Healthy Bodies:
Promoting Good Nutrition and
Physical Activity in Child Care
The National Training Institute for Child Care Health Consultants, 2012
1
 Name
 Agency
 Date
The National Training Institute for Child Care Health Consultants, 2012
4/13/2015
2
One Healthy Change
Icebreaker
Please share
 Your name,
 Your agency, and
 One change you have made to
your nutrition and physical
activity habits to improve
your health.
The National Training Institute for Child Care Health Consultants, 2012
4/13/2015
3
Training Objectives
 Understand the nutritional needs of
infants, toddlers, and preschoolers.
 Know how to store, prepare, and serve
food safely.
 Consider ways to encourage healthy
eating habits for yourself and others.
 Promote physical activity within
the child care setting.
The National Training Institute for Child Care Health Consultants, 2012
4/13/2015
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“Nourishing and attractive food is
the cornerstone for health, growth,
and development as well as
developmentally appropriate
learning experiences” (p. 152,
Caring for Our Children, 3rd
edition, 2011.).4.2.0.1
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Nutrition in Child Care
1. The food served must be safe.
2. The food served must meet
children’s nutritional needs.
3. The nutrition program must
promote a healthy eating
environment.
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Physical Activity in Child Care
 Kids need to move!
 Active play helps children develop
gross motor skills and self-confidence
and maintain a healthy weight.
 An estimated 20% of children 2 – 5
years old are overweight or
obese (Ogden et al., 2010).
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The Nutrition Plan






Kitchen layout;
Food budget;
Food procurement and storage;
Menu and meal planning;
Food preparation and service;
Kitchen and meal service staffing;
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The Nutrition Plan
(Continued)
 Nutrition education for children,
staff, and parents/guardians;
 Emergency preparedness for
nutrition services;
 Food brought from home including
food brought for celebrations;
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The Nutrition Plan
(continued)
 Age-appropriate portion sizes of
foods to meet nutritional needs;
 Age-appropriate eating utensils and
tableware; and
 Promotion of breastfeeding and
provision of community resources
to support mothers.
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Selecting Food
 All food stored, prepared, or served
should be safe for human
consumption by observation and
smell.4.9.0.3
 Foods from dented, rusted, bulging or
leaking cans; and food from cans
without labels should not be
used.4.9.0.3
 Meat must be governmentinspected or approved by the
local health authority.4.9.0.3
The National Training Institute for Child Care Health Consultants, 2012
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Choosing the Right Milk
 Offer pasteurized and Grade A milk
products (preferably fortified with Vitamins
A and D).
 Children ages 12-24 months should be
served whole or 2% milk.
 Children over the age of 2 should be
served 1% or skim milk.4.3.1.7, 4.9.0.3
 Children between the age of 12 and 24
months who are at increased risk for
overweight or obesity may receive
reduced fat milk (2%).4.3.1.7, 4.9.0.3
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Foods High-Risk for Choking for
Children Under Age 4
hot dogs (whole
•
chips
or sliced into rounds)
•
peanuts
•
raw carrot rounds
•
popcorn
•
whole grapes
•
rice cakes
•
hard candy
•
marshmallows
•
nuts and seeds
•
spoonfuls of peanut butter
•
raw peas
•
large chunks of meat
•
hard pretzels
•
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Refrigeration
 Danger Zone is between 40° F
and 140° F.
 Refrigerators should maintain
temperatures below 40°F.
 Freezers should stay below
0°F.
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Refrigerator Storage
 Foods should be covered or wrapped
tightly to avoid contamination.4.9.0.5
 Meat, poultry, fish, eggs, dairy products,
and foods containing these should be
stored in the coldest part of the
refrigerator.
 Raw foods should be stored below
cooked or ready-to-eat foods.4.9.0.5
 All foods should be labeled and dated,
and remain refrigerated until
immediately before use.4.3.1.5, 4.9.0.3
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Thawing Foods
Defrost foods by:
 placing them in the refrigerator,
 putting them under cold running water,
 cooking them, or
 using the defrost setting of the microwave
oven.4.9.0.3
Frozen human milk should be thawed
under cold running tap water or in
the refrigerator.4.3.1.3, 4.3.1.9
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Cooking Temperatures
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Cooling and Reheating
 Hot food should be quick-cooled in shallow
containers in an ice bath and stirred frequently
before refrigeration.4.9.0.5
 Cooked foods stored in the refrigerator should
be served within 24 hours.4.9.0.4
 Open containers of ready-to-feed or
concentrated formula should be covered,
refrigerated, labeled with date and child’s full
name, and discarded at 48 hours if not
used.4.3.1.5
 Leftovers should be reheated and used
only once. (Human milk, formula and
infant food should not be reheated.)
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Warming Formula or
Human Milk
 Put bottles in a pan of hot (not
boiling) water for 5 minutes or until it
reaches the desired temperature.
 Do not overheat!
 Do not microwave!
 Test temperature before giving
to infant.4.3.1.3, 4.3.1.5
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Clean-Up and Leftovers
 Avoid plastics containing Bisphenol
A (BPA) or phthalates (those
labeled with #3, #6, or #7).4.3.1.3
 After meals and snacks, any
leftover food that has already been
served should be discarded.4.3.1.12,
4.9.0.4
 “When in doubt, throw it out!”
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Storing Dry Foods
 Store dry foods at least 6 inches
above the floor in containers that
have tight-fitting lids and no
holes.4.9.0.6, 4.9.0.7
 Store food away from cleaning
supplies and pesticides.
 Maximum storage time for
canned food is one year.
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Food Brought from Home
 Foods from home should be clearly
labeled with the child's full name,
the date, and the contents, and be
stored properly.4.6.0.1
 Food from home must still meet
the nutritional needs of the
children. Use the program’s
menu as a guide. 4.2.0.9, 4.6.0.2
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Food Safety Quiz
 Divide into teams.
 Choose a group leader.
 Ring the buzzer/bell if your team
knows the answer.
 Let’s play!
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Dietary Trends
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Nutrition and Growth
 Most infants increase body length by
55%, head circumference by 40%, and
triple their birth weight by age one.
 During the preschool years (3-6), the
rate of physical growth slows and
stabilizes to a fairly constant rate.
 Monitor growth with Body Mass
Index (BMI).
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Nutritional Needs of Infants
 The AAP strongly recommends breastfeeding as
the preferred feeding for all infants (AAP, 2005).
 Iron-fortified infant formulas are the most
appropriate substitutes for healthy, full-term
infants until 12 months of age (AAP, 2005).
 The nutrient content of human milk and infant
formula meet all the nutritional needs of an
infant from birth until about 6 months of age.
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Supporting
Breastfeeding Mothers
 Providing a breastfeeding-friendly
environment, welcoming mothers to nurse
their babies at the facility
 Displaying posters and brochures that
support breastfeeding and show best
practices
 Teaching clients to properly store
and label their milk for child care
facility use
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Supporting Breastfeeding
Mothers (continued)
 Contacting and coordinating with local
skilled breastfeeding support and actively
referring
 Continually updating facility information
and learn about breastfeeding support
 Training all staff to handle and feed
human milk properly
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Storing Human Milk
 Expressed human milk should be placed
in a clean and sanitary bottle with a nipple
that fits tightly.
 Bottle should be properly labeled with the
infant’s full name and the date and time
the milk was expressed.
 Bottle should immediately be stored in
the refrigerator on arrival.4.3.1.3
 Caregiver/teacher should always
hold the infant during feeding.4.3.1.8
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Infant Formula
 CACFP Meal Pattern and the AAP
recommend only iron-fortified infant
formula for infants up to 12 months of
age.
 Child care facilities must offer at least one
type of infant formula; formula should be
factory-sealed and mixed according to
the manufacturer’s instructions.4.3.1.5
 Infants should be fed whenever
they are hungry.4.3.1.2
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Fruit Juice
 NO fruit juice should be offered in the first
twelve months of life.4.2.0.7
 Children ages 1-6 years should consume
no more than 4 to 6 ounces of 100%
pasteurized fruit juice per day.4.2.0.7
 Juice should be offered in a cup, rather
than a bottle.
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Solid Foods for Infants
 Solid foods can be introduced after 6
months of age.
 Offer new foods slowly - one new food
at a time at least one week apart.
 Around 8-10 months, allow finger
feeding (supports development of
eye-hand skills and
coordination).4.5.0.10
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Nutritional Needs of
Toddlers/Preschoolers
 Adequate calories for energy for
active play
 Plenty of fluids, preferably water
(before, during, and after play)
 Opportunities to eat more
frequently (with small portions
and additional servings)4.3.2.2
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Meals and Snacks for
Toddlers/Preschoolers
Hours
in Care
# of Meals / Snacks
8 hours
1 meal /2 snacks
OR
2 meals/ 1 snack
9 or
more
hours
2 meals/2 snacks
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Acceptance of
New Foods
 Children at this age may:

eat more at one time than another,

like a food one day, but not the next, and

resist trying new foods.
 Acceptance of new foods may
require 8 to 10 exposures.
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Meeting Nutrition
Requirements
 Toddlers need about 1,000-1,400
calories a day (USDA and USDHHS,
2010).
 Resources:

CACFP Requirements for
Children Ages 1 through 12

Choose My Plate

Dietary Guidelines for
Americans
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Foods to Eat in
Moderation
 Limit sugar in both foods and
beverages.
 For children older than 2, choose
foods low in saturated fat and
cholesterol and
moderate in total
fat.
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Children with
Special Needs (CSN)
 Any special nutrition or feeding requirements
should be obtained in writing.4.2.0.8
 Staff should not administer folk or homemade
remedy medications or supplements without a
prescribing health professional’s order and
complete pharmaceutical labeling.3.6.3.1, 9.2.3.9
 Child care staff should have a rapid
response plan for handling any food
emergencies, such as allergic reactions
or choking.4.2.0.8
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Menu Planning
 Menus should be planned in advance and
under the guidance of the child care
nutritionist/registered dietitian.4.2.0.9, 4.7.0.1
 Menu-Planning Tools




Nutrition and Physical Activity Self-Assessment
for Child Care (NAP SACC)
Let’s Move
I am Moving, I am
Learning
Some state Public
Health Departments
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Benefits of
Menu Planning
 Allows for more variety, so food is less
repetitious
 Facilitates meeting the CACFP meal
pattern requirements
 Takes advantage of seasonal food
bargains
 Facilitates purchase of bulk priced
items
 Saves time at the store by having
an organized shopping list
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Benefits of Menu
Planning (continued)
 Reduces the number of trips to the store
 Facilitates planning food for children with
special needs
 Ensures that infants and children are
served a variety of culturally familiar and
diverse foods 4.5.0.8
 Improves communication with
parents/guardians about what and
when foods are being served
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Snacks
 MyPlate and CACFP guide in selecting
snack foods that have a high nutritional
value.
 Avoid snacks that have a high sugar
content or are sticky.4.2.0.7
 Create and enforce policies about
food brought in for celebrations
and holidays. Encourage nonfood treats.
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Handwashing Mix-Up
 Divide into teams of eight.
 Put the handwashing cards in
the correct order.
 The first team to stand in the
correct order wins!
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Food Allergies
 In 2007, approximately 3 million children
under age 18 years (3.9%) were reported
to have a food or digestive allergy in the
previous 12 months (CDC, 2008).
 Infants and young children are more
susceptible because their digestive and
immune systems are still developing.
 Most children outgrow food
allergies by age four.
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90% of All Food Allergies
 Milk
 Soy
 Eggs
 Wheat
 Peanuts
 Tree Nuts [e.g.,
walnuts, pecans,
hazelnuts, etc.]
 Fish
 Shellfish
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Food Allergy
Symptoms
 Symptoms can occur within minutes or hours.
 Common allergic symptoms include:

itching, hives, rash, vomiting, diarrhea, abdominal
pain, and/or swelling of the lips, tongue, and/or
face.
 Symptoms can gradually increase to include:

light-headedness, shortness of breath,
sneezing, cramping, vomiting, and diarrhea.
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Anaphylactic Shock
 A serious, life-threatening symptom that can
result in loss of consciousness and death.
 Initial symptoms include feeling warm,
flushing, tingling of the mouth, or rashes.
 May require prescription of an EPIPEN®,
EpiPen Jr® Auto-Injectors, or Ana Kit®.
 Staff must know where these
medications are, know how to
administer them, and be prepared
to call 911 immediately.
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Managing Food
Allergies
 Ask parents/guardians to provide
complete information about the allergy,
e.g., foods to avoid, cross-sensitivities,
treatment, and home, work and
emergency numbers.
 Give prior notice of activities involving
the reactive food.
 Notify of any behavioral changes
or symptom occurrence.
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Managing Food Allergies
(continued)
 Discourage food sharing or trading.
 Consider banning certain foods if children
have severe food allergies.
 Inform support or substitute staff of a
child’s food allergies and any special
needs.
 Use proper food handling techniques
to decrease food allergy reactions.
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Physical Environment
 Children should



be seated comfortably around the table,
be provided durable, age-appropriate
furniture,
use age-appropriate eating utensils (plates,
cups, and silverware).4.5.0.1
 Attractive, colorful eating utensils
may be used to make eating more fun.
 Colorful posters or photos about
foods and nutrition may be hung.
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Emotional Environment
 Staff should experiment with the activity
scheduled just before mealtime. Consider
ways to ease the transition.
 Encourage older children to help set and clear
the table.4.5.0.7
 Caregivers/teachers should sit at the table and
eat the meal or snack with the children.4.5.0.4
 Meals served family-style encourage
children to serve themselves and to take
second helpings when they are ready.4.5.0.4
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Emotional Environment
(continued)
 A child who is just learning to feed
himself/herself should be supervised closely by
staff seated adjacent to, or at the same table
with, the child.4.5.0.6
 Meal or snack time should be used as an
opportunity to encourage social interaction and
conversation, especially about food,4.7.0.1 eating
behaviors, and daily events.4.5.0.4
 Extra assistance and time should be provided
for slow eaters.4.5.0.4
 Foods can be used to help teach children
about counting, sorting, measuring,
colors, shapes, textures, temperatures,
odors, and tastes.4.5.0.4, 4.7.0.1
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Emotional Environment
(continued)
 Food should never be used to reward or
punish behavior. 4.5.0.11
 Child care staff should model good table
manners and praise the children for their
manners.
 After clearing and cleaning the table,
children should wash their hands and
brush their teeth.
 Before leaving the table, children
should be informed of the next
activity to make their dismissal
less hectic.
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Nutrition Education
 Encourage children to look at, taste, smell,
and touch different foods while they eat;
 Talk about textures, colors, and shapes of
foods during mealtime;
 Help children understand where foods
come from by planting a garden, or
visiting a garden, farm, or farmer’s
market;
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Nutrition Education
(continued)
 Use nutrition education activities to introduce
new foods;
 Facilitate learning by letting children help
prepare foods;
 Read books related to nutrition or food; and
 Use arts and crafts activities to learn about
nutrition. (Adapted from Holt et al., 2011;
and the National Foodservice
Management Institute, 2009)
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Healthy House Activity
 Take the ingredients you need to
create a healthy house.
 We will view each other’s houses
before eating them.
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Being Physically
Activity Helps Kids





Maintain a healthy weight,
Increase strength and coordination,
Reduce stress,
Build self-confidence, and
Reduce the risk of
heart disease, high
blood pressure, and
Type II diabetes.
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Physical Activity
Recommendations
All children should participate daily in
 two to three occasions of active play
outdoors when the conditions do not pose a
safety or significant health risk;
 two or more structured or
caregiver/teacher/adult-led activities or
games that promote movement over the
course of the day – indoor or outdoor;
and
 continuous opportunities to develop
and practice age-appropriate gross
motor and movement skills.
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Infants Should:
 Have opportunities to explore movement
and the environment in safe settings that
facilitate physical activity and do not
restrict movement for prolonged periods
of time.2.2.0.2
 Be taken outside two to three times per
day, as tolerated.3.1.3.1
 Have supervised awake tummy
time every day.3.1.3.1
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Infant Activity
 Lying on the back or tummy on an
activity mat
 Crawling across a surface toward
bright-colored objects
 Playing games such as patty-cake
or peek-a-boo
 Reaching for objects just out
of reach
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Toddlers Should:
 Engage in at least 30 minutes of structured
physical activity each day, and at least 60
minutes of unstructured physical activity
each day.
 Not be sedentary for more than 60
minutes at a time.
 Have opportunities to develop
movement skills.
 Have access to indoor and
outdoor play spaces.
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Toddler Activity






Playing on playground structures
Riding on tricycles, scooters, and riding toys
Jumping on and off floor patterns
Chasing bubbles or butterflies
Completing obstacle courses
Tossing a ball or small objects to buckets or
hoops on the floor
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Preschoolers Should:
 Engage in at least 60 minutes of structured
physical activity each day, and at least 60
minutes of unstructured physical activity
each day.
 Not be sedentary for more than 60
minutes at a time.
 Have opportunities to develop
movement skills.
 Have access to indoor and
outdoor play spaces.
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Preschooler Activity
 Digging and building in a sandbox
 Going on a “treasure hunt” that requires a
variety of movement skills
 Running around a “race track”
 Stretching and moving like different
animals
 Dancing to music and learning
dances to different tempos of music
 Playing “Simon Says”
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Physical Activity Policy
 Promote physical activity and remove
potential barriers to participation with wellwritten policies.
 Include a schedule of daily activities that
foster developmental progress in a healthy
and safe environment.
 Allow flexibility to capture the interests
and the individual abilities of the
children.
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Physical Environment
for Safe Play
 Play outdoors only when the
conditions do not pose a safety or
significant health risk.
 Indoor and outdoor equipment
must be developmentally
appropriate for safety.
 Children should always be
supervised while playing on
playground equipment!
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Physical Environment for
Safe Play (continued)
 If an outside play area is unavailable, an
indoor play area that is similar in size
works well.
 The outdoor play area should be
enclosed with a fence or a natural barrier.
 Outdoor activity areas should be wellmaintained.
 The play area and equipment should
be inspected for safety at regular
intervals. Observations should be
documented.
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Activities for
Physical Education
 Get kids moving with active games!
 Encourage upper-body strength in
toddlers by preparing structured activities
that require supporting body weight with
hands.
 Roll around on a big, soft, colorful ball,
dance to music, play chase, tumble on
soft mats, ride tricycles, throw a ball
around in a circle, or go for walks
around the local environment.
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Limiting Screen Media
 Media viewing (TV/DVD/videos) and
computer use should not be permitted for
children younger than 2 years old.
 For children 2 years and older, total
media time should be limited to 30
minutes once a week and for educational
or physical activity use only.
 Computer use should be limited to
no more than 15 minute
increments.
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Modeling
Healthy Habits
 Model healthful eating, good table
manners, and willingness to try
new foods.
 Make sure you and the children are
comfortably seated around the
table and that the TV and
computer are off.
 Sit down with the children and
eat the same food they eat.
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Modeling Healthy Habits
(continued)
 Encourage children to learn by doing.
Invite them to help wash and prepare
foods and create new ways to be
physically active.
 Remove toys that advertise food brands,
and replicas of any food that provides
poor nutrition.
 Do not force or bribe children to
eat. Do not use food as a reward
or punishment.
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Additional Resources
 NAP-SACC (Nutrition and Physical Activity
Self-Assessment for Child Care) www.napsacc.org
 Let’s Move Child Care - www.letsmove.gov
 I am Moving, I am Learning (Head Start)
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Review of
Training Objectives
 Understand the nutritional needs of
infants, toddlers, and preschoolers.
 Know how to store, prepare, and serve
food safely.
 Consider ways to encourage healthy
eating habits for yourself and others.
 Promote physical activity within
the child care setting.
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Group Review
 Work with your group to identify
the three most important things
we covered about your topic.
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Evaluation
 Please take a few minutes to
complete the evaluation.
 Thank you!
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