The Academy Position Paper- Benchmarks for Nutrition in Child Care

NFS 2000- The Professional Issues in Dietetics

Maryam Akhdar
March 12, 2018
 It is the position of the American Dietetic Association that child care programs should

achieve recommended benchmarks for meeting children’s nutrition needs in a safe, sanitary,

and supportive environment that promotes optimal growth and development. This position is

in effect until December 31, 2015. The authors are Sara E. Benjamin Neelon, PhD, MPH, RD

(Duke University Medical Center, Durham, NC) and Margaret E. Briley, PhD, RD, LD (The

University of Texas at Austin, Austin, TX).

Approximately three quarters of children aged 3 to 6 years in the United States spend

time in a child care (1), and more than three quarters are cared for by a family, friend, or

neighbor. The number of children attending child cares continues to increase yearly and it is

necessary to promote healthful eating in all these facilities to make sure that children are

getting proper nutrition and learning healthy eating habits. Children that attend child care

consume most of their snacks and meals at the child care since they typically spend most of the

day there. These children are influenced by the environment surrounding them and will pick up

food habits acquired in the child care. It is very important to promote healthful eating and to

achieve the recommended benchmarks for nutrition in child care programs to help prevent

health problems and the development of chronic diseases.

The foods and beverages served in child care programs should follow dietary guidelines

including the DRI and DGA. A proportional share of daily nutrient requirements should be

provided through the snacks and meals offered to the children. Children in part-time programs

should receive at least one third of the daily nutrient requirements at the child care, and those

in full-time programs should receive at least one half to two thirds of daily nutrient

requirements at the child care through the foods and beverages provided (2). Meals and snacks
should be offered to children every 2 to 3 hours in child care programs (3). A Variety of

nutritional foods including whole grains, vegetables, fruits and low fat dairy products should be

offered to children daily. The DGA recommends that children consume five or more servings of

fruits and vegetables, especially dark-green and yellow vegetables and citrus fruits every day

(4). The fruits and vegetables served should have sufficient amounts of vitamins A and C.

Serving the fruits and vegetables raw rather than cooked helps increase the amount of dietary

fiber, minimize fat and sodium in the diet, and avoid the loss of nutrients through cooking. Juice

given to children should be limited to less than 4 to 6 oz/day because children are most likely

consuming juice at home. Less fiber and fewer nutrients is provided in juice and excessive juice

consumption may contribute to the development of obesity (5,6). Furthermore, at least six

servings of a combination of breads, cereals, and legumes should be given daily, and at least

half of all grains consumed should be whole grains to provide adequate amounts of dietary

fiber. Dairy products given to children should be low-fat or fat-free and the DGA recommends

an average of 2 cups daily since dairy is an important source of calcium and vitamin D. Foods

and beverages high in sugar, energy and sodium should be limited as these foods are related to

obesity, diabetes and other health problems. Child-care programs are an important setting for

the promotion of healthful eating and the prevention of obesity (7,8).

Child care programs should provide menus that reflect actual foods and beverages served

to help keep families informed about meal patterns and foods and beverages provided. This will

help the parents to identify healthy choices and know when and what they should be feeding

their children. It is also very important that foods and beverages served in child care is stored,

prepared, and presented in a safe and sanitary manner. This will help prevent foodborne illness
and will ensure the health and safety of children in child care. Furthermore, children should be

taught how to properly wash their hands before and after eating and why it is necessary.

In addition, nutrition education should be incorporated into the daily routines of the

children. They should develop a basic understanding of the origin of food through books,

posters, hands-on experiences, and conversations with providers. Also, physical activity is an

important part of quality child care and children should accumulate 60 minutes of physical

activity daily (4). Regular physical activity promotes a healthy weight, enhances motor skills,

and improves cardiovascular function (9,10). It is also important to work with families to ensure

that foods and beverages brought home meet nutritional guidelines.

These benchmarks can all be achieved through interventions, policy and regulation. There

are several programs aimed to help children meet nutritional guidelines and teach them to stay

healthy. Also, states are able to pass laws to help with the problems faced regarding nutrition in

children.

RDN’s have a big part in helping ensure that these benchmarks for nutrition in child care

are met. Their role is to provide consultation to the programs and encourage families to

become active in their child care nutrition programs. They are to provide assessment of

children’s nutritional status, assist with menu planning, train foodservice personnel and provide

nutrition education to providers. Furthermore, registered dietitians have a job of review the

scientific literature, guidelines for federal nutrition assistance programs, state regulations for

child care, dietary guidelines, and nutrition-education resources regularly to offer providers
timely and current information. Also, they have a role in participating in research to help

provide the best practices for nutrition in child-care programs.

I agree with the position of the American Dietetic Association. It should be mandatory to

achieve the recommended benchmarks for nutrition in child care programs and make sure that

they acquire healthy eating habits. Teaching them to eat healthy and how to choose the right

foods at a young age will help ensure that they develop healthy habits and promote optimal

health and wellbeing. Child care is increasing and is now the norm for the majority of families in

the United States (1); therefore, it is essential that RDN’s work with child care providers and

families to provide them with models of healthful eating and active lifestyles. Young children

are very likely to be influenced by adults in an eating environment, so providing them with

proper nutrition education and role models will have a positive influence on them (11). Also,

food habits and patterns of nutrient intake acquired during childhood usually continue into

adolescence and adulthood, so having children acquire healthy eating habits at a young age will

help make sure that they continue that way (12,13). Meeting children’s nutrition needs and

providing a safe and pleasant environment is necessary to promote healthful eating and obtain

optimal growth and development. Furthermore, child care programs are an important setting

for the promotion of healthful eating and the prevention of obesity (7,8). One study linked part-

time child care with a decreased risk of obesity later in childhood compared to children cared

for at home (14). The information, facts and statistics presented in this position paper make it

clear that child care programs should achieve recommended benchmarks for meeting children’s

nutrition needs in a safe, sanitary, and supportive environment that promotes optimal growth

and development.
 Reference Page

Reference of position paper

Benjamin Neelon S, Briley M. Position of the American Dietetic Association: Benchmarks for

Nutrition in Child Care. Available at: https://www.eatrightpro.org/practice/position-and-

practice-papers/position-papers/academy-position-papers-by-subject. Accessed March

2018.

(1) Federal Interagency Forum on Child and Family Statistics. America’s children: Key National

Indicators of Well-Being. Washington, DC: US Government Printing Office; 2002.

(2) Legislation and regulations: Head Start program performance standards (45 CFR part 1304).

Administration for Children and Families Web site. http://www.acf.hhs.gov/

programs/ohs/legislation/index.html. Accessed May 27, 2010.

(3) American Academy of Pediatrics, American Public Health Association, National Resource

Center for Health and Safety in Child Care and Early Education. Preventing Childhood

Obesity in Early Care and Education: Selected Nutrition and Physical Activity Standards

from the Third Edition of Caring for Our Children. Aurora, CO: National Resource Center

for Health and Safety in Child Care and Early Education; 2010.

(4) Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for

Americans, 2010. http://www.cnpp.usda.gov/ DGAs2010-DGACReport.htm. Accessed

September 29, 2010.

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