods.
Milk products, eggs, and tea hinder the absorption of less absorbable iron.
Vitamin C increases the absorption of iron, so serving orange juice with meal or snack would help with
the absorption of iron.
Eggs are high in iron. In the past, eggs were used in milkshakes to help with iron deficiency. Today,
however, no raw eggs can be used in formula or milk shakes as they can cause foodborne illness.
Section 8: Special Medical Conditions: Choking on Foods
SLIDE # 25: When you read the statistic that every 5 days, a child dies from choking on food, you realize
the need to prevent this danger when feeding small children. Why is this often a problem in this age
group? First of all, young children lack chewing skills. Foods that are sticky or are big and round can
block the air passages.
Some common foods that causing choking are: hot dogs, nuts, hard candies, grapes, apple pieces,
peanut butter sandwiches, cookies, carrots, popcorn, peanut butter, and pineapple chunks.
SLIDE # 26: Dietary management of choking involves following these simple procedures.
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Supervision during meal times allows you to observe and interact with the children to help
prevent this problem.
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Keep a calm atmosphere during meal times. Too much talking or even crying can lead to the
problem.
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Encourage chewing all foods well.
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Infants should be fed solids only when they’re sitting up.
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Serve appropriate foods, and avoid problem foods that are too sticky or are big and round.
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Children under 4 should not eat the foods we mentioned previously. If you serve grapes, for
example, cut them up in halves or quarters so they can be easily chewed and swallowed.
Section 9: Special Medical Conditions: Diabetes
SLIDE # 27: Diabetes mellitus (MEL'-lae-tus) is a disease of carbohydrate metabolism. That’s why a
person with this disease needs a constant amount of carbohydrates during the day. Diabetes isn’t
contagious.
Some children with special food needs, including diabetes, may use their disease to manipulate their
parents and/or care givers.
When the child with diabetes is accepted into a child care setting, the parents should provide the care
giver with the child’s diabetes dietary instructions from their physician and/or dietitian. It will serve as
a reference to the foods and amounts the child needs throughout the day and self-care instructions,
such as activities and medications.
The meal and snack plan should replace too many sugars, desserts, and less nutrient-filled foods with
more vegetables, fruits, and whole grain breads and cereals.
SLIDE # 28: In diabetes management, it’s very important for you to know which foods have either
MORE or LESS impact on blood glucose levels since diabetes is a disease of carbohydrate metabolism.
In the treatment of diabetes, keeping blood glucose levels constant is the goal.
The food groups with more carbohydrates have more of an impact on blood glucose levels increasing
in the body. They are:
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starchy foods, such as breads, cereals, pasta, rice, and starchy vegetables;
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fruits;
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milk, yogurt, and dairy-like foods; and
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sweets, desserts, and other carbohydrates.
Food groups with less carbohydrates have less of an impact on blood glucose levels increasing in the
body. They are:
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nonstarchy vegetables with a higher fiber content,
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meats, and
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fats.
SLIDE # 29: Some guidelines for those who care for children with diabetes include:
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Ask for training opportunities in diabetes education, such as having a dietitian or nurse speak to
you about nutrition and self-care tips.
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Treat all the children the same, and avoid making a “big deal” over the child with diabetes or
any other disease.
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Be matter-of-fact in your meal service, and serve meals with an enjoyable substitute that won’t
cause blood glucose levels to increase more. For example, serve fresh fruit instead of a candy
bar.
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Enlist a buddy for the child with diabetes. If the child with diabetes should have a crisis, the
buddy can get help and alert you of the possible problem.
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If necessary and advised by the health professional via the parents’ instructions, help with
blood glucose testing and/or insulin injections.
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Encourage exercise on a daily basis for all the children.
Section 8: Special Medical Conditions: Developmentally Disabled
SLIDE # 30: What does developmentally delayed or disabled mean? Developmentally delayed children
may have one of these conditions: Cerebral palsy, Cleft palate, Down’s syndrome, Epilepsy, Prader-Willi
syndrome, or Spina bifida. These neural tube defects are disorders that arise early in the development
of the fetus. These defects can cause serious lifelong complications, including death and paralysis,
among other things.
Do these children require special nutritional guidelines? Yes, nutritional guidelines for developmentally
disabled include the following:
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Does the child need to eat more or fewer calories? Were you given instructions from the child’s
health care providers, via the parents?
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Have you been told that certain foods react with medications the child is taking? Are you
avoiding serving these foods to this child?
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Have you noticed if the child has a hard time eating or feeding?
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Does the child lack the coordination that prevents feeding?
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Does the child have extreme sensitivities to hot or cold foods?
SLIDE # 31: While the child who is developmentally disabled is in your care, you’ll want to follow these
guidelines:
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Watch and help the child develop self-feeding skills.
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If the food is too dry and hard for the child to chew and swallow, add some liquids to the
chopped or ground meat or vegetables.
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When necessary, some children have to obtain their meals in a more liquid form, such as
pureed.
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Some who are unable to walk, run, or have a lack of mobility at all may have problems with
constipation. Including stewed fruits, such as apricots, prunes, and apples; prune juice; whole
grain cooked cereals; and stewed vegetables will help in preventing constipation.
•
If weight gain is a problem, cut down on fats, sugars, desserts, and serving sizes.
Section 11: Summary
SLIDE # 32: In summary, child care providers should ensure that all parents of children with special
conditions provide them with:
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dietary and self-care instructions;
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special dietary requests;
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a listing of allowed meals and snacks for the treatment of their child’s condition;
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any special feedings or medications that they must be given; and
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utilize reliable resources in your child care setting.
Section 12: References & Additional Resources
To learn more about the topics we discussed today, visit the websites below.
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Academy of Nutrition and Dietetics (ANAD), Nutrition Care Manual,
http://nutritioncaremanual.org/
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Child Care & After-School Programs, CSREES-USDA, 2012,
http://www.nifa.usda.gov/childcareafterschoolprograms.cfm
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ChooseMyPlate.gov, US Departments of Agriculture & Health/Human Services, 2011,
http://www.choosemyplate.gov/
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Daily Food Plan for Preschoolers, http://www.choosemyplate.gov/health-nutrition-informationpreschoolers/daily-food-plan-preschoolers.html
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Dietary Guidelines for Americans, US Departments of Agriculture & Health/Human Services,
2010, http://www.choosemyplate.gov/dietary-guidelines.html
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Dietary Reference Intakes (DRI), Institute of Medicine (IOM), 2011,
http://www.iom.edu/Reports.aspx?Series={508F5CFF-EE88-4FF6-92BF-D6CAB46F52E}&page=1
•
Health and Nutrition Information for Preschoolers,
http://www.choosemyplate.gov/preschoolers.html
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Meal and Snack Patterns and Ideas for Preschoolers,
http://www.choosemyplate.gov/preschoolers/meal-and-snack-patterns-ideas.html
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Meals without Squeals, Child Care Feeding Guide and Cookbook, 3rd Ed., C. Berman,RD & Jackie
Fromer, Bull Publishing Co., Palo Alto, CA, ISBN 978-1-933503-00-4.
http://healthymeals.nal.usda.gov/schoolmeals/Resource_Cafe/Resource_Details.php?ID=1247
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Nutrients at a Glance, E589, 589S (Spanish), Texas AgriLife Extension Service, The Texas A&M
System, Revised, 2011,
https://agrilifebookstore.org/publications_details.cfm?whichpublication=498 (English) and
https://agrilifebookstore.org/publications_details.cfm?whichpublication=1492 (Spanish)
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Nutrition Facts Label, US Food and Drug Administration (FDA), 2011,
http://www.fda.gov/Food/LabelingNutrition/ConsumerInformation/default.htm
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Providers > Providing Care for Children with Special Needs, ChildCare.gov, U.S. Government
Web Portal, 2012, http://www.childcare.gov/xhtml/links/g_3/t_33.html
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USDA Daily Food Plan for Preschoolers, 2012, http://www.choosemyplate.gov/health-nutritioninformation-preschoolers/daily-food-plan-preschoolers.html
This module was authored by:
Mary "Mickey" Kinney Bielamowicz, PhD, MS, RD, LD, CFCS
Regents Fellow
Professor and Nutrition Specialist
Texas AgriLife Extension Service
The Texas A&M System
Educational programs of the Texas AgriLife Extension Service are open to all people without regard to race, color, sex, disability, religion, age, or national origin.
The Texas A&M University System, U.S. Department of Agriculture, and the County Commissioners Courts of Texas Cooperating