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Healthy
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Foods Brought From Home
Three-year-old Sam will eat only a peanut butter and raisin sandwich made with English muffins and he will only eat the sandwich his mom makes even if the same foods are made in his preschool program. While Sam loves the sandwich his mom makes, bringing food into the childcare setting might not be the best for Sam or his playmates.
Food-borne illness can result from food that is not stored properly or prepared correctly. One way to ensure that foods are safe and nutritious is to prepare all foods on site. However, if children are allowed to bring food from home, a written policy should be developed and provided to parents.
Caring for Our Children; National Health and Safety Performance Standards; Guidelines for Out-of-Home Child Care Programs has a clear policy on foods from home. The Standards state that meals provided by the parent/guardian require a written agreement between the parents and staff and that foods are not shared with other children. In developing your own "foods from home" policy, you should include (at a minimum) the following:
- Foods are not shared among children but eaten only by the child who brings them.
- Foods or lunches are clearly marked with the child's name, date and type of food.
- Foods are properly stored (refrigerated if necessary).
- Foods are served correctly at the appropriate temperatures-and with hand washing.
It is important that children be provided nutritious foods in sufficient quantities. The childcare program director should inform parents/caregivers of these nutritional requirements and suggest ways to meet them if food is prepared at home for children. Caregivers should also be aware of each child's nutritional needs. The center should have food available for a child if the food from home does not meet the child's nutritional requirements.
If staff is concerned that foods brought from home are nutritionally inadequate, or are unsafe (prepared or stored incorrectly), then a staff person should discuss the concerns with the parent. The parent may be unaware of the importance of child nutrition, or may not have access to or money for appropriate foods. When discussing childcare issues such as these, staff should be sensitive to the parent's feelings, and make every effort to encourage and support the parent.
The National Health and Safety Performance Standards recommend that if the food provided by a parent consistently fails to meet food safety or nutritional requirements, staff should refer the family for a nutritional consultation by a nutritional specialist or by the child's primary health care provider. The program director is responsible for assuring that such referrals are made in a respectful manner, and to the appropriate resource.
Special Occasions
When special occasions such as birthdays or holidays are celebrated, parents may want to bring a treat into the classroom. Suggest that parents arrange to have the foods prepared by a store or restaurant approved and inspected by the local health authority. Institutional outbreaks of gastrointestinal illnesses have been linked to improperly prepared homemade foods.
Bottles From Home
Infants who are bottle fed do require foods that their parents have prepared. Ask parents to label each bottle with the child's name and date and only use bottles labeled for that date. Unlabeled bottles should not be accepted; if they are accidentally accepted, they should not be used. This assures that the child receives the correct bottle.
If an infant is using a formula, keep a record of the type of formula. If you keep extra formula on hand and anticipate providing formula to an infant, get a written release from the parent allowing you to do so.
When preparing bottles for infants, use the following recommended procedures:
Bottles that have been frozen should not warm at room temperature for long periods of time as bacteria can develop. Thaw bottles of frozen expressed breast milk in the refrigerator or under cold water.
Microwaves should never be used for thawing or warming. Microwaves often heat the liquid unevenly and create hot spots that could burn an infant's mouth. Refrigerated bottles should be taken to a kitchen or other area away from children and heated in a pan of hot (not boiling) for five minutes. Always shake the bottle after heating to prevent hot spots and then check the temperature on the back of your hand.
If a child mistakenly receives the wrong bottle, immediately check the contents and contact the parents to be sure the child is not allergic or sensitive to the milk or formula.
If a bottle of breast milk mistakenly is given to the wrong child, it should be treated as a possible HIV exposure. The parents should be informed that their child was accidentally given another child's bottle of expressed milk and that while the risk of contamination is very small, the child's physician should be notified and a baseline test for HIV should be given. The mother of the child who supplied the expressed milk should be asked whether she has ever had an HIV test. If she has not or does not remember the date of the last HIV test, ask if she would be willing to be tested or contact her physician to see if HIV test results can be shared in confidence. If the mother is HIV positive, she may not want to disclose this information. The mother should also be asked when the milk was expressed and how it was handled before arriving at the center.
The physician of the exposed child should be provided information on the exposure, when the milk was expressed and how it was handled in the childcare facility.
Childcare providers have very little risk of being exposed to HIV through contact with breast milk. Risk of skin or mucous exposure to HIV is very low and staff does not need to wear gloves when feeding children bottles of expressed milk. If breast milk is spilled on the skin, the area should be thoroughly washed with soap and water.
Clear policies on bringing foods from home into the childcare setting can help staff and parents know how to best meet the nutritional and food safety needs of the children. Foods from home might be comfort food for some children but for safety's sake, duplicating these comfort foods in the childcare setting keeps safety as a top priority.
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