Standard 5: NAEYC Accreditation Criteria for Health Standard

The following chart presents the accreditation criteria for this topic area. Each criterion provides specific details to guide program plans, policies and practices. The criteria are numbered (01, 02, 03, etc.) within their topic area. Each criterion within each program standard is identified by its relevant age group (or groups). Many criteria are identified as "universal" (U), meaning that all classrooms and programs pursuing NAEYC Accreditation must address these criteria. These aspects of quality should be seen in any programs or classrooms serving birth through kindergarten, though they may look somewhat different in practice depending on the children's age.

Age Groups:
U = universal
I = infant
T = toddlers/twos
P = preschool
K = kindergarten

5.B.
Ensuring Children's Nutritional Well-being

5.B.01
U   I   T   P   K
If the program provides food for meals and snacks (whether catered or prepared on-site), the food is prepared, served, and stored in accordance with the U.S. Department of Agriculture (USDA) Child and Adult Care Food Program (CACFP) guidelines.

5.B.02
U   I   T   P   K
Staff take steps to ensure the safety of food brought from home:

• They work with families to ensure that foods brought from home meet the USDA's CACFP food guidelines.
• All foods and beverages brought from home are labeled with the child's name and the date.
• Staff make sure that food requiring refrigeration stays cold until served.
• Food is provided to supplement food brought from home if necessary.
• Food that comes from home for sharing among the children must be either whole fruits or commercially prepared packaged foods in factory-sealed containers. (This indicator only is an Emerging Practice.)

5.B.03
U   I   T   P   K
The program takes steps to ensure food safety in its provision of meals and snacks Staff discard foods with expired dates. The program documents compliance and any corrections that it has made according to the recommendations of the program's health consultant, nutrition consultant, or a sanitarian that reflect consideration of federal and other applicable food safety standards.

5.B.04
U   I   T   P   K
For all infants and for children with disabilities who have special feeding needs, program staff keep a daily record documenting the type and quantity of food a child consumes and provide families with that information.

5.B.05
U   I   T   P   K
For each child with special health care needs or food allergies or special nutrition needs, the child's health provider gives the program an individualized care plan that is prepared in consultation with family members and specialists involved in the child's care. The program protects children with food allergies from contact with the problem food. The program asks families of a child with food allergies to give consent for posting information about that child's food allergy and, if consent is given, then posts that information in the food preparation area and in the areas of the facility the child uses so it is a visual reminder to all those who interact with the child during the program day.

5.B.06
U   I   T   P   K
Clean sanitary drinking water is made available to children throughout the day. (Infants who are fed only human milk do not need to be offered water.)

5.B.07
U   I   T   P   K
Liquids and foods that are hotter than 110 degrees Fahrenheit are kept out of children's reach.

5.B.08
I
If the program provides food to infants, then the program staff work with families (who are informed by their child's health care provider) to ensure that the food is based on the infants' individual nutritional needs and developmental stage.

5.B.09
I
The program supports breastfeeding by

• accepting, storing, and serving expressed human milk for feedings;
• accepting human milk in ready-to-feed sanitary containers labeled with the infant's name and date and storing it in a refrigerator for no longer than 48 hours (or no more than 24 hours if the breast milk was previously frozen) or in a freezer at 0 degrees Fahrenheit or below for no longer than three months;
• ensuring that staff gently mix, not shake, the milk before feeding to preserve special infection-fighting and nutritional components in human milk; and
• providing a comfortable place for breastfeeding and coordinating feedings with the infant's mother.

5.B.10
I
Except for human milk, staff serve only formula and infant food that comes to the facility in factory-sealed containers (e.g., ready-to-feed powder or concentrate formulas and baby food jars) prepared according to the manufacturer's instructions. (This indicator is an Emerging Practice.) Bottle feedings do not contain solid foods unless the child's health care provider supplies written instructions and a medical reason for this practice. Staff discard after one hour any formula or human milk that is served but not completely consumed or is not refrigerated. If staff warm formula or human milk, the milk is warmed in water at no more than 120 degrees Fahrenheit for no more than five minutes. No milk, including human milk, and no other infant foods are warmed in a microwave oven.

5.B.11
I
Teaching staff do not offer solid foods and fruit juices to infants younger than six months of age, unless that practice is recommended by the child's health care provider and approved by families. Sweetened beverages are avoided. If juice (only 100% fruit juice is recommended) is served, the amount is limited to no more than four ounces per child daily.

5.B.12
I
Teaching staff who are familiar with the infant feed him or her whenever the infant seems hungry. Feeding is not used in lieu of other forms of comfort.

5.B.13
I   T
The program does not feed cow's milk to infants younger than 12 months, and it serves only whole milk to children of ages 12 months to 24 months.

5.B.14
I   T  P
Staff do not offer children younger than four years these foods: hot dogs, whole or sliced into rounds; whole grapes; nuts; popcorn; raw peas and hard pretzels; spoonfuls of peanut butter; or chunks of raw carrots or meat larger than can be swallowed whole.

Staff cut foods into pieces no larger than 1/4-inch square for infants and 1/2-inch square for toddlers/twos, according to each child's chewing and swallowing capability.

5.B.15
T   P   K
The program prepares written menus, posts them where families can see them, and has copies available for families. Menus are kept on file for review by the consultant described in criterion 5.A.02.

5.B.16
T   P   K
The program serves meals and snacks at regularly established times. Meals and snacks are at least two hours apart but not more than three hours apart.