Policy Memo 162

DOH-CACFP: Number 162 (02/12)

TO: CACFP Sponsoring Organizations of Day Care Homes

FROM: Lois Hazelton, Director, Centers Administration Unit, Child and Adult Care Food Program

SUBJECT: Fluid Milk and Milk Substitutes, Questions and Answers

I. Purpose and Scope

CACFP issued Policy Memo DOH-CACFP Number 161 (07/11), Nutrition Requirements of the Healthy, Hunger-Free Kids Act of 2010 (the Act) in July 2011, which explained new requirements for fluid milk, milk substitutes, and water availability that went into effect October 1, 2011. The purpose of this memorandum is to clarify guidance on the implementation of the requirements to serve 1% (low-fat) or skim (non-fat) milk to children 2 years of age and older and adults in care.

II. Questions and Answers

  1. Compliance
    1. Parents or guardians may request in writing non-dairy substitutes without providing a medical statement. If a parent or guardian provides a non-dairy substitute that does not meet the USDA's nutritional standards, can the caregiver serve it and still receive reimbursement?
      No. Caregivers should inform the parent or guardian about the types of creditable, non-dairy milk substitutes. If a product supplied by the parent or guardian does not meet USDA nutrition standards outlined in Attachment 2, then the meal is not reimbursable.
    2. When submitting menus for review, do caregivers need to document the type of milk that they serve?
      No. Caregivers are not required to document the type of milk served on their menus. However, the State or Sponsor, as applicable, will check that the correct type of milk is being served when conducting monitoring reviews.
    3. What happens if a caregiver is observed serving reduced-fat (2%) or whole milk at a monitoring visit?
      Effective October 1, 2011, meals served, to participants two years of age and older and adults, that include reduced-fat (2%) or whole milk are not reimbursable. When the State or Sponsor observes any non-reimbursable meal, it must be disallowed. In addition, the caregiver would need to submit a corrective action plan, which will be followed-up by the State or Sponsor.

  2. Child Participants
    1. What type of milk should one-year old children be served?
      The milk requirements for children one year of age remain unchanged at this time. It is recommended that children 12- through 23-months of age be served unflavored whole milk only.
    2. Can a parent request that their infant over 12 months of age continue to be fed breastmilk?
      Yes. Mothers who wish to continue providing breastmilk for their babies over 12 months of age can do so without having to submit a medical statement. Breastmilk is a substitute for cow's milk in the meal pattern for children.
    3. Can a parent request that their infant over 12 months of age continue to receive infant formula?
      A transition time of one month (from the date the infant turns 12 months to 13 months) is permitted when a parent requests the continued feeding of infant formula. However, if the parent requests the infant formula be served beyond the age of 13 months, a medical statement is required.
    4. If one-year-old and two-year-old children sit together for the same meal, must they be served different types of milk?
      Yes. Caregivers must ensure that children of various ages seated at the same meal receive the appropriate type of milk.
    5. Where can I get more information about the nutritional differences between fat-free (skim), low-fat (1%), reduced-fat (2%) and whole milk?
      The CACFP Sponsor's Association (TSA) developed a flyer, which describes the nutritional differences between the types of cow's milk and the reasons for limiting fat. The flyer, called Milk…Part of a Healthy Diet, is available to order from TSA's website www.cacfp.org and is an allowable cost.

III. Summary of Changes

The purpose of this memo is to clarify the milk requirements of the Healthy, Hunger-Free Kids Act of 2010. The Act requires fat-free (skim) or low-fat (1%) fluid milk be served to children two years of age and older and adults participating in CACFP. Sponsors were required to implement these provisions and be in full compliance by October 1, 2011. Meals that do not meet the requirements specified above must be disallowed beginning October 1, 2011.