2013-14 Early Childhood Provider Toolkit by Let's Go!

5-2-1-0 Goes to Child Care Provider Toolkit

Spring 2013 5-2-1-0 Goes to Child Care is program aimed at increasing healthy eating and physical activity in the child care environment. The program is part of a larger project called Let’s Go!. Let’s Go!, a program at The Barbara Bush Children's Hospital at Maine Medical Center, is implemented in partnership with MaineHealth. To learn more about Let’s Go! visit the website at www.letsgo.org. The program is based on the following easy-to-remember message:

5-2-1-0 Goes to Child Care incorporates the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) 5-step intervention process and the Let’s Move! Child Care Checklist to help child care facilities implement lasting changes.

The Provider Toolkit contains the following resources, many of which have been taken and adapted from our 5-2-1-0 Goes to School Toolkit:  5-2-1-0 Goes to Child Care Binder: Contains overall program information with suggestions on how to incorporate the 5-2-1-0 message into your child care setting.  5-2-1-0 Grab & Go Activities: User friendly ring-bound “Redy-To-Go” activities grouped by age.  5-2-1-0 Posters Our hope is that 5-2-1-0 Goes to Child Care will help support child care programs in raising and educating a healthier generation of children. Please direct any feedback, questions, or comments you may have to Let’s Go! at 207.662.3734, or email info@letsgo.org.

Victoria W. Rogers, MD Director, The Kids CO-OP & Let’s Go! The Barbara Bush Children’s Hospital at Maine Medical Center

www.napsacc.org

Emily Cooke, RD, LD Early Childhood Program Manager, Let’s Go! The Barbara Bush Children’s Hospital at Maine Medical Center

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Letâ&#x20AC;&#x2122;s Go! is generously funded by our: Founding Partners

Platinum Sponsors

Gold Sponsor

Walmart Foundation

Bronze Sponsors

Rite Aid Foundation Visiting Board of the Childrenâ&#x20AC;&#x2122;s Hospital

Additional Funders The Estate of Mary R. Hodes

What is Let’s Go!? Let’s Go!, a program at The Barbara Bush Children’s Hospital at Maine Medical Center, uses a multi-setting approach to reach youth and families where they live, learn, work, and play to reinforce the importance of healthy eating and active living. The program is based on the premise that if families are exposed to the same health promotion messages through several settings, and if those settings have policies and environments that support healthy choices, they will be more likely to adopt or maintain the behaviors in their daily lives. The Let’s Go! multi-setting model is pictured below and includes the core principles of: Healthy Places Support Healthy Choices  Consistent Messaging Across Settings is Essential  Strategies are Based on Science & Recommended by the Medical Community 

The Let’s Go! program interventions center on the use of the common message of “5-2-1-0”. These behaviors are supported by science and endorsed as recommendations by medical professionals:

Let’s Go! has identified strategies and created tools to support and evaluate those strategies. All of these settings are supported by a marketing campaign that utilizes multiple methods of communication including social media. For more information, contact the Let’s Go! Home Office at 207.662.3734, or email us at info@letsgo.org.

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or more fruits & vegetables hours or less recreational screen time* hour or more of physical activity sugary drinks, more water & low fat milk *Keep TV/Computer out of the bedroom. No screen time under the age of 2.

Table of Contents Tab 1: Getting Started

Breakfast is Best!

5-2-1-0 Goes to Child Care Program Overview

A Meal is a Family Affair

Scientific Rationale for 5-2-1-0

To have fruits and vegetables year round, add frozen or canned.

10 Strategies for Success 5-2-1-0 at Your Program Flow Chart Prepping Your Child Care Program to be 5-2-1-0 Ready Letter to Parents Announcing a New Partnership: Template Everyone Has a Role to Play in 5-2-1-0 Goes to Child Care

What’s a Healthy Portion? The Fittest Food Handling a 'Choosy' Eater The Lunch Box: Appealing Lunches for Preschool Children Making Your Own Baby Food Help and Hinder Phrases

Tab 2: Provide healthy choices for snacks and celebrations; limit unhealthy choices.

Choose MyPlate Brochure

Provide Healthy Choices

What’s in Your House? Creating a Healthy Food Environment Eating Between Meals: Snacking for Kids

Fruits and Vegetables Feeding Practices Foods Offered Outside of Regular Meals and Snacks Meats, Fats, and Grains Menus and Variety Supporting Healthy Eating Nutrition and Physical Activity Education Coloring Sheets  Choose MyPlate (blank)  Choose MyPlate (with food groups)  ‘5’ Message PARENT HANDOUTS Eat at least five fruits and vegetables a day

Choose MyPlate: 10 tips to a great plate How can I Influence What My Child Eats?

Tab 3: Provide water and low fat milk; limit or eliminate sugary beverages. Beverages Make-Your-Own Sugar Bottle Display 5-2-1-0 Every Day! Water Posters  Fill Up Here!  Refresh!  Thirst Quencher ‘0’ Coloring Sheet PARENT HANDOUTS

Feeding Infants

Drink water and low fat milk; limit or eliminate sugary beverages

Feeding Toddlers and Preschoolers

What should young children drink?

Stopping the Bottle

For Growing Bones…Which Milk?

Healthy Kids Snacks

Water is Fuel for Your Body

Healthy Celebrations Parent Letter: Template

Enlightening Facts About Juice

Go Foods, Slow Foods, Whoa Foods

Keeping Your Baby’s Teeth Healthy From The First Tooth

Healthy Shopping On A Budget Understanding Food Labels Maine Seasonal Food Guide

Redy icon represents a priority strategy

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Table of Contents Tab 4: Provide non-food rewards.

PARENT HANDOUTS

Provide Non-Food Rewards

Limit recreational screen time to two hours or less.*

Alternatives to Using Food as a Reward

*Keep TV/Computer out of the bedroom. No screen time under the age of 2.

PARENT HANDOUTS

Promote Healthy Viewing Habits

Non-Food Rewards at Home

Screen Time and the Very Young National Screen-Free Week

Tab 5: Provide opportunities for Unplugged! children to get physical activity every Tips for Reading to Very Young Children day. Avoid Being a Family of Sofa Slugs Active Play and Inactive Time

Nutrition and Physical Activity Education

Tab 7: Participate in local, state, or national initiatives that support healthy eating and active living.

Quick Physical Activity Breaks

Healthy Dates to Celebrate

Play Environment Supporting Physical Activity

Physical Activity Breaks from Take-Time!

March is National Nutrition Month®

Outdoor Play on Winter Days

National Screen-Free Week

WinterKids: Guide to Outdoor Active Living Preschool Edition

WinterKids Guide to Outdoor Active Living: Preschool Edition

StoryWalk™ Interested in Creating Your Own StoryWalk™? The StoryWalk™ Project FAQ ‘1’ Coloring Sheets PARENT HANDOUTS Get one hour or more of physical activity every day. How to Make Your Home an Active One Physical Play Every Day! Pamphlets  6 months to 1 year  1 year to 2 years  2 years to 3 years  Ages 3 and 4 years  Ages 4 and 5 years Take It Outside!

Tab 6: Limit recreational screen time. Television in Child Care: What Do We Need to Know?

Tab 8: Engage community partners to help support healthy eating and active living at your site. Engage Community Partners Please Give Nutritiously

Tab 9: Partner with and educate families in adopting and maintaining a lifestyle that supports healthy eating and active living. Introduction to Partnering with Families Letter to Parents Announcing a New Partnership: Template 5-2-1-0 Every Day! Refer to each tab’s ‘Parent Handouts’ section for strategy-specific parent handouts.

‘2’ Coloring Sheet Continued on next page...

Table of Contents Resources to Help Child Care Providers and Tab 10: Implement a staff wellness Breastfeeding Families program that includes healthy eating Whenever Wherever! Campaign Overview: Maine and active living. Worksite Wellness at Your Site (includes the StairWELL initiative) Move and Improve! Program

Tab 11: Collaborate with Food and Nutrition Programs to offer healthy food and beverage options.

Welcomes Nursing Moms

Tab 13: Evaluation Evaluating Your Program’s 5-2-1-0 Interventions Recognition Program for Let's Go! 5-2-1-0 Goes to Child Care Self-Assessment Tool Self-Assessment Instruction Sheet and Glossary

Child and Adult Care Food Program (CACFP)

Tab 12: Breastfeeding Are you interested in becoming a more breastfeedingfriendly child care?

Tab 14: Resources Original 5-2-1-0 Song - CD & Lyric Sheet (Insert) Fun Songs About Nutrition

Steps to Becoming a Breastfeeding-Friendly Child Care

5-2-1-0 Grab & Go Activities Ring - Activity Submission Form

Basics of Breastfeeding Support for Moms, Babies and Businesses

5-2-1-0 Sample Policies

‘Breastfeeding Welcome Here’ Sign How To Meet the Needs of Breastfed Babies in Child Care

NAP SACC Sample Policies Resources for Free Promotional Materials Select Resources

Caregiver’s Guide to the Breastfed Baby

Healthy Activity Booklist

Posters

Healthy Eating Booklist

   

This Child Care Supports Breastfeeding It’s Perfectly Natural A New Me! Superhero

Sample Breastfeeding Policy for Child Care Centers Sample Breastfeeding Policy for Family Child Care Providers Sample Infant Feeding Log for Birth-6 months Sample Infant Feeding Log for 6 months and older Breastfeeding-Friendly Reading Materials PARENT HANDOUTS Breastfeeding vs. Formula Feeding Breastfeeding FAQs: Safely Storing Breast Milk ‘Safely Storing Breast Milk’ Cheat Sheet Requesting a Breast Pump from Your Health Insurance Carrier Sample Letter to Employers

Tips for Reading to Very Young Children 5-2-1-0 Every Day! Placemat 5-2-1-0 in the First Year Booklet (Insert) Healthy Favorites: A Booklet Full of Healthy Tips & Recipes (Insert)

Tab 1: Getting Started 5-2-1-0 Goes to Child Care Program Overview Scientific Rationale for 5-2-1-0 10 Strategies for Success 5-2-1-0 at Your Program Flow Chart Prepping Your Child Care Program to be 5-2-1-0 Ready Letter to Parents Announcing a New Partnership: Template Everyone Has a Role to Play in 5-2-1-0 Goes to Child Care

TAB 1 Getting Started

In This Section

5-2-1-0 Goes to Child Care Program Overview Let's Go! is a nationally recognized childhood obesity prevention program designed to increase healthy eating and active living in children from birth to 18. Let's Go! works in six settings (schools, early childhood, after school, healthcare, workplace and community) to reach children and families where they live, study, work, and play. Let's Go! is centered on the common message of "5-2-1-0".

5-2-1-0 Goes to Child Care is a program of the Let’s Go! early childhood sector. The program focuses its work around the tools developed by Let’s Go!, Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC), and Let’s Move!. Through the use of the 5-2-1-0 strategies listed below, NAP SACC’s 5-step intervention process, and the Let’s Move! Child Care Checklist, child care programs can address the policies, practices, and environments that influence healthy lifestyle behaviors. In addition to a toolkit, this program provides Maine state licensing contact hours for completing certain program steps, free educational workshops for staff, and personalized guidance and assistance to support the child care programs in the adoption of the 10 strategies. 1. 2. 3. 4.

Provide healthy choices for snacks and celebrations; limit unhealthy choices. Provide water and low fat milk; limit or eliminate sugary beverages. Provide non-food rewards. Provide opportunities for children to get physical activity every day.

5. 6. 7. 8.

Limit recreational screen time. Participate in local, state, and national initiatives that support healthy eating and active living. Engage community partners to help support healthy eating and active living at your site. Partner with and educate families in adopting and maintaining a lifestyle that supports healthy eating and active living. 9. Implement a staff wellness program that includes healthy eating and active living. 10. Collaborate with Food and Nutrition Programs to offer healthy food and beverage options.

For more information, contact the Let’s Go! Home Office at 207.662.3734, or email us at info@letsgo.org Redy icon represents a priority strategy

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Scientific Rationale for 5-2-1-0 or more fruits and vegetables. A diet rich in fruits and vegetables provides vitamins and minerals, important for supporting growth and development and for optimal immune function in children. High daily intakes of fruits and vegetables among adults are associated with lower rates of chronic diseases such as heart disease, stroke, high blood pressure, diabetes, and possibly, some types of cancers. Emerging science suggests fruit and vegetable consumption may help prevent weight gain, and when total calories are controlled, may be an important aid to achieving and sustaining weight loss.

hours or less recreational screen time*. According to the American Academy of Pediatrics (AAP), the typical child watches an average of 5–6 hours of television a day. Watching too much television is associated with an increased prevalence of overweight and obesity, lower reading scores, and attention problems. The AAP recommends that children under age 2 shouldn’t watch any television. For children age 2 and older, the AAP recommends no TV or computer in the room in which the child sleeps, and no more than 2 hours of screen time a day.

hour or more of physical activity. Regular physical activity is essential for weight maintenance and prevention of chronic diseases such as heart disease, diabetes, colon cancer, and osteoporosis. While most school age children are quite active, physical activity sharply declines during adolescence. Children who are raised in families with active lifestyles are more likely to stay active as adults than children raised in families with sedentary lifestyles.

sugary drinks, more water & low fat milk. Sugar-sweetened beverage consumption has increased dramatically since the 1970s; high intake among children is associated with overweight and obesity, displacement of milk consumption, and dental cavities. It is recommended that children 1–6 years old consume no more than 4–6 ounces of 100% juice per day and youth 7–18 years old consume no more than 8–12 ounces. Whole milk is the single largest source of saturated fat in children’s diets. Switching to low or non-fat milk products (once a child reaches 2 years old) significantly reduces dietary saturated and total fat, as well as total calories. *Keep TV/computer out of the bedroom. No screen time under the age of 2. Adapted from the Maine Center for Public Health

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10 Strategies for Success Let’s Go! is a nationally recognized program designed to increase healthy eating and active living in children from birth to age 18. Let’s Go! works in six settings (schools, early childhood, after school, healthcare, workplace and community) to reach children and families where they live, study, work, and play. Let’s Go! Is centered on the common message of “5-2-1-0”.

The 10 Let’s Go! evidence-based strategies connect to Let’s Go!’s core message and align with the CDC and the Institute of Medicine’s recommendations to support healthy eating and active living. Your work should be focused on these strategies to improve environments and policies in school, after school, and child care settings. Let’s Go! recommends creating and implementing strong policies around these strategies. Please refer to the Let’s Go! Toolkits for more ideas on how to implement each strategy. 1. Provide healthy choices for snacks and celebrations; limit unhealthy choices. For example:  Encourage parents to provide only healthy options  Have non-food celebrations 2. Provide water and low fat milk; limit or eliminate sugary beverages. For example:  Allow easy access to free water via water fountains and/or water jugs  Allow water bottles  Create sugar bottle displays  Put limits on 100% juice 3. Provide non-food rewards. For example:  Use physical activity as a reward  Have non-food birthday celebrations

4. Provide opportunities for children to get physical activity every day. Children should get one hour or more of physical activity every day. Help children achieve this goal. For example:  Use physical activity as a reward  Have non-food birthday celebrations Redy icon represents a priority strategy

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5. Limit recreational screen time. Children should limit recreational screen time to two hours or less a day. Keep TVs and computers out of the bedroom. For children under the age of 2 there should be no screen time. Help children achieve this goal. For example:  Work with parents to reduce screen time at home  Find active alternatives to indoor recess  Promote National Screen-Free Week  Provide activity bags that can encourage screen-free evenings 6. Participate in local, state, and national initiatives that support healthy eating and active living. For example:  Local: Local gardening programs, Buy Local initiatives  State: Take Time, WinterKids, Walk and Bike to School Day  National: National Nutrition Month, NAP SACC, Screen-Free Week, Safe Routes to School 7. Engage community partners to help support healthy eating and active living at your site. For example:  Doctors, dentists, dieticians, local colleges, food banks, libraries, farmers, and local community coalitions like Healthy Maine Partnerships 8. Partner with and educate families in adopting and maintaining a lifestyle that supports healthy eating and active living. For example:  Distribute Let’s Go! parent handouts  Sponsor family education events  Introduce Let’s Go! at parent/teacher conferences and kindergarten orientation 9. Implement a staff wellness program that includes healthy eating and active living. For example:  Support healthy staff celebrations  Encourage walking meetings  Allow for physical activity breaks throughout the day  Encourage staff to participate in physical activity with the children… no standing on the sidelines! 10. Collaborate with Food Nutrition Programs to offer healthy food and beverage options. For example:  Make your school nutrition director part of your Let’s Go! team  Partner with the Child and Adult Care Food Program

Redy icon represents a priority strategy

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5-2-1-0 at Your Program Flow Chart

Ongoing Support

CONNECT

Let’s Go! Contact and Child Care Connect

Child Care Registers & Chooses Champion

ASSESS

Champion Completes Self-Assessment Tool

PLAN

Action Planning Meeting & Toolkit Introduction

LEARN

Participate in Staff Workshops

SUSTAIN

Write Strategies/ Best Practices Standards into Handbooks

EVALUATE

May/June - Repeat Self-Assessment Tool

REPEAT!

Celebrate Your Progress, Re-register, and Set New Goals!

From Your Local Let’s Go! Contact

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Prepping Your Child Care Program to be 5-2-1-0 Ready  Hang 5-2-1-0 posters throughout the facility and in each classroom.  Dedicate one or more bulletin boards to promoting the 5-2-1-0 program and wellness events or activities.  Make daily or weekly announcements about the program.  Dedicate a section of your program newsletter to 5-2-1-0 and related topics.  Decorate the classroom walls with age-appropriate educational posters promoting physical activity and healthy eating (and breast-feeding if you serve infants and toddlers).  Provide healthy snacks and beverages when serving food.  Allow physical activity (inside or out) to be used as a reward.  Encourage all program staff to role model 5-2-1-0 behaviors.  Schedule your staff trainings (5 total) to help engage all staff in 5-2-1-0 (contact hours provided).  Embed the 5-2-1-0 message into lesson plans and the curriculum, especially in health and physical education themed lessons.  Send parent handouts home to reinforce what children are learning during the program day.  Urge parents and caregivers to support the goals of the program by limiting the distribution of unhealthy high-fat, high-sugar foods and beverages. Ask us how and refer to your “Provide Healthy Choices” document in the next section.  Develop collaborations with local community organizations, including recreation centers, doctors’ offices, and Healthy Maine Partnerships. These collaborations can help your program promote the messaging outside of the program day and sometimes even provide funding opportunities.  Trigger program-wide excitement about the program by planning a kick-off, during the program day or at a special family night, with activities based on nutrition and physical activity.

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Letter to Parents Announcing a New Partnership Date: Dear Parents: We are pleased to announce that has teamed up with 5-2-1-0 Goes to Child Care, a program that is part of a larger project called Let’s Go!. Let's Go! is designed to increase healthy eating and active living in children from birth to age 18 by working with children and families where they live, study, work, and play. Let's Go! works in 6 settings (schools, early childhood, after school, healthcare, workplace and community) and is centered on the common message of "5-2-1-0".

Eating right and being physically active can be a challenge in today’s busy world. 5-2-1-0 Goes to Child Care is here to help! As a part of 5-2-1-0 Goes to Child Care, our program will be working hard to improve our nutrition and physical activity environment and incorporate the 5-2-1-0 messages into our daily activities. As part of our work, you will probably notice some changes in our facility and may also receive parent-geared information, which will highlight the messages your child is learning in this program. Don’t hesitate to get involved and help us with the changes or ask what areas we are planning on improving. For more information about 5-2-1-0 Goes to Child Care, visit www.letsgo.org, contact at or email the Let’s Go! Early Childhood program staff at info@letsgo.org. Sincerely,

Please Note: A modifiable version of this letter can be found in the online toolkit on our website.

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Everyone Has a Role to Play in 5-2-1-0 Goes to Child Care The Role of the Classroom:  Increase opportunities for physical

activity and healthy eating during the program day using the 5-2-1-0 strategies.

 Educate children of the importance of physical activity and healthy eating.

The Role of the Child Care Program:

 Implement a strong wellness policy that supports 5-2-1-0 strategies.

 Role model 5-2-1-0 behaviors.  Create an environment that is

supportive of 5-2-1-0 strategies.

The Role of the Community:

The Role of the Family:

 Local doctors, dentists, parents, and

 Create a home environment that is

other professionals share their expertise with child care programs.

 All school programs, child care

programs, recreation centers, and libraries can promote and practice 5-2-1-0 to support consistent messaging.

supportive of 5-2-1-0 behaviors.

 Become involved in 5-2-1-0 Goes to

Child Care and other initiatives that promote physical activity and healthy eating.

 Role model 5-2-1-0 behaviors.

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In This Section Tab 2: Provide healthy choices for snacks and celebrations; limit unhealthy choices. Provide Healthy Choices Fruits and Vegetables

Meats, Fats, and Grains Menus and Variety Supporting Healthy Eating Nutrition and Physical Activity Education Coloring Sheets  Choose MyPlate (blank)  Choose MyPlate (with food groups)  ‘5’ Message

PARENT HANDOUTS Eat at least five fruits and vegetables a day Feeding Infants Feeding Toddlers and Preschoolers Stopping the Bottle Healthy Kids Snacks Healthy Celebrations Parent Letter: Template Go Foods, Slow Foods, Whoa Foods Healthy Shopping On A Budget

Continued on backside...

TAB 2

Foods Offered Outside of Regular Meals and Snacks

Provide Healthy Choices

Feeding Practices

In This Section Understanding Food Labels Maine Seasonal Food Guide Breakfast is Best! A Meal is a Family Affair To have fruits and vegetables year round, add frozen or canned. What’s a Healthy Portion? The Fittest Food Handling a 'Choosy' Eater The Lunch Box: Appealing Lunches for Preschool Children Making Your Own Baby Food Help and Hinder Phrases Choose MyPlate Brochure Choose MyPlate: 10 tips to a great plate How can I Influence What My Child Eats? What’s in Your House? Creating a Healthy Food Environment Eating Between Meals: Snacking for Kids

Provide Healthy Choices For Snack Time

Most children enjoy a snack at child care during the day. What a child has for snack can affect their ability to concentrate and learn.

There are sever al things a child care program ca encourage healt n do to hy snacks. Send home the Healthy Kidsâ&#x20AC;&#x2122; Sn acks parent han dout. Send home a qu arterly newslett er with easy snac k ideas. Offer a fruit and vegetable tastin g to encourage children to try n ew foods. Set a program-w ide snack policy. Be a role model

for children.

: s n io t a r b le e C r Fo child care are in ts n e v e d n a s Celebration lty, and fatty sa t, e e sw , n e ft o exciting. All too terpiece of n e c e th e m o c e foods b gs you can do to in th re a re e h T celebrations. ons at your ti ra b le e c y h lt a e encourage h program. arent letter p d e id v ro p e th Send home ns. It provides o ti ra b le e c y h lt a about he eats that can tr n o ti a r b le e c y ideas for health be sent in. , consider d o fo e lv o v in t a th For celebrations ail mix, or fruit tr , e s e e h c , rs e fruit platt smoothies.

For Nonfood Celebrations: Set a healthy celebration policy or write guidelines for your program. Use the sample policy language in the resources section of this toolkit. Have the birthday child be the first to do each activity and/or be the line leader for the day. Birthday Library: Each child donates a book to the program library on his/her birthday. Read the book aloud in honor of the child. Create a “Celebrate Me” book. Have teachers or peers write stories or poems and draw pictures to describe what is special about the birthday child. Create a special birthday package. The birthday child wears a sash and crown, sits in a special chair, and visits the director’s office for a special birthday surprise (pencil, sticker, birthday card, etc.).

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Nutrition and Physical Activity Self-Assessment for Child Care

FRUITS AND VEGETABLES Here’s Why… Exposing children to different types of foods helps them learn to enjoy new things. The child care setting presents a perfect opportunity to challenge children’s taste buds. The CACFP guidelines offer many good suggestions for meal planning. While 100% fruit juice is presented as an alternative to whole fruit, it contains more sugar and doesn’t have the fiber that whole fruit does. Try adding fruits and vegetables to all meals and snacks. They are an important part of a child’s diet, offering necessary vitamins and minerals to support healthy growth.

Choices You Make for Your Facility Take advantage of fresh fruits and vegetables in season when they are abundant and inexpensive. Try some innovative ways to serve fruits and vegetables. Slice and freeze seedless grapes or bananas for a new taste treat. Serve raw veggies with low-fat dip or hummus. Be careful when cooking frozen and canned vegetables. Overcooking results in a mushy texture and dull color. Serve vegetables that aren’t cooked with fat, and hold the cheese and cream sauces!

Checklist p We offer fruit two or more times each day for full-time facilities.

p We offer fruit canned in its own juice (no syrups), fresh or frozen.

p We offer vegetables two or more times each day for full-time facilities.

Purchase canned or frozen fruits and vegetables when they are out of season to save money. Buy no salt/sugar added varieties if possible; if not, rinse canned fruits and vegetables to wash away added salt or sugar.

p We offer vegetables

Serve 100% fruit juice occasionally and not in place of whole fruit or vegetables.

p We offer a variety of fruits

Use herbs to spice up vegetables instead of salt and butter.

steamed, boiled, or roasted without added meat fat, butter or margarine. and vegetables, taking advantage of a rainbow of colors.

Getting Support From the Parents Encourage parents to bring in fruits and vegetables for snacks and birthdays. Send home recipes for fruit or vegetable snacks that children make at the center. Have a fruit or vegetable taste test for the parents at pick-up time.

Getting the Kids on Board Serve fruits and vegetables regularly. Have a new fruit or vegetable tasting party by offering unusual fruits or vegetables like kiwi or sweet red pepper. Have a theme week by color or letter and incorporate a fruit and a vegetable that match, talk about it, show pictures, show the item, and then taste test it! For â&#x20AC;&#x153;orangeâ&#x20AC;?, you could do oranges and carrots. Many children are more likely to eat vegetables raw, like carrots, sweet peppers, snow peas, and even turnips. Serve brightly colored fruits and vegetables to make them more appealing to children. Let children create their own fruit or vegetable snack.

For more information, please visit: http://www.fruitsandveggiesmatter.gov/ http://www.fns.usda.gov/tn/Resources/fv_galore.html Published by the NAP SACC Program, Center for Health Promotion and Disease Prevention, The University of North Carolina, Chapel Hill, NC, May 2007. Permission to reprint in its entirety. For noncommercial use only.

Plant a garden outside or in the classroom. It can be as simple as growing a tomato plant in a pot. Talk to young children about where food comes from.

Nutrition and Physical Activity Self-Assessment for Child Care

Feeding Practices Here’s Why… Young children are notoriously picky eaters and can challenge the best of adults with their ability to love a food one minute and hate it the next. While frustrating, forcing children to try a food or to clean their plates can lead to negative associations with food, overeating and weight problems. Therefore, gently encourage children to try a new food, but don’t force. As a best practice, offer kids healthy foods and snacks and then let them decide if and how much they want to eat. It often takes ten or more introductions to a new food before a child will try it. Be patient! Make snack and mealtime stress free and fun! Offering food as a reward or punishment places undue emphasis on foods as “good” or “bad,” so offer all children the same foods, regardless of good or bad behavior.

Choices You Make for Your Facility Encourage children to eat a variety of foods, but don’t force them to try foods if they resist.

Checklist q Staff ask children if they feel full when they eat very little of a meal or snack.

Offer the same foods to all children, regardless of behavior. Use stickers or other non-food rewards to encourage good behavior like picking up toys.

q Staff ask children if they are

Children vary in the amount of time needed to finish eating a meal. Extra time may be needed for slow eaters.

q Children are encouraged

Control waste by encouraging small portion sizes and allowing children to take seconds of requested food items. Teach children to listen to their bodies. Ask them if they are still hungry when they request more food and ask them if their belly feels full before removing their plate. Introduce new foods one at a time with other, more familiar items.

still hungry before giving second helpings. by staff to try a less favorite food in a gentle and positive manner.

q Food is not taken away for bad behavior and not given as a reward for good behavior.

Getting Support From the Parents Encourage parents to visit the facility during mealtime to observe the centerâ&#x20AC;&#x2122;s approach to serving food. Provide parents with the centerâ&#x20AC;&#x2122;s nutrition plan, which outlines your policies for mealtime and serving foods. Show parents that their child has learned to listen to his or her body to decide if he or she is hungry or full and have parent encourage this at home.

Getting the Kids on Board Create alternatives other than food for rewarding good behavior. Give them more time outside to play instead! Let the children help out during mealtime. They can set the table and clean up. Make mealtime a fun time by talking with the children. Experiment with new foods that will be offered, such as asparagus. Talk about how they grow, their color, shape, texture, etc. This will allow for the food to become familiar. Teach children in a fun way what it means to listen to their body. For more information, please visit: http://www.nfsmi.org/Information/Newsletters/Mealtime_memo_ index.html http://betterkidcare.psu.edu/TIPS/TIPS07.pdf Published by the NAP SACC Program, Center for Health Promotion and Disease Prevention, The University of North Carolina, Chapel Hill, NC, May 2007. Permission to reprint in its entirety. For noncommercial use only.

Nutrition and Physical Activity Self-Assessment for Child Care

FOODS OFFERED OUTSIDE OF REGULAR MEALS AND SNACKS Here’s Why… A child care facility should be a fun and healthy place for kids, their families, and staff. Meals and snacks aren’t the only times to think about healthy foods. Birthdays and celebrations can include many healthy treats and help kids appreciate and learn about other cultures. Another time to think about healthy options is fundraising. Be creative and look for ways to raise money for your facility without selling sweets. Everyone will benefit from healthy choices and it sends a message to families that good nutrition is important at your facility.

Choices You Make for Your Facility Work with your staff to create a nutrition plan. Include ideas for healthy celebrations as well as good fundraising options. Make this your facility’s policy on celebrations and fundraisers, and share it with families. Often fundraising is necessary to help support child care facilities. Try selling healthier alternatives like fruit and nuts, or non-foods like wrapping paper and coupon books. If you have a vending machine in your facility, ask the vending supplier to provide healthier options like 100% juice, water, dried fruit, and nuts. If you don’t have a vending machine in your facility, way to go!

Checklist q We have written guidelines for holidays and celebrations that encourage healthier options.

q We provide healthy foods or non-food treats at birthdays and other celebrations.

q We sell healthy foods or non-foods like wrapping paper and coupon books for fundraisers.

Getting Support From the Parents Share your facility’s nutrition policy with parents. Ask parents to help decide on healthy alternatives for fundraisers. Share recipes for healthier treats for parties and celebrations with parents. Ask parents to provide games for celebrations instead of food. Encourage parents to celebrate their child’s birthday with a favorite food other than cupcakes or cake. Maybe their child loves fruit salad or macaroni and cheese and would be happy to share that instead. Celebrate birthdays with party hats and balloons instead of food!

Getting the Kids on Board Make parties and celebrations healthy and fun by letting the kids help prepare healthy treats. For a celebration, fill a piñata with toys, toothbrushes, granola bars, and other fun and healthy items. For celebrations, incorporate favorite group games as a treat instead of food.

For more information, please visit: http://www.mdpta.org/documents/Healthy_Celebrations. pdf

Published by the NAP SACC Program, Center for Health Promotion and Disease Prevention, The University of North Carolina, Chapel Hill, NC, May 2007. Permission to reprint in its entirety. For noncommercial use only.

Nutrition and Physical Activity Self-Assessment for Child Care

MEATS, FATS, AND GRAINS Here’s Why… Adults often make assumptions that children will only eat chicken nuggets and french fries. While they do like these items, try challenging their taste buds with healthier alternatives! Studies show that children who are offered many types of food are more likely to make good choices. Plan menus to have lots of variety including: whole grains, beans, baked chicken, turkey, or fish. Be creative and don’t give up!

Checklist q We offer fried meats like

Choices You Make for Your Facility Make your own french fries! Be creative: slice or chop any type of potato, toss in a little oil, and salt and bake!

chicken nuggets and fish sticks once a week or less.

q We offer fried or pre-fried potatoes like french fries or tater tots once a week or less.

When serving commercially prepared foods, like french fries and fried chicken, bake rather than fry. Also, be aware that these items were fried prior to freezing and contain lots of additional fat regardless of how you prepare them.

q We offer high-fat meats like

Use alternatives to higher fat meats; lean ground turkey or beef, turkey bacon, sausage, and hot dogs. Kids won’t be able to tell the difference!

q We offer beans or lean

Soups are an easy way to incorporate lean meats such as turkey and baked chicken (and you can even add beans!). Don’t have time? Try low-sodium canned soups. Serve whole grain bread products (whole wheat toast and English muffins) and cereals (Cheerios® and Wheat Chex®) for breakfast instead of biscuits and muffins, which have a lot of added sugar and fat and little fiber. Try serving fresh fruit, whole grain crackers, and cheese cubes for a snack instead of prepackaged cookies and snack bars.

sausage, bacon, hot dogs, and bologna once a week or less. meats like baked or broiled chicken, turkey or fish at least once a day.

q We offer high-fiber foods such as whole wheat bread, brown rice, Cheerios®, and oatmeal at least twice a day.

q We offer sweets, high-fat and high-salt foods like cookies and chips once a week or less.

Getting Support From the Parents Ask parents to bring their child’s favorite baked chicken and potato recipes. Create a recipe book for families! Tell parents that you’re trying to serve less fried foods, less high sugar, fat or salt foods and more whole grains. Send a list home to parents of “new foods” that were offered to their child. Encourage them to try these new foods at home also! For more information, please visit: http://www.cspinet.org/nutritionpolicy/healthy_school_ snacks.pdf http://betterkidcare.psu.edu/101snacksWeb.pdf http://www.nfsmi.org/Information/Newsletters/ meme2007-04.pdf http://www.nfsmi.org/Information/Newsletters/ meme2007-05.pdf Published by the NAP SACC Program, Center for Health Promotion and Disease Prevention, The University of North Carolina, Chapel Hill, NC, May 2007. Permission to reprint in its entirety. For noncommercial use only.

Getting the Kids on Board Encourage staff to talk to children about what they are eating and how they enjoy nonfried foods. Instead of frozen pizza, have children make mini pizzas on whole wheat English muffins. Have a topping bar that includes cheese, different vegetables, beans, cooked chicken, and turkey pepperoni. Children eat with their eyes! Serve foods that have different colors and textures. Ask kids to share a favorite healthy food from their own culture.

Nutrition and Physical Activity Self-Assessment for Child Care

MENUS AND VARIETY Here’s Why… Remember the saying “variety is the spice of life”? Kids need variety just like adults, especially for establishing lifelong healthy eating habits. Children spend many hours at your facility, so it is important to offer them a wide variety of foods every day. To increase acceptance of new foods, serve them with familiar favorites. Serving foods from other cultures is also a great way to increase the variety of foods served in your facility. It teaches children about diversity by introducing them to new foods and new cultures.

Choices You Make for Your Facility Try different shapes, colors, textures, and temperatures of food. Fruits and vegetables come in many different shapes and colors. Adding new fruits and vegetables to your menu is a quick way to get more variety. If you purchase your food from another kitchen or caterer, talk to them about ways to increase the variety in the menus. Most caterers are happy to work with you to improve the variety of food. Talk to your caterer about the length of your cycle menu. Increasing the length of your cycle menu means greater variety. You can also talk to your caterer about a winter, spring, summer and fall cycle menu to take advantage of fruits and vegetables in season. Don’t give up! Children often have to be exposed to a new food at least ten times before they will taste it. Keep trying and one day you’ll be surprised!

Checklist q We use a cycle menu of three weeks or greater that changes with the seasons.

q We serve new foods with familiar foods.

q Our menus reflect healthy food options from a variety of cultures.

q We offer a variety of different foods on the weekly menu.

Getting Support From the Parents Talk to the parents about healthy foods their children eat at home that might not be served at your facility. Ask parents to suggest cultural foods that your facility could introduce in the menus, and ask the parents to share their healthy food recipes. Have parents participate in theme days by bringing in small items like decorations or items that relate to their culture (chopsticks, maps, pictures, etc.).

For more information, please visit: http://www.opi.mt.gov/schoolfood/cyclecare.html http://teamnutrition.usda.gov/Resources/menu_ magic.pdf http://teamnutrition.usda.gov/Resources/childcare_ recipes.html Published by the NAP SACC Program, Center for Health Promotion and Disease Prevention, The University of North Carolina, Chapel Hill, NC, May 2007. Permission to reprint in its entirety. For noncommercial use only.

Getting the Kids on Board Kids love food that is colorful and fun. Add foods that are bright in color or have interesting textures to the menu. Let kids help prepare a new or unfamiliar food in the classroom and then taste their hard work. Ask kids to share a favorite healthy food from their own culture. Have theme days such as Italian, Mexican, Spanish and Chinese; discuss culture, food and have taste tests.

Nutrition and Physical Activity Self-Assessment for Child Care

SUPPORTING HEALTHY EATING Here’s Why… Mealtimes at your facility should be similar to mealtimes at home. Teachers and kids that eat together as one big “family” have the opportunity to enjoy a relaxing meal. Conversation at the table adds to the pleasant mealtime environment and provides opportunities for modeling appropriate eating behaviors and informal nutrition education. Serving meals family style is a great way to encourage fine motor skills and table manners as well as teach children how to “listen to their bodies” when serving themselves portions of food.

Choices You Make for Your Facility Serve food family style and let the children serve themselves. They can determine what foods they want to try and how much of each to take. Staff should be positive nutrition role models. If you want the children in your care to eat their vegetables, the staff should eat theirs and enjoy them! Eating together provides an opportunity for staff to teach children about table manners, and to stop eating when full. Encourage, but don’t force a child to try a food. Mealtime should be a happy time. This is a great opportunity for staff to talk with the kids and make them feel special.

Checklist q Our staff and children sit and enjoy meals together.

q We serve meals or parts of each meal family style.

q Our staff eat the same foods that the children eat all of the time.

q Our staff model healthy eating to the children at every meal or snack.

q Our staff informally talk with children about enjoying healthy foods at every meal or snack.

q We provide visible support for good nutrition in 2-to 5-year old classrooms and common areas through use of posters, pictures, and books.

Getting Support From the Parents Parents influence childrenâ&#x20AC;&#x2122;s eating habits and interest in food by what they do and say. Talk to parents about how to be a good role model for their children when it comes to healthy eating. Let parents know that you serve family style meals and snacks. Share positive comments about their childrenâ&#x20AC;&#x2122;s behaviors that you observed during mealtime. Suggest that parents sit down as a family for meals as frequently as possible. Invite parents to join their children at a mealtime so they can observe the positive atmosphere.

Getting the Kids on Board Pick one child a day to talk about what they see on their plate. Ask the child about the different colors, textures, and food groups. Ask children to try a new food at home and report back. Ask children to talk about their favorite foods. Are they foods that should be eaten every day or only occasionally?

For more information, please visit: http://www.olemiss.edu/depts/nfsmi/Information/Newsletters/meme2004-4.pdf http://www.nfsmi.org/Information/Newsletters/ meme2003-2.pdf http://www.nfsmi.org/Information/Newsletters/ meme2002-6.pdf http://www.nfsmi.org/Information/Newsletters/ meme2003-3.pdf

Nutrition and Physical Activity Self-Assessment for Child Care

NUTRITION AND PHYSICAL ACTIVITY EDUCATION Hereâ&#x20AC;&#x2122;s Whyâ&#x20AC;Ś Nutrition and physical activity are important parts of good health. Enjoying and learning about food and physical activity in childhood leads to healthy behaviors for a lifetime. Many adults would like to learn more about these issues as well. Your facility is a great place to offer nutrition and physical activity training for both parents and staff. The more information people receive, the more likely they are to make healthy choices. Learning can be fun and helpful for both kids and adults!

Choices You Make for Your Facility Provide staff with training in both nutrition and physical activity. Take advantage of your community resources, such as Cooperative Extension, your CACFP representative, and child care health consultants. Also, try your community center, public school system or local university for training information and opportunities. Staff can teach children about the taste and smell of foods. The children should feel the textures and learn different colors and shapes of foods. Children are more likely to try new foods if they have had the opportunity to touch and smell them first. Fun nutrition activities like making simple snacks can be a great way to teach kids about food and nutrition. Staff can teach children about body movement and development. The children should know their bodies and ways to move to be healthy. Fun physical activities, like dancing, can be a great way to teach children about physical activity and get children moving!

Checklist q We offer training for staff on both nutrition and physical activity at least two times a year.

q We provide both nutrition and physical activity education to children through a standardized curriculum at least one time a week.

q We offer both nutrition and physical activity education to parents at least two times a year.

Getting Support From the Parents Keep parents informed about the fun nutrition and physical activity education activities that take place in your facility. These activities can be announced through newsletters or parent meetings. Send home easy recipe ideas that parents and children can make together. Send home family physical activity ideas. Send home the NAP SACC parent handouts. For more information, please visit: http://betterkidcare.psu.edu/AngelUnits/OneHour/ Garden/GardenLessonA.html http://www.iowa.gov/educate/component/option, com_docman/task,doc_view/gid,510/ http://www.iptv.org/rtl/downloads/TNactivity1.pdf http://www.nfsmi.org/Information/Newsletters/ meme2007-02.pdf

Getting the Kids on Board Use mealtimes for very informal education about food. Give children the opportunity to make their own snacks. This teaches them about healthy food in a fun way! Make physical activity education fun through active play. Kids love to move and learn new skills!

Center for Nutrition Policy and Promotion

EAT

SERVINGS

FRUITS

AND

VEGGIES

EVERY DAY!

What I like about VEGETABLES:

EAT

SERVINGS OF

FRUITS

AND

VEGGIES

EVERY DAY!

What I like about FRUITS:

Eat at least five fruits and vegetables a day.

t h g u o h t r o f d o Fo What is a serving? Adults ll size of a tennis ba A whole fruit the  s d fruit or veggie 1/2 cup of choppe  y greens 1 cup of raw, leaf  uits 1/4 cup of dried fr  Kids their hand Size of the palm of  seasons Choose with the on ies that are in seas ays available Buy fruits and vegg  d veggies are alw an ts ui fr en oz fr lt or fat. Don’t forget that  t any added sugars, sa ou ith w e os th se oo ce; ch and are a healthy choi

Redy’s Rules Try it!

Try the three bite rule. Offer new fruits and veggies different ways and try at least three bites each time—it can take 7 to 10 tries before you like a new food.

Many fruits and veggies taste great with a dip or dressing. Try a low fat salad dressing with yogurt or get protein with peanut butter.

Make a fruit smoothie with low fat yogurt.

Mix it!

Add them to foods you already make, like pasta, soups, casseroles, pizza, rice, etc.

Add fruit to your cereal, pancakes, or other breakfast foods.

Be a good role model for your family and have at least one veggie at every meal.

Slice it!

Wash and chop veggies and fruits so they are ready to grab and eat.

Most people prefer crunchy foods over mushy ones. Enjoy them fresh or lightly steamed.

Did you know? A diet rich in frui ts an vegetables provides d vitamins and miner als, important for supp orting growth and develo pment, and for optim al immune function. Family mealtime:

• Do  Do reate notno stim untdeun ate the resde tim the im po rtanc importance of fam ily me:eatak of e family mealtim l- e timmi e;nu tates ke to10sit-15 minute 10-15 s er. to down togeth sit down to ther.  Get your family ge involved with meal • Get your fam planning and prepaily involved with meal planning.ration.

a odel. le M Be a RoBe ck on fruits and veggies. Role Model.

Sna gies.  Snack on fruits and veg als.. plane me meals lp par fam nily&hepre the pla ve p Ha hel  Have the family

08/08 R04/11

Feeding Infants Babies are the best judge of how much food they need and their appetite may vary greatly from day to day. Follow these tips to help your little ones learn to be healthy eaters:  Feed infants when they are hungry; do not restrict them to a meal schedule.  Let the child eat their way – much or little, fast or slow, steady or start-and-stop.  If an infant is full, let him stop eating. It is not necessary to finish off a bottle, container of food or food on the plate. Note: Ignoring fullness cues may cause a child to lose the ability to tell when they are hungry or full and lead to overeating.  To avoid waste, start with small amounts and add more if the baby is still hungry (see hunger cues below). Hunger cues: Putting fists in mouth Rooting (when an infant opens her mouth and turns her head towards anything near the mouth) Excited arm and leg movements Sucking or smacking lips Aim to feed an infant before they get too upset and are crying from hunger (crying is a late hunger cue) Fullness cues: Clamping lips together Turning head away Spitting out nipple Pushing away bottle Decreased or stopped sucking Milk dribbling out corner of mouth Bottle Feeding Techniques:  Put only breast milk or formula in the bottle. Do not put cereal, other food, juices, or other drinks in the bottle.  Give the bottle to the baby at feeding time only, not nap time, and do not let the baby go to sleep with the bottle.  Always hold the baby while feeding instead of propping the bottle in the baby’s mouth. Do not let the baby walk or crawl around with the bottle. Tip the bottle so that milk fills the nipple and air does not get in.  Never force a baby to finish what is in the bottle. Babies are the best judge of how much they need. To avoid wasting milk or formula, start with a smaller amount and add more if the child is still hungry.

What do babies drink? It is not recommended to give children under 6 months of age anything to drink besides breast milk or iron -fortified infant formula. After 6 months it is okay to start introducing a small amount of water after feedings. Hold off on any other fluids (including 100% fruit and vegetable juices) until 1 year of age. Age

Item

Up to 4 months

         

4-6 months 6-8 months

8-12 months

Amount*

Breast milk (preferred) Iron-fortified infant formula Breast milk (preferred) Iron-fortified infant formula Breast milk (preferred) Iron-fortified infant formula Plain unflavored water Breast milk (preferred) Iron-fortified infant formula Plain unflavored water

 4-6 oz/feeding  4-8 oz/feeding  4-8 oz/feeding  Small amounts of water can be given after breast milk or formula.  6-8 oz/feeding  Small amounts of water can be given after breast milk or formula.

Feeding Solid Foods  Introduction of solids can begin as early as 4-6 months.  Introduce one “single-ingredient” new food at a time and wait 3-5 days before introducing anything else to watch for possible allergic reactions.  Choose foods that will provide key nutrients and help children meet their energy needs. Recommended first foods include: single-grain cereals, pureed vegetables and fruits, and pureed lean poultry or meats. You can make your own foods and thin them to a soupy consistency with breast milk or formula.  Introduce a variety of foods by the end of the first year. Remember, when offering a new food, it may take up to 15 exposures till the child accepts the food, so keep trying!  Avoid adding salt or any kind of sweetener. These are not necessary to make children like a food – this can be done by repeatedly introducing a food (see above). Age Up to 4 months 4-8 months

8-12 months

Item

Amount* No Solids Recommended

Single-grain, iron-fortified cereal Fruits and/or vegetables Pureed lean poultry and meats Single-grain, iron-fortified cereal Fruits and/or vegetables Lean poultry, meat, egg, cooked beans or peas Cottage cheese or yogurt Cheese Bread Crackers

Up to 3 Tbsp

1-4 Tbsp ½ oz to 2 oz ¼ to ½ slice 2 crackers

*An infant may eat or drink more or less than what is listed here. Pay attention to hunger and fullness cues and talk to your doctor if you’re concerned about your infant’s intake. Resources – 1) Nemors: Best Practices for Healthy Eating, 2) Team Nutrition Feeding Infants: Guide for Use in the Child Nutrition Programs 3) American Academy of Pediatrics: Pediatric Nutrition Handbook

07/11 R05/13

Feeding Toddlers and Preschoolers Children need less food than adults. What may seem like a small amount to an adult may be the right amount for a child. Most children are capable of “listening” to their body cues and will stop eating when they are full if you allow them. Not paying attention to hunger and fullness cues can lead to overeating or turn children off to foods they should be eating. What counts as one serving? In general, a toddler-size portion is ¼ to ½ an adult size portion. A preschoolersize portion is close to or the same size as an adults. For example, a one-year-old child would start with a one-quarter serving, while a 3-year-old would start with a half. NOTE: this refers to serving sizes recommended by the 2010 Dietary Guidelines and MyPlate, not portions served in many restaurants.

General Guidelines For each type of food offered, serve: 1) about 1 tablespoon per year of age, OR 2) a portion the size of the child’s palm. The table below offers more specific measurements:* Type of Food Grains and Breads

Dairy

Fruit and Veggies

Meat and Meat Substitutes

1-2 years old

Always start by offering one serving of each food and then let the child decide how much to eat. If he or she is still hungry, they can ask for more food.

3-4 years old

5-6 years old

¼ slice bread 2 tbsp cereal 2 tbsp rice or pasta

½ slice bread ¼ cup cereal ¼ cup rice or pasta

1 slice bread ½ cup cereal ⅓ - ½ cup rice or pasta

¼ - ½ cup whole milk ¼ - ⅓ slice cheese 2 tbsp yogurt

½ - ¾ cup skim/low fat milk ½ slice cheese ¼ cup yogurt

¾ -1 cup skim/low fat milk 1 slice cheese ½ cup yogurt

2 tbsp cooked or canned 2-3 pieces fresh ¼ small whole fruit No more than 2oz 100% juice per day

¼ cup cooked or canned 4-5 pieces fresh ½ small whole fruit No more than 4oz 100% juice per day

½ cup cooked or canned 6-7 pieces fresh 1 small whole fruit No more than 6oz 100% juice per day

1 oz meat** 1 tbsp nut butter ½ large egg 2 tbsp beans/peas 1-2 tbsp tofu

1 ½ oz meat** 1-2 tbsp nut butter ¾ large egg ¼ cup beans/peas 2-3 tbsp tofu

2 oz meat** 2 tbsp nut butter 1 large egg ½ cup beans/peas ¼ cup tofu

*These are general guidelines to give you an idea of how much food to offer young children at meal time; children may eat much more or less than what is listed here. Pay attention to children’s hunger and fullness cues; if you are concerned about your child’s weight or eating habits, consult their pediatrician. **For reference, 3 oz of cooked meat is about the size of a deck of cards.

Tip: Not sure what a tablespoon or a ¼ cup of food looks like? Use measuring spoons and cups to portion out foods for a few days until you learn what the appropriate portion size looks like on your plates and bowls.

Tip: Offering two or three types of fruits and vegetables at each meal will help children meet the daily recommendations.

How do I know if a child who can’t talk yet is full? Watch for these signs: pulling away from the spoon turning away/become distracted no longer opening mouth for food pushing food or spoon back out of the mouth throwing the food on the floor/playing shaking head “no” Children’s appetites change from day to day. It is okay if your child does not eat a whole serving or asks for more food. Children tend to eat just the amount they need over several days. DON’T force more food or stop your hungry child from eating. DO provide meals and snacks at the same time every day and offer a variety of foods in child-size servings. Trust your child to eat the amount that is right for him or her.

Be a grea t role mod Eat your f el! ruits and veggies! Mix it up! Resources: 1) eatright.org - American Dietetic Association 2) www.extension.org - University of Maine Cooperative Extension

07/11 R05/13

Stopping the Bottle

http://kidshealth.org/PageManager.jsp?dn=KidsHealth&lic=1&ps=...

KidsHealth.org The most-visited site devoted to children's health and development

Stopping the Bottle Many toddlers become attached to their bottles. They have them with them much of the time, so besides providing nourishment, bottles also mean comfort and security. But it's important for parents to start weaning babies from bottles around the end of the first year and start getting them comfortable drinking from cups. The longer parents wait to start the transition, the more attached kids become to their bottles and the more difficult it can be to break the bottle habit. Switching from bottle to cup can be challenging, but these strategies can make the change easier for parents and kids.

Timing the Transition Most doctors recommend introducing a cup around the time a baby is 6 months old. In the beginning, much of what you serve in a cup will end up on the floor or on your baby. But by 12 months of age, most infants have the coordination and manual dexterity to hold a cup and drink from it. Age 1 is also when doctors recommend switching from formula to cow's milk, so it can be a natural transition to offer milk in a cup rather than a bottle. If you're still breastfeeding, you can continue feeding your baby breast milk, but do so by offering it (as well as diluted juice or water) in a cup.

Tips to Try Instead of cutting out bottles all at once, try eliminating them gradually from the feeding schedule, starting at mealtimes. If your baby usually drinks three bottles each day, for example, start by eliminating the morning bottle. Instead of giving the baby a bottle right away, bring the baby to the table and after the feeding has started, offer milk from a cup. You might need to offer some encouragement and explanation, saying something like "you're a big boy now and can use a cup like mommy." As you try to eliminate the morning bottle, keep offering the afternoon and evening bottles for about a week. That way, if your child asks for the bottle you can provide assurance that one is coming later. The next week, eliminate another bottle feeding and provide milk in a cup instead, preferably when your baby is sitting at the table in a high chair. Generally, the last bottle to eliminate should be the nighttime bottle. That bottle tends to be a part of the bedtime routine and is the one that most provides comfort to babies. Instead of the bottle, try offering a

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Stopping the Bottle

http://kidshealth.org/PageManager.jsp?dn=KidsHealth&lic=1&ps=...

cup of milk with your child's evening snack and continue with the rest of your nighttime tasks, like a bath, bedtime story, or teeth brushing. It might help to give your child a comforting object to cuddle with, like a blanket or a favorite toy.

More Strategies Here are some other tips to keep in mind: Spill-proof cups that have spouts designed just for babies (often referred to as "sippy cups") can help ease the transition from the bottle. When your child does use the cup, offer plenty of praise and positive reinforcement. If grandma is around, for example, you might say, "See, Emma is such a big girl she drinks milk in a cup!" If you keep getting asked for a bottle, find out what your child really needs or wants and offer that instead. If your child is thirsty or hungry, provide nourishment in a cup or on a plate. If it's comfort, offer hugs, and if your child is bored, sit down and play! As you're weaning your baby from the bottle, try diluting the milk in the bottle with water. For the first few days, fill half of it with water and half of it with milk. Then gradually add more water until the entire bottle is water. By that time, it's likely that your child will lose interest and be asking for the yummy milk that comes in a cup! Get rid of the bottles or put them out of sight. If you continue to have problems or concerns about stopping the bottle, talk with your doctor. Reviewed by: Mary L. Gavin, MD Date reviewed: July 2010

Note: All information on KidsHealthÂŽ is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor. ÂŠ 1995-2013 The Nemours Foundation. All rights reserved.

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Healthy Kids’ Snacks Snacks are a bigger part of kids’ diets than in the past. Snacks can make positive or negative contributions to kids’ diets …depending on the choices we offer. Next time your children say, “I’m hungry,” or if you need to get them through to the next meal, reach for one of these healthy snacks.

Vegetables Most of the snacks served to children should be fruits and vegetables, since most kids do not eat the recommended five to thirteen servings of fruits and vegetables each day. Popular vegetables that can be served raw with dip or salad dressing include:

Low Fat Dairy Foods

Fruit

Fruit is naturally sweet, so most kids love it. Fruit can be Dairy foods are a great source served whole, sliced, cut in of calcium, which can help to half, cubed, or in wedges. build strong bones. However, Canned, frozen, and dried dairy products also are the fruits often need little biggest sources of arterypreparation; choose varieties clogging saturated fat in kids’ with no added sugar. diets. To protect children’s Apples bones and hearts, make sure Broccoli all dairy foods are low fat or Apricots nonfat after age 2. Baby carrots Bananas Celery sticks Blackberries Yogurt Cucumber Blueberries Lower fat cheese like Peppers Cantaloupe cheese sticks, Swiss cheese, Snap peas Cherries and American cheese slices Snow peas Clementines Low fat pudding and frozen String beans Grapefruit yogurt (Serve only as Grape or cherry tomatoes Grapes (red, green, or occasional treats because they Yellow summer squash purple) are high in added sugars) Zucchini slices Honeydew melon Kiwifruit Mandarin oranges Mangoes Nectarines such s g n i Oranges ress sand d d a l u ho Peaches y sa S: Tr anch or T ips, bean P I D Pears FOR /low fat r ht light d hich t g w h u ( g o i s l Pineapple as e-b mu sa, , stor ole, hum vors), sal d n a l Plums Is acam iety of fla u g , s r Raspberries va dip s in a tter. e m o u c Strawberries b anut or pe Tangerines

Healthy Kids’ Snacks (continued) Other popular fruit forms: Applesauce (unsweetened), fruit cups and canned fruit (in juice). Dried fruit—Try raisins, apricots, apples, cranberries, and fruit leathers with little or no added sugars. Frozen fruit Fruit salad—Get kids to help! Popsicles—Look for popsicles made from 100% fruit juice with no added caloric sweeteners.

Important for Toddlers! Feed only age appropriate snacks. Allow toddlers finger foods only under supervision. Be sure they stay seated as they eat and are not lying down or running around. Avoid raw fruits and vegetables that snap into hard chunks, such as carrot and celery sticks and firm apples. Peel and slice grapes. Whole grapes can cause choking.

Healthy Grains

Important!

Try to serve mostly whole grains, which provide more fiber, vitamins, and minerals than refined grains, and include a source of protein like peanut butter, hummus, or low fat cheese. Whole wheat English muffins, pita, or tortillas Breakfast cereal—either dry or with low fat milk. Whole grain cereals like Cheerios, Grape-Nuts, Raisin Bran, Frosted Mini-Wheats, and Wheaties make good snacks. Look for cereals with no more than about 8 grams of sugar per serving. Whole grain crackers like Triscuits® Popcorn Baked tortilla chips Granola and cereal bars— look for whole grain granola bars that are low in fat and sugar. Pretzels, rice cakes, breadsticks, and flatbreads—these low fat items can be offered as snacks now and then. However, most of these snacks are not whole grain and most pretzels are high in salt.

Water should be the main drink served to kids at snack times. Water satisfies thirst and does not have sugar or calories. Water is free or lowcost! If kids are used to getting sweetened beverages at snack times, it may take a little time for them to get used to drinking water. Be a great role model by drinking water yourself!

For more tips, go to www.cspinet.org/nutritionpolicy 03/10 R06/12

Healthy Celebrations Letter to Parents Date: Program: Dear Parents and Families, Our program is participating in an exciting initiative called 5-2-1-0 Goes to Child Care, a program that is part of a larger project called Let’s Go! which is a nationally recognized childhood obesity prevention program. Let’s Go! is a program at The Barbara Bush Children's Hospital at Maine Medical Center, and is implemented in partnership with MaineHealth. To learn more about Let’s Go! visit www.letsgo.org. The program emphasizes the importance of:

As a part of our efforts towards health and wellness, our program is addressing the kinds of celebrations we have. Celebrations and events are exciting and important for children and staff. Birthday parties and holiday celebrations provide a unique opportunity to help make healthy eating fun and for children to practice wise food choices. As a program, we are encouraging healthy celebration treats, like: Fruit and Cheese Kabobs – Put grapes, melons, cheese cubes, and berries onto a wooden kabob stick. Make Your Own Trail Mix – Provide bags of granola or whole grain dry cereal, dried fruit, and nuts for students to make their own trail mix. Fruit Smoothies – Show up at snack time with a blender, frozen fruit, and yogurt! (Be sure to make arrangements with the program first!) Yogurt Parfaits – Layer granola, fruit, and yogurt in plastic cups. Send in on a tray covered with plastic wrap Vegetable or Fruit Platters with Low Fat Dip As a program, we are also focusing on nonfood ways to celebrate our children. On your child’s birthday, we will celebrate them in nonfood ways, like having them wear a special hat, sash, or letting them lead age appropriate activities. Please help us promote a healthy environment and healthy kids! Sincerely,

Please Note: A modifiable version of this letter can be found in the online toolkit on our website.

01/09 R07/13

Go Foods, Slow Foods, Whoa Foods Lots of kids want to know which foods to eat to be healthy. Here’s something kids can do to eat healthier: Learn the difference between Go, Slow, and Whoa foods.

● Go Foods ● Slow Foods ● Whoa Foods

You probably know that foods fit into different categories. The USDA puts them into these categories (visit www.ChooseMyPlate.gov for the newest data): Grains ■ Milk and dairy products ■

Vegetables ■ Meat, beans, fish, and nuts ■

Fruits ■ Oils ■

But now, foods can be classified in three new groups: Go, Slow, and Whoa. In 2005, the U.S. National Heart, Lung, and Blood Institute (part of the National Institutes of Health) suggested kids start thinking about whether foods are Go foods, Slow foods, or Whoa foods.

Go Foods

Slow Foods

Whoa Foods

These are foods that are good to eat almost anytime. They are the healthiest ones. Example: skim & low fat milk; most fruits & veggies. See the back of this sheet for more examples.

These are sometimes foods. They aren’t offlimits, but they shouldn’t be eaten every day. At most, eat them a few times a week. Example: waffles & pancakes.

These foods should make you say exactly that— Whoa! Should I eat that? Whoa foods are the least healthy and the most likely to cause weight problems, especially if a person eats them all the time. That's why Whoa foods are once-in-a-while foods. Example: french fries.

For a chart of Go, Slow, and Whoa foods, visit http://www.kidshealth.org/kid/stay_healthy/food/go_slow_whoa.html

● Go Foods ● Slow Foods ● Whoa Foods Go Foods

Slow Foods

Whoa Foods

■

Baby carrots

■

100% fruit juice

■

French fries

■

Celery sticks

■

Snap peas

Fruits canned in light syrup

Fruits canned in heavy syrup

■

Grape tomatoes

■

White bread

■

Doughnuts

■

Apples

■

Muffins

■

Cherries

French toast, waffles, and pancakes

■

Whole milk

■

Fried hamburgers

■

Tuna canned in oil

■

Melon

■

Oranges

■

Chicken nuggets

■

Peaches

■

Pears

■

Ice cream

■

Whole grain breads

■

Low fat and skim milk

■

Chicken and turkey without skin

■

Lower fat cheese and yogurt

■

Water

08/08 R07/11

Healthy Shopping On A Budget Healthy shopping on a budget takes planning! Planning helps you SAVE TIME, MONEY, and EAT HEALTHIER. Tips: 

Make a list and stick to it – this helps you avoid impulse buys that are usually unhealthy and expensive.



Shop mostly the perimeter of the store – spend most of your grocery budget on natural foods found around the outside of the store like fruits, vegetables, dairy and protein foods that are good for your body. Limit your shopping in the middle isles to staples like pasta, canned tuna, and peanut butter, avoiding other expensive manufactured, and often unhealthy, packaged foods.



Shop when you are NOT hungry or stressed – people who shop when hungry or stressed tend to not only buy MORE food but also unhealthier food.



Compare unit prices – bigger is not always better! Use the unit price to compare similar products and make sure you’re getting the best deal. The unit price is the cost per a standard unit (like ounce or pound) and is usually found on a sticker on the shelf beneath the product.



Weigh the cost of convenience – if food tends to rot in your fridge before you prepare it, then you could actually save money by purchasing fresh fruits and veggies that have been washed and chopped for you.



Try frozen and canned – canned and frozen produce keeps for a long time and may be cheaper per serving than fresh. For frozen, make sure you look for items with no added sauces or sugar. For canned, choose fruit canned in 100% juice and vegetables that are labeled either “low sodium” or “no added salt”.



Use store flyers to plan your menu – save money by planning your menu around what fruits, vegetables and other items are on sale each week and save time by already knowing what you are going to make for dinner each night.



Try store brands – store brands on average are cheaper by about 26% to 28% and their quality usually at least meets, and often surpasses, that of name brand products.



Shop in season – buying fruits and vegetables in season generally means your food not only tastes better, but is more nutritious and more affordable.



Buy in bulk when foods are on sale – frozen and canned produce, and some fresh items like apples and carrots will last a long time. If you have the storage space, stock up on the foods you eat regularly when they are on sale to save some money.

07/11 00/00

Understanding Food Labels What can I use the Nutrition Facts label for? Getting a general idea about what’s in a food (i.e. how nutritious a food is). Figuring out what counts as one serving and how many calories are in each serving. Comparing two similar products to choose the healthiest option.

S H Start by checking what counts as one TART

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serving size and how many servings there are per package.

C C :  How many calories would you eat if HECK

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you ate a whole package? Multiply the number of “servings per container” by the “calories”.

L N  Aim to eat only small amounts of IMIT THESE

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saturated fat, cholesterol and sodium. Keep transfat to 0.

QUICK GUIDE TO % DAILY VALUE ·5% or less is Low ·20% or more is High. Use the % Daily Value to compare similar foods and choose the healthiest option.



G E N  Aim to get enough fiber, vitamins and minerals. ET

NOUGH OF THESE

UTRIENTS

Watch out for these common misconceptions: Assuming sugar-free or fat-free means calorie-free; it’s not true! Buying something because it says “organic”, “natural”, “multigrain” or has some other “healthy” claim. These statements do not mean a product is good for you! Assuming that because a package looks like it should only be one serving it actually is. Many beverage bottles and packages of chips, cookies and candy are actually 2 or 3 servings! Resources: http://www.fda.gov/Food/IngredientsPackagingLabeling/LabelingNutrition/ucm20026097.htm

07/11 R07/13

Maine Seasonal Food Guide What are the advantages of knowing which foods are in season? Buying fruits and vegetables that are in season means getting them at their freshest and saving money. Buying from local farms also means supporting our local farmers and their ability to produce nutritious, fresh food. The chart below lists what produce is available locally depending on the time of year. January to April Apples, Dry Beans, Beets, Cabbage, Carrots, Celeriac, Leeks, Onions, Parsnip, Potatoes, Rutabaga, Sweet Potatoes, Turnip, Winter Squash, Garlic May to June Rhubarb, Asparagus, Radishes, Salad Turnips, Scallions, Peas, Fiddleheads, Chives and Parsley, Greens July to August Berries (strawberries, raspberries, blueberries, blackberries), Plums, Peaches, Earliest Apples, Melons, Beets, Broccoli, Cabbage, Carrots, Cauliflower, Celery, Cucumbers, Eggplant, Fennel, Green Beans, Greens, Leeks, Onions, Scallions, Shallots, Peas, Peppers, Potatoes, Radishes, Salad Turnips, Summer Squash, Zucchini, Tomatoes, Garlic – scapes and bulbs September to October Apples, Pears, Cranberries, Melons, Raspberries, Broccoli, Broccoli Raab, Brussel Sprouts, Cabbage, Cauliflower, Kohlrabi, Celeriac, Celery, Sweet Corn, Cucumbers, Fennel, Greens, Leeks, Onions, Scallions, Shallots, Beets, Carrots, Parsnips, Potatoes, Rutabaga, Sweet Potato, Turnips, Radishes, Salad Turnips, Green Beans, Shell Beans, Soy Beans (edamame), Summer Squash, Zucchini, Eggplant, Peppers, Tomatillos, Tomatoes, Winter Squash, Pie Pumpkins, Garlic November to December By this time of year, most local produce is coming from cold storage although you may be able to find some fresh greenhouse-grown products at your winter farmer’s market.

Apples, Pears, Dry Beans, Beets, Brussel Sprouts, Cabbage, Carrots, Celeriac, Late season greens (like kale and spinach), Kohlrabi, Leeks, Onions, Parsnips, Potatoes, Radishes, Rutabaga, Sweet Potatoes, Turnips, Winter Squash, Garlic Maine-produced foods that are in season all year long: FRUIT: Blueberries & Apples VEGETABLES: Potatoes, Carrots, Beets and Beet Greens, Garlic, Salad & Braising Greens, Tomatoes, Winter Squash, Cabbage, Onions DAIRY: Milk & Cheese PROTEIN: Eggs, Ground Meat, Seafood, Dry Beans GRAINS: Wheat Where to find local foods through the winter: Winter Farmers Market, Winter CSA (Community Support Agriculture), Natural Food Store, Local Food Coop (visit www.mofga.org and click on “Directories” for more information) Resource: www.mofga.org

07/11 R06/12

Breakfast Is Best! Boost your energy and brain power! Why eat breakfast every day? It will give you the energy you need to start your day. It is “fuel” for the body! It can help you do better in school! It can help you feel and act your best! It can help with weight control and keep you healthy! Not hungry in the morning? Try a variety of Start small… try: healthy foods! a cup of low fat fruited yogurt Find the ones a piece of fruit such as a banana, orange or apple YOU like! a bowl of wholegrain cereal with low fat milk a slice of wholewheat toast with peanut butter and a glass of low fat milk

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half of a toasted English muffin with a slice of low fat cheese trail mix of raisins, nuts and cereal

A Meal is a Family Affair In such a busy world, mealtimes often revolve around our lifestyles. As a result of this, we miss meals or eat foods that are not the best for our bodies. Did you know that experts have found that kids who eat regularly with their families are more likely to eat fruits, vegetables, and whole grains? So, no matter how busy life may seem, itâ&#x20AC;&#x2122;s important to make family meals a priority.

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To have fruits and vegetables year-round, add frozen or canned. For health: Just as good for you as fresh fruit and vegetables—nutrients are preserved in the canning and freezing process ■ Choose fruit packed in their natural juice, not in syrup ■ Choose canned vegetables that are salt free and season to taste ■

For savings: ■

Cost less than fresh fruit and vegetables

For convenience: Always in season ■ Lots of choices ■ Easily stored ■ Already washed and cut—ready for your favorite recipe ■

Eat at least five fruits and vegetables a day!

Use Frozen and Canned by Adding: Vegetables to: ■ Chili ■ Soup or stews ■ Stir fry Tomatoes for sauce Black beans & corn to spice up a Mexican dish Chick peas, kidney or garbanzo beans to any salad

Fruits to: ■ Smoothies ■ Yogurt parfaits ■ Plain yogurt ■ Fruit salad ■ Cereal ■ Stir fry (pineapple)

sa Or use ah! side dis

04/09 R03/10

What’s a Healthy Portion? Food portions are larger than ever these days—usually much more than you need. The recommended serving size is enough. But how much is that? These tips will help keep your portions, as well as your waistline, right-sized.

Here are some tips to help you keep your portions under control: Teach your children portion size by relating food to everyday items. For example, a deck of cards is equal to a serving of meat, fish, or poultry. An apple or serving of fruit is about the size of a tennis ball. Please note: For young children, use the palm of their hand as an indicator of portion size Sta

■

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Teach your children the concept of the divided plate. Think of a plate divided into four equal sections. Use one of the top sections for protein, and the other one for starch, preferably a whole grain; fill the bottom half with veggies (none of the foods should overlap or be piled high).

Check the label on your food to see if it meets some basic needs in your diet, like calcium or Vitamin C; if it’s not “good” for you, eat less of that food.

Check

the serving size and remember that if you eat more than one serving, you are eating more calories.

Avoid eating directly out of the package. Try putting snacks into a small bowl or snack-size baggie. ■ Eat three meals a day; this way you won’t stuff yourself if you have skipped a meal. ■

■

Serve food on smaller plates.

Serve meals from the stove. This tip will keep you from feeling tempted to eat more when you are not hungry. ■ Skip the “clean plate” club. Instead, encourage your children to start with smaller portions and eat until they are satisfied. ■ At restaurants, ask for a lunch-size portion or share your meal. ■ Role model the behaviors that you want your children to develop. ■

The Fittest Food Nutritious foods give your family the most vitamins, minerals and other nutrients for the fewest calories. Naturally nutritious foods make your child’s calories count: I

Brightly colored fruits

Vibrant-colored vegetables

Lean meat, skinless poultry, fish, eggs, beans, and nuts TIP: Choose cuts of meat that end in "loin" or "round". I Fat-free and low fat milk, cheese, and yogurt I

Whole, fortified, and fiber-rich grain foods

Tips to Help Your Kids Eat Healthier: Picky eaters? Remember, experts say that parents and caregivers, not children, should decide what foods to buy and serve. New foods may have to be offered many times before they are accepted. Here are some easy ways to get your child to accept unfamiliar nutritious foods: I

Combine whole grain/high-fiber cereals with your child’s favorite cereal.

Make your own pizza with prepared whole wheat dough, a few veggies, and part-skim mozzarella cheese.

Children age 2 and older: slowly step down from whole milk to low fat to fat-free milk. I

ds are o fo s u io it r t u n These venient: n o c d n a e iv s n e inexp

Clean and cut up fresh veggies in advance. Kids love dips, so serve them with salsa or hummus!

On-the-go options: dried fruits, nuts, hard boiled eggs, low fat cheese sticks, yogurt cups, and single-serve fruits canned in water or 100% fruit juice.

Handling A “Choosy” Eater What would you do? • Sara-Mei will not eat anything green – she even refuses a whole meal if one green pea appears on her plate. • Santiago is interested in everything at the table BUT eating. • Dillion gets upset when one food on his plate touches another. • Mariffa will not eat anything but an orange or a banana; two days ago she would only eat peanut butter sandwiches. “Choosy” eating is a childsize step toward growing up and showing independence. In fact, what seems like a challenge to you may be an early step toward making food choices. A child’s “No” does not always mean no. What seems “choosy” may just be your child’s awkward first steps in learning to make decisions.

What appears to be “choosy” eating may instead be a smaller appetite. Preschool-age children grow and develop at a slower rate than toddlers do. If left alone, most children become hearty eaters again when their body’s growth pattern requires more food for energy.

The best advice for you: Relax and be patient!

Ten Effective Ways To Handle a “Choosy” Eater 1. Treat food jags casually since food jags do not last long anyway.

2. Consider what a child eats over several days, not just at each meal. Most kids eat more food variety than a parent thinks.

3. Trust your child’s appetite rather than force a child to eat everything on the plate. Forcing a child to eat more encourages overeating.

4. Set reasonable time limits for

the start and end of a meal then remove the plate quietly. What is reasonable depends on each child.

5. Stay positive and avoid criticizing or calling any child a “picky eater.” Children believe what you say!

Learn how to handle eating challenges and how to avoid conflict. That way, your child will not learn to use food as a way to exert control. Provided by

NIBBLES FOR HEALTH 13 Nutrition Newsletters for Parents of Young Children, USDA, Food and Nutrition Service

Handling A “Choosy” Eater 6. Serve food plain, and respect the “no foods touching” rule if that’s important to your child. This will pass.

7. Avoid being a short-order cook by offering the same food for the whole family. Plan at least one food everyone will eat.

8. Substitute a similar food –

9. Provide just two or three

choices not a huge array of food. Then let your child decide.

10. Focus on your child’s positive

eating behavior not on the food.

Check (✓) what you do already. Circle

what you can try right away.

if a child does not like a certain food; instead of squash, offer sweet potatoes.

Provided by

NIBBLES FOR HEALTH 13 Nutrition Newsletters for Parents of Young Children, USDA, Food and Nutrition Service

um aine .e du

http://umaine.edu/publicatio ns/4309e/

Making Your Own Baby Food By Nellie Hedstrom, Extension nutrition specialist. Peer reviewers: Kathleen Savoie, Extension educator, and Jane Conroy, Extension educator For information about UMaine Extension programs and resources, visit extension.umaine.edu. Find more of our publications and books at extensionpubs.umext.maine.edu. With a little planning, and a blender, a f ork, a strainer, a f ood mill or a baby f ood grinder, you can make f oods f or your baby at home. Homemade inf ant f ood may help cut f ood costs, and provide baby with f ood as nutritious, if not more nutritious, than store-bought baby f oods. Making your own baby f ood will also help baby get used to f oods the f amily eats. Pureed f ruits and vegetables can be prepared f rom f reshcooked f ruits and vegetables. Use the cooked f ruits and vegetables without added salt, sugar or f at. Puree means to put f ood through a sieve or grinder to make the f ood into a liquid-like, smooth texture. Some f oods, like ripe bananas, can be mashed or pureed with a f ork and won’t need to be precooked. It may be necessary to add some f luid (f ormula, breast milk, water or cooking water) to other pureed f ood to make it the right consistency f or your baby. Canned or f rozen f ruits and vegetables may also be pureed and used. When using commercially processed canned or f rozen f ruits and vegetables, check the ingredient label. Make sure you are not adding extra sugar, salt and f at to your baby’s diet. Other unnecessary additives may also be in canned or f rozen f oods. Some commonly home-prepared f ruits f or babies are ripe mashed bananas, and pureed bananas and applesauce. Dried prunes that have been cooked and pureed are another f ood f or baby. Fresh pears or peaches in season may also be sof t-cooked and pureed. Fresh vegetables that can be home prepared and pureed include potato, winter squash, sweet potato, peas, asparagus, and green or wax beans. Later, when baby is between 8 months through 11 months, table f ood can be added to her diet. By that time, your baby will be able to move her tongue f rom side to side, and will have begun to spoon f eed herself with your help. She’ll also start chewing with her new teeth, and f eed herself with her f ingers. With your help, she will also drink f rom a cup. At this stage, try f eeding mashed or diced f ruit, sof t cooked or mashed vegetables; mashed, cooked egg yolk; strained meats or poultry; mashed, cooked dry beans and peas; cottage cheese or cheese cubes; sliced bread; crackers; and juice in a cup.

Tips f or Making Homemade Baby Food Work under the most sanitary conditions possible. Wash your hands with hot water and soap, scrub, rinse and dry with clean towel bef ore f ixing your baby’s f ood, bef ore f eeding your baby, and af ter changing your baby’s diapers. Scrub all working surf aces with soap and hot water. Scrub all equipment with soap and hot water, and rinse well. Prepare f resh f ruits or vegetables by scrubbing, paring or peeling, and removing seeds. Prepare meats by removing all bones, skin, connective tissue, gristle and f at. Cook f oods, when necessary, boiling them in a small, covered saucepan with a small amount of water until tender. T he amount of water is important — the less water used, the more nutrients stay in the f ood. Puree f ood using a blender, f ood processor, baby f ood grinder, spoon or f ork. Grind up tough f oods. Cut f ood into small pieces or thin slices. Take out seeds and pits f rom f ruit. Test f or smoothness by rubbing a small amount of f ood between your f ingers. Add a liquid such as f ormula, water or f ruit juice to achieve a desired consistency. If pureed f ood is not being used right away, ref rigerate quickly. To f reeze: pour cooled, pureed f ood into a paper cupcake liner or a section of a clean ice cube tray, and cover with f oil. When f rozen solid, store cubes in a f reezer container in the f reezer in a f reezer bag or box. Reheat f rozen cube in a heat-resistant container in a pan of hot water. When cooking f oods f or the f amily, remember to separate the baby’s portion bef ore adding seasoning or spices. Babies need very little, if any, added salt or sugar.

Thawing and Warming Baby’s Food Here are some suggestions on thawing and warming f ood f or your baby. Frozen f ood can be thawed in the ref rigerator or the microwave oven on the def rost setting. But remember, f ood that has been thawed should never be ref rozen. Stove Method:To warm f ood, place it directly in a saucepan and slowly warm over low heat, stirring of ten. Stir and test temperature of f ood bef ore f eeding it to your baby. Microwave Method:Microwave ovens heat f oods unevenly and cause hot spots. T here may be hot spots even if the f ood f eels cool to you. It is important to stir f ood well to prevent burns to you or your baby. Here are some other tips: Cover dish with a microwave-saf e cover, not plastic wrap. Stir f ood and turn the dish of ten during the heating process. Allow f ood to sit f or a f ew minutes; stir well and test temperature bef ore f eeding your baby. It is not recommended to heat pureed meats in the microwave. Hot spots in the meat could seriously burn your baby. For other f oods, heat f ood in a microwave-saf e dish or an opened baby-f ood jar. Q: Should I avoid certain foods if I make my own baby food?

A:High-nitrate vegetables, such as beets, broccoli, cabbage, carrots, celery, collard greens, lettuce, spinach and turnips, should not be f ed to babies in large quantities. T he naturally occurring nitrates in these vegetables can change to nitrites, which bind iron in the blood and make it dif f icult to carry oxygen. T his can make it hard to breathe and cause the skin to become blue. Limit the serving size of these vegetables to one to two tablespoons per f eeding.

Equipment Needed to Make Baby Food Sieve/strainer:It should have a small mesh. You can press f oods through it with the back of a spoon. It can be used f or juices, sof t f ruits and vegetables, but not meats. Spoon, forks and potato masher:Use these to mash sof t f oods, such as most canned f ruits, egg yolks, bananas and potatoes, to the right consistency. Food mills or grinders:You may already have a f ood mill in your canning supplies, but if you donâ&#x20AC;&#x2122;t, they are available in stores that sell kitchen supplies. T he smaller size baby f ood mill is similar to the larger version. T hey can be purchased in the baby section of department stores. It can be used at home or when traveling. T he larger mills and grinders are usef ul when preparing sof t meats and both can be used f or cooked f ruits, vegetables and sof t f resh f ruits. Blenders:Your blender can come in handy to prepare f ood f or the baby. Food items cooked f or the f amily can be blended smooth f or baby or to f reeze f or later. Hand-held blenders are usef ul pieces of equipment that you may want to consider. Plastic ice cube trays:Use trays f or f reezing extra f ood that you prepare. Af ter the f ood is f rozen, remove the cubes and store in a container designed f or f reezing.

Pureed Baby Food Recipes Pureed Fruit Delight 1/2 cup freshly cooked (Try apples, pears, peaches or prunes) Remove skin and seeds. Press through a sieve, or put ingredients in f ood mill or blender and puree until smooth. Serve or f reeze. Freeze no longer than 1 month.

Bananas Plain and Simple Ripe bananas may be pureed or mashed and f ed to your baby directly.

Veget able Medley 1/2 cup cooked fresh, frozen or low sodium canned vegetables (potato, sweet potato, green beans, peas, carrots, yellow squash), without salt added Cook f resh vegetables or use f rozen or canned vegetables without salt or seasoning. (Read labels f or ingredients.) Press vegetable chunks through a sieve or baby f ood mill, or put in a blender. If necessary, thin purĂŠed vegetables with a small amount of cooking liquid, expressed breast milk or f ormula to desired

consistency. If not serving immediately, do not thin prior to serving. Freeze no longer than 1 month. Note:Af ter the individual vegetables have been f ed several times, some good combinations are: potatoes and carrots, potatoes and green beans, carrots and peas.

Simple PurĂŠed Meat or Poult ry (f or babies over 8 months) 1/2 cup cooked meat (small pieces of lean chicken, beef, turkey or pork) Cook lean meat (f at and skin removed) over low heat in a small amount of water. Puree meat until smooth. If serving, meat puree can be thinned by adding a small amount of water, reserved cooking broth, expressed breast milk, or inf ant f ormula. If f reezing, do not add liquid. Freeze no longer than one month.

Your Choice Combo Dish (f or babies over 8 months) 1 cup cooked, cubed or diced meat (cut off fat) 1/2 cup cooked rice, potato, noodles or macaroni 2/3 cup cooked, diced vegetables Combine and blend until smooth. Serve or f reeze in serving-size containers. If f rozen, use within 1 month. Note:If you prepare combination dishes, use them only af ter you have f ed the individual f ood several times. Information in this publication is provided purely for educational purposes. No responsibility is assumed for any problems associated with the use of products or services mentioned. No endorsement of products or companies is intended, nor is criticism of unnamed products or companies implied. ÂŠ 2002, 2013 Published and distributed in f urtherance of Cooperative Extension work, Acts of Congress of May 8 and June 30, 1914, by the University of Maine and the U.S. Department of Agriculture cooperating. Cooperative Extension and other agencies of the USDA provide equal opportunities in programs and employment. Call 800.287.0274 or T DD 800.287.8957 (in Maine), or 207.581.3188, for information on publications and program offerings from University of Maine Cooperative Extension, or visit extension.umaine.edu. The University of Maine does not discriminate on the grounds of race, color, religion, sex, sexual orientation, including transgender status and gender expression, national origin, citizenship status, age, disability, genetic information or veteranâ&#x20AC;&#x2122;s status in employment, education, and all other programs and activities. The following person has been designated to handle inquiries regarding non-discrimination policies: Director, Office of Equal Opportunity, 101 North Stevens Hall, 207.581.1226.

Phrases that HELP and HINDER As the caregiver, you play the biggest role in your child’s eating behavior. What you say has an impact on developing healthy eating habits. Negative phrases can easily be changed into positive, helpful ones!

Phrases that HINDER

Phrases that HELP

INSTEAD OF ...

TRY ...

Eat that for me. If you do not eat one more bite, I will be mad.

This is kiwi fruit; it’s sweet like a strawberry. These radishes are very crunchy!

Phrases like these teach your child to eat for your approval and love. This can lead your child to have unhealthy behaviors, attitudes, and beliefs about food and about themselves.

Phrases like these help to point out the sensory qualities of food. They encourage your child to try new foods.

INSTEAD OF ...

TRY ...

You’re such a big girl; you finished all your peas. Jenny, look at your sister. She ate all of her bananas. You have to take one more bite before you leave the table.

Is your stomach telling you that you’re full? Is your stomach still making its hungry growling noise? Has your tummy had enough?

Phrases like these teach your child to ignore fullness. It is better for kids to stop eating when full or satisfied than when all of the food has been eaten.

Phrases like these help your child to recognize when he or she is full. This can prevent overeating.

INSTEAD OF ...

TRY ...

See, that didn’t taste so bad, did it?

Do you like that? Which one is your favorite? Everybody likes different foods, don’t they?

This implies to your child that he or she was wrong to refuse the food. This can lead to unhealthy attitudes about food or self.

Phrases like these make your child feel like he or she is making the choices. It also shifts the focus toward the taste of food rather than who was right.

INSTEAD OF ...

TRY ...

No dessert until you eat your vegetables. Stop crying and I will give you a cookie.

We can try these vegetables again another time. Next time would you like to try them raw instead of cooked? I am sorry you are sad. Come here and let me give you a big hug.

Offering some foods, like dessert, in reward for finishing others, like vegetables, makes some foods seem better than others. Getting a food treat when upset teaches your child to eat to feel better. This can lead to overeating.

Reward your child with attention and kind words. Comfort him or her with hugs and talks. Show love by spending time and having fun together.

Adapted from “What You Say Really Matters?” in Feeding Young Children in Group Settings, Dr. Janice Fletcher and Dr. Laurel Branen, University of Idaho.

Let's eat for the health of it

Dairy Fruits

Vegetables

Grains

Protein

ChooseMyPlate.gov

Start by choosing one or more tips to help you...

Build a healthy plate

Cut back on foods high in solid fats, added sugars, and salt

Eat the right amount of calories for you

Be physically active your way

4Build a healthy plate Before you eat, think about what goes on your plate or in your cup or bowl. Foods like vegetables, fruits, whole grains, low-fat dairy products, and lean protein foods contain the nutrients you need without too many calories. Try some of these options.

Make at least half your grains whole. • Choose 100% wholegrain cereals, breads, crackers, rice, and pasta.

Make half your plate fruits and vegetables.

• Check the ingredients list on food packages to find whole-grain foods.

• Eat red, orange, and dark-green vegetables, such as tomatoes, sweet potatoes, and broccoli, in main and side dishes.

Vary your protein food choices.

• Eat fruit, vegetables, or unsalted nuts as snacks—they are nature’s original fast foods.

• Twice a week, make seafood the protein on your plate.

Switch to skim or 1% milk. • They have the same amount of calcium and other essential nutrients as whole milk, but less fat and calories. • Try calcium-fortified soy products as an alternative to dairy foods.

• Eat beans, which are a natural source of fiber and protein. • Keep meat and poultry portions small and lean. Keep your food safe to eat—learn more at www.FoodSafety.gov.

4Cut back on foods high in solid fats, added sugars, and salt Many people eat foods with too much solid fats, added sugars, and salt (sodium). Added sugars and fats load foods with extra calories you don’t need. Too much sodium may increase your blood pressure.

Eat fewer foods that are high in solid fats. • Make major sources of saturated fats—such as cakes, cookies, ice cream, pizza, cheese, sausages, and hot dogs—occasional choices, not everyday foods.

Choose foods and drinks with little or no added sugars.

• Select lean cuts of meats or poultry and fat-free or low-fat milk, yogurt, and cheese.

• Drink water instead of sugary drinks. There are about 10 packets of sugar in a 12-ounce can of soda.

• Switch from solid fats to oils when preparing food.*

• Select fruit for dessert. Eat sugary desserts less often. • Choose 100% fruit juice instead of fruit-flavored drinks. Look out for salt (sodium) in foods you buy— � it all adds up.

• Compare sodium in foods like soup, bread, and frozen meals—and choose the foods with lower numbers. • Add spices or herbs to season food without � adding salt. �

*Examples of solid fats and oils Solid Fats

Oils

Beef, pork, and chicken fat Butter, cream, and milk fat Coconut, palm, and palm kernel oils Hydrogenated oil Partially hydrogenated oil Shortening Stick margarine

Canola oil Corn oil Cottonseed oil Olive oil Peanut oil Safflower oil Sunflower oil Tub (soft) margarine Vegetable oil

4Eat the right amount of calories for you � Everyone has a personal calorie limit. Staying within yours can help you get to or maintain a healthy weight. People who are successful at managing their weight have found ways to keep track of how much they eat in a day, even if they don’t count every calorie. Enjoy your food, but eat less. • Get your personal daily calorie limit at www.ChooseMyPlate.gov and keep that number in mind when deciding what to eat. • Think before you eat…is it worth the calories? • Avoid oversized portions. • Use a smaller plate, bowl, and glass.

Cook more often at home, where you are in control of what’s in your food. When eating out, choose lower calorie menu options. • Check posted calorie amounts. • Choose dishes that include vegetables, fruits, and/or whole grains. • Order a smaller portion or share when eating out. Write down what you eat to keep track of how much you eat. If you drink alcoholic beverages, do so sensibly—limit to 1 drink a day for women or to 2 drinks a day for men.

• Stop eating when you are satisfied, not full.

4Be physically active your way � Pick activities that you like and start by doing what you can, at least 10 minutes at a time. Every bit adds up, and the health benefits increase as you spend more time being active.

Note to parents What you eat and drink and your level of physical activity are important for your own health, and also for your children's health. You are your children’s most important role model. Your children pay attention to what you do more than what you say. You can do a lot to help your children develop healthy habits for life by providing and eating healthy meals and snacks. For example, don’t just tell your children to eat their vegetables—show them that you eat and enjoy vegetables every day.

Use food labels to help you make better choices

Most packaged foods have a Nutrition Facts label and an ingredients list. For a healthier you, use this tool to make smart food choices quickly and easily. Check for calories. Be sure to look at the serving size and how many servings you are actually consuming. If you double the servings you eat, you double the calories. Choose foods with lower calories, saturated fat, trans fat, and sodium. Check for added sugars using the ingredients list. When a sugar is close to first on the ingredients list, the food is high in added sugars. Some names for added sugars include sucrose, glucose, high fructose corn syrup, corn syrup, maple syrup, and fructose.

Dietary Guidelines for Americans Dietary Guidelines for Americans U.S. Department of Agriculture U.S. Department of Health and Human Services www.dietaryguidelines.gov

The Dietary Guidelines for Americans, 2010 are the best science-based advice on how to eat for health. The Guidelines encourage all Americans to eat a healthy diet and be physically active.

For more information, go to:

Improving what you eat and being active will help to reduce your risk of chronic diseases such as diabetes, heart disease, some cancers, and obesity. Taking the steps in this brochure will help you follow the Guidelines.

• www.Health.gov/paguidelines

• www.DietaryGuidelines.gov • www.ChooseMyPlate.gov

• www.HealthFinder.gov

USDA Publication number: Home and Garden Bulletin No. 232-CP HHS Publication number: HHS-ODPHP-2010-01-DGA-B June 2011 The U.S. Departments of Agriculture and Health and Human Services are equal opportunity providers and employers.

10 tips

choose MyPlate 10 tips to a great plate

Nutrition

Education Series

Making food choices for a healthy lifestyle can be as simple as using these 10 Tips. Use the ideas in this list to balance your calories, to choose foods to eat more often, and to cut back on foods to eat less often.

balance calories

Find out how many calories YOU need for a day as a first step in managing your weight. Go to www.ChooseMyPlate.gov to find your calorie level. Being physically active also helps you balance calories.

enjoy your food, but eat less

Take the time to fully enjoy your food as you eat it. Eating too fast or when your attention is elsewhere may lead to eating too many calories. Pay attention to hunger and fullness cues before, during, and after meals. Use them to recognize when to eat and when you’ve had enough.

avoid oversized portions

Use a smaller plate, bowl, and glass. Portion out foods before you eat. When eating out, choose a smaller size option, share a dish, or take home part of your meal.

foods to eat more often

They have the same amount of calcium and other essential nutrients as whole milk, but fewer calories and less saturated fat.

make half your plate fruits and vegetables

Choose red, orange, and dark-green vegetables like tomatoes, sweet potatoes, and broccoli, along with other vegetables for your meals. Add fruit to meals as part of main or side dishes or as dessert.

Center for Nutrition Policy and Promotion

make half your grains whole grains

To eat more whole grains, substitute a whole-grain product for a refined product—such as eating wholewheat bread instead of white bread or brown rice instead of white rice.

foods to eat less often

Cut back on foods high in solid fats, added sugars, and salt. They include cakes, cookies, ice cream, candies, sweetened drinks, pizza, and fatty meats like ribs, sausages, bacon, and hot dogs. Use these foods as occasional treats, not everyday foods.

Eat more vegetables, fruits, whole grains, and fat-free or 1% milk and dairy products. These foods have the nutrients you need for health—including potassium, calcium, vitamin D, and fiber. Make them the basis for meals and snacks.

switch to fat-free or low-fat (1%) milk

compare sodium in foods

Use the Nutrition Facts label to choose lower sodium versions of foods like soup, bread, and frozen meals. Select canned foods labeled “low sodium,” ”reduced sodium,” or “no salt added.”

drink water instead of sugary drinks

Cut calories by drinking water or unsweetened beverages. Soda, energy drinks, and sports drinks are a major source of added sugar, and calories, in American diets.

DG TipSheet No. 1 June 2011

Go to www.ChooseMyPlate.gov for more information.

USDA is an equal opportunity provider and employer.

Nutrition and Physical Activity Self-Assessment for Child Care

How Can I Influence What My Child Eats? Here’s Why It’s Important… Parents have a lifelong effect on their child’s eating behaviors. Your children are influenced not just by what you do, but also by what you say. There are many things parents can do to help their children establish healthy eating habits. Parents control what foods enter the house.

Quick Breakfast Ideas Peanut butter toast Bagels with cream cheese Oatmeal with applesauce Pita bread and yogurt

Parents decide how food is prepared and served. Parents can encourage children to try new foods and role model this behavior themselves. Happy, fun family mealtimes will create a positive outlook towards food and vice versa. Eating as a family improves academic achievement scores and overall nutrient intake, and helps reduce behavior problems.

Cereal with milk and fruit Toasted waffle with sliced fruit

Make Mealtimes Count! Turn off the TV and computer. Turn off the phone and enjoy conversation with your family. Sit down together. Take time to talk to each other. Listen to everyone. Let your children talk about things they are interested in. Keep conversations positive so mealtimes are happy times!

Division of Responsibility

Tips for Feeding Your Kids Set a good example! Eat the foods you want your child to eat.

Children like to be in control and often one of the only things a child may be able to control is what he/she eats. Therefore, to avoid mealtime battles and encourage healthy eating; it is helpful to give children the power of control. In doing so, keep “the division of responsibility” in mind. It is your responsibility to buy, prepare and serve healthy meals and snacks. It is the child’s job to decide if, how much, and what to eat. If this “division of responsibility” is respected, children will learn to try new foods, recognize their fullness cues, and maintain lifelong healthy eating behaviors.

Introduce new foods with familiar favorites.

Don’t bribe your child with food, such as “If you eat your broccoli, you can have dessert.” This places “value” on food and relates healthier foods to unpleasant experiences. This may also increase your child’s desire for sweets.

If your child refuses to eat, don’t make it a power struggle, instead say, “You must not be hungry. You may have something later at snack time.”

Encourage children to serve themselves or serve small portions for them; this will avoid overwhelming them. Also, give them control over seconds.

Gently and positively encourage your child to try a small bite of something, but don’t force your child to eat!

Encourage your child to help prepare meals or involve them in menu planning. This gives everyone a vote in what the family eats.

Offer healthy snacks between meals. Children have small stomachs and often need to eat every three hours.

When offering a new food for the first time, talk about the food’s color, shape, size and texture and remember to stay casual. This will give your child an opportunity to try something new without pressure.

Avoid being a short-order cook. Prepare one meal that includes at least one item that each person will eat and don’t force the others.

Be persistent! It may take ten or more exposures before a child accepts a new food.

For more information, please visit:

Involve children at the grocery store and allow them to pick out healthy foods (fruits, vegetables); encourage them to find something new.

http://www.ellynsatter.com/

http://www.betterkidcare.psu.edu/ http://www.mypyramid.gov/kids/

Published by the NAP SACC Program, Center for Health Promotion and Disease Prevention. The University of North Carolina, Chapel Hill, NC, May 2007. Permission to reprint in its entirety. For non-commercial use only.

Nutrition and Physical Activity Self-Assessment for Child Care

What’s in Your House? Creating a Healthy Food Environment Here’s Why It’s Important… Healthy eating is not only important for weight control, but it is linked to better behavior and academic performance in kids; therefore it is important to provide an environment that supports healthy eating. Parents that provide healthy foods in a supporting environment will be the most successful in creating healthy lifelong eating habits for their children. After all, you want your family to have energy, be healthy and stay well!

What Does a Healthy Food Environment Look Like? Stock up on fruits and vegetables. Keep them within easy reach for your children. Or better yet, keep some washed and cut up on the counter for quick snacks. Keep frozen and canned fruits and vegetables on hand for days when you have less time to prepare fresh ones. Choose low-sodium canned vegetables and fruits canned in their own juice or rinse with water before serving. Limit the amount of chips, cookies, ice cream, and other unhealthy snacks in your house. When you do have them, store them where children cannot reach or see them. They are likely to forget they are there! Buy whole grain foods such as breads, oatmeal, brown rice, whole wheat pasta, and whole grain cereals such as Cheerios®, Raisin Bran®, Total®, Wheaties®, or shredded wheat cereals. Make sure children have access to water at all times. When thirsty, reach for the water first!

Choose beverages wisely; they can add a lot of unnecessary calories. Keep 1% or skim milk on hand for meals and make sure your children don’t drink more than 4-6 oz. of 100% fruit juice each day. Eat together as a family more often! Studies show that, when families eat together, children eat more fruits and vegetables.

Quick Changes You Can Make Today Get the kids involved! They can slice bananas, mix ingredients, wash fruits and vegetables, and set the table. Keep a grocery list so you aren’t tempted by impulse buys. Start a fruit bowl and keep it out at all times. Keep a pitcher of fresh water with lemon slices on a low table with cups for children to pour when thirsty. Store “snack-size” packages of dried fruit, pretzels, baked chips, or graham crackers for a grab-and-go snack. For more information, please visit: www.fitcitychallenge.org/Families www.mypyramid.gov/kids

Whole Grain Pita Pizzas Makes 2 servings 2 round 6-7” whole wheat pitas 6 oz. spaghetti sauce (about 1/4 of a typical jar) 3 oz. part-skim shredded mozzarella cheese 1 cup chopped vegetables (onions, peppers, mushrooms, spinach, olives—your choice) 1/2 cup chopped chicken or tofu

1) Preheat oven to 350°. Spread half the sauce on each pita round. If you’re using chopped fresh spinach, add it now, before the cheese, so it won’t dry out too much. 2) Top with cheese, divided between the two pizzas, and then vegetables and meat. 3) Bake at 350° for 15 minutes on a pizza pan or cookie sheet. Much healthier than store or restaurant pizza because you have a whole grain crust, plenty of vegetables and a reasonable amount of cheese.

Nutrition and Physical Activity Self-Assessment for Child Care

Eating between Meals: Snacking for Kids Here’s Why It’s Important… Snacks are important and may add up to 25% of a child’s food intake in one day! If a child is not very hungry at lunch he or she may compensate at snack time; therefore, serving healthy snacks is important. See below for some GOOD snack choices. Snacks are a great way to get children to try new foods. Have children create their own snacks by making yogurt sundaes with fresh or frozen fruit and unsweetened cereal. Snacks should be rich in vitamins and minerals and low in added sugar to keep children healthy. Snacks with lots of added sugar contain extra calories, which can contribute to unhealthy weight gain. They also increase our preference for sweet foods and increase the occurrence of cavities!

Simple Snack Ideas Instead of...

Try...

L Soda or diet soda

J Carbonated water mixed with 100% fruit juice

L Chips with dip

J Crunchy raw carrots, pepper strips, and cucumber

slices with low-fat Ranch or hummus.

L Cookies and whole milk

J Graham Crackers with peanut butter and skim milk

L Ice cream

J Plain or vanilla yogurt mixed with fresh fruit

L Snack bars

J Whole grain crackers (ex. Triscuits) with cheese cubes

L Cheese puffs/doodles

J Small bag of plain popcorn

L Fruit snacks (roll-ups and gummies)

J Sliced peaches with cottage cheese

L Pop-Tarts

J Granola bar

L Candy

J Trail mix (raisins, cheerios, pretzels, banana chips)

Recipes

Rules for Snacking

Child-pleasing snacks that will bring out the creativity in everyone!

• Sit down in a quiet place with no TV visible. This will allow for time to talk with your child about healthy foods.

Purple Cow

• Allow approximately 10-15 minutes for snacks.

¼ cup unsweetened grape juice 1 cup skim milk 1 sliced banana Mix all ingredients together in a blender. Makes 4-6 small servings.

Tortilla Roll-up 1 whole wheat tortilla ¼ cup shredded carrot ¼ cup shredded apple peanut butter or almond butter honey Spread peanut or almond butter on tortilla. Add carrots and apples and drizzle lightly with honey. Roll up and cut into small pieces. For more information, please visit: http://www.fitcitychallenge.org/Families/MenusSnacks.aspx http://www.betterkidcare.psu.edu/page01c.html

• Give small servings and when more is requested, ask if your child is still hungry. • Snacks are a great way to add extra fruits and vegetables to your child’s diet. • Water is an excellent beverage with snacks; beverages high in calories such as 100% fruit juice and other fruit drinks may fill children up and do not provide the nutrition of other healthy snacks.

In This Section Tab 3: Provide water and low fat milk; limit or eliminate sugary beverages. Beverages Make-Your-Own Sugar Bottle Display 5-2-1-0 Every Day! Water Posters  Fill Up Here!  Refresh!  Thirst Quencher ‘0’ Coloring Sheet PARENT HANDOUTS Drink water and low fat milk; limit or eliminate sugary beverages

Water is Fuel for Your Body Enlightening Facts About Juice Keeping Your Baby’s Teeth Healthy From The First Tooth

TAB 3

For Growing Bones…Which Milk?

Provide Water & Low Fat Milk

What should young children drink?

Nutrition and Physical Activity Self-Assessment for Child Care

BEVERAGES Here’s Why… Children play hard and need enough fluid to stay well hydrated. They should be encouraged to drink throughout the day because they often don’t know when they are thirsty. Offer a variety of beverages to maintain good health with a focus on low-fat milk and water. Child care facilities have some options in choosing beverages. If your facility follows CACFP guidelines, serve 1% or skim milk for breakfast and lunch and water or milk for snacks. Reach for water when children say they are thirsty and save 100% fruit juice for the occasional snack, not as a replacement for whole fruit.

Choices You Make for Your Facility Have cold water available at all times by placing a pitcher and cups on a low table for children to self-serve. Encourage children to drink water when they come in from the playground. In hot weather, bring cold water outdoors to prevent dehydration. Offer children ages 2-5 1% or skim milk. These contain the same vitamins and minerals as whole and 2% milk without the extra fat. If your facility has soda machines, keep them in an area not visible to children and families. Alternatively, ask vendors to include healthier choices like 100% fruit juice and water.

Checklist q We provide water that children can see and serve to themselves.

q We rarely offer sugary drinks, other than 100% juice, to children.

q We offer 1% or skim milk to children over two years.

q We offer 100% fruit juice twice a week or less.

q We do not allow vending machines at this facility.

Getting Support From the Parents Encourage parents to bring in bottled water or 100% juice for birthdays and celebrations. Serve water and 100% juice in place of soda or sweet tea at parent meetings.

Getting the Kids on Board Encourage all children to drink at least one cup of water each day. Give each child who meets this goal a sticker. Show the kids that adults in your facility like to drink 1% or skim milk and water too. To make it more fun, give the children fun straws to drink beverages during snacks and meals. Add lemon, lime, or orange slices to a pitcher of water to make it more appetizing for children.

Let parents know your facility uses water as the first choice for thirst.

For more information, please visit: http://betterkidcare.psu.edu/TIPS/Tips55.pdf

Make-Your-Own Sugar Bottle Display Let’s Go! has discovered the power of our Sugar Bottle Display; making your own is a great classroom activity. This is one of the best ways to graphically show how much sugar is in some of the most consumed beverages—you’ll be surprised. This is a tool that can be used to help students and staff to make smart beverage choices. Directions to Make-Your-Own Sugar Bottle Display

Supplies:  Bottles of your favorite beverages—refer to the table on the next page for suggestions.  Bag of White Sugar  Teaspoons  Funnels Directions: 1. Empty, wash and completely dry bottles—keep the labels on the bottles. Tip: Bottles take at least 24 hours to dry completely. 2. Find the Nutrition Facts box on the bottle label. 3. Take note of serving size (many bottles contain two or more servings — something to think about!) Tip: Make sure to pay attention to the information listed Per Bottle. 4. Record how many grams of sugar are in a bottle. (Continued on page 2)

5. Figure out how many teaspoons of sugar are in each bottle by dividing the grams of sugar by 4.2 (number of grams of sugar in a teaspoon.)  Serving size: 1 bottle  Sugars=48g  Teaspoons=48 divided by 4.2≈11.  Amount of sugar to put in bottle=11 teaspoons. 6. Put funnel into mouth of bottle and put in computed amount of sugar. Replace cap. Screw on tight! 7. Make a chart like the one below corresponding to the drinks you chose. 8. Display in your school so students and staff can see how much sugar is in some of their favorite drinks. 9. Other ideas:  Take a photo of your display and use along with chart and hand-outs from “Tab 4 - Provide Water & Low-Fat Milk…” to make a bulletin board.  Make a game out of it by having people guess how many teaspoons of sugar are in their favorite drinks and give the winners a 5-2-1-0 approved prize!  Have a poster contest around sugar-sweetened beverages.

Common Drink Choices

Drink Mountain Dew® Coca-Cola® Classic Dunkin’ Donuts Strawberry Fruit Coolata® Sprite® Monster Energy® Drink Arizona® Green Tea & Honey Minute Maid® 100% Apple Juice Glaceau Vitamin Water® Gatorade™ Starbucks Bottled Frappuccino® Water

Size 20 oz 20 oz

Total Calories 290 cal 240 cal

Sugar Grams 77 g 65 g

Teaspoons Sugar 18 15

16 oz 20 oz 16 oz 20 oz 10 oz 20 oz 20 oz 9.5 oz Any size

290 cal 240 cal 200 cal 175 cal 140 cal 125 cal 130 cal 200 cal 0 cal

65 g 64 g 54 g 42 g 32 g 32.5 g 34 g 32 g 0g

15 15 13 10 8 8 8 8 0

05/10 R07/13

SUGARY DRINKS

MORE LOWFAT MILK

AND WATER

EVERY DAY!

Why WATER and MILK make me feel good:

Drink water and low fat milk; limit or eliminate sugary beverages.

e c i u j n o s t i m i l t Pu

contain ” or “punch” often k, rin “d ” e, ad “ed el s” and I Juice products lab e only difference between these “juice 5% juice or less. Th ified with Vitamin C. fort soda is that they ’re ice. whole fruits over ju se oo ch to y tr s ay I Alw 0% juice. serve juice, buy 10 to se oo ch u yo If I ould be limited to: I Each day, juice sh ildren 1-6 years old • 4-6 ounces for ch ildren 7-18 years old • 8-12 ounces for ch r 6 months and unde • No juice for children

child’s juice. ding water to your ad by ly w slo s ge I Make chan stead of juice. er or low fat milk in at w of ss gla a t es I Sugg

Redy’s Rules Water

Keep It Handy, Keep It Cold: I Keep bottled water or a water bottle on hand. I Add fresh lemon, lime, or orange wedges to

water for some natural flavor. I Fill a pitcher of water and keep it in the fridge. I Drink water when you’re thirsty. It’s the best choice. I Cut back slowly on sugar-sweetened drinks. I Replace soda with water, instead of other sugar-sweetened beverages,

such as juice or sports drinks.

Be a Role Model: I Grab a glass of water instead of soda. I Try mixing seltzer with a small amount of juice.

Milk

ilkshake Make a m t milk, fa using low r u o y d n a ice, rries. e b e it r favo

Encourage low fat milk instead of sugar-sweetened drinks: According to the national dairy council: I Children ages 4–8 years old should be consuming three 8-ounce glasses of milk or other dairy each day. I Children ages 9–18 years old should be consuming four and a half 8ounce glasses of milk or other dairy each day.

Did you know? Soda has no nutriti onal value and is high in sugar. Just nine ounces of soda has 110-15 0 empty calories. Many sodas als o contain caffeine, which kids do n’t need. Energy drinks are N OT sports drinks and should ne ver replace water during exercis e. Water is fuel for yo ur body: I Water is the m ost important nutrient for active people. I Between 70-80% of a child’s body is made up of water. I When you exer cise, you sweat, and when you swea t you LOSE water and minerals – it is important to replac e the water you lose when you sweat. I Water is the # 1 thirst quencher!

08/08 R03/10

What should young children drink? The best drinks for preschoolers — and for kids of all ages — are milk and water.

 Children between one and two years old should be drinking whole milk and/or breast milk.

What Your Child Care Program Can Do:

 Preschoolers should consume 2 cups of low fat or

nonfat milk (or equivalent dairy products) every day.



 Try to avoid premixed chocolate or strawberry

drinks, which often contain considerably more calories, sugar, and fat than milk you flavor yourself.

 Limit juice, which has a significant amount of sugar, to



no more than one serving of 100% juice, about 4-6 ounces, a day.

 Kids may be less likely to drink enough milk if soda

and other sugar-sweetened beverages are available.

 

DRINK

SIZE

CALORIES

SUGAR 

Water

8 ounces

0 grams

Low-Fat Milk

8 ounces

100

11 grams

100% Orange Juice

8 ounces

110

22 grams

Juice Drink

8 ounces

150

38 grams

8 ounces

24 grams

8 ounces

100

27 grams

(10% fruit juice)

Powdered Drink Mix

 

Promote water and low fat milk as the drinks of choice at all program-related events. Offer low fat milk, skim milk, and other milk alternatives in place of whole milk in the meal program. Develop guidelines encouraging low fat milk and water. Use the Drink Comparison Chart to demonstrate how much sugar is in a variety of drinks. Encourage parents to provide water and low-fat milk instead of sugarsweetened drinks at celebrations. Be a role model by drinking water or milk. Visit a local dairy farm.

(with sugar added)

Soda

03/10 R02/12

For Growing Bones… Which Milk? Why Milk? Check the Nutrition Facts label on milk cartons. You will see several nutrients that everyone in your family needs. • Calcium and vitamin D for your child’s growing bones and teeth. These same nutrients help your bones stay healthy. • Protein for building a growing body. It also keeps your body in good repair. • Vitamin A for healthy eyes and skin. Offer milk or water to satisfy thirst. Your child needs plenty of fluids to stay healthy, too.

Whole Milk

Lowfat Milk 1%

Fat-Free Milk (Skim)

Nutrition Facts

Nutrition Facts Serving Size 8 fl oz Servings Per Container 1

Nutrition Facts

Serving Size 8 fl oz Servings Per Container 1 Amount Per Serving

Amount Per Serving

Calories 150

Calories from Fat 70

Calories 100

Calories from Fat 20

13 %

Saturated Fat 5g

25 %

Cholesterol

35mg

11 %

Sodium 120mg Total Carbohydrate

11g

Dietary Fiber 0g

2.5g

Saturated Fat 1.5g

Cholesterol

10mg

Sodium 125mg

Total Carbohydrate

12g

Dietary Fiber 0g Protein

Vitamin A 6%

•

Vitamin C 4%

Calcium 30%

•

Iron 0%

* Percent Daily Values are based on a 2,000 calorie diet.

Calories from Fat 0 % Daily Value*

Total Fat

Saturated Fat 0g 5mg

Cholesterol

Sodium 135mg

Total Carbohydrate

Trans Fat 0g

2% 5% 13g

Dietary Fiber 0g

4% 0%

Sugars 12g

Sugars 12g Protein

Total Fat

Trans Fat 0g

Calories 90

% Daily Value*

Total Fat

Serving Size 8 fl oz Servings Per Container 1

Protein

Vitamin A 10%

•

Vitamin C 4%

Calcium 30%

•

Iron 0%

* Percent Daily Values are based on a 2,000 calorie diet.

Vitamin A 10%

•

Vitamin C 2%

Calcium 30%

•

Iron 0%

* Percent Daily Values are based on a 2,000 calorie diet.

Which milk would you buy? What is different? What is the same? Nutrition Facts labels on milk cartons can help you make choices for your family. Your child will get the same amount of bone-building calcium no matter what type you pick. Lowfat milk has less fat and fat-free milk has none.

Provided by

NIBBLES FOR HEALTH 6 Nutrition Newsletters for Parents of Young Children, USDA, Food and Nutrition Service

For Growing Bones… Which Milk? Which Milk for Your Child?

Change slowly to lowfat or fat-free milk:

Starting at age 2, children can drink lowfat milk. It is a good habit for your whole family to learn. Drinking lowfat milk is one way to get less fat, especially saturated fat. That is healthy!

• Switch first from whole to 2% milk. When your child gets used to the flavor, try lowfat or fat-free milk.

If you have a child under 2 years, offer whole milk after discontinuing breast milk or formula. Babies and toddlers need the fat from whole milk to grow properly.

• Try chocolate lowfat or fat-free milk. The flavor is about the same as in higher fat chocolate milk. • Offer lowfat or fat-free milk on cereal and in smoothies. Your child probably will not notice.

Try this: Drink milk to protect your bones – and your child will do what you do. The secret to success is having milk in your refrigerator. Have enough for you and your child, too.

Remember, children ages 2 to 5 need 2 cups of milk or equivalent milk products each day.

Provided by

NIBBLES FOR HEALTH 6 Nutrition Newsletters for Parents of Young Children, USDA, Food and Nutrition Service

Water is Fuel for Your Body Ever wonder why you need water? Like food, water acts like fuel in your body and helps your body function. To keep your body running smoothly, drink plenty of water throughout the day. Children who eat healthy, drink enough water, and sleep well at night will have energy for all their sports and activities. I Water is the most important nutrient for active people. I Between 70-80% of a child’s body is made up of water. I Water is the #1 thirst quencher!

el! fu e r o m d e e n u hen yo w r e t a w h it w y Fuel your bod LOSE water u sweat, you

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“In a game, when my players get thirsty, water gets the call.” —Arnie Beyeler, Manager, Portland Sea Dogs

08/08 R03/10

Enlightening Facts About Juice ACCORDING TO THE AMERICAN ACADEMY OF PEDIATRICS (AAP):  Fruit juice offers no nutritional benefits for infants younger than 6 months.  Fruit juice offers no nutritional benefits over whole fruit for infants older than 6 months and children.  Fruit “drinks” are not nutritionally equivalent to fruit “juice” (see below).  Fruit juice is NOT appropriate in treating dehydration or diarrhea.  Excessive juice consumption may be associated with malnutrition.  Excessive juice consumption may be associated with diarrhea, flatulence, abdominal distention, and tooth decay.  Calcium-fortified juices do provide calcium, but lack other nutrients present in breast milk, formula, or cow’s milk.

RECOMMENDATIONS :  If you decide to give your child juice, it is recommended that you do not introduce it until your infant is twelve months old.

 Serve juice in open cups, not bottles or “sippy” cups that allow children to consume juice easily throughout the day. Do not allow your child to carry a cup or box of juice throughout the day.  Offer and encourage children to eat whole fruit instead of juice. They will get all the great fiber and other nutrients of the whole fruit and feel more full than with drinking juice.  Serve only pasteurized juices.

 Choose 100% juices instead of fruit “drinks,” which, by definition, could contain between 10% and 99% juice and most likely contain added sweeteners and flavors.  Offer age-appropriate servings of 100% fruit juice. Young children age 1 to 6 years should have only 4-6 ounces of juice a day, if any at all. Children age 7 years and older should be limited to 8-12 ounces of juice a day, if any at all.

UMB: H T F RULE O ter off giving bet it You are ren whole fru ild . your ch of fruit juice instead

Adapted from the American Academy of Pediatrics Committee on Nutrition

01/09 R05/13

Have Your Baby’s Teeth Checked By Age One All babies should have their teeth checked by a dentist or doctor by their first birthday. Ask your dentist or baby’s doctor when to bring your baby for their first visit.

Keeping Your Baby’s Teeth Healthy From The First Tooth From the First Tooth is an initiative of MaineHealth funded by the Sadie and Harry Davis Foundation in partnership with EMHS and MaineGeneral Health and Boston University Goldman School of Dental Medicine Center for Research to Evaluate and Eliminate Dental Disparities.

www.fromthefirsttooth.org

Taking Care of your Baby’s Mouth Clean your baby’s mouth with a wet cloth and use a soft toothbrush as soon as the first tooth comes in. Clean all sides of your baby’s teeth every night before bed. At the age of 2, start to use small amount of toothpaste about the size of a pea. Check your baby’s teeth once a month. Lift the lip and check for white or brown spots on teeth. If spots do not come off, take your child to the dentist. Do not share germs. Cavities are caused by bacteria and are passed to the baby by saliva. Do not share toothbrushes or feeding spoons. Do not put the baby’s pacifier in your mouth before giving it to your baby. Take care of yourself. Your children learn by watching you. Show them that you care about your health and teeth.

Healthy Foods for Healthy Teeth No bottles in bed. Formula, milk, breast milk, sugary water, soda and other sweet liquids cause cavities when left in the baby’s mouth while sleeping. If you must give a bottle in bed, fill it with water only. Wean from the bottle by age one. Begin to offer a sippy cup at meals and snack time starting at 6 months. Limit sugar. The bacteria (germs) feed on sugar. More sugar causes more cavities. Limit juice to meal times. When your child is thirsty, give them water. Fruits, vegetables, and cheese are healthy foods that do not have too much sugar.

Protect your Baby’s Teeth with Fluoride Fluoride is a mineral that helps make teeth stronger and fight cavities. Ask your baby’s dentist or doctor about fluoride treatments. If your tap water is not fluoridated, check with the baby’s dentist or doctor about fluoride drops or tablets.

In This Section Tab 4: Provide non-food rewards. Provide Non-Food Rewards Alternatives to Using Food as a Reward PARENT HANDOUTS Non-Food Rewards at Home

TAB 4

Provide Non-Food Rewards

Provide Non-Food Rewards -Food n o N g ovidin r P f o ts Benefi : healthy s r e t s o ds t that f ages n e m Rewar n o r ess nvi

Classrooms that provide non-food rewards are healthy classrooms!

e m ides an ports 5-2-1-0 v o r P quent  p e r u f s e d r n o eating a ty for m i n u t r o the opp l) s w o l l d as a A sefu e s u u f i ( y t i s v reward ical acti s y h p f i fitness o t s d d them! k A s a t s rds! Ju d as a a o w reward o e r F d g vidin non-foo o r r e f P e r f p o ces  Kids equen

Cons d: Rewar

health y foods r h o t l o a p e h o t n of un o i tributes t n p o m C u  vercons o s e g a ur habits g n i t a e  Enco oor often ( p s o d t o s o e f tribut r those o f e  Con c n prefere s e s a e r  Inc sweets) Consider:  Developing guidelines that discourage the use of food as a reward

 Offering a monthly indoor or outdoor physical

activity to celebrate students’ accomplishments in lieu of food-based rewards

 Offering rewards that endorse physical activity Extra play time, longer play time, outdoor activities, a walk with a favorite provider.

 Offering rewards that endorse academics

Pens, pencils, notebooks, books, art time, activity sheets, etc

08/08 R02/12

Alternatives to Using Food as Reward One in three children is overweight; one in seven is obese. The rates have doubled in children and tripled in adolescents in the last twenty years. An overweight four‐year‐ old is 20% more likely to become an obese adult; an overweight teen, eighty percent. While there are many reasons for this obesity “epidemic,” one that providers can control is using food to reward, comfort or punish the children in their care. The following statements are common examples of these negative methods:



“If you pick up the toys, I will give you each a cookie.” (reward)



“I know you got hurt when you fell down, here is a piece of candy.” (comfort)



“Eat all of your peas or we will not go to the playground.” (punishment)

Non‐Food Alternatives

Avoid these kinds of statements and instead consider non‐food alternatives as rewards. Some rewards that work well with young children individually or as a group:       

Sit by friends Teach the class Have extra art time Enjoy class outdoors Have an extra recess Play a favorite game or puzzle Walk with a favorite provider during a transition

      

Eat lunch outdoors/ have a picnic Eat lunch with a teacher or the director Be a helper in another class Dance to favorite music in the classroom Provider can perform special skills (i.e. sing) Field trips Provider can read a book of that child’s choosing

Normal Consequences

Even more effective than rewards is the delivering of consequences when a child behaves in a way other than the expectation that had been clearly explained prior. Look for opportunities to provide “normal consequences” whenever possible. “Normal consequences” usually refers to temporary limitations a provider sets that connect with the problem behavior that just occurred. Examples include:



“You threw that block so you may no longer play in the Block area today.”



“You two were fighting over that toy so neither of you may play with it today.”



“All of the caps were left off of the markers in our Art Area this morning so they have all dried out. We will not have markers to use for a while.”

Feel free to post or distribute this resource, adapted from the online provider training lesson: “Making Meal Times a Pleasant Experience” © 2011 National Association of Child Care Resource & Referral Agencies To learn more and enroll, please visit www.naccrra.smarthorizons.org

Non-Food Rewards at Home How can you celebrate a job well done without using food treats? Here are ways to reward your child: Make a list of fun, non-food rewards that don’t cost much and post it where the whole family can see it. Have a separate list of special and inexpensive rewards for those really big achievements. Give certificates or ribbons for healthy behaviors. Allow your child to have a few friends over after school to play sports. Invite a few of their friends to a sleepover. Have a family game night. Keep a box of special toys or art supplies that can only be used on special occasions. Go to a sports game.

Words of appre ciatio can go a long w n a Children love to y. hear “ You did a gr eat job” or “I appreciate your help.”

Camp out in the back yard. Encourage the use of electronics that support physical activity, like Dance Dance Revolution. Choose toys and games that promote physical activity like jump ropes, balls, or Skip-Its.

ard: w e R a s a d o o F Using to poor health s te u ib tr n o C I of erconsumption v o s e g ra u o c n I E s unhealthy food habits to poor eating s te u ib tr n o C I nce for sweets re fe re p s se a re I Inc

id giving o v a o t e r Be su nt of o r f n i e m i extra t mputer o c r o V T the rd! as a rewa

08/08 R07/11

In This Section Tab 5: Provide opportunities for children to get physical activity every day. Active Play and Inactive Time Play Environment Supporting Physical Activity Nutrition and Physical Activity Education Quick Physical Activity Breaks Physical Activity Breaks from Take-Time! Outdoor Play on Winter Days WinterKids: Guide to Outdoor Active Living - Preschool Edition StoryWalk™ Interested in Creating Your Own StoryWalk™? The StoryWalk™ Project FAQ ‘1’ Coloring Sheets PARENT HANDOUTS Get one hour or more of physical activity every day. How to Make Your Home an Active One

TAB 5

Take It Outside!

Provide Opportunities for Physical Activity

Physical Play Every Day! Pamphlets  6 months to 1 year  1 year to 2 years  2 years to 3 years  Ages 3 and 4 years  Ages 4 and 5 years

Nutrition and Physical Activity Self-Assessment for Child Care

ACTIVE PLAY AND INACTIVE TIME Here’s Why… Children spend much of their day at child care facilities, so the amount of physical activity they receive while in care is especially important. Children need time to move their bodies! They need at least 120 minutes of active play time every day and are happiest when they aren’t sitting more than 30 minutes at a time (except for nap time and eating). Movement is essential to all parts of child development, not just physical or motor development; be creative and incorporate physical activity into all sorts of lessons and activities!

Choices You Make for Your Facility A daily outdoor play schedule allows teachers to bring children outside at specific times both in the morning and afternoon. Kids are more active when they are outside! Storytelling, books and rhymes can all incorporate activity. Children can act out the movements and the rhymes. Kids love to dance! Turn on some music and get your classrooms going! Encourage movements such as marching, hopping, skipping, twisting their hips, etc. Limit TV use to special occasions only. It is not essential to learning and often takes the place of much needed active play time. Limit seated time and provide plenty of opportunities throughout the day for children to move.

Checklist p We provide at least 120 minutes of active play time to all children, every day.

p We provide opportunities for outdoor active play two or more times a day.

p We provide teacher-led physical activity to all children two or more times per day.

p We ensure that children are not seated (excluding nap time) for periods of more than 30 minutes.

p We do not withhold active play for children who misbehave; we reward good behavior with extra active play.

p We rarely show television or videos.

Getting Support From the Parents Talk to parents about activities that the children did that day. Encourage parents to spend time enjoying active play with their kids at home. Encourage parents to have “TV-free” days at home.

Getting the Kids on Board Children enjoy movement; it doesn’t take much to get them on board! Credible physical activity curricula (eg., Color Me Healthy and Be Active Kids) provide a number of fun activities involving movement for children.

Inform parents of the facility’s TV viewing practices.

Playing with the children (throwing balls, tossing bean bags, etc.) shows them that you are interested in what they do.

Invite parents into the center to help plan “TV-free” days or to play with the children.

Turn on music and ask the children to make up their own dance moves.

For more information, please visit: http://www.communityplaythings.com/c/Resources/Articles/OutDoorPlay/MakingTheMost.htm http://www.aahperd.org/naspe/peappropriatepractice/ AppropriatePractices3-5.pdf http://movingandlearning.com/Resources/Activities.htm http://betterkidcare.psu.edu/AngelUnits/OneHour/OutdoorPlay/OutdoorPlayLessonA.html Published by the NAP SACC Program, Center for Health Promotion and Disease Prevention, The University of North Carolina, Chapel Hill, NC, May 2007. Permission to reprint in its entirety. For noncommercial use only.

Reinforce good behavior with stickers or extra active play time. Ask the children to come up with a list of activities that involve body movement. When you are tempted to turn the TV on, turn to the list instead for some ideas.

Nutrition and Physical Activity Self-Assessment for Child Care

PLAY ENVIRONMENT Hereâ&#x20AC;&#x2122;s Whyâ&#x20AC;Ś Kids love variety, especially in their play. Fixed and portable play equipment that stimulates a variety of gross motor skills (large muscle movements) are important. Kids need to move their bodies in many different ways in order to develop muscles, build strong bones, and grow. Safety is always important, so make sure your kids are active and safe!

Choices You Make for Your Facility Inventory your fixed equipment to see that it meets safety standards. Make ALL equipment available to children at all times Observe the children to see if what is on the playground presents opportunities for children of different ages. When possible, add fixed equipment that is appropriate for the range of children you serve. Provide portable play equipment for children outdoors and during indoor time. This may include balls of all sizes and textures, hoops, scoops, wagons, wheeled toys, push carts, etc. If possible, provide bicycles or tricycles for children to use. These can make fun indoor toys as well (in a gym or large multipurpose room).

Checklist q Fixed play equipment (swings, slides, climbing equipment, or overhead ladder) is extensive and varied.

q Portable play equipment that stimulates gross motor skills (such as wheeled toys, balls, and tumbling mats) is available at all times for all children to use.

q Outdoor play spaces include running spaces and a track/path for wheeled toys.

q An indoor play space is available that allows for all activities including running.

Getting Support From the Parents Communicate with parents about why the facility supports a variety of fixed equipment on the playground. Share the importance of balls and other equipment for the motor development of young children. Use the parent handouts on physical activity. Let parents know how their child uses certain kinds of equipment to help reinforce this practice at home.

For more information, please visit: http://www.nccic.org/poptopics/playgrounds.pdf

Getting the Kids on Board Providing opportunities is all it takes for children to engage in active play! Allow children of similar ages onto the playground at the same time. This will encourage greater access to the equipment. Add new, small equipment on a regular basis. Play group games that are inclusive of the whole class; various types of relay races and â&#x20AC;&#x153;Red light, Green light.â&#x20AC;? Encourage more sedentary children through new and different equipment. All children can find something active they love to do.

Nutrition and Physical Activity Self-Assessment for Child Care

SUPPORTING PHYSICAL ACTIVITY Here’s Why… Fundamental motor skills such as jumping, catching, or kicking are learned as children get older. Children look to adults for encouragement and instruction on how to use their bodies. Being physically active with children helps advance these skills and teaches them more complex movements such as skipping, hopping, dribbling, and throwing—skills that they will need to participate in activities as they get older. If children do not learn these skills at the appropriate age, they will be at a disadvantage in later years and may be more likely to develop sedentary lifestyles. It is important to help children learn how to use their bodies so that they will have the tools they need to be healthy and active later in life.

Choices You Make for Your Facility Being physically active together allows staff to teach children how to play together. Encourage, but don’t force, a child to engage in active play. Active playtime should be a happy time. This is a great opportunity for staff to interact with children and make them feel special. Encourage staff to incorporate physical activity into lessons and circle time each day. In addition to being good for their bodies, it helps them learn more effectively. Remember to always make activity fun and exciting so children look forward to moving their bodies and learning new movements. Create and enforce a physical activity policy for the center that shows your support for daily physical activity.

Checklist q Our staff often join in active play and encourage children to move more during play time.

q We provide visible support for physical activity in classrooms and common areas through use of posters, pictures, and books.

Getting Support From the Parents Parents’ attitudes and actions influence children’s interest in physical activity. Talk with parents about ways to be good role models for children when it comes to being physically active. Share positive comments with parents about children’s active play that you observe during the day. Share ideas for games and activities that parents can use at home.

For more information, please visit: http://www.movingandlearning.com/ http://www.aahperd.org/naspe/peappropriatepractice/AppropriatePractices3-5.pdf

Getting the Kids on Board Pick one child a week to share an active play idea and have the whole class participate. Ask the children to try a new play activity at home and report back. Stimulate their imagination and boost their activity: Give children a special prop and have them create a game with it. See how many ideas they come up with.

Nutrition and Physical Activity Self-Assessment for Child Care

Checklist q We offer training for staff on both nutrition and physical activity at least two times a year.

q We provide both nutrition and physical activity education to children through a standardized curriculum at least one time a week.

q We offer both nutrition and physical activity education to parents at least two times a year.

Quick Physical Activity Breaks High Knee Run/March

Run or march in place, lifting your knees in front of you as high as you can.

Hula Hoop

Around Your Waist. Do the best you can and have fun! Keep moving your hips! Hula hoop twirling builds abdominal strength. Twirling two hula hoops builds hand-eye coordination.

Tree Pose

Balance on one foot. Place your other foot on the inside of your balanced leg. Your knee should be pointing to the side and your heel pointing up your leg. It is okay to leave your toes on the ground if you need to. Bring your hands together in front of you or overhead. Change legs after a count to 30.

Wood Chopper

Stand with your feet hip distance apart. Squat down with arms extended in front of you with a ball between your hands or just bring your hands together in a fist. As you lower in a squat bring the ball towards the ground. As you rise up, bring the ball over your head. Keep your eyes looking straight ahead the entire time.

Chair Pose

Feet together. Legs together. Keeping your knees together, sit back like you were sitting in a chair. Hold that position as long as you can. Relax when you need to, and then try again.

Skate in Place

Pretend to ice skate in place as you hop side to side bringing your heel behind you as high as you can. Swing your arms side to side. You can do this without hopping by stepping side to side.

Agility Ladder

Form a line at one end of the ladder. Run through the ladder without stepping on the white bars. Pick your knees up high! Run up the ladder and then jog around to the end of your class line.

Jump the Hurdles

Form a line at the cone. The first person begins by stepping/jumping over the hurdles. When the student before you gets to the 3rd hurdle, the next person begins. Keep the line moving!

Squeeze the Ball

Place a ball between your hands, elbows pointing out to the side. Squeeze your palms in towards the ball. Feel your arms working hard!

Jump Rope

You can pretend jump rope or use a real jump rope. Keep moving! Jumping rope builds endurance. Jumping rope is an activity recommended for both children and adults, and can be done individually or in a group setting.

Hands to Knee

Extend your arms overhead. Lock your thumbs together. Lift one knee up as you pull your arms down to touch that knee. Arms go back overhead as that foot goes back down to the ground. Lift the other knee as you pull your arms down to touch the knee. Stand nice and tall to help your abdominal muscles get strong!

There are several ways to incorporate the above ideas into the day. You could: 1. Use them in the classroom as a quick and easy physical activity break 2. Put a few together for indoor recess 3. Combine them all for use at a health fair or field day These activity breaks came from Kerra Cartwright, First Grade teacher, Young Elementary School, Saco, 2008

01/09 R03/10

Physical Activity Breaks

Designed for activities at desks or round tables where space is limited.

Have a Seat Stand up and pull your chair away from the table. Stand in front of your chair. Sit…Stand…Sit…Stand and repeat 5-6 times. Sit half way down…Stand…Sit half way down and hold for 10 seconds…Stand. Sit…Lift 2 inches up…hold 10 seconds…Stand Barely Sit (“brush” touch)…Stand….Repeat 10-12 times

Apple Picking Walk (in place) to the imaginary apple orchard, wave to the farmers as you go by. Climb the imaginary ladder on the tree. Knees up high. Reach arms to the tallest branches where the best apples are. Reach high and pick the apples. Reach low and put them in your basket. Repeat several times to get a lot of apples. Carrying the imaginary heavy basket full of apples, walk briskly back to the house. Sit down and eat an apple to help you reach your 5 A Day.

Hugging Earth Stand and reach both arms in front of you. Now, alternate pushing one and then the other. Push the imaginary doors open. Feel your shoulder blades open as you really reach and push. Now, clasp hands together and hold them far away from your chest “Bend your elbows slightly as if you are holding a beach ball. Imagine that your beach ball is planet Earth. Now touch the north pole with your nose, stretching the back of your neck. Again, open your shoulder blades.

Titanic Stand at the bow of the ship with your arms out wide to each side. Feel the wind in your hair as you look to the horizon. Place your hands on your low back squeeze your elbows towards each other. If you can, interlace hands behind you. Open your chest and stand tall. If you choose (not everyone is able)â&#x20AC;Ślift your arms upward and really stretch. Continue to stand tall as you breathe the salty sea air.

Writing Lesson Stand and push your chair in towards the table. Stand away from the table and chair. Pretend you have a pencil stuck to your waist. Using your waist, write your name with the imaginary pencil. Repeat using your arms, hips, head or other body part. Now, using one leg at a time write your name with the imaginary pencil (requires balance).

Helping Hands Turn sideways with your left hip against the table. Place your hands on the shoulders of the person in front of you. Give them a shoulder massage! Ahhhhhhhâ&#x20AC;Ś.. I hope you did a good job because now turn around. Switch!

Take Time! Physical Activity and Nutrition Program Contact: Amy Root, USM/Muskie School www.maine-nutrition.org

The Basics of

Caring for Children In Your Home Outdoor Play On Winter Days Children need to play outside every day, even in winter. Going outside to run, jump, yell, and wiggle gives children the chance to use their large muscles and work off extra energy. Moving out into the fresh air is healthier for children than keeping them inside a closed building where germs can easily spread. Watch temperature and wind chill. When the temperature goes below 40° F or if the wind chill dips low, you may want to limit outdoor play time to 15 to 25 minutes at a time. But you can still go outside if the children have the right clothes. Dress for the weather Tell parents that you will be taking their children out-

side to play every day. They need to bring the proper clothes for winter outdoor play — winter coats, snow pants, hats, scarves, mittens, and boots. It would also be a good idea to have a change of clothes in case anything gets wet while the children are playing outside. Keep Children Active The body stays warmer if you’re active than if you’re standing still. Plan some fun activities for outdoor play on winter days.

Snow Pile Olympics Ice Blocks You’ll need: clean milk cartons, plastic containers like those from margarine, cottage cheese, etc. (ask parents to help you save containers) What to do: The children can help you fill the containers with water and set them outside to freeze. When they are frozen solid, peel away the cartons or dip the containers in a bucket of hot water to remove the ice block. Make sure all the children wear mittens or gloves. Let them stack and build with the ice blocks. They may want to build an ice house!

What to do: Try some of these ideas for making your own snow pile olympics: • Long Jump — Draw a starting line in the snow. Let children stand at the starting line and jump as far as they can. Compare footprints to see who jumped the farthest. • Snowball Throw — Have children stand at a starting line to see how far they can throw snow balls. • Snow pile hurdles — The children can help you make piles of snow. They can run through the yard, jumping over the piles as they come to them. • Snow obstacle course — Use the same piles of snow that you made for the hurdle. Set up a course where they jump over one, hop around the next, etc. 1-4

Let’s Find It

Snow Pies

What to do: With the children’s help, make a list of five things to look for on a walk. The list can be things like a red door, a mailbox, a dog house, etc. or you can base your list on a theme, such as signs of winter.

You’ll need:

Look for things on your list as you take the children on a walk. The first person to find all five things gets to make up a new list of five things to find.

What to do:

Snowball Target Throw What to do: Give the children some real targets for snowball throwing. Targets can be as simple as making a circle in the snow for children to aim their snowballs into the circle. You could do the same thing by laying a hula hoop in the snow.

sandbox toys clean aluminum pie pans or frisbees natural materials

Bring out the sand toys to let budding chefs create their own snow pies. Give each child a clean aluminum pie pan or a frisbee to be the “pie plate.” They’ll love making their own pies with pebble or dirt toppings, layer cakes with leaves, etc. You may want to bring out some bird seed or stale bread crumbs to top some pies. Set the finished pies near a window to watch the birds come to enjoy the pie treats.

Children may also enjoy throwing snowballs into containers. Collect clean containers, such as those from cottage cheese, ice cream tubs, sand buckets, etc. Mark a throwing line in the snow. Set the containers at different distances from the starting line. You can set the containers in the snow, bury them up to their rims, or push them into a snowbank at an angle. Have the children make some snowballs and start tossing!

Snow Creatures What to do: Snow creations don’t always have to be people. Try making animals, dinosaurs, birds, fish, or space creatures in the snow. Children need to play outside every day

Snow Maze What to do: Walk through the snow to make a pattern for the children to follow. You may want to make the maze very straight or add lots of twists and turns. Have the children walk through the maze to see if they can find the quickest way from start to finish. The children may want to pretend they are cars going down the road as they walk through the maze. You may have to draw a line down the middle of the “road” to make the maze a two-lane highway.

Developed by Lyn Horning, Better Kid Care Program Supported by funds from the Pennsylvania Department of Public Welfare, Pennsylvania Child Care/Early Childhood Development Training System, Developed by the Penn State Better Kid Care Program • 253 Easterly Parkway, State College, PA 16801 • Phone: 1-800-452-9108 • Website: betterkidcare.psu.edu.

Cooperative Extension College of Agricultural Sciences This publication is available in alternative media on request. Penn State is an affirmative action, equal opportunity university.

Make learning fun and active! WinterKidsâ&#x20AC;&#x2122; Preschool GOAL makes it easy for preschool teachers to integrate fun, outdoor activity into their winter lessons...all while meeting education standards. From "Moving Mathematics" to "The Science of Sledding," the Preschool GOAL offers creative lessons that engage children and get them moving!

Features Completely revised in 2012-2013! Aligned with Maine Early Learning Guidelines Contains six weekly plans for indoor and outdoor activities, including easy to follow activity descriptions Includes a winter-themed book list relating to each unit of study

To order your copy, please visit www.winterkids.org or call us at 207-871-5700

StoryWalk™ What is StoryWalk™? Combining physical activity with literacy may seem like an odd mix, but it’s an innovative way to get people of all ages out walking while reading children’s picture books. Pages of a book are transformed into signs that are then laid out on a trail inviting families, children, caregivers, teachers and others to follow the path of pages. Our StoryWalk™ pilot was developed using the picture book, Scoot! by Maine author/illustrator, Cathryn Falwell. Cathryn gave Let’s Go! permission to use her book in this way, and Don’t let winter weather get in the way of your StoryWalk™! created extra illustrations that demonstrate to children how they can move like the animals featured in the pages of Scoot!.This StoryWalk™ set contains 29 pages or signs that can be placed along any path.

Where can I use a StoryWalk™? StoryWalk™ can easily be set up on playgrounds, walking paths, hiking trails, or fields. Our signs are wind-proof and waterproof and can be placed at different heights for various age levels.

Why a StoryWalk™? Let’s Go! wanted to offer an activity rich in literacy and healthy movement. A StoryWalk™ is a great simple way to encourage physical activity and increase reading among youth and families.

1st Graders moving and grooving Scoot!-style!

Scoot! By Cathryn Falwell

For more information on how you can bring a StoryWalk™ to your site, please contact Let's Go! at info@letsgo.org or at 207.662.3734. The StoryWalk™ Project was created by Anne Ferguson of Montpelier, VT and developed in collaboration with the Vermont Bicycle & Pedestrian Coalition and the Kellogg Hubbard Library.

05/10 R07/11

Interested in Creating Your Own StoryWalk™? The StoryWalk™ Project FAQ Here are some frequently asked questions and answers about the process of creating your own StoryWalk™ adapted from the Vermont Bicycle & Pedestrian Coalition’s website, www.vtbikeped.org. What is required of me if I would like to offer StoryWalk™ in my community? Please use the name StoryWalk™ and include the following statement in all promotion of the project: The StoryWalk™ Project was created by Anne Ferguson of Montpelier, VT and developed in collaboration with the Vermont Bicycle & Pedestrian Coalition (VBPC) and the Kellogg Hubbard Library. What are some examples of the costs involved? If you want to create a StoryWalk™ yourself, here are the approximate costs for the way the VBPC makes them: 3 copies of each book (2 for mounting, one for damage repair/replacement); books cost between $7 and $17 each so that can range from $25 to $50. Lamination costs about $1per page for 5 ml- a range of $25 to $40, for 10 ml – a range of $40 $80 for each book depending on its length. Stakes (good ones that don't splinter, aren't heavy, won't break easily) cost close to $1 each most books need about 30. Sticky backed industrial strength Velcro to hold the books onto the stakes cost about $15 that will accommodate a 30 page book. Not including tape and staples (if not using Velcro), and labor (which is the most costly) to assemble and mount the books, costs run about $100 - $150 per book. What basics should I know about preparing the books? In general, use 10 ml lamination sheets and reinforce the staple path with fiber tape, (or use Velcro) and use four foot mahogany stakes, (they are stronger and lighter than pine). Each page is mounted on card stock with the page number and contact info on the back of each page. What about copyright laws? The books cannot be altered in any way and the pages cannot be scanned or reproduced without permission from the publisher. They can be mounted on card stock and laminated. It’s good practice to make a point of purchasing new books, not taking donations or buying used books, in order for the writers and illustrators to get full benefit. Try to buy your supplies from local businesses as a great way to support your community. How do you select a book for The StoryWalk™ Project? Selection of books focuses on minimal text, finding illustrations that don't cross the center of the book, and have a great story line. Smaller books work best for this project. Look for books that can be used in different seasons and that incorporate movement of some kind. Below you will find some examples of books that have worked well for the VBPC. You might also check out the Healthy Eating and Physical Activity Book lists included in this toolkit for some great 5-2-1-0 friendly stories! Our StoryWalk’s have separate story-relevant “movement” cards e.g. hop like the frog in the story to the next page, that are placed throughout the StoryWalk to encourage children to exercise their bodies as well as their minds! Continued on next page…

…continued from previous page

Gossie by Olivia Dunrea If You Give a Pig a Pancake by Laura Numeroff The Dot by Peter Reynolds Leaves by David Ezra Stein Olivia by Ian Falconer A Hat for Minerva Louise (with Spanish translation) by Janet Stoeke Whoever You Are by Mem Fox Sheep Take a Hike by Nancy Shaw Rail Trail Alphabet Adventures by Carolyn Siccama South by Patrick McDonnell Over in The Meadow Illustrations by Ezra Jack Keats Corduroy by Dan Freeman I Took My Frog to the Library by Eric Kimmel A House for Hermit Crab by Eric Carle Tracks in the Snow by Wong Herbert Yee How far apart do you space the pages? That depends on the length of the route available, the number of forks or intersections it has and the number of pages in the book. Make sure that the readers know where to find the following page, it is best if the next page can be seen. About 40 paces or so seems like a good distance between pages. The VBPC has found that a half-mile total distance works well for small children. What suggestions do you have for someone interested in creating The StoryWalk™ Project in his or her town? Start by finding some other like-minded people to work with on this project. The VBPC work well as a team and offer different perspectives and experiences. This project combines the benefits of physical activity, time outdoors in nature, literacy, and family time. Because of that, many community partners are interested in it and it lends itself well to funding from different sources. Try to involve other members of the community in the project in different ways; it lends itself to creative adaptations. Here are some ways the VBPC worked with their community: a senior center group translated a book into French, a high school Spanish class translated one as well, and a children’s nature center was inspired to write and illustrate their own books. The possibilities are endless!

For more information on the StoryWalk™ Project and creating your own StoryWalk™, contact Anne Ferguson at storywalkvt@yahoo.com, Nancy Schulz at nancy@vtbikeped.org, or Rachel Senechal at rysenechal@kellogghubbard.org. For more information on borrowing a StoryWalk™contact the Let’s Go! Home Office at info@letsgo.org or at 207.662.3734.

Adapted from The StoryWalk™ Project FAQ found at http://www.vtbikeped.org/index.php?option=com_content&view=article&id=83:the-storywalkproject-faq-&catid=17:current-from-the-coalition&Itemid=89

04/11 R02/12

GET

HOUR OF

PHYSICAL ACTIVITY

EVERY DAY!

What I like to do OUTSIDE:

HOUR OF

PHYSICAL ACTIVITY

EVERY DAY!

What I like about EXERCISE:

Get one hour or more of physical activity every day.

Redy’s Rules Day! Move An Hour Every ily

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Tips from Redy Make Physical Activity Easie r.

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s to increase your level of physical activity.

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I Incorporate physical

activity into your daily

routines.

I Try tracking the level

of your physical activity using a pedometer .

I Turn off the TV and

computer and keep them out of the bedroom .

I Limit recreational co

mputer time.

Did you know?

One hour of moderate physical activity means:

I Choose toys and gam

• Doing activities where you breathe hard like hiking or dancing

I Encourage lifelong ph

20 minutes of vigorous physical activity means:

I Keep physical activit

• Doing activities where you sweat, like running, aerobics, or basketball Physical activity… • Makes you feel good • Helps you keep a healthy weight

es that promote

physical activity.

ysical activity by incorporating physical act ivity into your routine. y fun!!

Be A Role Model. I Use a pedometer.

• Makes your heart happy

I Take a walk after din

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• Makes you stronger • Makes you flexible

08/08 R03/10

Nutrition and Physical Activity Self-Assessment for Child Care

How to Make Your Home an Active One Here’s Why It’s Important… Children need time to move their bodies! Active play and the outdoors contribute to learning in young children. Social skills blossom as children interact with adults, other children, and even objects found in the environment. Through experiences, encouragement, and instruction children acquire necessary motor skills such as jumping, hopping, galloping, kicking, and throwing. Active play can take place both indoors and outdoors and allows children to use up their energy (which helps when it comes to nap time or bedtime!). Remember to keep active play fun, creative, and noncompetitive for all preschool children!

Activity Recommendations for Your Preschool Child

Remember, joining your child in active play allows you to reach your physical activity goal of 30 minutes/ day and also spend quality time with your family!

Children should accumulate at least 60 minutes of structured activity, which is activity that is led by an adult. The American Academy of Pediatrics recommends that this structured activity be done in 15 to 20 minute bouts. Children should accumulate at least 60 minutes and up to several hours of daily, unstructured physical activity, where they choose what to do. Children should not be seated for more than 30 minutes at a time except when sleeping or eating.

Ways to Be Active as a Family Being active is a great way to spend time with your family. You will learn more about your children and they will greatly appreciate the attention from you, even if it’s only for thirty minutes. Set up an obstacle course around the house or in a garage with chairs, trash cans, balls, etc. Have them skip, walk backwards, crawl, bounce or throw a ball in different parts of the obstacle course. Move to music. Put on music to get your children moving. Mix up the music (some fast, some slow). Props can be added such as scarves or musical instruments. Get children started by stomping, marching, and hopping. Go on a nature walk. Have children bring a plastic bag to collect leaves, small sticks and acorns. Ask them about each item as they put it in their bag. They can even make a collage with their findings when you get home. Have a special day(s) of the week, such as Bike Day, Pool Day, Park Day, or (your child’s name) Day. Let your children pick any outdoor activity of their choice for that day. Go sledding on a small slope in the winter. Make snow people, snow structures and snow angels.

It Only Takes a Few Small Changes at Home… Keep TVs out of children’s bedrooms. Purchase multipurpose and inexpensive toys such as different size balls, hula hoops, jump ropes, scarves, and used tricycles and scooters. Remove breakable items from your child’s room and/or any play rooms. This will allow for more activity without worrying about breaking anything! Schedule family active play time daily. For more information, please visit: http://www.kidshealth.org/parent/ nutrition_fit/fitness/fit_preschooler.html http://www.shapeup.org/fittips/20_tips.php http://www.fitcitychallenge.org/Content/ m1/Families/PDF/FunFitness.pdf

Active Play Movements to Try Patting

Reaching

Releasing

Stretching Creeping

Crawling

Grasping

Walking

Ideas for Physical Play Toys Crib gyms Mobiles Floor Mirrors Snap-lock beads Pat Mat 3 inch Chime bells or Clutch balls Low climbing platforms

Physical Play Every Day! Fun Ways To Keep Your Child Active and Fit

Infant Swings with safety belt Push and Pull toys Simple cars Animals on wheels

New Hampshire Department of Health and Human Services, Division of Public Health Services, Nutrition and Health Promotion Section, WIC Program, 29 Hazen Drive, Concord, NH 03301 Adapted from Hofstra University ’s “Parent’s Guide to Physical Play”. 2008

(6 months to 1 year)

Why Physical Play? Physical play is important for healthy growth and development of young children. Through active play, children learn: • • •

about their bodies, what their bodies can do, and how to control things around them.

A love of physical play is one of the most important gifts you can give your child. The next page has physical play activities for 6 month to 1 year old children. As your child grows older they will be able to do more.

Let’s Play! Shake It Up! Move your body and shake a rattle to encourage your child to react to the following action rhyme. “Shake, shake, shake, wiggle, wobble, quake, Shake it up..., shake it down…, Shake it round and round and round.” Bubble Burst With child in an infant chair or car seat, blow bubbles within reaching distance of the child and show him how to pop the bubbles. “Pretty bubble in the sky, pop each one as it floats by.” Kick! Kick! Kick! Sew bells to a light weight pillow and place within kicking distance of the child’s legs. Touch each body part as you repeat this rhyme. “Leg, foot, toe, leg, foot, toe, kick, kick, kick, the pillow!”

Try some of the following with your child and have fun!

Row, Row, Row Our Boat While sitting on the floor, place child between your legs so that both of you are facing forward. Hold an empty paper tube in front of your child’s arms so that you are both holding it. Gently reach forward and back in a rowing motion while reciting the following rhyme. “Row, row, row the boat, down the river we float. Pushing and pulling on our oar, sitting together on the floor.”

Active Play Movements to Try Clapping

Grabbing

Squeezing

Rolling

Pressing

Arching

Stamping

Pushing

Pulling

Walking

Jumping

Ideas for Physical Play Toys Squeeze toys Plastic bowling set

Physical Play Every Day!

Bean bags Activity tables Wagon– low and open Tot tunnels– crawling

Fun Ways to Keep Your Child Active and Fit

Ride-ons– moved by child’s feet, no pedals, 4 wheels Cymbals, drums, xylophones Large, light weight balls Small doll carriage

(1 Year to 2 Years )

Why Physical Play? Physical play is important for healthy growth and development of young children. Through active play, children learn: • • •

about their bodies, what their bodies can do, and how to control things around them.

A love of physical play is one of the most important gifts you can give your child. The next page has physical play activities for 1 year to 2 year old children. As your child grows older they will be able to do more.

Try some of the following with your child and have fun!

Let’s Play! Body Part, Follow the Leader! Move your body parts as you repeat the rhyme and encourage your child to do the same. “Can you do this…...?” “Shake a leg…, touch your toes…., clap your hands… wave your arms…, make circles with your hips, wiggle your fingers…, grin with your lips.” Squeeze Me Encourage your child to grasp, squeeze and release cloth, yarn or crumpled paper balls, and to move the object around different body parts. “Squish, crumple, squeeze, Grip, grasp, grab, please..” Let’s see, I’ll be... With your child pretend to be.... A tree, moving in the wind…,the sun rising………., a cat arching its back…., a kangaroo jumping…, a train chugging along a track….. See What I Can Do Walk Give your child a chance to walk winding pathways, up and down small inclines or hills, along ledges, and up and down low steps. . “Follow me as we go, up and over high then low. Now I’ll follow you wherever you go, moving fast or moving slow!”

Active Play Movements to Try Marching

Shuffling

Running

Rolling

Climbing

Sliding

Waddling

Turning

Holding

Balancing

Jumping

Twisting

Exploring

Hiding

Ideas for Physical Play Toys Pull toys with strings

Physical Play Every Day!

Wagon Light wheelbarrow Hippity hops Spinning seat

Fun Ways to Keep Your Child Active and Fit

Rocking Horse– waist height, with handles Ride-ons– moved by child’s feet, no pedals, 4 wheels Light weight balls for bowling or basketball games Cymbals, drums, xylophones Play barrels

(2 Years to 3 Years )

Why Physical Play?

Let’s Play!

Physical play is important for healthy growth and development of young children.

Chase Me, Chase Me! Playfully chase your child safely throughout your house or playground and hug and say the following upon capture.

Through active play, children learn: • • •

about their bodies, what their bodies can do, and how to control things around them.

A love of physical play is one of the most important gifts you can give your child. The next page has physical play activities for 2 year to 3 year old children. As your child grows older they will be able to do more.

Try some of the following with your child and have fun!

“You chase, I flee can you catch me? All around we run. Exercise is so much fun!” Super Kids Increase your child’s ability to jump and land safely by holding his/her hand while jumping from low steps, curbs, or boxes. Have your child practice landing on both feet and bending their knees when they land. “We’ll leap tall buildings with a single bound. Landing firmly on the ground. Super kids can jump this way, because they practice every day.” Balance Trail Design a balance trail of objects such as a wooded plank, a twisted rope and taped pathways that encourage your child’s movement and improve balance skills. “Watch each step as you follow the trail. Begin moving slowly like a snail. Raise your arms out from your side. It helps your balance if you hold them wide!” Log Rolling Show your child how to make a long , stiff log shape on the floor with his/her fingers held above their head so they “hide” their ears. See if your child can “roll like a log” by keeping his/her legs stretched and “glued” together. “Logs roll down a hill, then off they go to the saw mill”

Active Play Movements to Try Hopping

Bouncing

Tossing

Galloping

Darting

Dashing

Flying

Jumping

Searching

Tossing

Trudging

Slithering

Twisting

Exploring

Hiding

Wandering

Ideas for Physical Play Toys Tricycle**, stick pony Foam flying disks Wading pools

Physical Play Every Day!

Whiffle balls Double blade ice skates Adult-like push toys: shopping cart, doll strollers, vacuum, lawnmowers Light weight pedal ride-ons

Fun Ways to Keep Your Child Active and Fit

Soft baseball and bat Pillow cases, ribbon wands, jump ropes Cymbals, drums, xylophones Light weight balls for bowling or basketball games ** Wear safety helmet. New Hampshire Department of Health and Human Services, Division of Public Health Services, Nutrition and Health Promotion Section, WIC Program, 29 Hazen Drive, Concord, NH 03301 Adapted from Hofstra University ’s “Parent’s Guide to Physical Play”. 2008

(Ages 3 and 4 Years )

Why Physical Play? Physical play is important for healthy growth and development of young children. Through active play, children learn: • • •

about their bodies, what their bodies can do, and how to control things around them.

A love of physical play is one of the most important gifts you can give your child.

Let’s Play Read, Run, and Race About Pick a favorite action storybook and encourage your child to act out the actions and expressions of the characters as the story is read aloud.

Ride ’em Cowboy/girl Place a jump rope under your child arms and grasp the “pretend reins” as your child gallops around. “Giddy up horse walk…., trot…, run…, Whinny “whee hee hee!” oh what fun. Riding together, just you and me, galloping across our wide prairie.”

Bodies in Motion

Ask your child to follow along.

;;

The next page has physical play activities for children ages 3 and 4 years old . As your child grows older they will be able to do more.

“Our bodies are made of special parts. Wave your arms (child’s name), Shake a leg…, Nod your head…, and touch your chest to feel your heart. Stamp your feet (child’s name), Snap your fingers…, Rub your belly…, And wiggle your toes…, Now stand very tall and touch your nose.”

Cape Capers Have your child use a small blanket or bath

Try some of the following with your child and have fun!

towel as a cape, hold out his/her outstretched hands and follow along: “Flap your wings like an eagle in the sky…..,then soar like an airplane flying high…, float like a ghost and say “WHOOO!” Then drift like a giant cloud in the sky of blue, become a super hero, dash and dart about. “I am coming to the rescue!” Is what you want to shout.”

Active Play Movements to Try Skipping Hopping Strutting Throwing Tip-toeing Flying Bouncing

Prancing Tumbling Twisting Catching Balancing Waddling Rolling

Chasing Jumping Turning Rolling Stretching Dodging Sneaking

Running Galloping Trotting Hiding Bending Marching Collapsing

Ideas for Physical Play Toys Full size rocking horse Wagon

Physical Play Every Day!

Climbing ropes Kites Jump rope Foam hockey mitts Velcro catching mitts

Fun Ways to Keep Your Child Active and Fit

Junior size: Soccer ball, football, basketball, bats and batting tee Bicycle ** with training wheels, scooter** ** Wear safety helmet New Hampshire Department of Health and Human Services, Division of Public Health Services, Nutrition and Health Promotion Section, WIC Program, 29 Hazen Drive, Concord, NH 03301 Adapted from Hofstra University ’s “Parent’s Guide to Physical Play”. 2008

( Ages 4 and 5 Years )

Why Physical Play?

Let’s Play!

Search and Find

Physical play is important for healthy growth and development of young children. Through active play, children learn: • • •

about their bodies, what their bodies can do, and how to control things around them.

A love of physical play is one of the most important gifts you can give your child. The next page has physical play activities for children 4 and 5 years old . As your child grows older they will be able to do more.

Hide five to ten slips of paper throughout a two to three room area and keep your child’s interest with a promise of a “favorite activity” when the slips are collected. Write parts of the favorite activity on each piece of paper so that it is spelled out when all the papers are found. Example: “Hide and Seek”

HI Targets • • • • •

AND

Make targets for aiming and throwing practice.

Draw on or cut out holes in cardboard boxes Line up plastic bottles and/or cans Roll a Hula-Hoop™ Scatter paper plates Use chalk to make different shapes

Movement Month

Use a large monthly calendar and ask your child to help you in filling each daily block with one of the “Active Play Movements” listed on the back cover. Ask your child to place a √ next to the activity each day, after doing it .

Balloon Body Juggling Try some of the following with your child and have some fun!

Toss a balloon and call out the part of your child’s body to be used to hit it. ( i.e. knee, foot, elbow…) The balloon can also be batted, kicked or bounced the papers are found. Example: “Hide and Seek” between you and your child or another child. “Balloon juggle with your body. Can you hit it with your knee? Bounce it twice on your elbow. Kick it up if it goes low.” NOTE: Balloons can be a choking hazard. If you have other children under 3 years old in your home, use another light weight balls like a NERF ball™ or beach ball instead.

Take It Outside! With so much technology, it can be hard to pull ourselves away from indoor attractions like computers, TVs, and video games. As a result, we miss out on the exciting and beautiful world of nature that is right outside our door. Spending time in nature alone and with our families has positive outcomes for everyone. Did you know that experts have found that kids who have greater contact with nature are happier, healthier, smarter, more creative, more optimistic, more focused, and more self-confident? Families also have stronger bonds and get along better if they participate in activities outside. Getting outside can even help prevent diabetes, behavioral disorders, and depression. So, no matter how tempting staying inside may be, making time for nature is really important! Tips to get kids involved:  Make a list of nature activities that your kids want to do and then use those activities as rewards  Encourage kids to go outside with you while you do yard work  Help kids plant a garden that they can take care of  Check out books on local animals, like birds, and help your kids pick them out  Get other friends and families involved in your nature outings too – the more, the merrier! Here are some fun, family-friendly outdoor activities you can try:  Go apple or berry picking  Follow animal tracks  Go sledding  Sleep in the backyard  Go fishing  Jump in puddles  Go stargazing and pick out your favorite constellations  Plant a vegetable garden  Go for a hike or nature walk  Collect seashells on the beach Resources:  Children and Nature Network | http://www.childrenandnature.org/  Let’s Go! | http://www.letsgo.org/  Maine Bureau of Parks and Lands | http://www.parksandland.com  Healthy Maine Walks | http://www.healthymainewalks.org/

07/11 00/00

Television in Child Care: What Do We Need to Know? ‘2’ Coloring Sheet PARENT HANDOUTS Limit recreational screen time to two hours or less.* *Keep TV/Computer out of the bedroom. No screen time under the age of 2.

Promote Healthy Viewing Habits Screen Time and the Very Young National Screen-Free Week Unplugged! Tips for Reading to Very Young Children Avoid Being a Family of Sofa Slugs

TAB 6

Tab 6: Limit recreational screen time.

Limit Recreational Screen Time

In This Section

Better Kid Care Program

TIPS The Basics for Caring for Children In Your Home

Television in Child Care: What Do We Need to Know?

The research is in: The percentage of children in this country who are overweight has doubled in the last ten years, childhood obesity is a national problem, and diabetes is diagnosed in children at an alarming rate. A component often associated with these topics is television. As early educators, what do we need to know about television and how does it affect our work with young children?

The American Academy of Child and Adolescent Psychiatry states, “Time spent watching television takes away from important activities such as reading, school work, playing, exercise, family interaction, and social development. Children also learn information from television that may be inappropriate or incorrect. They often cannot tell the difference between the fantasies presented on television versus reality. They are influenced by the thousands of commercials seen each year, many of which are for alcohol, junk food, fast foods, and toys.”

Health warnings Watching TV may encourage excessive snacking and portray unhealthy food choices, violence, and inappropriate information. Equally important is that fact that while watching TV, children are just sitting. This lack of physical exercise is strongly correlated to too much time spent on electronics, TV being a strong forerunner. Without proper amounts of time for physical exercise, children cannot stay healthy. The President’s Council on Physical Fitness and Sports shows two-thirds of American children can’t pass a basic physical: 40 percent of boys and 70 percent of girls age six to seventeen can’t manage more than one pull-up, and 40 percent show early signs of heart and circulation problems. Many health educators recommend that children experience one hour or more of physical play and exercise daily.

“Time spent watching television takes away from important activities such as reading, school work, playing, exercise, family interaction, and social development.”

9-5

TV viewing affects food intake

Should we watch TV in child care?

A recent Penn State University study conducted by Dr. Lori Francis shows that “TV viewing can either increase or decrease preschool children’s food intakes . . . When children consistently view TV during meals, TV viewing may distract children from normal fullness cues, which can lead to overeating in children as it may in adults.”

The American Academy of Pediatrics recommends no electronic screens or television watching for children under the age of two. The AAP also states that children need active play to promote their developmental, physical, and social skills. Two hours of quality television programming per day is the maximum recommendation for children over two years of age.

When children need to self-regulate, or learn ways to care for themselves, TV may cause interference. Consider rest and nap time. When children are presented with a movie or TV show, they can miss cues from their own body. Instead, they are focused on the issue or action in the show, as opposed to their own self-regulating mechanisms. They tune out instead of tuning in to their body’s signals.

Families look to their early caregivers and practitioners to be knowledgeable on issues affecting young children. Therefore, our role regarding television and children is to inform families of what we have learned about television and to present only positive, appropriate experiences with television. Do we know how the family feels about children watching television? Are our families informed of the research on TV and children? Making the decision to watch TV in child care should be based on research, the development and age of each child, and the opinions of the family and early educator.

Adults can help by being active participants at meal times as well as provide nutritious foods, guide conversations, and discuss issues of how full or hungry we feel.

The American Academy of Pediatrics recommends no electronic screens or television watching for children under the age of two.

Dr. James E. Van Horn, CFLE, Better Kid Care Program Director Developed by Christine Belinda, Penn State Better Kid Care Program 253 Easterly Parkway, State College, PA 16801 • Phone: 1-800-452-9108 • Website: betterkidcare.psu.edu Supported by funds from the Pennsylvania Department of Public Welfare, Office of Child Development and Early Learning.

College of Agricultural Sciences Cooperative Extension

This publication is available in alternative media on request. Penn State is committed to affirmative action, equal opportunity, and the diversity of its work force. Source: American Academy of Child and Adolescent Psychiatry, “Children and Watching TV,” March 2001 American Academy of Pediatrics, Children’s Health Topics: Media Use Penn State Extension, Linking Research to Family and Youth Programs; Dr. Lori Francis, “TV Viewing During Lunch Affects Preschool Children’s Intake,” April 1, 2006 The President’s Council on Physical Fitness and Sports

HOURS

OR LESS

RECREATIONAL SCREEN TIME SPEND MORE TIME OUTSIDE

EVERY DAY!

What I do INSTEAD of TV:

Limit recreational screen time to two hours or less.*

! n u F e h t n o n r Tu

hen you join in! w n fu re o m ts lo TV. Life is stead of watching in s e ti vi ti ac se e Try th g.

Ride a bike. re hike. Go on a natu a puzzle. Put together usic and dance. Turn on the m or magazine. Read a book tching up with Spend time ca your family. to the park Take your kids or beach. mes. Play board ga

jo Walk, run, or l. Start a journa tball, ke Play ball (bas

catch, soccer, etc.). rary. Go to the lib s in your Explore gym . community Rollerblade. . Play charades owshoe. sn Sled, ski, or

Redy’s Rules Tame the TV and Computer! Set Limits – know how much TV your child is watching.

Set some basic rules, such as no TV or computer before homework or chores are done.

Do not watch TV during mealtime.

Use a timer. When the bell rings it’s time to turn off the TV.

Eliminate TV time during the week.

Tips from Redy in advance. Help your child plan television viewing

es in the family room. Keep books, magazines, and board gam ad of being in front of Make a list of fun activities to do inste a screen. ate shows. Set family guidelines for age-appropri

Did you know? Screentime inclu des TV computer, Playstatio , n, Gameboy. All are im and portant to limit. Watching TV is as socia more snacking and ted with increased obesity. Too much TV ha s been to lower reading scor linked es and attention problems. Healthy screen tim e: • No TV/computer un der the age of 2 • No TV/computer in the room the child sleeps • One hour of educat ional TV/computer time between ages 2 and 5 • After the age of 5, 2 hours or less

*Keep TV/Computer out of the bedroom. No screen time under the age of 2.

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Promote Healthy Viewing Habits DID YOU KNOW? That according to the Kaiser Family Foundation (KFF): two-thirds of infants and toddlers watch a screen an average of two hours a day. kids under age six watch an average of about two hours of screen media a day, primarily TV and videos or DVDs.

HOW MUCH IS TOO MUCH? The American Academy of Pediatrics (AAP) recommends that kids under 2 years old not watch ANY TV and that those older than 2 watch no more than 1-2 hours a day of quality programming.

WHY DO YOU ASK? The first 2 years of life are considered a critical time for brain development. TV and other electronic media can get in the way of exploring, playing, and interacting with parents and others, which encourages learning and healthy physical and social development.

Here are some tips you can use to help your child develop positive TV and computer habits. Keep TVs, DVD players, video games, and computers out of your childâ&#x20AC;&#x2122;s bedroom. Turn off the TV during meal time. Treat TV as a privilege to be earned â&#x20AC;&#x201D; not a right. Establish and enforce family TV viewing rules, such as TV is allowed only after chores and homework are completed. Make a list of fun activities to do instead of being in front of the screen. Keep books, magazines, and board games easily available.

Adapted from KidsHealth.org

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Screen Time and the Very Young The American Academy of Pediatrics recommends NO screen time for children under 2 years of age. Excessive screen time (over two hours a day) can put young children at risk. Listed below are some of the effects that screen time can have on the very young Excessive screen time...

can be habit-forming. The more time a young child is engaged with screens, the harder time they have turning them off as older children.

for children under 3 is linked to irregular sleep patterns and delayed language acquisition.

takes time away from meaningful interactions with parents, family members and caretakers.

can be associated with problems in later childhood, including lower math and school achievement, reduced physical activity, social issues, and increased BMI.

has been associated with increased early childhood aggression. simply put, means less time involved in creative play—the foundation of learning, constructive problem solving, and creativity. Reduced screen time...

may lead to decreased interest in it as older children. can help prevent childhood obesity by allowing time for more physical activity and less exposure to television advertising for unhealthy foods targeted at children.

allows for doing better in school, having a healthier diet, being more physically active and having the opportunity to better engage in school as older children.

can start now! Limiting exposure before age 6 greatly reduces the risks of excessive screen time. Do yourself and your young children a favor—create an electronic-media-free bedroom, and role model by reducing your own recreational screen time.

Adapted from Kids and Screens, Campaign for a Commercial-Free Childhood. www.commercialfreechildhood.org,

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National Screen-Free Week Screen-Free Week (formerly TV Turn-Off Week) — the annual national celebration where children, families, schools, and communities turn off TV, video games, computers, and hand-held devices and turn on life. Instead of relying on screens for entertainment, they play, read, daydream, explore nature, and enjoy spending time with family and friends. This event is presented by the Campaign for a Commercial Free Childhood, and endorsed by many organizations, including American Public Health Association, the National Head Start Association, KaBOOM!, the National Coalition for Promoting Physical Activity and the US Play Coalition. Get ready for national Screen-Free Week, by limiting recreational screen time to two hours or less daily and by turning on the fun!

e.org e r f n e e r c w.s Visit ww formation and in for more resources. great 11, 2014 y a M – 5 May Life is a lot more fun when you join in! Think about creative ways to appeal to your “community” and make it easier for kids to resist turning on that screen! Here are some ideas to start with:  Organize a group walk.  Hold a bike parade.  Plan a nature hike or scavenger hunt.  Invite families to participate in a field day.  Host a game night — have everyone bring their favorite game or puzzle to share.  Hold regular story times.  Organize a family dance.  Visit www.screenfree.org for more great ideas!

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Unplugged! Life is a lot more fun when you join in! Try some of these "unplugged" activities instead of watching TV. Life is a lot more fun when you join in! Try these activities instead of watching TV. Take a walk.

Play a board game.

Ride a bike.

Read a book.

Go on a nature hike.

Play outside.

Put together a jigsaw puzzle.

Turn on the music and dance.

Go camping (even if it’s just in the backyard).

Start a journal.

Go to a school sporting event.

Useful We b

Pages: www.turno ffyourtv.com www.screen tim www.cmch.t e.org v

INTERESTING FACTS ABOUT TV

h s spend in meaningful conversation wit ent par t tha ek we per s ute min of er • Numb their children: 38.5 1,680 the average child watches television: • Number of minutes per week that 20,000 ls seen in a year by an average child: • Number of 30-second commercia o have TVs in their bedrooms: 50% • Percentage of children ages 6-17 wh t use TV during a typical day: 70% • Percentage of childcare centers tha an youth spends in school: 900 hours eric Am e rag ave the r yea per urs Ho • rs an youth watches television: 1500 hou • Hours per year the average Americ : 66% rly watch television while eating dinner • Percentage of Americans that regula

– www.turnoffyourtv.com

08/08 R05/10

Tips for Reading to Very Young Children Reading to your child at least 20 minutes a day is so important, even with infants. Concepts like stories, numbers, colors, shapes, and many more come to life when you read to your child and spend time looking at the book. Reading to your child naturally helps bonding and closeness while helping a growing brain develop. The first five years are also the prime time for children to learn language.

Here are some great tips to help make reading to your very young child a joy for everyone involved!  If your child tends to be squirmy when you're reading,

try not reading the text and using your own words instead. Try pointing to the objects on the page while you or the text "talks" about them.  Put life into the reading with your voice. Be

expressive. Give different voices to different characters. Make the sounds of the animals pictured.  Move your fingers across the page to show

that movement is taking place.  You might find that your child enjoys book-time more

if, each time you read a book, you talk about the same things using the same words. Children love repetition and enjoy it when you say something they expect you to say and they adore the sound of your voice.  Encourage your child to participate in the story by pointing at objects, saying

the words after you, or by simply adding sound effects!  Just talk about the pictures, and don't stay on one page too long. Don’t even

expect to finish the book!

 Start with "easy-to-read," bright, simple and maybe even aesthetically

unappealing (to you, anyway) picture books. Children often need to be taught to appreciate the classy, beautiful art in so many books. Introduce these often among favorites, and when s/he's about 12-18 months old, teach your child to turn pages.  If your child is still at the point of needing you to zip right through page-turning

at a pretty good clip (to hold her interest), you might find that you shouldn't bother reading text with a plot. Talk about the pictures, instead, and forget the plot for now.  Use the book the way you want to use it. For instance: you don't have to teach

numbers to a one-year-old with that beautiful counting book. Just talk about the pictures, instead. You don't have to read what the book says. If the story includes a particular event or emotion you'd rather not present, make up your own version.

Even if you don't feel like reading, remember: many requests for book-time are merely indications that your child wants to sit and cuddle.

Adapted from a list compiled by Anita West/http://www.chinaberry.com/service/musings.cfm?qid=29

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Nutrition and Physical Activity Self-Assessment for Child Care

Avoid Being a Family of Sofa Slugs Here’s Why It’s Important…

Choices You Can Make for Your Child Turn off the TV! When it is off, children won’t watch it. Limit TV viewing; set rules and guidelines for the whole family. Pick educational videos/TV shows for your child. Watch TV with your child and discuss the show during commercials. Record TV shows to limit advertising. Avoid using TV as a baby sitter; instead, involve your children in daily household activities. Set a good example: watch TV after your child goes to bed.

A recent study by the Kaiser Family Foundation found that children six and under spend spend three times more each day with screen media (TV, videos/DVDs, computer, and video games) than reading or being read to. In addition, screen media are being used for about the same amount of time as playing outside, approximately two hours per day. The study also found that 30% of 0-3 year olds and 43% of 4-6 year olds have a television in their bedroom.

According to the American Academy of Pediatrics, children under the age of 2 should not watch television at all and children 2 and older should watch no more than 1-2 hours of educational, nonviolent programs a day.

Our Children Are Spending Way Too Much Time in Front of the Television! Too much TV promotes an inactive lifestyle and has been linked to overweight. When children are watching TV or sitting in front of a computer, they are usually inactive and their gross motor needs are not being met, which is critical for very young children. Children, infants, and toddlers learn best through relationships, interactions, and experiences, not through media exposure.

“Why do so many Americans want their children to watch less TV, yet continue to expand the opportunities for them to watch it? More important, why do so many people no longer consider the physical world worth watching?”

Instead of Turning the TV on: Play together as a family. Dance to music. Read a book together.

– Richard Louv

Rules for TV Eat meals as a family without the TV on. If it is sunny outside, no TV! Your child will learn to appreciate the outdoors and will begin to choose this over TV.

Set up an obstacle course inside or outside and take turns going through it.

Set a time limit per day and per week. Example: 30 minutes per day and six hours a week (more time allowed for the weekend). Your child can save up time to use another day.

Go on a family treasure hunt in the backyard or in your neighborhood.

Chores must be completed before the TV comes on.

Look at a picture book/magazine. Tell stories and act them out.

Go to a local museum. Do crafts. Take a walk around the neighborhood. Explore a nearby forest or wooded area. Go to the library for story time. Make dinner together. Create an active outdoor game with your child. Go to a local park or zoo. Teach your child a new gross motor skill, such as riding a bike or skipping rope. Published by the NAP SACC Program, Center for Health Promotion and Disease Prevention. The University of North Carolina, Chapel Hill, NC, May 2007. Permission to reprint in its entirety. For noncommercial use only.

For more information, please visit: http://www.limitv.org http://www.aap.org/family/smarttv.htm http://www.familytlc.net/

In This Section Tab 7: Participate in local, state, or national initiatives that support healthy eating and active living. Healthy Dates to Celebrate March is National Nutrition Month速

TAB 7

WinterKids Guide to Outdoor Active Living: Preschool Edition

Participate in Local, State & National Initiatives

National Screen-Free Week

Healthy Dates to Celebrate MONTH

SPECIAL OBSERVATIONS

September

Fruits and Veggiesâ&#x20AC;&#x201D;More Matters www.fruitsandveggiesmorematters.org Family Health and Fitness Day USA www.fitnessday.com

October Week 2

Health Literacy Month www.healthliteracy.com International Walk to School Month www.iwalktoschool.org National School Lunch Week www.schoolnutrition.org

November

American Diabetes Month www.diabetes.org

December

National Handwashing Awareness Month www.henrythehand.com

January Week 2 Week 4

February March Week 2

April Week 1 Week 4

May

National Fiber Focus Month healthymeals.nal.usda.gov/features-month-1 Oatmeal Month National Fresh-Squeezed Juice Week www.fns.usda.gov Healthy Weight Week www.samhsa.gov National Sweet Potato Month healthymeals.nal.usda.gov/features-month-1 American Heart Month www.heart.org National Nutrition Month www.eatright.org National School Breakfast Week www.schoolnutrition.org National Garden Month www.nationalgardenmonth.org National Public Health Week www.nphw.org National Screen-Free Week www.screenfree.org National Strawberry Month National Physical Fitness and Sports Month healthymeals.nal.usda.gov National Bike Month www.bikeleague.org

1st Wed

All Children Exercise Simultaneously (ACES) www.lensaunders.com/aces

June

National Fresh Fruit and Vegetable Month www.agfoundation.org For more special monthly observations, go to: healthymeals.nal.usda.gov/features-month-1 Developed by the Children in Balance initiative at the Friedman School of Nutrition Science and Policy of Tufts University

08/08 R06/10

March is National Nutrition Month® Celebrate National Nutrition Month® at your site! National Nutrition Month® is a nutrition education and information campaign created annually in March by the American Dietetic Association. The campaign focuses attention on the importance of making informed food choices and developing sound eating and physical activity habits. Visit www.eatright.org/nnm/ for more information. This is a great month to get your kids involved in healthy shopping and cooking!  Let kids help select, wash, chop,

snap, peel, stir, measure and mash fruits and vegetables you are preparing for meals and snacks  Play games that teach about healthy eating. Check out foodchamps.org for ideas  Pick stories to read that talk about healthy eating  Try a new healthy food each week (like a fruit, vegetable, bean, whole grain, lean meat/ poultry/fish, or low fat dairy product)  Make a picture collage of all the healthy foods your family likes to eat  Take a recipe you like and experiment to see if you can make it healthier Check out www.fruitsandveggiesmorematters.org for some great recipe ideas!

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07/11 R06/13

To order your copy, please visit www.winterkids.org or call us at 207-871-5700

In This Section Tab 8: Engage community partners to help support healthy eating and active living at your site. Engage Community Partners Please Give Nutritiously

TAB 8

Engage Community Partners

Engage Community Partners Engaging community partners in your child care program can add enthusiasm, expertise, and excitement to your efforts. There are many community partners that are often willing and excited to go into child care programs for short presentations. The trick is finding them! Do you want to get the greater community into your classroom? Consider contacting:  Local businesses (bike shops, health  Local colleges food stores, sports clubs)  Hospitals  Seniors’ organizations or groups  Recreation departments

   

Culinary associations Dentists’ offices Doctors’ offices Health centers

   

Local food bank

County extension office Local library Grocery stores

And feel free to contact us at Let’s Go!. We have many contacts and may know of individuals who would be interested in getting involved with your program.

be a health o t r e id v o a r sultant althcare p give them n e o d h n C a a h h is it lt t a w n He sulta tract o your con Child Care. Health have a con h s w m r a r o t g c o e r dir to care p as . Ask your ed with 5-2-1-0 Goes m a Many child r g o r ivities, such ipts t p c a e h lv t m o a v r r in g fo o pared scr e consultant hey are willing to be y participating in pr r p s a h ! o if t db t’s G call to see me involve r 5-2-1-0 lessons. Le sage with children. o c e b ld u o o es s sc consultant hysical activity event discuss the 5-2-1-0 m rp to nutrition o e providers can use .org car fo@letsgo in t a that health s u n. Email informatio e r o m r fo

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In This Section Tab 9: Partner with and educate families in adopting and maintaining a lifestyle that supports healthy eating and active living. Introduction to Partnering with Families Letter to Parents Announcing a New Partnership: Template 5-2-1-0 Every Day!

Most parent handouts are associated with a specific Letâ&#x20AC;&#x2122;s Go! strategy and can be found within that strategyâ&#x20AC;&#x2122;s tabbed section of this toolkit.

TAB 9

Partner with Families

Continued on next page...

Partner with and educate families in adopting and maintaining a lifestyle that supports healthy eating and active living.

Did you know?

a healthy lifestyle te o m o pr to s ay w fective althier habits as a One of the most ef he pt o ad to is n childre my of Pediatrics, de and behaviors for ca A an ic er m A to the children's health, ng family. According ci en flu in in le itical ro le”. “families have a cr of the family lifesty ic st ri te ac ar ch al and health is a re

Here are a few ways you can partner with and educate families: 



Ask one of your kid’s parents to be a representative for your 5-2-1-0 Goes to Child Care program at local meetings. Ask parents to become a part of your team (parents can attend conference without the need of a substitute). Send letters home to parents letting them know about your 5-2-1-0 Goes to Child Care program, what the messages and strategies are, and how they can support your work at school.



Ask parents to send only healthy snacks and meals in with their child and share ideas with them that can make it more affordable.



Utilize the skills of parents (e.g. nutritionist, carpenter, artist, etc). Pull them into 5-2-1-0 projects!



Encourage fundraisers that support 5-2-1-0 messages and strategies.

Parents can benefit from this relationship too! Children who eat healthy and have an active lifestyle are more likely to:

 maintain a hea lthy weight  have better se  sleep better

lf esteem

 do better acad emically  avoid health is

sues such as heart disease, type 2 diab etes, bone and joint problems, etc

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Please Note: A modifiable version of this letter can be found in the online toolkit on our website.

03/10 R07/13

Every Day! Follow the 5-2-1-0 message to a healthier you.

 Try new fruits and vegetables multiple times.

 Keep TV and computer out of the bedroom.

 A meal is a family affair—have the family

 No screen time under the age of two.

help plan meals.

 Frozen and canned are just as nutritious as

fresh.

 Let physical activity be free, easy and fun!  Take a family walk.  Turn on the music and dance.  Use the stairs.

 Turn TV off during meal time.  Plan your TV viewing ahead of time.

 Drink water when you are thirsty. It’s the #1

thirst quencher!  Keep a water bottle on hand.  Put limits on 100% juice.

For more ideas visit www.letsgo.org 05/10 R07/11

In This Section Tab 10: Implement a staff wellness program that includes healthy eating and active living. Worksite Wellness at Your Site (includes the StairWELL initiative) Move and Improve! Program

TAB 10

Implement a Staff Wellness Program

Worksite Wellness at Your Site 5-2-1-0 Goes to Child Care addresses the policies, environments, and practices that influence health behaviors in the child care setting. An important aspect of the child care setting is the employees. By providing resources and some simple steps, we hope you will be able to incorporate some of the same 5-2-1-0 strategies being used at your site with your kids and families with staff as well. Employees' physical and mental health are essential to the success of a work place. The promotion of staff members' own health helps them to become positive role models for children and increases their commitment to promoting children's health. Worksite health promotion is often overlooked in many child care settings. Worksite health promotion programs for staff may not only impact the health of child care faculty and staff, but also have effects on the children, their families, and community members. Healthier staff may even save child care sites money. Some examples of health promotion programs for child care staff include: health screenings, physical activity and fitness programs, nutrition education, weight management, smoking cessation, and stress management. One of the first steps of worksite health promotion is to develop a Wellness Team to help drive the project.

Steps to Develop a Wellness Team 1. Recruit wellness team members from all areas of your child care (i.e. food service, classroom, staff, and parents). 2. Develop an action plan based on whatâ&#x20AC;&#x2122;s important and achievable in your child care community. 3. Identify resources that can facilitate implementation of your action plan and assign responsibility. 4. Take action.

Once wellness and health promotion programs are available, encourage staff to participate in these programs. Examples of promotion ideas include introducing wellness programs to new staff at their orientation sessions, presenting information at regular staff meetings, including flyers and brochures with paychecks, putting information into newsletter articles and e-mail messages, and offering health insurance discounts for participants.

5. Celebrate and share your successes and monitor your progress.

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Worksite Wellness and 5-2-1-0  Promote healthy snacks at staff meetings. Ensure at least one fruit and vegetable

are served whenever food is offered to staff.  Staff Soup Club - Once a month a person volunteers to bring soup into the staff

lounge. Others may volunteer to bring bread.

 Healthy Recipe Exchange - Share healthy recipes and perhaps compile into a

recipe book.

 Encourage staff Wellness Team to approach vending machine company for

information on their company’s healthy snack program.

 Don’t forget that the more time you spend sitting watching TV or surfing the

internet, the less time your body is up and moving!

 Make your free personal or family time active time.  Work with Wellness Team to promote staff participation in Screen-Free Week

or similar Campaigns.

 Participate in a Let’s Go! StairWELL initiative (www.letsgo.org).  Work with Wellness Team to promote opportunities for staff to be physically

active.

 Make your meetings walking meetings.  Implement Move and Improve! or other State physical activity promotion

programs for staff (see resources at end of tab).

 Calculate and post average walking distances around the child care facility.  Work with Wellness Team to make sure all beverage machines in staff lounges

have water in them.

 Have water available at all meetings where beverages are served.  Work with Wellness Team to encourage staff to model the zero message for

the children.

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Let’s Go! StairWELL Initiative The Let’s Go! StairWELL Initiative is based on the Centers for Disease Control and Prevention’s (CDC) program, “StairWELL to Better Health.” Stairwells represent an important opportunity to increase daily physical activity because of low personal cost and convenience. Point of Decision Prompts and Motivational signs that encourage stair use are a great way to promote your initiative. Placing signs at the places where people have a choice between the stairs and the elevator is a key aspect of encouraging people to use the stairs. It will also remind employees that there are stairs for them to use! The messages contained in Let’s Go! StairWELL Initiative posters were reviewed by the StairWELL Subcommittee and deemed appropriate for use at their respective organizations. However, each organization is different and messages that motivate some may not be motivating to others. It is important to consider your audience and tailor the messages accordingly. Let’s Go! has created a StairWELL Initiative Toolkit that provides tools for Maine employers to improve employee health by implementing a StairWELL initiative within their organization. The toolkit provides options for businesses that do not have stairwells, including links to tools to help map out walking paths around worksites and additional resources to help promote physical activity in the workplace to all employees.

ELL W r i a t S t’s Go! e L cludes: e n h i T t i k l ve Too Initiati urvey)

onent (S p m o C ation  Evalu Ideas otional m o r P  s le e-mail p t m a S  n Promp rows) io is c e D t of ight Ar R d n  Poin a t f (Le Posters sters nd ional Po t The Let’s Go! StairWELL Initiative a iv t o s (Left a r e t  M s o P Toolkit contains ready to use materials oute alking R s) W   that can be used to take advantage of a ow ight Arr R worksite’s built environment as a way ces to promote and encourage physical activity during  Resour the work day and is available FREE online at www.letsgo.org.

07/11 00/00

Worksite Wellness Resources CDC’s Healthier Worksite Initiative. Information, policies, resources, and step-by-step toolkits for workplace health promotion program planners in state and federal government. www.cdc.gov/nccdphp/dnpa/hwi/index.htm The Wellness Councils of America – WELCOA Website Free Resources www.welcoa.org/freeresources The Wellness Council of Maine works to advance and promote good health among employees state-wide. They strive to assist communities throughout Maine to become healthier by consulting with companies to develop and improve their worksite wellness programs, educating companies in the Well Workplace model, and recognizing companies who achieve excellence in employee health promotion www.wellnesscouncilofmaine.org/ Health Observances: www.welcoa.org/observances Healthy People 2020 challenges individuals, communities, and professionals to take specific steps to ensure that good health, as well as long life, are enjoyed by all www.healthypeople.gov Map Walking Routes. Type in your town or city and create a walking route near your organization. www.gmap-pedometer.com Pedestrian and Bicycle Information Center: www.walkinginfo.org Bicycle Coalition of Maine: www.bikemaine.org Maine in Motion is a program of the Maine Governor’s Council on Physical Activity aimed at increasing the daily level of activity for Mainers. www.maineinmotion.org

Physical Activity and People with Disabilities: The National Center on Physical Activity and Disability, Department of Disability and Human Development www.ncpad.org Disabled Sports USA www.dsusa.org National Center on Accessibility www.indiana.edu/~nca American Council on Exercise (IDEA) http://www.acefitness.org/acefit/

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What if someone told you that by moving more in your day, you could promote, maintain or improve your health! Seems basic enough, but consider this, people who engage in minimal physical activity are consistently linked with increased risk of premature chronic health conditions and mortality. That is one of the reasons why the American College of Sports Medicine and the American Heart Association recommends that adults engage in at least 30-minutes of moderate physical activity on five (if not all) days of the week and children engage in 60-minutes of moderate physical activity every day. The EMHS Move and Improve program is designed to help people challenge themselves to meet these standards. Through the use of structured goals, Move and Improve gives you the opportunity to identify the goal that best fits your needs as well as tips and helpful information to keep you motivated along the way!

Program Cost.............................Free Program Length........................12-weeks (Starting early March through May each year) Program Registration..............January – March of each year Program Goals...........................Engage in physical activity at a moderate level of intensity for a minimum of eight of the 12 weeks selecting one of the goals listed below: • 30 minutes per day for 4 days per week • 30 minutes per day for 5 days per week • 45 minutes per day for 5 days per week • 60 minutes per day for 5 days per week • 60 minutes per day for 7 days per week Program Location....................Offered on-line at: www.moveandimprove.org Are you interested in learning more about the program? Visit www.moveandimprove.org and mark your calendar for the upcoming program to join the thousands of Mainers who participate in this initiative to improve their health! For more information: Contact Nicole Hammar 207-973-7245 or nhammar@emhs.org

www.moveandimprove.org

Tab 11: Collaborate with Food and Nutrition Programs to offer healthy food and beverage options. Child and Adult Care Food Program (CACFP)

TAB 11 Collaborate with Food and Nutrition Programs

In This Section

Child and Adult Care Food Program (CACFP) The Child and Adult Care Food Program (CACFP), a program of the USDA, provides nutritious meals and snacks to infants and children as a regular part of their day care. A variety of public or private nonprofit child care centers, Head Start programs, outside-school-hours care centers, and other institutions which are licensed or approved to provide day care services participate in CACFP. Forprofit centers that serve lower income children may also be eligible. CACFP reimburses centers at free, reduced-price, or paid rates for eligible meals and snacks served to enrolled children, targeting benefits to those children most in need. For more information, please visit http://www.fns.usda.gov/cnd/care/ ChildCare.htm.

Please Note: Eligible public or private nonprofit child care centers, outside-school-hours care centers, Head Start programs, and other institutions which are licensed or approved to provide day care services may participate in CACFP, independently or as sponsored centers. For profit centers must receive title XX funds for at least 25 percent of enrolled children or licensed capacity (which ever is less) or at least 25 percent of the children in care must be eligible for free and reduced price meals. Meals served to children are reimbursed at rates based upon a childâ&#x20AC;&#x2122;s eligibility for free, reduced price, or paid meals.

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In This Section Tab 12: Breastfeeding Are you interested in becoming a more breastfeeding-friendly child care? Steps to Becoming a Breastfeeding-Friendly Child Care Basics of Breastfeeding Support for Moms, Babies and Businesses How To Meet the Needs of Breastfed Babies in Child Care Caregiver’s Guide to the Breastfed Baby Posters  This Child Care Supports Breastfeeding  It’s Perfectly Natural  A New Me!  Superhero Sample Breastfeeding Policy for Child Care Centers Sample Breastfeeding Policy for Family Child Care Providers Sample Infant Feeding Log for Birth-6 months Sample Infant Feeding Log for 6 months and older Breastfeeding-Friendly Reading Materials PARENT HANDOUTS Breastfeeding vs. Formula Feeding Breastfeeding FAQs: Safely Storing Breast Milk ‘Safely Storing Breast Milk’ Cheat Sheet Requesting a Breast Pump from Your Health Insurance Carrier Sample Letter to Employers Resources to Help Child Care Providers and Breastfeeding Families Whenever Wherever! Campaign Overview: Maine Welcomes Nursing Moms

TAB 12 Breastfeeding

‘Breastfeeding Welcome Here’ Sign

Are you interested in becoming a more breastfeeding-friendly child care? Then Let’s Go! encourages you to focus on: 1) Providing mothers' pumped breast milk to their babies. 2) Accommodating moms who want to nurse. 3) Supporting mom’s infant feeding decisions. The 5-2-1-0 Goes to Child Care Nutrition and Physical Activity Self-Assessment has an entire section dedicated to breastfeeding practices. Below you’ll find tips and resources organized under the same heading found on the assessment to help child care programs achieve best practice standards. Breastfeeding Environment  Provide a designated area for mothers to breastfeed other than a bathroom that is private and sanitary. All you need is: □ a relaxing chair, □ a small table for her pump and bottle supplies, □ an electrical outlet (for electric breast pumps), and □ a privacy barrier (a door, curtain, or room divider)

TIP: If you’re short on space, consider converting an unused corner or closet into a breastfeeding/pumping station that’s clean, private and comfortable.

State of Maine law supports having a designated area for employees to breastfeed as well. The two could be combined. The Maine law says: DID  Employers must make a reasonable effort to provide a private place other than YOU a bathroom for mothers to breastfeed or express their milk up to 3 years after KNOW? birth.  Employers are to offer flexible breaks to pump or nurse; if the amount of break time exceeds lunch and two 15 minute breaks then the break time may be negotiated between employer and employee.  Display culturally appropriate breastfeeding support materials. Consider these: □ Your Guide to Breastfeeding. A magazine-like booklet with a variety of tips and info for the nursing room. Order up to 50 at a time for FREE from US DHHS Office of Women’s Health (www.womenshealth.gov or 1-800-9945-9662). □ 101 Reasons to Breastfeed Your Child. A ProMOM brochure; order by emailing info@promom.org.  Provide storage space for expressed milk. □ Dedicate some refrigerator and freezer space for breast milk storage. □ Implement a policy that states your programs acceptance of breastfed babies and the provision of storage for expressed milk.

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Breastfeeding Environment Continued...  Have learning and play materials that normalize breastfeeding available for children. □ Add some of the children’s books from the ‘Breastfeeding-Friendly Reading Materials’ list to your collection (found in this same tab of your toolkit).  Use a feeding and health plan that is filled out by a parent/guardian and/or healthcare provider and is posted and regularly updated. □ Sample infant feeding plans for infants birth to 6 months and 6 months and older can be found in this tab of your toolkit. Breastfeeding Education  Offer training on age-appropriate infant feeding practices (such as safe storage and handling of human milk) and on promoting and supporting breastfeeding (including exclusive breastfeeding) to providers annually. □ View the webinar training modules on breastfeeding topics available on the Early Childhood Trainings Page at www.letsgo.org. □ Reach out to your local hospital’s Lactation Consultants, and your local WIC and La Leche League offices for training opportunities. Don’t forget to also ask your 5-2-1-0 Goes to Child Care partner what they know of!  Instruct breastfeeding families on how to properly label and store human milk for use in the child care facility. □ Share the parent handouts found in this tab of your toolkit with breastfeeding families. Breastfeeding Policy  Implement a written and explicit policy for promoting and supporting breastfeeding families. Communicate the policy to expectant mothers, families with infants, and visitors. □ See the sample breastfeeding policies for centers and family-based providers in this tab of your toolkit.

Adapted from resources compiled by the 2012 Maine Breastfeeding Stakeholder Workgroup

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How to Be a BreastfeedingBreastfeeding-Friendly Child Care are Support for Families Who Breastfeed: The families you serve rely on your child care to keep their children happy and healthy. Supporting breastfeeding is just one more way to play that role. When moms have support, they are able to reach their personal breastfeeding goals, and that’s good for both mom, baby, the family and the whole community! Breastfed babies experience lasting health effects including reduced risk of infectious diseases, diabetes, childhood cancers, obesity and asthma. Women who breastfeed their children are at lower risk for breast cancer and ovarian cancer. Families who breastfeed can save between $1,200–$1,500 in formula expenditures in just the first year (“Surgeon General’s Call to Action to Support Breastfeeding” 2011). Breastfeeding also reduces waste, saving resources used for production, shipping, storage and preparation of formula.

Steps to Being a Breastfeeding-Friendly Child Care: 1. Develop a written policy for promoting and supporting breastfeeding and assure that all staff and mothers are aware of the policy. See appendix A 2. Offer flexibility around feeding times so that mothers may breastfeed at drop-off, pick-up and in between – when able. Provide a comfortable area for mothers to breastfeed their babies. If possible, offer a private space for pumping, other than a bathroom. 3. Offer sufficient refrigeration and freezer space that is always available for breastfeeding mothers needing to store their expressed milk. 4. Normalize breastfeeding by providing culturally appropriate breastfeeding support materials (e.g., pictures, posters, brochures, pamphlets, books, and/or toys). 5. Train all staff so that they are able to carry out breastfeeding promotion and support activities.

WeAllBenefit.org

The Basics of Breastfeeding Support  The American Academy of Pediatrics recommends 6 months of exclusive breastfeeding and a diet consisting primarily of breast milk until at least age one. Studies show this provides decreased incidence of: Ear infection Allergies Celiac disease Childhood leukemia Sudden infant death syndrome

Respiratory infection Eczema Type I diabetes Childhood lymphoma Necrotizing Entercolitis

Asthma Inflammatory bowel Type II diabetes Obesity

 Recent national survey shows that while 75% of mothers initiate breastfeeding, only 13% meet these recommendations. Breastfeeding rates were the lowest in non‐Hispanic black mothers and low‐income families.

 Mothers experience benefits, too ‐ with lower incidence of postpartum depression, type II diabetes, rheumatoid arthritis, high blood pressure, high cholesterol, heart disease, and breast and ovarian cancer.1

 If mothers were supported in meeting these recommendations, there would be a national savings of $13 billion per year.2

 Breastfed babies are easier to provide care for. Your children will be sick less often with a greater defense against contagious, fatal, and chronic disease. They are less likely to spit up, have constipation and diarrhea issues, and have less dirty diapers with less odor.

 Your childcare service will be more marketable and will perform better in nutrition and health assessments.3

Appendix F: Business Guide to Breastfeeding ‐ Fact Sheet

Business Case for Breastfeeding ‐ Fact Sheet The benefits of breastfeeding don't stop with mother and child. Helping your employer to better understand the advantages to supporting nursing mothers can help ease the transition back to work and increase the likelihood of success for meeting breastfeeding goals. It can also save them $3 for every $1 invested.1,8,16,19

 Two simple actions have been found to be extremely cost‐effective for worksites with nursing mothers:  Providing dedicated space for nursing mothers (as small as 4'x5')  Providing worksite lactation support  Breastfeeding parents are less likely to miss work due to child illness. "One‐day absences to care for sick children occur more than twice as often for mothers of formula feeding infants."16,20

 Breastfeeding support in the workplace means lower healthcare costs. "One study found that for every 1,000 babies not breastfed, there were 2,033 extra physician visits, 212 extra hospitalization days, and 609 extra prescriptions for three illnesses alone ‐ ear, respiratory, and gastrointestinal infection."16,21 "The Insurance company CIGNA conducted a 2‐year study of 343 employees who participated in their lactation support program, and found that the program resulted in an annual savings of $240,000 in health care expenses, 62 percent fewer prescriptions, and $60,000 savings in reduced absenteeism rates."16,22

 Lower turnover rates, higher productivity and a greater loyalty. "Being able to keep experienced employees after childbirth means lowering or eliminating the costs a company otherwise would incur to hire temporary staff or to recruit, ire, and train replacement staff, both of which involve additional lost revenue.."16

"..83 percent of employees were more positive about the company as a result of the program, and 67 percent intended to make it their long‐term employer."16,23

 Copies can be obtained from the HRSA Information Center (1‐888‐ASK‐HRSA) For details: http://www.womenshealth.gov/breastfeeding/government‐in‐action/business‐case‐for‐breastfeeding/ For more information: http://www.usbreastfeeding.org/Portals/0/Publications/Workplace‐2002‐USBC.pdf

Handout taken from the "2013 Midcoast Public Health CTG Breastfeeding Resource Toolkit for Early Childcare and Education Centers".

Breastfeeding Welcome Here

Breastfeeding Works!

How to Meet the Needs of

Breastfed Babies in Child Care Massachusetts Department of Public Health Bureau of Family and Community Health Nutrition and Physical Activity Unit WIC Nutrition Program Max Care: Maximizing the Health and Safety of Children in Out-of-Home Care

2004

Breastfed Babies in Child Care As a child care provider, you play an important role in helping mothers succeed in their decision to breastfeed. Creating a breastfeeding friendly program helps mothers to continue breastfeeding.This will benefit both you and your families. Breastfed babies become healthier children with healthier mothers. Breastfed babies are healthy babies...healthy babies are happy babies...and parents and child care providers with healthy, happy babies are less stressed! Breastfed babies are healthy babies! Breastfed babies have stronger immune systems. Breastfed babies tend to be at a lower risk for: • ear infections • colds and other illnesses • asthma and allergies • episodes of diarrhea and constipation • Sudden Infant Death Syndrome (SIDS) • chronic conditions such as diabetes and obesity Breastfed babies are less fussy! Breastmilk is more easily digested than formula.This translates to fewer episodes of spitting up, diarrhea, and fussiness. The American Academy of Pediatrics and the American Academy of Family Physicians recommend exclusive breastfeeding for six months and continuing to breastfeed until at least 1 year of age, and then for as long as mutually desired. There are many ways that you can help a mother to continue breastfeeding while her child is in your care.You can provide a clean, comfortable place for mothers who want to breastfeed in your child care program.When a mother can’t come to your site to breastfeed, she may express (pump) her milk and then store it in the refrigerator or freezer for later use.You play a vital role in ensuring the safety of the stored breastmilk that is given to babies in your care. Will a mother’s milk supply decrease if she returns to work or school? A full supply of breastmilk can be maintained if a mother breastfeeds fulltime when she is with her baby and pumps her breastmilk when they are separated. Her supply is directly related to the baby’s demand.

Welcoming Breastfed Babies to Your Program ◆ Encourage a mother to breastfeed

Let current and prospective families know that you are willing to find ways to help breastfeeding mothers. There are several steps that you can take to ease a breastfeeding baby’s transition into your child care program as a mother prepares to return to work or school.

on site: • before leaving her child in your care • during her lunch break (when possible) • when she picks her child up from your program ◆ Discourage or limit the use of

◆ Invite the parents to bring the

baby in for one or two short visits before returning to work or school. This helps the whole family get used to child care and it helps you get to know the baby. ◆ A baby needs to get used to bottle

feeding before entering child care. For breastfed babies, this process should be delayed until they are about four weeks old. At this time, the introduction of a bottle is less likely to interfere with the establishment of breastfeeding skills. Parents should practicegiving a bottle (a few per week to one per day) before the baby starts child care.

pacifiers for breastfeeding babies. At first, they may delay the development of sucking skills. Later, they may contribute to the child eating less. ◆ Ask parents to bring breastmilk in

labeled hard plastic bottles with a tight lid. Encourage parents to fill each bottle with the amount that the baby drinks in one feeding. If this cannot be done, pour enough breastmilk for only one feeding into a separate bottle and immediately put the rest back in the refrigerator. ◆ Ask the families of exclusively

breastfed babies to provide you with enough frozen breastmilk for 1-2 additional feedings.

◆ Ask parents to write down an

approximate feeding schedule. Also, ask them what to do in cases of emergency, such as when pickup is delayed. ◆ Plan a baby’s feedings so that

they fit into the mother’s schedule. For example, if the mother wants to nurse when she picks the child up, try not to feed the 1/ baby for 1 to 2 hours 2before she is due to arrive.

Setting up a Breastfeeding Friendly Space ◆

Provide breastfeeding mothers with a clean, quiet place away from the hustle and bustle of activities.

◆ Offer

mothers a comfortable chair with arms.You might also want to provide extra pillows.

◆ Make

sure mothers know there is a place where they can wash their hands.

◆ Ensure

a nearby electrical outlet in case mothers need to pump their breastmilk.

Feeding Time: How to Handle Breastmilk ◆ Wash

your hands before handling breastmilk or feeding a baby. Make sure that the bottles, nipples, and cups that you use are clean.

◆ When

you prepare a bottle, use just enough breastmilk for a single feeding. Any breastmilk that a baby does not drink during a single feeding should be discarded. Rule of Thumb: • For younger infants, about 2-4 ounces per feeding. • For older infants, 6-8 ounces per feeding.

◆ Do

not thaw frozen breastmilk at room temperature. Instead, thaw frozen breastmilk by placing it in the refrigerator or running it under cool water. Once breastmilk has been thawed, do not refreeze it. Use thawed milk within 24 hours.

◆ Place

refrigerated bottles in warm water for five minutes before you feed the baby.

◆ Do

not warm refrigerated bottles in boiling water. If the water is too hot, some of the benefits of the breastmilk may be destroyed.

use a microwave oven to warm bottles. This is dangerous for the baby because the milk is not heated evenly; this can lead to “hot spots” that can burn a baby’s mouth.The microwave can also destroy some of the vitamin C and immune components in the breastmilk.

◆ Never

◆ After

you have warmed a bottle of breastmilk, gently swirl the bottle to mix the layers and test the temperature before you feed the baby.

Guidelines for Using Stored Breastmilk The American Academy of Pediatrics and the American Public Health Association support the following storage guidelines: Refrigerated (< 40 degrees F)

Frozen (0 degrees F)

Thawed (then refrigerated)

Use within 48 HOURS

Use within 3 MONTHS

Use within 24 HOURS

The following procedures will help you to ensure that stored breastmilk is safe for the babies in your program: ◆ Advise

parents to keep breastmilk cool during transport to the child care site.They can use a cooler with ice packs.

◆ After

you remove breastmilk from the refrigerator, never let it sit at room temperature for more than one hour. If a bottle of breastmilk sits at room temperature for more than an hour, it should be thrown out because of the risk of bacterial growth.

◆ Only

accept bottles labeled with a name and the date that the milk was expressed.

◆ When

parents arrive at child care with breastmilk, immediately refrigerate the bottle(s).

Never refreeze thawed breastmilk.

◆ Keep

thermometers in your refrigerator and freezer to ensure that they are at the temperatures listed in the above guidelines.

◆ Check

the dates and times on labeled bottles daily. Be sure that you are using the bottle with the oldest date first. If the breastmilk is expired (according to the above guidelines) it must be discarded.

Frequently Asked Questions How often should the baby be fed? Babies should be fed whenever they are hungry. Signs of hunger include turning the head, opening the mouth wide, sucking on the hands, and/or slight fussing. Crying is a late sign of hunger. Breastmilk digests more quickly than formula; so, breastfed babies usually eat more often than formula-fed babies do. As a general rule of thumb, babies should be fed every 2-4 hours. Newborns and babies going through a growth spurt may eat more frequently. You should talk to parents about a baby’s feeding schedule and the amounts that the baby should be fed so that you can accommodate each baby’s individual needs. How can I tell if the baby is getting enough breastmilk? During an 8-hour day at child care, you can expect most babies to eat about 3 times depending on the child’s age.The amount of milk that breastfed infants drink from a bottle varies widely. Some babies will only drink small amounts (2-4 ounces at a time), and then nurse frequently in the evening when they are with their moms. Other babies may drink larger amounts. Content and alert babies are probably getting enough breastmilk. If a baby is fussy you should talk to the parents and have them discuss the problem with their health care provider. If a baby acts listless and sick and has dark yellow urine and/or a dry mouth and lips, he or she may be dehydrated. A baby who is dehydrated needs immediate medical attention. If a baby only drinks part of a bottle, is it okay to reuse the rest of the breastmilk later on? No! Once a baby starts feeding, the milk becomes contaminated.The baby’s saliva creates an environment that can lead to bacterial growth. Any breastmilk that has not been consumed during a single feeding should be thrown away.To avoid wasting breastmilk, measure out small amounts at first.This can be increased as the baby’s appetite grows.

Should water, formula, or solid foods be given to the baby? Babies should have only breastmilk or formula until about 4-6 months of age (unless indicated by a physician). At that time, you should get specific instructions from the parents regarding the age-appropriate introduction of solids and liquids. The breastmilk has a layered look. Does this mean that it is spoiled? No, the breastmilk is not spoiled.When breastmilk sits for a while, the fat can separate out, giving it a layered appearance. Gently swirl the bottle to mix the layers that have separated. What should I do if a baby is accidentally given the wrong bottle? If a baby does get fed from the wrong bottle, inform both mothers immediately.To minimize the chances of having this type of accident occur, make sure that you have procedures that ensure proper labeling and storage of breastmilk. Do I need to wear gloves to clean up spilled breast milk? Since the risk of infection to caregivers who are feeding expressed human milk is very low, wearing of gloves to feed or clean up spills of expressed breast milk is unnecessary. However, caregivers with open cuts on their hands should avoid direct contact with breast milk. Where can I get more information about breastfeeding? You can speak with your child care health consultant. Other local resources include nutritionists, community health centers, and lactation consultants.You will also find some useful resources listed on the last page of this brochure.

Resources Max Care Health Line, Massachusetts Department of Public Health, 800-487-1119 WIC Nutrition Program, Massachusetts Department of Public Health, 800-942-1007 Nursing Mothers Council, 617-244-5102 La Leche League, 800-LA-LECHE www.lalecheleague.org National Center for Education in Maternal and Child Health, 703-524-7802, www.ncemch.org Breastfed Babies Welcome Here! United States Department of Agriculture, 703-305-2746 Caring for Our Children, National Health and Safety Performance Standards, National Resource Center for Health and Safety in Child Care, 800-598-KIDS, http://nrc.uchsc.edu Health and Safety in Child Care, Massachusetts Department of Public Health, 1995 Available at the State House Bookstore, 617-727-2834 Massachusetts Breastfeeding Coalition, www.massbfc.org Working and Breastfeeding, National Healthy Mothers, Healthy Babies Coalition, 703-836-6110, http://www.hmhb.org National Center for Infants,Toddlers and Families, www.zerotothree.org Healthy Child Care America, www.healthychildcare.org Feeding Infants: A Guide for Use in the Child Nutrition Programs, www.fns.usds.gov/tn/resources/feeding-infants.pdf

Support for this brochure was provided in part through the US Department of Health and Human Services Health Resources and Services Administration, Maternal and Child Health Bureau Healthy Child Care America program.

WIC Nutrition Program â&#x20AC;˘ 1-800-WIC-1007 Nutrition Division â&#x20AC;˘ MA Department of Public Health TDD/TTY: 617.624.5992 USDA is an equal opportunity provider and employer.

Caregiver’s Guide to the Breastfed Baby breastfeedingbasics.com /articles/caregivers-guide-to-the-breastf ed-baby T here may be times when, f or a variety of reasons, nursing mothers need or want to leave their nursing baby with a caregiver. T his may be a ‘once only’ event, or a regular daily arrangement. T he f ollowing inf ormation is intended as a guide f or the caregiver of a breastf ed baby, so she/he can better understand how to care f or the baby and the expressed breastmilk (EBM) lef t f or the baby’s use. General Information Human milk does not look like f ormula or cow’s milk. It may be a dif f erent color or consistency, and it is normal f or it to be bluish, greenish, or even brownish in color. Frozen milk, or milk expressed during the early days of nursing (which still contains colostrum) may look yellowish. Human milk that is properly stored is not spoiled, unless it smells sour or tastes bad. Because human milk is not homogenized, it will naturally separate into layers of milk and cream. T his is normal, and does not mean the milk is spoiled. If the milk separates, heat and swirl it gently to mix. Several batches of EBM expressed at dif f erent times may be mixed and/or stored together to make enough f or one f eeding. A mother’s EBM should only be used f or her baby. For health reasons, milk f rom dif f erent mothers should not be pooled. Because a baby digests and uses human milk so completely, less breastmilk than f ormula may be needed at a f eeding. T here is no way to predict exactly how much milk a baby will need at each f eeding, but you will soon learn how much milk the baby usually takes. In exclusively breastf ed babies, milk intake increases quickly during the f irst f ew weeks of lif e, then stays about the same between one and six months – though it is likely to periodically increase during growth spurts. During the f irst six months, most babies will take in about the same amount of milk: around 25 ounces in 24 hours. It’s a good idea to have some 1-2 ounce portions available f or snack f eedings. At some point af ter six months, depending in how much of his nourishment comes f rom other f oods and how of ten he nurses, your baby’s milk intake will gradually decline as his nutrient intake f rom other sources increases. T he ‘average baby’ will ‘usually’ take f rom two to f our ounces, but this varies greatly f rom baby to baby. Remember, these are only guidelines and don’t apply to each unique little person. As a rule of thumb, babies 3 months and under usually take between 2-4 ounces, and babies over 3 months will take f rom 4-6 ounces. Until you get a f eel f or how much the baby will consistently take at each f eeding, of f er small amounts of EBM at a time. If the baby is not very hungry, you will not then have to waste large quantities of milk. If he needs more, prepare another smaller amount. You should be aware that a breastf ed baby may not be on the same f eeding schedule as a f ormula f ed baby. Breastmilk is digested quickly, and the baby may need to f eed more f requently. Also, many nursing babies are used to nursing f or comf ort as well as nutrition, and my need extra cuddling and rocking, especially at naptime. Be f lexible, and as you spend time with the baby you will get to know his own

unique schedule, and you will be able to comf ort him in your own way. Breastf ed baby’s bowel movements are looser than f ormula f ed inf ants, and may be more f requent (especially in the early weeks). It is not unusual f or a newborn nursing baby to have a loose stool every time he f eeds, but this is not diarrhea (unless accompanied by f ever, lethargy, vomiting, or other symptoms of illness). In breastf ed babies older than 6 weeks, it is not unusual f or babies to go several days without stooling. In a totally breastf ed inf ant, this is not considered constipation. Constipation consists of hard, dry stools that are painf ul to pass. An older nursing baby may not stool every day, but the stool will be loose and plentif ul when he does pass it. Totally breastf ed baby’s stools are usually mustard yellow and seedy, but may also be yellow green or brownish. T hey are much milder smelling than a f ormula f ed baby’s stools. Thawing and Heating To thaw f rozen EBM, it is best to leave it in the ref rigerator f or about 12 hours. If you need to thaw it quickly, hold the container of milk under cool running water, and gradually add warmer water until the milk is thawed and heated to room temperature, gently swirling to mix in the f at. To heat ref rigerated EBM, put the container of milk in a pan of warm (not hot) water just until the chill is of f . Many babies don’t mind if the milk is cold, and serving it right out of the ref rigerator is not harmf ul. Run the nipple under warm water, though, as most babies don’t like the f eel of a cold nipple. NEVER thaw or heat EBM in a microwave. T his can destroy valuable nutrients, and can also create dangerous ‘hot spots’ that can burn the baby’s mouth, even though the bottle may f eel cool to the touch. For the same reasons, do not boil or overheat EBM. Use thawed EBM within 24 hours. EBM that has been ref rigerated but not f rozen will keep f or up to 8 days in a ref rigerator. Encouraging Baby to Feed Many breastf ed babies are reluctant to take a bottle at f irst. A hard rubber nipple f eels and tastes very dif f erent f rom sof t skin. Babies may ref use to take a bottle f rom their mother since they associate her with nursing, but will take it more readily f rom a caregiver, especially if the mother is not in the room. Most babies adjust more easily if they get to know their caregiver gradually, so it may be helpf ul to try a program of visits and short stays (that include a f eeding time) bef ore baby is lef t f or longer periods. Tips to get the baby to take a bottle include: Of f er the bottle bef ore the baby gets f rantically hungry. Of f er the bottle in a position other than the traditional cradle hold – many babies associate this position with nursing). It sometimes works well to sit the baby in an inf ant seat or prop him on your knees while of f ering the bottle. Wrap the baby in a piece of the mother’s clothing while of f ering the bottle. Tickle the baby’s mouth gently with the bottle nipple and let him draw it in himself , rather than pushing it in. Run warm water over the nipple bef ore of f ering it. Try dif f erent types of nipples to f ind a shape and f low rate that the baby will accept. Try moving rhythmically – rocking, walking, or swaying f rom side to side while of f ering the bottle. If the baby will absolutely not take the bottle, he can be f ed EBM by other methods, such as cup, spoon, syringe, or dropper. With a little time and patience, he will usually learn to accept the bottle.

When the Mother Will Be Returning Soon If the baby becomes unsettled, try rocking and talking to him rather than f eeding him. Of f er a pacif ier if he is used to using it, and the mother approves. When the mother returns, she will probably want to f eed him as soon as possible f or practical reasons – her own comf ort, closeness with her baby, and to stimulate her milk supply. If you can’t get him settled, of f er a small amount of EBM. If no milk is available, of f er a small amount of boiled water. T he mother should be consulted bef ore any other liquids are of f ered to her baby. If the baby is old enough to eat solid f oods, you may be able to of f er something that has been tolerated previously. Always check this with the mother f irst. Your Relationship With the Baby’s Mother You can be an enormous help to the baby’s mother in supporting her ef f orts to provide breastmilk f or her baby. Mothers choose to provide EBM f or their inf ants when they have to be separated f rom them because they want the very best f or their babies. Making the decision to leave breastmilk rather than f ormula, and to continue the nursing relationship even af ter returning to work or school requires a great deal of commitment on the mother’s part. Your encouragement and support can make all the dif f erence, especially if the mother arranges to come to your home or day care center to f eed her baby. T here are times when a baby may go through periods of appetite increase. T hese “growth spurts” of ten occur at about six weeks, three months, and six months. If you let the mother know, she will then try to express more milk. Sometimes it takes a f ew days f or her supply to catch up. If the mother knows you support her ef f orts to provide breastmilk f or her baby, you will be contributing in a very positive way to helping her continue to nurse. Remember: BREAST MILK IS T HE PERFECT FOOD FOR BABIES! Your encouragement and support is very important.

This Child Care Supports Supports Breastfeeding!

To support families who breastfeed, we:

Offer a comfortable place for mothers to breastfeed – including a quiet, private space for those who would like that

Display positive breastfeeding messages

Discuss feeding patterns with parents

Be flexible on feeding times so that mothers may breastfeed drop-off, pick-up and in between – when able

Allow infants to feed on cue, preferably by a consistent caregiver. Research supports feeding infants on cue rather than on schedule can help to prevent childhood obesity

Encourage mothers to provide a back-up supply of frozen or refrigerated expressed milk

Supply information about community resources that provide breastfeeding support i.e. Lactation Consultants, businesses that support breastfeeding mothers

Ensure that all staff members receive appropriate training in breastfeeding support, promotion, and proper milk handling and storage

Provide emotional support concerning mothers decisions about breastfeeding and weaning

Benefits of Breastfeeding Breastfed babies experience lasting health effects including reduced risk of infectious diseases, diabetes, childhood cancers, obesity and asthma. Women who breastfeed their children are at lower risk for breast cancer and ovarian cancer. Families who breastfeed can save between $1,200–$1,500 in formula expenditures in just the first year (“Surgeon General’s Call to Action to Support Breastfeeding” 2011). Breastfeeding also reduces waste, saving resources used for production, shipping, storage and preparation of formula.

WeAllBenefit.org

California WIC Program, California Department of Public Health | This institution is an equal opportunity provider. Photos and some content compliments of the Texas Department of State Health Services WIC Program. Programa de WIC de California, Departamento de Salud Pública de California | Esta institución es un proveedor que ofrece igualdad de oportunidades. Las fotografías y parte del contenido son cortesía del Departamento Estatal de Servicios de Salud de Texas, Programa de WIC. 1-800-852-5770 #960089 8/12

I not only became a MOM, I discovered a new me Nineteen year old Renae chose to breastfeed her daughter. â&#x20AC;&#x153;It was the best decision I ever made.â&#x20AC;?

breastfeeding saved my son’s LIFE ”Age nineteen was a huge year for me. I was experiencing pregnancy for the first time while recovering from the death of my mother. I was trying to ‘mother’ my twin two-year old brothers and also adapting to a new husband. But my future had a far greater challenge in store for me.

Cynthia

From the very start, being a teen mother was a whirlwind experience. I wanted to do everything right but wasn’t always sure what ‘right’ was and I no longer had my mother for guidance and support. I remembered seeing the look in her eyes when she breastfed my brothers. There was a tenderness in them; complete devotion. And I wanted the same experience for my son. Even though family and friends thought it was weird that I chose to breastfeed him, I did it anyway.

My son was in intensive care for three weeks. Well meaning nurses suggested I use formula, hoping to help me during this difficult time. I refused. I knew that breast milk was best for my baby—especially when he was struggling for life. I made many decisions at an early age that changed my life. Breastfeeding was one of the best. When I accepted the responsibility of having a child I committed myself to being the best mother I could be. Breastfeeding my child was just part of my commitment but it’s something I couldn’t be more proud of.”

My son’s health took a dive about a month after he was born. He was rushed to the hospital where the doctors told me his intestines were twisted. He had emergency surgery that day. His doctors told me that it was my breast milk that had probably saved his life.

WIC Nutrition Program • Nutrition Division MA Department of Public Health TDD/TTY: 617.624.5992 • www.mass.gov/wic ‘This institution is an equal opportunity provider.’

Cover photography by Michael Young www.yamstudio.com

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You alone have the power to give your baby the best start in life. The power to forge a unique mother-child bond. The power to protect your baby from illness. By breastfeeding, you become your childâ&#x20AC;&#x2122;s superhero. Breastfeeding: A true super power.

Not just a NEW mom,

a supermom

breastfeeding: It’s enough to make you WONDER “My mother formula fed her children. At the time it was the more socially acceptable way to feed your baby. So having never experienced breastfeeding herself she was skeptical when I told her I wanted to try it. She thought it was bizarre, assumed it would be difficult, doubted whether I would stick with it, and predicted great pain. But in my gut I knew that breastfeeding was best. It was as natural as loving my baby. My mother came to stay with me for five weeks following the delivery of my son. During that time I watched her transform from curious skeptic to pro-breastfeeding expert!

Mom watched me breastfeed with great interest. At first she wondered if breastfeeding would be painful. I wondered, too. There were some times during the first weeks when it was a challenge, but I kept telling myself to give it a full two weeks before making any decisions. I did. And after 14 days I felt great. My mom wondered if my milk was rich enough— especially after she saw how thin it was. I wondered that too. But when I saw the way my son was growing, I knew my milk was better than gold even though it looked thinner than formula. Mom wondered if I produced enough milk. Actually I wondered about that, too. But the happy, peaceful look on my son’s face after breastfeeding assured me that a miracle was certainly happening. My body was supporting my son’s growth in an amazing way. And I felt so proud. Breastfeeding was a blessing to my son and me—we have a bond that continues to grow stronger every day. But it was also a blessing to my mother. She is proud of me for breastfeeding my son, her grandson. And she is such a strong supporter of breastfeeding now. In fact, she admitted that she wished she had breastfed her children too. In the end, breastfeeding not only strengthened the bond between me and my son but also between me and my mother.”

Luci WIC Nutrition Program • Nutrition Division MA Department of Public Health TDD/TTY: 617.624.5992 • www.mass.gov/wic ‘This institution is an equal opportunity provider.’

Cover photography by Michael Young www.yamstudio.com

TH13 12/06

Sample Breastfeeding Policy for Child Care Centers Because breastfeeding has been shown to be the superior form of infant nutrition, providing a multitude of health benefits to both infant and mother, and because breastfeeding mothers, including employees, need ongoing support from childcare providers to provide their milk for their babies, (name of the program) adheres to the following policy. Breastfeeding mothers shall be provided a place to breastfeed or express their milk. Breastfeeding mothers, including employees, shall be provided a private and sanitary place to breastfeed their babies or express milk whenever possible. This area provides an electrical outlet, comfortable chair, and nearby access to running water. A refrigerator will be made available for storage of expressed breast milk. Breastfeeding mothers and employees may store their expressed milk in the center refrigerator. Mothers should provide their own containers, clearly labeled with the name and date. (name of the program) will follow guidelines from the American Academy of Pediatrics and Centers for Disease Control in ensuring that breast milk is properly treated to avoid waste. Universal precautions are not required in handling human milk. Sensitivity will be shown to breastfeeding mothers and their babies. (name of the program) is committed to providing ongoing support to breastfeeding mothers, including providing an opportunity to breastfeed their baby in the morning and evening, and holding off giving a bottle, if possible, when mom is due to arrive. Artificial baby milks (formula) and solid foods will not be provided unless the mother has requested. Babies will be held closely when feeding and bottles will never be propped. Staff shall be trained in handling human milk. All childcare center staff will be trained in the proper storage and handling of human milk, as well as ways to support breastfeeding mothers. Breastfeeding employees shall be provided flexible breaks to accommodate breastfeeding or milk expression. Breastfeeding employees shall be provided a flexible schedule for breastfeeding or pumping to provide breast milk for their children. The time allowed would not exceed the normal time allowed for lunch and breaks. For time above and beyond normal lunch and breaks, sick/annual leave must be used, or the employee can come in a little earlier or leave a little late to make up the time. Breastfeeding promotion information will be displayed. (name of the program) will provide information on breastfeeding, including the names of area resources should questions or problems arise. In addition, positive promotion of breastfeeding will be on display in the center. This policy will be communicated with all employees, expectant mothers, families and visitors. (name of the program) will include information about being breastfed baby friendly in the information packet provided to prospective families. Adapted from resources compiled by the 2012 Maine Breastfeeding Stakeholder Workgroup [Policy language adapted from the Mississippi Breastfeeding Coalitionâ&#x20AC;&#x2122;s Building Breastfeeding Friendly Communities project by the Wisconsin Department of Health and Family Services in collaboration with the Wisconsin Breastfeeding Coalition Division of Public Health â&#x20AC;&#x201C; Nutrition Section PPH 40070 (06/03) www.dhfs.state.wi.us/WIC]

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Sample Breastfeeding Policy for Family Child Care Providers Because breastfeeding has been shown to be the superior form of infant nutrition, providing a multitude of health benefits to both infant and mother, and because breastfeeding mothers need ongoing support from childcare providers to provide their milk for their babies, (name of the program) adheres to the following policy. Breastfeeding mothers shall be provided a place to breastfeed or express their milk. Breastfeeding mothers, including employees, shall be provided a private and sanitary place to breastfeed their babies or express milk whenever possible. This area provides (list amenities you are able to provide; e.g. an electrical outlet, comfortable chair, and nearby access to running water). Refrigerator space will be made available for storage of expressed breast milk. Breastfeeding mothers [and employees] may store their expressed milk in the program’s refrigerator. Mothers should provide their own containers, clearly labeled with the name and date. (name of the program) will follow guidelines from the American Academy of Pediatrics and Centers for Disease Control in ensuring that breast milk is properly treated to avoid waste. Universal precautions are not required in handling human milk. Sensitivity will be shown to breastfeeding mothers and their babies. (name of the program) is committed to providing ongoing support to breastfeeding mothers, including providing an opportunity to breastfeed their baby in the morning and evening, and holding off giving a bottle, if possible, when mom is due to arrive. Artificial baby milks (formula) and solid foods will not be provided unless the mother has requested. Babies will be held closely when feeding and bottles will never be propped. The program owner [and all employees] shall be trained in handling human milk. All childcare program staff will be trained in the proper storage and handling of human milk, as well as ways to support breastfeeding mothers. Breastfeeding promotion information will be displayed. (name of the program) will provide information on breastfeeding, including the names of area resources should questions or problems arise. In addition, positive promotion of breastfeeding will be on display in the child care areas. This policy will be communicated with [all employees], expectant mothers, families and visitors. (name of the program) will include information about being breastfed baby friendly in the information packet provided to prospective families. FOR PROGRAMS WITH STAFF MEMBERS BESIDES THE PROGRAM OWNER: Breastfeeding employees shall be provided flexible breaks to accommodate breastfeeding or milk expression. Breastfeeding employees shall be provided a flexible schedule for breastfeeding or pumping to provide breast milk for their children. The time allowed would not exceed the normal time allowed for lunch and breaks. For time above and beyond normal lunch and breaks, sick/annual leave must be used, or the employee can come in a little earlier or leave a little late to make up the time. Adapted from resources compiled by the 2012 Maine Breastfeeding Stakeholder Workgroup [Policy language adapted from the Mississippi Breastfeeding Coalition’s Building Breastfeeding Friendly Communities project by the Wisconsin Department of Health and Family Services in collaboration with the Wisconsin Breastfeeding Coalition Division of Public Health – Nutrition Section PPH 40070 (06/03) www.dhfs.state.wi.us/WIC]

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Sample Infant Daily Feeding Logs (Birth-6 months old) EXAMPLE 1) Child’s Name:_________________________ Parent Signature:___________________________ Caregiver’s Name:___________________________ Date:__________________ Milk Type: Breast Milk / Formula (type_____________) (_______oz _____Time)

(______ oz____ Time)

(______oz_____ Time)

(____oz______ Time)

(_______oz _____Time)

(______ oz____ Time)

(______oz_____ Time)

(____oz______ Time)

Water (if indicated by doctor or parent): (_______oz _____Time) (______ oz____ Time)

(______oz_____ Time)

(____oz______ Time)

Notes/Special Instructions: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________

EXAMPLE 2) Child’s Name:_________________________ Parent Signature:___________________________ Caregiver’s Name:___________________________ Date:__________________

Milk

Amount (oz)

Time

Breast Milk / Formula (type___________)

Notes/Special Instructions: _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________

Adapted from resources compiled by the 2012 Maine Breastfeeding Stakeholder Workgroup 06/13 R00/00

Appendix C: Sample 6+ months Infant Feeding Plan

Monday

Tuesday

Wednesday

Thursday

Friday

Breast milk (or substitute)

Solid food

Lunch Time: __________ Fed by:_________

Breast milk (or substitute)

Solid food

Breast milk (or substitute)

Solid food

Breakfast Time: _____________ Fed by:____________

Infant feeding plan (oz./ cup or bottle)

Snack Time: __________ Fed by:_________

Child name:_________________________________ Parent signature:_________________________________ Week of___________ 20____

Notes/Special instructions:________________________________________________________________________________________________ ______________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________

Handout taken from the "2013 Midcoast Public Health CTG Breastfeeding Resource Toolkit for Early Childcare and Education Centers".

Appendix B: Breastfeeding‐friendly Reading Materials

Book Author (Illus.) Recommended by La Leche League17: We Have a Baby (1993) Cathyrn Falwell We Like to Nurse (1995) Chia Martin Breastmilk makes my Cecelia Moen tummy yummy (1999) Mama, Daddy, Baby and Lisa Gewing (Donna Me (1989) Larimer) Look What I See! Where can Dia L. Michels. (Michael I Be? In the Neighborhood J. N. Bowles) (2001) The World is Full of Babies! Mick Manning (Brita (1996) Granström) Supermom (2001) Mick Manning (Brita Granström) Happy Birth Day! (1996) Robie H. Harris (Michael Emberley) Only the Cat Saw (1982, Ashley Wolff 1996) Hello Baby! (1999) Lizzy Rockwell What Baby Needs (2001) William Sears MD, Martha Sears RN, Christie Watts Kelly (Renee Andriani) Baby on the Way (2001) William Sears MD, Martha Sears RN, Christie Watts Kelly (Renee Andriani) Will There Be a Lap for Me? Dorothy Corey (Nancy (1992) Poydar) One Round Moon and a Star Ingrid Mennen (Niki for Me (1994) Daly) The Best Gifts (1998) How Was I Born? (1994)

Breasts (1989, 1999) The Wonder of Mother's Milk (2005)

Special topics

Age level

New sibling Animals/mammals Toddlers/tandem nursing New sibling

1‐3 years 1‐3 years 2‐4 years

Babywearing, multicultural

2‐4 years

Multicultural

2‐6 years

Animals, multicultural

3‐6 years

Birth story

3‐8 years

Farm life

3‐8 years

New sibling New sibling, baby wearing, co‐sleeping, bottled breast milk

3‐6 years 5‐8 years

New sibling

3‐6 years

New sibling

3‐8 years

Multicultural, new sibling, father‐son bonding Growing up, family

3‐8 years

Marsha Forchuk Skrypuch (Halina Below) Lennart Nilsson and Lena New sibling, birth story, Katarina Swanberg conception, growth and development Genichiro Yagyu Mishawn Purnell‐O'Neal Multicultural, working (Dana T.C. Simpson) moms

2‐4 years

4‐8 years 4‐8 years

5‐8 years 5‐8 years 17

Appendix B: Breastfeeding‐friendly Reading Materials Recommended by Motherlove Herbal Company Breastfeeding Blog18: The Mystery of the Breast Victoria de Aboitiz (Afra) New sibling (2012) Mama's Milk (2008) Michael Elsohn Ross Animals/mammals, English/Spanish Nursies When the Sun Katherine Havener (Sara Night weaning, co‐ Shines (2013) Burrier) sleeping You, Me and the Breast Monoica Calaf (Mikel Growing up, weaning (2012) Fuentes) Mommy Feeds Baby (2011) Christina Jo Hendricks Multicultural, photography Best Milk (2010) Kate Carothers New sibling, animals, babywearing

3‐7 years 3‐8 years

We Like to Nurse (1994), and We Like to Nurse, Too (2009) This Milk Tastes Good! (2011) Mommy Breastfeeds my Baby Brother (2009)

Chia Martin (Shukyo Linn Rainey) and Mary Young (Zachery Parker) Chenniah Patrick (V. Kuroji) Mark Prepkin (David Moneysmith)

Animals/mammals, available in Spanish

2+ years

New sibling

I'm Made of Mama's Milk (2002) Michelle the Nursing Toddler (1998) Ready to Wean (2012)

Mary Olsen

Jane Pinczuk

4+ years

Elyse April (Diane Iverson) Mary Joan Deutschbein

Weaning

Weaning, new sibling

Animals/mammals

9+ years

Animals/mammals

Maggie's Weaning (1999)

If My Mom Were a Platypus Dia Michels (2005) Mammals and Their Milk Lucia Anderson (1985)

Handout taken from the "2013 Midcoast Public Health CTG Breastfeeding Resource Toolkit for Early Childcare and Education Centers".

Breastfeeding vs. Formula Feeding

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Breastfeeding vs. Formula Feeding Breast or Bottle? Choosing whether to breastfeed or formula feed your baby is one of the first decisions expectant parents will make. The American Academy of Pediatrics (AAP) joins other organizations such as the American Medical Association (AMA), the American Dietetic Association (ADA), and the World Health Organization (WHO) in recommending breastfeeding as the best for babies. Breastfeeding helps defend against infections, prevent allergies, and protect against a number of chronic conditions. The AAP says babies should be breastfed exclusively for the first 6 months. Beyond that, the AAP encourages breastfeeding until at least 12 months, and longer if both the mother and baby are willing. Although experts believe breast milk is the best nutritional choice for infants, breastfeeding may not be possible for all women. For many women, the decision to breastfeed or formula feed is based on their comfort level, lifestyle, and specific medical considerations that they might have. For mothers who are unable to breastfeed or who decide not to, infant formula is the alternative. Some women feel guilty if they don't breastfeed. You'll still bond with your baby just fine. After all, whether with breast milk or formula, feeding is an important time of connection between mother and baby. The decision to breastfeed or formula feed your baby is a very personal one. But here are some points you may want to consider as you decide which is best for you and your new addition.

About Breastfeeding Nursing is a wonderful experience for both mother and baby. It provides ideal nourishment and a special bonding experience that many nursing mothers cherish. Here are some of the many benefits of breastfeeding: Infection-fighting. Antibodies passed from a nursing mother to her baby can help lower the occurrence of many conditions, including: ear infections diarrhea respiratory infections meningitis Other factors help to protect a breastfed baby from infection by contributing to the infant's immune system by increasing the barriers to infection and decreasing the growth of organisms like bacteria and

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viruses. Breastfeeding is particularly beneficial for premature babies and also may protect children against: allergies asthma diabetes obesity sudden infant death syndrome (SIDS) As a group, breastfed babies have fewer infections and hospitalizations than formula-fed infants. Nutrition and ease of digestion. Often called the "perfect food" for a human baby's digestive system, breast milk's components â&#x20AC;&#x201D; lactose, protein (whey and casein), and fat â&#x20AC;&#x201D; are easily digested by a newborn's immature system. As a group, breastfed infants have less difficulty with digestion than do formula-fed infants. Breast milk tends to be more easily digested so that breastfed babies have fewer incidences of diarrhea or constipation. Breast milk also naturally contains many of the vitamins and minerals that a newborn requires. A healthy mother does not need any additional vitamins or nutritional supplements, with the exception of vitamin D. Breast milk does contain some vitamin D, and vitamin D is produced by the body when the skin is exposed to sunlight. However, sun exposure increases the risk of skin damage, so parents are advised to minimize exposure. As a result, the AAP recommends that all breastfed babies begin receiving vitamin D supplements during the first 2 months and continuing until the infant consumes enough vitamin D-fortified formula or milk (after 1 year of age). The U.S. Food and Drug Administration (FDA) regulates formula companies to try to ensure they provide all the known necessary nutrients (including vitamin D) in their formulas. Commercial formulas try to duplicate the ingredients in breast milk, but haven't matched their exact combination and composition. Why? Because milk is a living substance made by each mother for her individual infant, a process that cannot be duplicated in a factory. Free. Breast milk doesn't cost a cent, while the cost of formula quickly adds up. And because of the immunities and antibodies passed onto them through their mothers' breast milk, breastfed infants are sick less often than infants who receive formula. For example, researchers have determined that infants who are breastfed exclusively have fewer episodes of ear infections. That may mean they make fewer trips to the doctor's office, which equates to fewer co-pays and less money doled out for prescriptions and over-the-counter medications. Likewise, women who breastfeed are less likely to have to take time off from work to care for their sick babies. Different tastes. A nursing mother will usually need 500 extra calories per day, which means that she should eat a wide variety of well-balanced foods. This introduces breastfed babies to different tastes through their mothers' breast milk, which has different flavors depending on what their mothers have

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eaten. By tasting the foods of their "culture," breastfed infants more easily accept solid foods. Convenience. With no last-minute runs to the store for more formula, breast milk is always fresh and available. And when women breastfeed, there's no need to warm up bottles in the middle of the night. It's also easy for breastfeeding mothers to be active — and go out and about — with their babies and know that they'll have food available for whenever their little one is hungry. Obesity prevention. Some studies have found that breastfeeding may help protect a child from obesity. Smarter babies. Some studies suggest that children who were exclusively breastfed have slightly higher IQs than children who were formula fed. "Skin-to-skin" contact. Many nursing mothers really enjoy the experience of bonding so closely with their babies. And the skin-to-skin contact can enhance the emotional connection between mother and infant. Beneficial for mom, too. The ability to nourish a baby totally can also help a new mother feel confident in her ability to care for her baby. Breastfeeding also burns calories and helps shrink the uterus, so nursing moms may be able to return to their pre-pregnancy shape and weight quicker. In addition, studies show that breastfeeding helps lower the risk of breast cancer, high blood pressure, diabetes, and cardiovascular disease, and also may help decrease the risk of uterine and ovarian cancer. In one long-term study of the National Institutes of Health Women’s Health Initiative, women who breastfed for at least 7 to 12 months after giving birth had a lower risk of cardiovascular disease.

Breastfeeding Challenges Although it is the best feeding choice for babies and mothers, breastfeeding does come with some concerns that new mothers may share. Whereas it's easy from the get-go for some, it can be challenging. Sometimes, both mother and baby need plenty of patience and persistence to get used to the routine of breastfeeding. But all the effort is worth it in the long run — for both the mother and her baby. Common concerns of new moms, especially during the first few weeks and months, may include: Personal comfort. Initially, as with any new skill, many moms feel uncomfortable with breastfeeding. But with adequate education, support, and practice, most moms overcome this. The bottom line is that breastfeeding shouldn't hurt if the mother receives help and guidance. Latch-on pain is normal for the first week to 10 days, and should last less than a minute with each feeding. But if breastfeeding hurts throughout feedings, or if the nipples and/or breasts are sore, it's a good idea for breastfeeding mothers to seek the help of a lactation consultant or their doctor. Many times, it's just a matter of using the proper technique, but sometimes pain can mean that something else is going on, like an infection. Time and frequency of feedings. There's no question that breastfeeding does require a substantial time commitment from mothers. Then again, many worthwhile things in parenting do. Some women may be concerned that nursing will make it hard for them to work, run errands, or travel because of a breastfeeding schedule or a need to pump breast milk during the day. Many of these concerns can be addressed at a prenatal lactation consultant visit.

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Breastfeeding vs. Formula Feeding

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And breastfed babies do need to eat more often than babies who are fed formula, because breast milk digests faster than formula. This means mom may find herself in demand every 2 or 3 hours (maybe more, maybe less) in the first few weeks. This can be tiring, but once breastfeeding has been established (usually in about a month), other family members may be able to help out by giving the baby pumped breast milk if mom needs a break or is going back to work outside the home. And it's not long before babies feed less frequently and sleep through the night (usually around 3 months). Also, with a little organization and time management, it becomes easier to work out a schedule to breastfeed and/or pump. Diet. Women who are breastfeeding need to be aware of what they eat and drink, since things can be passed to the baby through the breast milk. Just like during pregnancy, breastfeeding women should avoid fish that are high in mercury, and limit lower mercury fish intake. If a woman has alcohol, a small amount can be passed to the baby through breast milk. She should wait to breastfeed at least 2 hours after a single alcoholic drink in order to avoid passing any alcohol to the baby. Caffeine intake should be kept to no more than 300 milligrams (about one to three cups of regular coffee) per day for breastfeeding women because it may cause problems such as restlessness and irritability in some babies. Some infants are sensitive enough to caffeine to have problems even with smaller amounts of caffeine. Discuss these situations with your health care provider or lactation consultant. Maternal medical conditions, medicines, and breast surgery. Medical conditions such as HIV or AIDS or those that involve chemotherapy or treatment with certain medications may make breastfeeding unsafe. A woman should check with her doctor or a lactation consultant if she's unsure if she should breastfeed with a specific condition. Women should always check with the doctor about the safety of taking medications while breastfeeding, including over-the-counter and herbal medicines. Mothers who've had breast surgery, such as a reduction, may have difficulty with supply if their milk ducts have been severed. In this situation, a woman should to talk to her doctor about her concerns and work with a lactation specialist.

About Formula Feeding Breastfeeding is considered the best nutritional option for babies by the major medical organizations, but it's not right for every mother. Commercially prepared infant formulas are a nutritious alternative to breast milk, and even contain some vitamins and nutrients that breastfed babies need to get from supplements. Manufactured under sterile conditions, commercial formulas attempt to duplicate mother's milk using a complex combination of proteins, sugars, fats, and vitamins that would be virtually impossible to create at home. So, if you don't breastfeed your baby, it's important that you use only a commercially prepared formula and that you do not try to create your own. In addition to medical concerns that may prevent breastfeeding, for some women, breastfeeding may be too difficult or stressful. Here are a few other reasons women may choose to formula feed: Convenience. Either parent (or another caregiver) can feed the baby a bottle at any time (although this

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is also true for women who pump their breast milk). This allows the mother to share the feeding duties and helps her partner to feel more involved in the crucial feeding process and the bonding that often comes with it. Flexibility. Once the bottles are made, a formula-feeding mother can leave her baby with a partner or caregiver and know that her little one's feedings are taken care of. There's no need to pump or to schedule work or other obligations and activities around the baby's feeding schedule. And formula-feeding moms don't need to find a private place to nurse in public. However, if mom is out and about with baby, she will need to bring supplies for making bottles. Time and frequency of feedings. Because formula is less digestible than breast milk, formula-fed babies usually need to eat less often than do breastfed babies. Diet. Women who opt to formula feed don't have to worry about the things they eat or drink that could affect their babies.

Formula Feeding Challenges As with breastfeeding, there are some challenges to consider when deciding whether to formula feed. Organization and preparation. Prepare your baby's formula by mixing water and the appropriate amount of powdered infant formula. The packaging on the side of the formula container will tell you how much to use. Carefully follow the directions. You can use tepid (room temperature) tap water, as long as your local or state health departments have labeled it as safe to drink. If you're concerned about your water, you may sterilize it to kill germs. Here's how: pour cold tap water into a teapot or sauce pan place pot on the stove over medium heat bring water to a rolling boil and let boil for about a minute let the water cool until it's at room temperature Test to see if the water is cool enough for your baby to drink by shaking a few drops of water on the inside of your wrist. If it stings, it's still too hot. Once water has cooled, don't let it sit longer than 30 minutes before adding it to the formula. Once prepared, the formula is ready to feed to your baby immediately without additional refrigeration or warming. Formula that's been prepared should be consumed or stored in the refrigerator within 1 hour. If it has been at room temperature for more than 1 hour, throw it away. And if your baby doesn't drink all the formula in the bottle, throw away the unused portion â&#x20AC;&#x201D; never save it for later. Formula may be prepared ahead of time (for up to 24 hours) if you store it in the refrigerator to prevent the formation of bacteria. Open containers of ready-made formula, concentrated formula, and formula prepared from concentrate also can be stored safely in the refrigerator for up to 48 hours. Lack of antibodies. None of the antibodies found in breast milk are found in manufactured formula, which means that formula doesn't provide the baby with the added protection against infection and illness that breast milk does.

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Expense. Formula can be costly. Powdered formula is the least expensive, followed by concentrated, with ready-to-feed being the most expensive. And specialty formulas (i.e., soy and hypoallergenic) cost more — sometimes far more — than the basic formulas. During the first year of life, the cost of basic formula can run about $1,500. Possibility of producing gas and constipation. Formula-fed babies may have more gas and firmer bowel movements than breastfed babies. Can't match the complexity of breast milk. Manufactured formulas have yet to duplicate the complexity of breast milk, which changes as the baby's needs change. Whatever nutritional option you choose, be sure to talk to your doctor about the choices available to help you make the decision that's best for both you and your baby. Reviewed by: Joseph DiSanto, MD, and Karin Y. DiSanto, IBCLC Date reviewed: January 2012

Note: All information on KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor. © 1995-2013 The Nemours Foundation. All rights reserved.

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Breastfeeding FAQs: Safely Storing Breast Milk

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Breastfeeding FAQs: Safely Storing Breast Milk Whether you're a new mom or a seasoned parenting pro, breastfeeding often comes with its fair share of questions. Here are answers to some common inquiries that mothers — new and veteran — may have.

How do I store my breast milk? You can freeze and/or refrigerate your pumped (or expressed) breast milk. You should store it in clean bottles with screw caps, hard plastic cups that have tight caps, or nursing bags (pre-sterilized bags meant for breast milk). It's helpful to put a label on each with your baby's name and the date indicating when the milk was pumped. You can add fresh cooled milk to milk that is already frozen, but add no more than is already in the container. For example, if you have 2 ounces of frozen milk, then you can add up to 2 more ounces of cooled milk.

How long, exactly, can I store my breast milk? For healthy full-term infants: You can store it at room temperature: for 4 to 10 hours (at no warmer than 77°F, or 25°C) You can store it in the refrigerator: for up to 8 days at 32°-39°F (0°-3.9°C) You can store it in the freezer (be sure to leave about an inch of space at the top of the container or bottle to allow for expansion of the milk when it freezes): for up to 2 weeks in a freezer compartment located inside the refrigerator for 6 to 12 months in a freezer that's self-contained and connected on top of or on the side of the refrigerator and is kept at 0°F (-18°C). Store the milk in the back of the freezer, not in the door) or in a deep freezer that's always 4°F (-20°C) To thaw frozen milk, you can move it to the refrigerator (it takes 24 hours to thaw), then warm by running warm water over the bag or bottle of milk and use it within the next 24 hours. If you need it immediately, then remove it from the freezer and run warm water over it until it's at room temperature. Do not refreeze it.

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Breastfeeding FAQs: Safely Storing Breast Milk

http://kidshealth.org/PageManager.jsp?dn=KidsHealth&lic=1&ps=...

Once your baby has started to drink from the bottle, you should use it within 1 hour. If the baby doesn't finish the bottle, you can put it back in the refrigerator, then warm it and use it at the next feeding. You may find that different resources provide different variations on the amount of time you can store breast milk at room temperature, in the refrigerator, and in the freezer. Talk to your doctor if you have any concerns or questions.

How much of my milk should I store in the freezer? Although some women may choose to pump large volumes to be frozen, it's a good idea to actually store the breast milk in 2 to 4 ounce (59.1 to 118.2 milliliters) portions so as not to waste any. Label the bottles, cups, or bags with the date and your baby's name, then freeze them. You could also pour the milk into ice cube trays that have been thoroughly cleaned in hot water, let them freeze until hard, store them in freezer bags, then count up the amount of cubes needed to make a full bottle.

My frozen breast milk changed color. Is this OK? Breast milk that's been frozen or refrigerated may look a little different from fresh breast milk, but that doesn't mean it's gone bad. It's normal for early breast milk to look kind of orange and the mature milk to look slightly blue, yellow, or brown when refrigerated or frozen. And it may separate into a creamy looking layer and a lighter, more milk-like layer.

How do I clean bottles and pump parts? Prior to the first use, you'll need to wash and then sterilize the nipples, bottles, and washable breast pump supplies (for example, the breast shields and any other part that touches your breasts or your milk) by boiling them for 5 to 10 minutes. Check the manufacturer's recommendations for the length of time to boil the parts. You also can sterilize the parts with a countertop or microwaveable sterilizer, but boiling works just as well and costs nothing. Thereafter, you'll need to wash the pump supplies in hot, soapy water (or run them through the dishwasher) after every use. Bottles and nipples need to be washed and sterilized for each use for the first 3 months of the babyâ&#x20AC;&#x2122;s life because they can transmit bacteria if they aren't cleaned properly.

Is it safe to microwave my baby's bottles? The microwave can create dangerous "hot spots" in bottles of formula or breast milk, so you should never microwave them. Instead, you can run the bottle or freezer bag under warm water for a little bit, swirl the bag or bottle around in a bowl of warm water, or thaw the milk in the refrigerator. You also can put your baby's bottles in a pan of warm water (away from the heat of the stove) and then test the temperature by squirting a drop or two on the inside of your wrist before feeding your baby. And bottle warmers are available for use at home or in the car. Reviewed by: Joseph DiSanto, MD, and Karin Y. DiSanto, IBCLC Date reviewed: January 2012

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6/20/2013 5:39 PM

Safely Storing Breast Milk Freshly Expressed Milk Room temperature Insulated cooler/icepacks

Temperature Up to 77º F or 25ºC

Storage Time 6-8 hours

5-39º F or 4º C

24 hours

Comments Containers should be covered and kept as cool as possible; covering the container with a cool towel may keep milk cooler. Keep ice packs in contact with milk containers at all times, limit opening cooler bag.

Refrigerated Milk Refrigerator (fresh milk)

39ºF or 4ºC

5 days

Store milk in the back of the main body of the refrigerator.

Frozen Milk Freezer compartment inside the refrigerator Freezer compartment of a refrigerator with separate doors. Chest or upright deep freezer

5ºF or -15ºC

2 weeks

0º F or -18ºC

3-6 months

- 4ºF / -20ºC

6-12 months

Store milk towards the back of the freezer, where temperature is most constant. (Milk stored for longer durations in the ranges listed is safe, but some of the lipids in the milk undergo degradation resulting in lower quality).

Safely Preparing and Storing Expressed Breast Milk: • •

• • •

Wash hands before expressing or handling breast milk. Store milk in clean containers, containers such as screw cap bottles, hard plastic cups with tight caps, or heavy-duty bags that lift directly into nursery bottles. Avoid using ordinary plastic storage bags or formula bottle bags, as these could easily leak or spill. Clearly label the breast milk container with the child’s name and date Do not add fresh milk to already frozen milk within a storage container. Tip from Do not save milk from a used bottle for use at another feeding. KellyMom.com

Thawing Breast Milk • •

Thaw breast milk by transferring it to the refrigerator for thawing or by swirling in the bag or bottle in a bowl of warm water. Avoid using the microwave oven to thaw or heat bottles of breast milk o Bottles may explode if left in the microwave too long. o Excess heat can destroy the nutrient quality of the expressed milk. o Microwaving can create “hot spots” that burn the child’s tongue.

To avoid waste and for easier thawing and warming, store milk in 11-4 ounce portions!

Reference: CDC. Proper Handling and Storage of Human Milk. www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm. Updated March 4, 2010. Accessed July 11, 2013.

Appendix H: Requesting a Breast Pump from Your Health Insurance Carrier

Requesting a Breast Pump from Your Health Insurance Carrier The recently passed Affordable Care Act (ACA) will now require health insurance carriers to provide breast pumps to pregnant and nursing mothers. It is important that you understand the provisions in your own private health insurance plan in order to gain maximum benefits. Understand your plan and the benefits of the ACA. Do your research. Before you call your insurer’s customer service department and ask about a breast pump, you will need to confirm your eligibility. Some policies (such as Tricare, which is considered a government program24) are ineligible and therefore are exempt from coverage. Be prepared with a list of questions when calling your health insurance carrier. It is important to ask about the specifics of the coverage within your plan.  Am I required to have a prescription in order to get a pump? Who do I get the prescription from, my OB/GYN or my Personal Care Physician? What does it need to say? Are specific codes required?  What type of pump would be covered under my plan?  Would it be a manual expression pump or an electric pump?  Where would I get the pumps? Would I purchase it and provide receipt for reimbursement?  Would I use a network vendor or Direct Medical Equipment (DME) supplier? Would it be delivered to my house?  Am I covered for out of network benefits? If so, can I get a pump from an out of network DME?  When can I order my breast pump? Would it be before or after the birth of my child(ren)?  Are lactation consultant services and visits covered in my policy?  Are there any restrictions such as the number of visits allowed with the lactation consultant?  If I need a hospital grade pump, how would I get one?  Would my accessories be covered, such as a car charger, battery packs, milk storage bags, etc?  Could I choose to upgrade to an electric pump if I was allotted a manual pump? Is there a cost and how much?  If there is co‐pay, can I pay it with my Health Savings Account/Flexible Spending Account?  What brands of pumps can I choose from? Document all conversations! It’s important that you take notes during your conversations with your carrier, paying special attention to details like the name of the person you spoke with, date and time, and what method of communication‐phone or email. Since the implementation of the ACA and its benefits are fairly new for the health industry, this will help you address any potential discrepancies. Be confident! These are your rights and benefits entitled to you by the law. Don’t be afraid to ask questions! Overwhelmed? Contact A Breastpump and More. This Durable Medical Equipment (DME) supplier will talk to your insurance provider for you to see if you are eligible for a breast pump and if they cannot supply your pump, they will put you in touch with a DME supplier who can. Visit: www.abreastpumpandmore.com email: cs@abreastpumpandmore.com (855) PUMP‐2‐YOU or (855) 786‐7296 Adapted with permission from Hygeia, Inc Blog post June 2, 2013. See more at: http://hygeiainc.com/requesting‐a‐ breast‐pump‐from‐your‐health‐insurance‐carrier/ Handout taken from the "2013 Midcoast Public Health CTG Breastfeeding Resource Toolkit for Early Childcare and Education Centers".

Appendix G: Employees' Guide to Breastfeeding and Working ‐ Sample Letter

You can use the sample letter below to tell your supervisor about your breastfeeding needs. Feel free to use your own words and relate it to your specific work situation. TO: [Supervisor’s Name] FROM: [Your name] RE: Lactation Support in the Workplace Thank you for your support during my [# of months or years] with [name of company]. This is an exciting time for my family and me as we prepare for the birth of our child. I am eager to work with you in making preparations that will allow me to return to work as soon as possible after the birth of my baby. After speaking with my doctor and other health professionals, I have made the decision to breastfeed my baby. Just as I try to give my best to the company when I am at work, I also want to give the best I can to my baby. My doctor tells me that breastfeeding is important in preventing many illnesses and diseases for both my baby and me. Many businesses across America help their employees make this possible, and I hope we can find solutions together. Here are my immediate needs: 1. A private area with an electrical outlet to express milk during the workday. This space need not be large…even a 4’ x 5’ area is sufficient. Many companies provide a lactation room for their employees to use, and an electric breast pump to express milk. 2. Flexibility to use break times to express milk. I will need to express milk about two to three times during an 8‐hour shift to relieve breast fullness and to maintain my milk supply. Pumping takes around 15 minutes (plus time to get to and from a place to pump). There may be occasions when I need to go over my allotted break time. If that happens, I would like to discuss options for making up the time. Thank you. Knowing my company is making it possible for me to continue breastfeeding will help me feel much better about leaving my baby to come back to work. I look forward to discussing this with you. Sincerely, [Your Name] This sample breastfeeding letter was taken from the U.S. Department of Health and Human Services Business Guide to Breastfeeding: Employees' Guide to Breastfeeding and Working. For more information go to: http://www.womenshealth.gov/breastfeeding/government‐in‐action/business‐case‐for‐breastfeeding/

Handout taken from the "2013 Midcoast Public Health CTG Breastfeeding Resource Toolkit for Early Childcare and Education Centers".

Resources to Help Child Care Providers & Breastfeeding Families 

Whenever, Wherever! Campaign: A Maine initiative to promote acceptance of breastfeeding in public spaces and increased workplace supports for nursing moms. Aims to inspire people to adopt an attitude that supports and celebrates nursing moms whenever, wherever! www.weallbenefit.org



www.KellyMom.com: Excellent evidence-based breastfeeding & pumping information including many free handouts; also has an active Facebook page where moms can connect. Search for “milk calculator” to calculate how much milk a baby needs.



www.MakingMoreMilk.com: Great information for women who want to increase their milk supply.



Find a Lactation Consultant (IBCLC): search by zip code, www.ilca.org



National Breastfeeding Hotline: Breastfeeding peer counselors can answer common breastfeeding questions and walk you through challenges on issues ranging from latching to pumping and storage. 1-800-994-9662, Monday through Friday, 9 a.m. to 6 p.m., EST.



www.workandpump.com: Information & resources about breastfeeding for working moms



Infant Risk Center: Up-to-date evidence-based information on the use of medications during pregnancy & breastfeeding; anyone can call with questions. www.infantrisk.org/,1-806-352-2519



Mothers’ Milk Bank of New England: Moms can donate extra milk or purchase donor milk. http://www.milkbankne.org/, 617-527-6263 To donate milk: donate@milkbankne.org To place an order for milk or for other questions: info@milkbankne.org



Academy of Breastfeeding Medicine: Guidelines for managing various situations that can impact breastfeeding. www.bfmed.org



Best for Babes: Has lots of great information and a helpful blog; also has an active Facebook page where moms can connect. www.bestforbabes.org/



La Leche League: Provides information, education and mother-to-mother support. www.lllusa.org/, 1-800-525-3243



Frequently asked questions about federal lactation support law are answered at www.usbreastfeeding.org.



www.womenshealth.gov/breastfeeding/: Wide variety of resources to help increase breastfeeding success; also find out what the government is doing to support breastfeeding mothers.



www.theleakyboob.com/: Helpful blog and articles for breastfeeding moms; also has an active Facebook page where moms can connect. Adapted from the Indiana Perinatal Network Resource List, www.indianaperinatal.org

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Maine Welcomes Nursing Moms The We All Benefit Initiative promotes acceptance of breastfeeding in public spaces and increased workplace supports for nursing moms. Breastfeeding is easiest when moms feel supported and welcomed at home, at work and in the community. How can child care providers support breastfeeding? Though three out of four Maine moms start off breastfeeding, less than half continue to six months. The challenges of returning to work or school play a major part. Your child care can help support moms in reaching their personal breastfeeding goals. You can: • Be flexible on feeding times so that mothers may breastfeed at drop-off, pick-up and in between – when able. • Discuss feeding patterns with parents. • Offer a private and comfortable space for mothers to express milk. • Ensure that all staff members receive appropriate training in breastfeeding support, promotion and proper milk handling and storage. • Supply information about community resources that provide breastfeeding support • Help educate moms and their families on Maine law regarding breastfeeding.

What is the Maine law? Maine law (5MRSA 4634) says “A mother may breastfeed her child in any location, public or private, where the mother is otherwise authorized to be.” In Maine, employees who are nursing have the right to: • Use break time or meal time (paid or unpaid) to pump their breast milk. • Use a clean, private place to pump • Exercise their rights without retaliation or discrimination

Want to do more? Join the Whenever Wherever campaign! Whenever Wherever partners with breastfeeding-friendly businesses and public spaces to recognize their efforts to support Maine families and to help educate the community. You can become a member of the campaign by emailing wheneverwherevermaine@gmail.com wheneverwherevermaine@gmail.com.. Your childcare will be listed in the Welcoming Spaces section of the website. Your support will also be noticed and appreciated by mothers and families throughout your community.

WeAllBenefit.org

In This Section Tab 13: Evaluation and Recognition Evaluating Your Programâ&#x20AC;&#x2122;s 5-2-1-0 Interventions Recognition Program for Let's Go! 5-2-1-0 Goes to Child Care Self-Assessment Tool Self-assessment Instruction Sheet and Glossary

TAB 13 Evaluation and Recognition

Evaluating Your Program’s 5-2-1-0 Interventions Conducting an evaluation of your child care program’s 5-2-1-0 interventions will help you understand where you have succeeded and where you may want to focus your efforts in the future. When we collect evaluation data from you, it helps us understand what changes are occurring in child care programs, and also helps us to learn about improvements we can make to the resources we offer. Every spring, we send a link to an electronic version of the self-assessment tool. Completing this post self-assessment allows you to compare where you currently are to where you started the year. It also asks about what healthy eating and physical activity related policies are written into your parent and staff handbooks and enforced in your program. We use this information to determine which of the 5-2-1-0 strategies you have implemented and who will be recognized as a Bronze, Silver, or Gold Let’s Go! Child Care Program. A blank copy of the Self-Assessment Tool can be found under this same “Evaluation and Recognition” Tab. We are here to assist you, so be sure to get in touch with us at info@letsgo.org if you have any questions!

s t l u s e r r r u u o o y y e e t r Sha elebra s! c e s d s an succe

03/10 R07/13

Recognition Program for Let’s Go! Schools, After School Programs and Child Care Programs We are excited to announce a new Let's Go! recognition program for schools, after school programs and child care programs. This has been created as a way to acknowledge all the hard work that is happening out there! Beginning this spring, we will recognize three levels of accomplishment, described below. While we hope lots of schools and after school and child care programs will be energized by this program, we know that achieving recognition, especially at the higher levels, will take time. We are here to help! It is our goal to provide the tools and support needed to help schools and after school and child care programs sustain the great work they are doing and be recognized for it! Bronze Level Any school or program that implements all 5 Let’s Go! priority strategies. Silver Level Any school or program that:  implements all 5 Let’s Go! priority strategies;  requires at least 1 and up to 4 of the priority strategies in written policy; and  enforces the written policy.* Gold Level Any school or program that:  requires all 5 Let’s Go! priority strategies in written policy, and  enforces the written policy.* We will use the surveys that we send out in the spring to determine which schools and programs have met the recognition criteria, and those sites will receive a certificate from Let’s Go! and will be recognized on the Let’s Go! web page. If you have any questions about the recognition program, please contact your local Let’s Go! partner or the Let’s Go! Home Office at 207.662.3734.

1. 2. 3. 4. 5.

Five Priority Strategies Provide healthy choices for snacks and celebrations; limit unhealthy choices. Provide water and low fat milk; limit or eliminate sugary beverages. Provide non-food rewards. Provide opportunities for children to get physical activity every day. Limit recreational screen time. *We will ask principals or directors to sign a statement verifying that the policy is enforced.

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2013-2014 Nutrition and Physical Activity Self-Assessment for Early Care and Education Programs INTRODUCTION Please read each statement or question carefully and check the response that best fits your child care program. Refer to the instruction sheet for a glossary of terms and phrases. Please enter the following information. Name of child care program: _______________________________________________________________________ Contact name at program: _________________________________________________________________________ Physical Address: ________________________________________________________________________________ Contact phone/email: ____________________________________________________________________________ Date Completed: ________________________ 3. Which age groups does your child care program serve? (Check all that apply)

 Infant (Birth-1 year)

 Toddlers (Ages 1-2)

 Preschoolers (Ages 3- 5)

4. My child care program is:  A full day program  A half day program 5. Which workshops or webinars did you and your staff participate in during the past program year? No one from our program attended (0%)

Some staff attended (less than 50%)

Most staff attended (at least 50%)

All staff attended (100%)

Supersizing Our Children: The Obesity Epidemic



Eat Right, Grow Strong: Nutrition for Young Children



Moving Children to Good Health: Physical Activity for Young Children



Growing Healthy Kids Together: Working with Families



Stepping Toward a Healthy Lifestyle: Personal Health and Wellness



Section 1. Nutrition

Nutrition: Food & Beverages Served (All Children) 6. Sweets or salty foods (cookies, cakes, muffins, chips, etc.) are offered:



1 or more times per day



3-4 times per week



1-2 times per week



Less than once a week or never



Not applicable, my program does not serve any food

7. Holidays and other special occasions are celebrated with mostly healthy foods or with non-food treats like stickers:



Rarely or never



Some of the time



Most of the time



All of the time

8. 100% fruit juice is offered:



In unlimited portions more than once a day



2 or more times per day, but limited to 4-6 oz. each occasion



No more than 4-6 oz. per day (OR NOT SERVED AT ALL)



No more than 4-6 oz. per day (OR NOT SERVED AT ALL) and parents are encouraged to support this limit

9. Sugary drinks (Kool-Aid, fruit drinks, sports drinks, sweet tea, soda) are offered:



More than once a month



Less than 1 time per month



Rarely, 1-2 times per year



Never

Nutrition: Provider Practices & Education (All Children) 10. In front of the children, providers consume the same food and drinks as children, and avoid unhealthy foods (e.g., soda, sweets, and fast food):



Rarely or never



Some of the time



Most of the time



All of the time

11. Providers join children at the table for meals and/or snacks and talk informally about trying and enjoying healthy food:



Rarely or never



Some of the time



Most of the time



All of the time

12. Food is used to encourage positive behavior:



All of the time



Most of the time



Some of the time



Rarely or never

13. Training opportunities in nutrition (other than food safety and food program guidelines) are offered to providers:



Rarely or never



Less than 1 time per year



1 time per year



2 times per year or more

Nutrition: Environment, Provider Practices & Education (Toddlers & Preschoolers) 14. The next set of questions refer only to toddlers and preschoolers. Does your program provide care for toddlers (ages 1-2) or preschoolers (ages 3-5)?



Yes



No (SKIP TO QUESTION 69)

15. Visual exposure and prompts to eat healthy foods (e.g. books, posters, fruit bowls, gardens) for toddlers and preschoolers occur through:



Few to no exposures or prompts



Some exposures and/or prompts, but limited variety



A large variety of exposures and prompts



A large variety of exposures and prompts, with new opportunities introduced regularly

16. For toddlers, providers support self-feeding skills (toddler encouraged to finger-feed self; fork and spoon introduced when ready) and transition to family style meals provided when appropriate:



Rarely or never



Some of the time



Most of the time



All of the time



Not applicable, my program does not serve toddlers

17. Providers teach toddlers and preschool children about healthy foods and the pleasure of eating using both formal (e.g. circle time lessons) and informal (e.g. mealtime conversations) opportunities:



Rarely or never



Some of the time



Most of the time



All of the time

18. Parents of toddlers and preschool children are offered nutrition education (workshops, activities, and/or take home materials):



Rarely or never



Less than 1 time per year



1 time per year



2 times per year or more

Nutrition: Food Served (Toddlers & Preschoolers) 19. Does your program provide meals and/or snacks to toddlers and/or preschoolers?



Yes



No (SKIP TO QUESTION 28)

20. Toddlers and preschoolers are offered fruit that is fresh, frozen or canned IN JUICE (not syrup):



Rarely or never



Some of the time



Most of the time



All of the time

21. Toddlers and preschoolers are offered a variety of vegetables, such as dark green, orange, red, and deep yellow vegetables (not including potatoes, corn, and green beans):



Less than 1 time per week



1-2 times per week



3-4 times per week



1 or more times per day

22. Fruit (not juice) and/or a vegetable (not including French fries, tater tots, hash browns, or dried beans) is offered to toddlers and preschoolers at every meal:



Rarely or never



Some of the time



Most of the time



All of the time



Not applicable, my program does not provide meals, only snacks

23. Cooked vegetables are prepared with added meat fat, margarine or butter:



All of the time



Most of the time



Some of the time



Rarely or never



Not applicable, my program does not provide meals, only snacks

24. Fried or pre-fried potatoes (French fries, tater tots, hash browns) are offered to toddlers and preschoolers:



2 or more times per week



1 time per week



Less than 1 time a week



Never

Not applicable, my program does not provide meals, only snacks

25. Fried or pre-fried (frozen and breaded) meats (chicken nuggets) or fish (fish sticks) are offered to toddlers and preschoolers:



2 or more times per week



1 time per week



Less than 1 time a week



Never

Not applicable, my program does not provide meals, only snacks

26. Beans or lean meats (baked or broiled chicken, turkey, or fish) are offered to toddlers and preschoolers:



Less than 1 time per week



1-2 times per week



3-4 times per week

1 or more times per day



Not applicable, my program does not provide meals, only snacks

27. Preschooler meals and/or snacks are served family style (children are encouraged to serve themselves with limited help):



Rarely or never



Some of the time



Most of the time

All of the time



Not applicable, my program does not serve preschoolers

Nutrition: Beverages Served (Toddlers & Preschoolers) 28. Drinking water is available:



Upon request



Upon request or during designated water breaks



Inside only, where it is visible and freely available



Inside and outside, where it is visible and available for self-serve

29. During indoor and outdoor play, providers prompt children to drink water:



Rarely or never



Some of the time



Most of the time

All of the time

30. Water is offered to children over the age of 1 year (but not as a substitute for milk when it is a required food component):



Rarely or never



1 time per week or less



2-4 times per week

1 time per day or more

31. Milk served to children ages 2 years and older is:



Whole or regular



Only 2% reduced fat



Always 1-2% low-fat



Always 1% or skim/nonfat



Not applicable, my program does not serve any milk



Not applicable, my program does not provide care for children ages 2 years and older

32. Flavored milk is served to children:



More than once a month



Less than 1 time per month

Rarely, 1-2 times per year



Never



Not applicable, my program does not serve any milk

Nutrition: Beverages Served, Provider Practices & Education (Toddlers & Preschoolers) 33. Beverages offered to toddlers over 1 year are offered in a bottle:



All of the time



Most of the time

Some of the time



Rarely or never



Not applicable, my program does not provide care for toddlers

34. Training opportunities on juice and other beverage recommendations for toddlers and preschoolers are offered to providers:



Rarely or never



Less than 1 time per year

1 time per year



2 or more times per year

35. Parents of toddlers and preschoolers are offered education on juice and other beverage recommendations (e.g., special programs, newsletters, information sheets):



Rarely or never



Less than 1 time per year

1 time per year



2 or more times per year

Section 2. Physical Activity/Screen Time for Preschoolers 36. The next set of questions refer only to preschoolers (ages 3-5). Does your program provide care to preschoolers?



Yes



No (SKIP TO QUESTION 58)

Physical Activity: Time Provided (Preschoolers) 37. Active play time (indoor and outdoor) is provided to all preschool children, including children with special needs:



45 minutes or less each day



46-90 minutes each day



91-120 minutes each day



More than 120 minutes each day

38. In preschool classrooms, structured (or teacher-led) activities are provided to all children, including children with special needs:



1 time per week or less



2-4 times per week



1 time per day



2 or more times per day

39. Outdoor active play time is provided to all preschool children, including children with special needs:



1 time a day for 30 minutes or less



1 or more times a day for a total of 30-45 minutes



1 or more times a day for a total of 45-60 minutes



2 or more times each day for a total of 60 minutes or more

40. During a typical day, excluding naps and meals, preschool children are expected to remain seated:



More than 30 minutes at a time, or 15-30 minutes on 3 or more occasions



15-30 minutes on 2 occasions



15-30 minutes but only 1 occasion



No more than 15 minutes at a time

Physical Activity: Provider Practices & Education (Preschoolers) 41. In preschool classrooms, active play time is:



Often withheld for misbehavior



Sometimes withheld for misbehavior

Never withheld for misbehavior



Never withheld for misbehavior and we have a written policy

42. During preschool children’s active play time, providers:



Supervise play only (mostly sit or stand)



Sometimes encourage children to be active



Sometimes encourage children to be active and join children in active play



Often encourage children to be active and join children in active play

43. Training opportunities in physical activity for preschool children (not including playground safety) are offered to providers:



Rarely or never



Less than 1 time per year

1 time per year



2 or more times per year

44. Parents of preschool children are offered physical activity education (e.g., special programs, newsletters, information sheets):



Rarely or never



Less than 1 time per year

1 time per year



2 or more times per year

Physical Activity: Environment (Preschoolers) 45. Indoor gross motor play area for preschool children, including those with special needs, consists of:



Space only suitable for quiet play



Space for limited movement (jumping and rolling)



Ample space for some active play (jumping, rolling, and skipping)



Space for all activities including running

46. Outdoor play areas for preschool children, including those with special needs, consists of:



1-2 different play areas (e.g., sandbox, swing set) but no open space for running or track/path for wheeled toys



2-3 different play areas, but limited space for running and use of wheeled toys



Multiple play areas, and either an open space for running or a track/path for wheeled toys



Multiple play areas, open space for running, and a track/path for wheeled toys

47. Portable play equipment (e.g., wheel toys, balls, hoops, ribbons) for preschool children consists of:



Limited variety and children must take turns



Some variety but children must take turns



Good variety both indoors and outdoors but children must take turns



Lots of variety both indoors and outdoors for children to use at the same time

Screen Time: Availability (Preschoolers) 48. The next set of questions refer to screen time for preschoolers. Does your program have a television or a computer?



Yes, my program has a television and/or a computer



No, my program does not have a television or a computer (SKIP TO QUESTION 58)

49. In preschool classrooms, televisions are:



Located in every classroom (100%)



Located in most classrooms (at least 50%)



Located in some classrooms (less than 50%)



Stored outside of classrooms, except for occasional use



Not applicable, my program does not have a television

50. For preschool children, the total amount of screen time:



Is not limited



At child care, we strive to achieve 2 hours or less per week



At child care, we strive to achieve no more than 1 hour per week



At child care, we strive to achieve no more than 30 minutes per week, and we work with parents/caregivers to ensure that children have no more than 1-2 hours per day

51. For preschool children, television/DVD viewing includes:



All types of programming and videos, with limited coordination with the curriculum



Educational and some commercial programming and videos, some of which are integrated with the curriculum



Mostly educational, ageappropriate programming and videos, many of which are integrated with the curriculum



Only commercial-free, age-appropriate, educational programming that is integrated with the curriculum



Not applicable, my program does not have a television, nor do we view shows using the internet

52. For preschool children, television/DVD viewing during meals or snack times occurs:



All of the time



Most of the time



Some of the time



Rarely or never



Not applicable, my program does not have a television, nor do we view shows using the internet

53. Television/video viewing is used as a reward in preschool children’s classrooms:



All of the time



Most of the time



Some of the time



Rarely or never



Not applicable, my program does not have a television, nor do we view shows using the internet

54. Among preschool children, computers are:



Available for use all of the time, and time allowed per child is unlimited



Available several times during the day and each child is allowed between 30 and 45 minutes per day



Available only during a set time of day, and each child is allowed between 15 and 30 minutes per day



Available only during a set time of day, and each child is limited to 15 minutes per day



Not applicable, my program does not have a computer

Screen Time: Provider Practices & Education (Preschoolers) 55. During screen time activities with preschool children, providers supervise and watch with the children:



Rarely or never



Some of the time



Most of the time



All of the time

56. Providers are offered training opportunities on screen time reduction and/or media literacy for preschool children:



Rarely or never



Less than 1 time per year



1 time per year



2 or more times per year

57. Parents of preschool children are offered screen time reduction and/or media literacy education (e.g., special programs, newsletters, or information sheets):



Rarely or never



Less than 1 time per year



1 time per year



2 or more times per year

Section 3. Physical Activity/Screen Time for Toddlers 58. The next set of questions refer only to toddlers (ages 1-2). Does your program provide care for toddlers?



Yes



No (SKIP TO QUESTION 69)

Physical Activity: Time Provided (Toddlers) 59. Active play time (indoor and outdoor) is provided to all toddlers, including children with special needs:



15-30 minutes per day



31-45 minutes each day



46-60 minutes each day



61-90 minutes each day

60. Outdoor active play time is provided to all toddlers, including children with special needs:



1 time a day for 30 minutes or less



1 or more times a day for a total of 30-45 minutes



1 or more times a day for a total of 45-60 minutes



2 or more times each day for a total of 60 minutes or more

Physical Activity: Environment & Provider Practices (Toddlers) 61. For toddlers, including those with special needs, indoor and outdoor play spaces consist of:



Space only suitable for quiet play



Space is available, but allows for only limited types of activities



Areas separate from preschoolers that provides space for exploration and skill building



Areas separate from preschoolers with space available for all types of activities

62. For toddlers, portable play equipment (e.g., wheeled toys, balls, hoops, ribbons) are age-appropriate and consist of:



Limited variety and children must take turns



Some variety but children must take turns



Good variety both indoors and outdoors but children must take turns



Lots of variety both indoors and outdoors for children to use at the same time

63. During toddlers’ active play time, staff:



Supervise play only (mostly sit or stand)



Sometimes encourage children to be active



Sometimes encourage children to be active and join children in active play



Often encourage children to be active and join children in active play

Physical Activity: Education (Toddlers) 64. Training opportunities in physical activity for toddlers (not including playground safety) are offered to providers:



Rarely or never



Less than 1 time per year

1 time per year



2 or more times per year

65. Parents of toddlers are offered physical activity education (e.g., special programs, newsletters, information sheets):



Rarely or never



Less than 1 time per year

1 time per year



2 or more times per year

Screen Time: Availability & Education (Toddlers) 66. Toddlers are allowed to watch television/videos:



1 or more times each day



2-4 times per week



1 time per week or less



Never



Not applicable, my program does not have a television, nor do we view shows/videos using the internet

67. Training opportunities on screen time reduction and/or media literacy for toddlers are offered to providers:



Rarely or never



Less than 1 time per year



1 time per year



2 or more times per year

68. Parents of toddlers are offered screen time reduction and/or media literacy (e.g., special programs, newsletters, or information sheets):



Rarely or never



Less than 1 time per year



1 time per year



2 or more times per year

Section 4. Breastfeeding 69. The next set of questions refer to infants and breastfeeding. Does your program provide care for infants (birth-1 year) OR any older breastfed children?



Yes



No (SKIP TO QUESTION 95)

Breastfeeding: Environment 70. A designated area for mothers to breastfeed their infants, other than a bathroom, is:



Not available



Only available upon request



Always available, has appropriate seating, but lacks either privacy or an electrical outlet



Always available, has appropriate seating, provides complete privacy, and has an electrical outlet

71. Culturally appropriate breastfeeding support materials (e.g., pictures, posters, brochures, pamphlets), not including those produced or supplied by commercial entities and/or manufacturers of infant formula, are:



Not displayed



Displayed, but are limited



Displayed and include multiple types of materials



Displayed in several areas of the facility and include pictures, posters, brochures, pamphlets, and other resources

72. For breastfeeding mothers needing to store expressed milk, the facility provides:



No refrigerator or freezer space



Limited refrigerator and freezer space, but it is not consistently available



Sufficient refrigerator and freezer space that is available most of the time



Sufficient refrigerator and freezer space that is always available

73. Learning and play materials for children which normalize breastfeeding (e.g., books that contain pictures of breastfeeding, baby dolls that are nursing), include:



No toys and books portraying breastfeeding are available



A few toys and books portraying breastfeeding



Toys and books portraying breastfeeding in most classrooms



Toys and books portraying breastfeeding in all classrooms

74. A feeding plan filled out by a parent/guardian and/or healthcare provider is:



Not used by my program

Posted



Posted, but not updated regularly



Posted and updated regularly



Posted, regularly updated, and is used to provide a daily report to parents

75. As part of the feeding plan, support for breastfeeding is:



Not explicitly included



Sometimes included, but relies on the provider to add additional information to standard form



Usually included, and part of the standard form to be filled in by parents



Always included, and covers age-appropriate introduction of solid food, feeding in response to baby’s cues, and inviting the mother to come to the facility to nurse



Not applicable, my program does not use feeding plans for our children

Breastfeeding: Education 76. Training on age-appropriate infant feeding practices, including safe storage/handling of human milk, is offered to providers:



Rarely or never



Only as part of new staff orientation



1 time per year



2 or more times per year

77. Training on promoting and supporting breastfeeding, including exclusive breastfeeding, is offered to providers:



Rarely or never



Only as a part of new staff orientation



1 time per year



2 or more times per year

78. Breastfeeding families are instructed on how to properly label and store human milk for use in the child care program:



Rarely or never



Informally, but not in writing



In writing



In writing, and providers check to make sure all milk provided is properly labeled

Breastfeeding: Policy 79. At our child care facility, a written and explicit policy for promoting and supporting breastfeeding families:



Does not exist



Is generally followed but is not written



Is written, generally followed, and sometimes shared with parents



Is written, available, followed, and always shared with parents

80. The facility’s breastfeeding-friendly policy is communicated to expectant mothers, families with infants, and visitors:



Rarely or never



Sometimes, if asked



Usually



Always

Section 5. Infant Care 81. The next set of questions refer only to infants (birth - 1 year). Does your program provide care for infants?



Yes



No (SKIP TO QUESTION 95)

Nutrition: Provider Practices (Infants) 82. For infants, providers support self-feeding skills (infant encouraged to finger-feed self; fork and spoon introduced when ready) and transition to family style meals provided when appropriate:



Rarely or never



Some of the time



Most of the time



All of the time

Physical Activity: Time Provided (Infants) 83. Short supervised periods of tummy time are provided for all infants, including those with special needs:



Less than once per day



Once per day, everyday



2 times per day, most days



Several times each day

84. Use of swings and infant seats (e.g., exersaucers, car seats, molded seats) is limited to 15 minutes (or less):



More than 4 times per day per child, or used for more than 15 minutes at a time



3-4 times per day per child



2-3 times per day per child



1-2 times per day per child

85. Infants, including those with special needs, are taken outside:



Less than 1 time per day



1 time per day



1-2 times per day



2-3 times per day

86. When outdoors, infants are provided opportunities for exploration (e.g., rolling, scooting, crawling, walking):



Less than 1 time per week or never



1-2 times per week

3-4 times per week



1 or more times each day

Physical Activity: Environment & Provider Practices (Infants) 87. For infants, including those with special needs, indoor and outdoor play spaces consist of:



Space only suitable for quiet play



Space is available, but allows for only limited types of activities



Areas separate from preschoolers that provides space for exploration and skill building



Areas separate from preschoolers with space available for all types of activities

88. Play equipment for infants (small push toys, balls, ramps for crawling, outdoor pad or blanket) are age appropriate and consist of:



Limited variety and children must take turns



Some variety but children must take turns



Good variety both indoors and outdoors but children must take turns



Lots of variety both indoors and outdoors for children to use at the same time

89. Providers engage with infants to encourage development of gross motor skills (e.g., reaching, sitting, standing, crawling, walking):



Rarely or never



Some of the time

Most of the time



All of the time

Physical Activity: Education (Infants) 90. Training opportunities in physical activity for infants (not including playground safety) are offered to providers:



Rarely or never



Less than 1 time per year

1 time per year



2 or more times per year

91. Parents of infants are offered physical activity education (e.g., special programs, newsletters, information sheets):



Rarely or never



Less than 1 time per year

1 time per year



2 or more times per year

Screen Time: Availability & Education (Infants) 92. Infants are allowed to watch television/videos:



1 or more times each day



2-4 times per week



1 time per week or less



Never



Not applicable, my program does not have a television, nor do we view shows using the internet

93. Training opportunities on screen time reduction and/or media literacy for infants are offered to providers:



Rarely or never



Less than 1 time per year



1 time per year



2 or more times per year

94. Parents of infants are offered screen time reduction and/or media literacy (e.g., special programs, newsletters, or information sheets):



Rarely or never



Less than 1 time per year



1 time per year



2 or more times per year

Section 6. Supportive Strategies 95. Within the past year, did your program participate in any local, state or national initiatives that support healthy eating/active living (other than 5-2-1-0 Goes to Child Care)?



Not yet, we’re still in the planning stage



Yes, in some or a few classrooms (less than 50%)

Yes, in most classrooms (at least 50%)



Yes, program-wide (100%)



Yes, program-wide before this year and we continued it this year

96. Within the past year, did your program engage community organizations (e.g., farms, grocery stores, food banks, local doctors' offices) to help support healthy eating/active living at your program?



Not yet, we’re still in the planning stage



Yes, in some or a few classrooms (less than 50%)

Yes, in most classrooms (at least 50%)



Yes, program-wide (100%)



Yes, program-wide before this year and we continued it this year

97. Has your program implemented a staff wellness program that includes healthy eating and active living?



No, but we have started to work on it



Yes, we implemented it this year



Yes, we implemented it before this year and we continued it this year



Not applicable, I am the only staff member

Section 7. Program Policies Please refer to your program's policies for these last several questions. **You may need to connect with your director to answer this section.** Let's Go! will audit a sample of responses to verify them, and will also reach out to you to ask you to submit copies of your policies to Let's Go!. The following words INDICATE A POLICY IS NOT REQUIRED: encourage, may, can, could, should, might, suggest, will strive to, will work to, try The following words INDICATE A POLICY IS REQUIRED: shall, will, must, have to, insist, require, comply, enforce

Policy: Nutrition 98. Our policies require that snacks provided to children by our program (not sent in from home) must be healthy.



False, this is not required by our policies



True, this is required by our policies but it is not usually enforced in our program



True, this is required by our policies and is usually enforced in our program, and our director has verified this



Not applicable, my program does not provide any snacks

99. Our policies require that celebration foods, whether brought in from home or supplied by our program, must be healthy.



False, this is not required by our policies



True, this is required by our policies but it is not usually enforced in our program



True, this is required by our policies and is usually enforced in our program, and our director has verified this



Not applicable, my program practices only non-food celebrations

100. Our policies prohibit using food as a reward.



False, this is not required by our policies



True, this is required by our policies but it is not usually enforced in our program



True, this is required by our policies and is usually enforced in our program, and our director has verified this

101. Our policies require that the availability of sugary beverages (including juice) is limited.



False, this is not required by our policies



True, this is required by our policies but it is not usually enforced in our program



True, this is required by our policies and is usually enforced in our program, and our director has verified this

Policy: Physical Activity & Screen Time 102. Our policies require that all children have opportunities for physical activity every day.



False, this is not required by our policies



True, this is required by our policies but it is not usually enforced in our program



True, this is required by our policies and is usually enforced in our program, and our director has verified this

103. Our policies require that recreational screen time (includes television, computer and DVDs) for all children is limited.



False, this is not required by our policies



True, this is required by our policies but it is not usually enforced in our program



True, this is required by our policies and is usually enforced in our program, and our director has verified this

Final Comments 104. Is there any other information about your work with CTG or Let's Go! this year that you would like to share?

Thank you very much for completing this survey! Your answers will help us understand what changes have occurred and will help us improve CTG and the Let's Go! programs. You will have an opportunity to review your completed survey with your CTG district coordinator or 5-2-1-0 Goes to Child Care representative.

Self-Assessment Instruction Sheet and Glossary GENERAL INSTRUCTIONS When completing this instrument, it is important to: 1) honestly assess your program’s environment and day-to-day practices. This way your local 5-2-1-0 Goes to Child Care Partner can help you set and meet specific nutrition and physical activity-related goals. 2) keep in mind what your facility does the majority of the time as your practices may fall into more than one category. If no answer seems quite right, just pick the closest fit. 3) involve any key staff members that are familiar with day-to-day practices and can help in answering questions (e.g. food service staff, lead teachers, etc.).

GLOSSARY CTG: Community Transformation Grant; a project of the Maine Center for Disease Control (CDC) that Let’s Go! works closely with. CTG Coordinators partner with Let’s Go! and use 5-2-1-0 Goes to Child Care to work with child care providers around healthy eating and active living.

Section 1: Food Served Canned in juice: Canned without additional sugars such as light and heavy syrups. Culturally Appropriate: Materials that are suitable to the culture of children you serve. For example, if you have children who speak primarily Spanish, then there should be some Spanishlanguage versions of materials displayed. Family style meals: Food is placed on plates or in bowls on the table and children are allowed and encouraged to serve themselves. Feeding Plan: A form or plan specific to each child that details what, how much, and how often an infant eats; in addition to listing any allergies and additional instructions. Formal discussion/education: This may be done using a pre-existing curriculum such as Color Me Healthy or I Moving I Am Learning or it can be lessons put together by the teacher. Formal nutrition education would be part of the lesson plan. Fruit: Includes all fruits, whether they are fresh, frozen, or canned, including applesauce and dried fruit. This does not include 100% fruit juice. Informal discussion/education: Discussion with the children by teachers that is not part of a formal lesson. This may include talk about that day’s lunch and how it is good for the body or talk on the playground about how running builds strong muscles. Materials supplied by commercial entities/manufacturers: Items that have company logos or other advertising as part of the materials that promotes that brand name and/or their products. Nutrition education for parents: Things such as workshops, activities, take home materials, and health fairs that provide families with information on healthy eating or cooking. Pre-fried: Often frozen chicken nuggets, fish sticks, french fries and tator tots were fried before processing. Even if you bake these items before serving they have extra fat due to frying. Self-feeding skills: The skills children acquire learning to feed themselves; includes finger-feeding and using a fork and/or spoon. Adapted from the NAP SACC Program, Center for Health Promotion and Disease Prevention, The University of North Carolina, Chapel Hill, NC, May 2007.

05/12 R07/13

Training opportunities on nutrition for providers: May include general information related to infant, toddler, or preschooler nutrition, introduction to a new nutrition curriculum, healthy meal/menu planning, etc. This does not include training on the food program guidelines or food safety/ sanitation. Vegetables: Includes all vegetables and potatoes, unless they are fried. Does not include beans like pinto, kidney and baked beans.

Section 2: Beverages Beverage education for parents: Things such as workshops, activities, take home materials, and health fairs that provide families with information on best beverage choices for children, strategies on decreasing intake of sugary beverages and/or encouraging more water and milk, etc. Training opportunities on beverage recommendations for providers: May include general information related to what kinds of beverages and serving sizes are appropriate for infants, toddlers and/or preschoolers, the amount of sugar found in different beverages, strategies on decreasing intake of sugary beverages and/or encouraging more water and milk, etc.

Section 3: Physical Activity Active play time: Indoor or outdoor play time, which allows children to be able to run, skip, hop, jump, etc. This type of play time does not have any limitations. Physical activity education for parents: Things such as workshops, activities, take home materials, and health fairs that provide families with information on the importance of physical activity and/or ideas for increasing physical activity. Standardized curriculum: This can be a pre-existing curriculum such as Color Me Healthy or I Moving I Am Learning or it can be lessons put together by the teacher. Formal physical activity education would be part of the lesson plan. Structured/Teacher-led physical activity: An activity that is led by the teacher, promotes active movements and is designed so all young children are active participants. Training opportunities in physical activity for providers: Includes education on specific areas related to physical activity such as ways to reduce sedentary time while at child care, ways to increase movement throughout the day, what are developmentally appropriate gross motor activities, etc. Does not include training on playground safety. Tummy Time: Time babies spend on their stomachs to strengthen neck and back muscles. This should only be done when babies are awake and supervised, not at nap times. Withholding active play time: Making a child sit inside or outside for an extended period of time or shortening active play time for the entire class. It is not defined by short time-outs.

Section 4 - Screen Time Educational programming: Television and videos that are commercial and advertisement-free and are solely for educational or learning purposes. Screen time: Includes time viewing television and DVDs in addition to computer time. Screen time reduction/media literacy education for parents: Things such as workshops, activities, take home materials, and health fairs that provide families with information on recommended screen time limits, strategies to reduce screen time and alternate activities, how media messages are interpreted by children, etc. Training opportunities on screen time reduction/media literacy for providers: May include education on strategies to reduce screen time, alternate activities, how to understand media messages and/or how messages are interpreted by children, etc.

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Section 5 - Supportive Strategies Including community organizations in wellness promotion activities: Using staff or other resources of organizations within your community to help promote healthy messages at your facility. For example: setting out pamphlets from local dentist’s office on sugar and tooth decay, hosting a healthy food drive at your program for a local food bank, borrowing a StoryWalk from your local library, or visiting a local farm and having the farmer talk with the kids about growing food. Local, state or national initiatives: Programs or campaigns centered around improving nutrition, physical activity and/or screen time reduction. For example: Local - local gardening or Buy Local programs; State - WinterKids or Hannaford Guiding Stars Program; National - Let’s Move! Child Care or National Nutrition Month. Staff wellness program: Taking purposeful steps to encourage and make it easier for staff to personally make healthier choices. For example: encouraging walking meetings, supporting healthy staff celebrations, or allowing for physical activity breaks throughout the day.

Section 6 - Program Policies Celebration Foods: Includes food for all events hosted by the facility; for example, birthdays, Holiday parties (Valentine’s Day, Halloween, etc), Family Fun Days, etc. Food as a reward: Using food (any kind of food, whether a sweet or a generally “healthy food”) as a prize or reward. For example: candy for potty training, pizza party for good behavior, extra crackers for listening to directions, etc. Opportunities for physical activity: Providing the time and space for children to move freely in whatever gross-motor movements are age-appropriate. For example: rolling, crawling and/or scooting for infants; running, climbing, and/or jumping for toddlers and preschoolers.

Adapted from the NAP SACC Program, Center for Health Promotion and Disease Prevention, The University of North Carolina, Chapel Hill, NC, May 2007.

05/12 R07/13

In This Section Tab 14: Resources Original 5-2-1-0 Song - CD & Lyric Sheet (Insert) Fun Songs About Nutrition 5-2-1-0 Grab & Go Activities Ring - Activity Submission Form 5-2-1-0 Sample Policies NAP SACC Sample Policies Resources for Free Promotional Materials Select Resources Healthy Activity Booklist Healthy Eating Booklist Tips for Reading to Very Young Children 5-2-1-0 Every Day! Placemat 5-2-1-0 in the First Year Booklet (Insert) Healthy Favorites: A Booklet Full of Healthy Tips & Recipes (Insert)

TAB 14 Resources

Original 5-2-1-0 Song & Lyrics You can use this song and lyrics to help children become familiar with the 5-2-1-0 message and to get them up and moving!

Click on the images above to access the song lyrics and the song recording.

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Fun Songs About Nutrition Objective: This series of songs was created by Food Service Director, Sandy Lewis and Dr. Carl Winter to create a connection between students and the food service program, otherwise known as the cafeteria. This medley was performed in the school talent show by the school lunch staff. The whole medley is choreographed and the staff were dressed in fruit and vegetable costumes. This skit could also be used by a classroom. VEGGIE MEDLEY

Sung to the tune of “Who Let the Dogs Out?” by the Baha Men

I WILL SURVIVE

Sung to the tune of “I Will Survive” by Gloria Gaynor

I’d listen to the news, I’d be petrified Another foodborne illness outbreak I’d be torn up inside But then I spent so many nights Worried ‘bout what I just ate, Could I be next? Did I have poisons on my plate? But now I’m back from cyberspace Determined I won’t be another foodborne STAYING ALIVE Sung to the tune of “Staying Alive” by the Bee Gees illness case I’ve learned some simple steps (count 16 beats) To keep my food all safe for me Well you can tell by the way I choose my food And if you do the same, you’ll raise your I’m a worried guy in a cautious mood life expectancy There are pesticides, Mad Cow Disease Sure don’t put my mind at ease I’ve got a sign on my fridge door Don’t want hepatitis or gastroenteritis Saying go away bacteria—you’re not welcome I’m just staying alive, staying alive anymore Scrubbin’ off my veggies and heatin’ all my Listeria don’t scare me, nor does Nasty E-Coli burgers up to 185, 185 Hey Salmonella—did you think I’d lay down Ah ah ah ah staying alive, ah ah ah ah staying and die? alive… Oh no not I—I will survive As long as I am careful with my food I’ll stay I WANNA HOLD YOUR HAND Sung to the tune of “I Wanna Hold Your Hand” by the alive Beatles I’ve got all my safety plans, I disinfect and wash my hands Oh yeah I’ll tell you something And I’ll survive, I will survive, Hey hey... I think you’ll understand For the sake of sanitation (Continued on other side) You better wash your hands You better wash your hands You better wash your hands (start after yippee-hi-oh) Who left the meat out? WHO WHO WHO WHO WHO Who left the meat out? WHO WHO WHO WHO WHO Who left the meat out?

05/10 00/00

BEAT IT

Sung to the tune of “Beat It” by Michael Jackson

(4 lines) Why must you be such a sickly young man Existing on granola and on powdered bran I’ll give you some advice cause you need a better plan Just eat it, just eat it Don’t want to argue, I don’t want to debate I just don’t think your food fears really carry weight What bothers me more is what’s left on your plate —so eat it Don’t tell me your scared Just eat it, just eat it… (verse)…DANCE Just eat it, eat it, just eat it Just eat it, eat it, just eat it

You’ve got a starch problem Yo, I’ll solve it Check out some rice rice baby Eat some brown rice rice baby Rice rice baby Eat some brown rice baby… ...WORD TO YOUR MOTHER…

YMCA

Sung to the tune of “YMCA” by The Village People

Young man, get your butt off that chair I said young man, go and get some fresh air I said young man, just put down that fried dough Get up, get out, this you should know Young girl, you just stop sitting there With that blank and boring long stare I said young girl, go and get your suit on You’re about to have some great fun

I’M A BELIEVER

It’s fun to swim at the YMCA It’s fun to swim at the YMCA

When I was young I stayed away from vegetables They were meant for someone, but not for me Veggies couldn’t taste good, that’s the way it seemed Whether they were stir fried, raw or steamed

JUMP AROUND

Sung to the tune of “I’m a Believer” by The Monkees

But then I had a taste, now I’m a believer Didn’t leave a trace of greens on my plate I was wrong—ooh, I’m a believer A veggie eater from now on

ICE ICE BABY

Sung to the tune of “Ice, Ice Baby” by Vanilla Ice

Alright stop It’s time to eat, so listen Rice is back here to help your digestion Ask Mom, she can cook it up nicely Extra bread, no instead use brown rice B Jam packed with some good carbohydrates Energy? Rice will set you straight

Sung to the tune of “Jump Around” by House of Pain

Jump around Jump around Jump around Jump around Jump around

WHIP IT

Sung to the tune of “Whip It” by Devo

(1 line) If you see a candy bar, you must skip it If you have some H2O, you must sip it If the cream is in the jar, you must whip it If you see a tether ball, you must tip it Now whip it… into shape Shape it up… get straight… go for it Move ahead…try to detect it It’s not too late … to whip it Whip it good

(pause...1 line)

05/10 00/00

5-2-1-0 Grab & Go Activities In response to feedback from program leaders and education coordinators, we created an easy-to-use “Redy-To-Go” Activity Ring with 5-2-1-0 themed activities grouped by age. We hope this tool will be the perfect antidote to those times when teachers just need a quick and easy new activity to present. We’ve aimed to make it appropriate for using during circle time, rainy days, stretch breaks, and anytime you need to get little bodies moving and brains thinking! We’ve sectioned it by age group:  Birth-18 months: Activities geared towards infants  18-36 months: Activities geared towards toddlers  3-5 years: Activities geared towards preschoolers

We’ve started you off with some activities collected and adapted from various sources, but would love to get YOUR contributions so that next time we put this out it will be filled with activities passed along by you and your peers in the Child Care field.You know best what works, so please, let us highlight your ideas. To make it easy to contribute your ideas, we’ve provided a link on our website to a blank form in both pdf and word format. You may also just photocopy the form on the backside of this page. Once you fill it out, please fax, email or post mail the form back to us. We look forward to feedback on this tool as well as contributions from you!

07/09 R06/13

5-2-1-0 Grab & Go Activities Form

Please include the following information and return to Let’s Go! via mail, fax, or e-mail: Mail to:

Maine Medical Center The Kids CO-OP Attn: Early Childhood Program 22 Bramhall St. Portland, ME 04102

Fax to: Email to:

207.662.4619 Attn: Early Childhood Manager info@letsgo.org

Your Name: ___________________________________________________________________ Name of Child Care Center: ___________________________________________________________________ Contact info (Phone/E-Mail:) _______________________________________________________ Appropriate Age Group (check all that apply): Birth-18 months

18-36 months

3-5 years

Name of Activity: _____________________________________________________________________ Activity Instructions (clear & simple): ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Additional Notes: ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Please note: Let’s Go! 5-2-1-0 Goes to Child Care will adapt your activity to the format in which we present the 5-2-1-0 Grab & Go Activities and will credit you and your child care facility. We will make every effort to stay true to your submitted activity.

5-2-1-0 Sample Policies We at (name of the program) support your child’s healthy food choices by:  Gently encouraging children to try fruits and vegetables and giving

positive reinforcement when they do.  Role-modeling positive behaviors by eating fruits and vegetables in the

presence of the children.

 Observing and supporting hunger and fullness cues.  Providing opportunities for nutrition education for parents and staff.  During celebrations and holiday parties, our program will offer fruits

and vegetables and other healthy foods.

 Not using food as a reward.

Providing good nutrition for your child is a partnership. We at (name of program) ask for your support:  For packed lunches, please include fruits and/or vegetables.  For celebrations and holiday parties, please provide healthy foods

(especially fruits and vegetables). An approved list of age-appropriate foods will be provided. We at (name of the program) understand that TV and other electronic media can get in the way of exploring, playing, and interacting with others, which encourages learning and healthy physical and social development. Therefore we will restrict screen time by:  Allowing a maximum of 30 minutes total per week of educational and

age appropriate screen time (television, video, and DVD).

 Allowing no more than 15 minutes of educational computer time per

day.  Not allowing any screen time during meals and snacks.  Having zero screen time (TV, video, and computer) for children under

the age of two.

Continued on next page…

…continued from previous page

We at (name of the program) understand that active play is important for healthy growth and development of young children. Because of this:  If weather is permissible, all children will receive at least 60 minutes of

outdoor play. When weather is NOT permissible, children will receive at least 60 minutes of indoor gross motor activity (active play). Indoor 'active play' activities will include: dancing, ball pit, toddler-related active play (e.g. Duck Duck Goose, Ring around Rosy, etc.) (fill in any other activities or equipment you have that fulfill this requirement).

 We will never withhold active play time as a punishment.  We will use physical activity as a reward.  We will have at least one provider join the children in active play daily.  We will provide opportunities for physical activity education for parents

and staff.

We at (name of the program) understand the importance of providing age appropriate food and beverages and because of this:  If a mother wishes to breast feed exclusively, the program will make

every effort to provide breast milk to the child and supplement only when breast milk is gone.

 We will continue supporting families who are breastfeeding beyond 12

months.

 We will follow the American Academy of Pediatrics recommendations

and not serve any food or drink other than breast milk and/or ironfortified infant formula in a bottle unless medically necessary.  We will only serve whole milk for children younger than 2 years old and

fat-free or 1% milk for children aged 2 years and older.  Water will be clearly visible and available to the children at all times

(indoors and outdoors).

We at (name of the program) are committed to our children’s health and nutrition. We recognize the importance of the staff as positive role models for the children as they learn to live healthy lives. Therefore:  Staff will not drink soda and sugary beverages in front of the children in

their care.

 During functions or meetings at the center, we will only permit water,

milk, or 100% fruit juice to be served.

04/11 R02/12

Child Care Nutrition and Physical Activity Policies

In an effort to provide the best possible nutrition and physical activity environment for the children in our facility, we have adopted the following policies. The administration and staff appreciate support from the parents in promoting the health of our children.

Nutrition: Fruits and Vegetables We offer fruit to children at least 2 times a day. We only offer fruit canned in its own juice (no syrups), fresh, or frozen. We offer vegetables to children at least 2 times a day. We only offer vegetables steamed, boiled, roasted, or lightly stir-fried with little added fat. Meats, Fats, and Grains We offer fried or pre-fried (frozen and breaded) meats (chicken nuggets) or fish (fish sticks) once a week or less. We offer fried or pre-fired potatoes (French fries, tater tots, hash browns) once a week or less. We offer high fat meats like sausage, bacon, hot dogs, or bologna once a week or less. We offer beans or lean meats at least once a day. We offer high fiber, whole grain foods at least 2X a day. We offer sweets or salty foods less than once a week or never. Beverages We make drinking water freely available so children can serve themselves both inside and outdoors. We rarely offer sweetened drinks other than 100% juice. We serve only 1% or skim milk to children age 2 or older. We do not have soda or other vending machines on site. Menus and Variety We have 3 week (or greater) cycle menu that allows for seasonal changes. Our menus include healthy items from a variety of cultures. Our menus include a combination of new and familiar foods.

Feeding Practices Our staff help children determine if they are full before removing their plate. Our staff help children determine if they are still hungry before serving additional food. Our staff gently and positively encourage children to try a new or less favorite food. We do not use food to encourage positive behavior. Foods Offered Outside of Regular Meals and Snacks We provide and enforce written guidelines for healthier food brought in and served for holidays and celebrations (see below). We celebrate holidays with mostly healthy foods or non-food treats. Our fundraising efforts consist of selling non-food items only. Supporting Healthy Eating Our staff join children at the table for meal times. We are always serve meals family style. Our staff always consume the same food and drink as the children. Our staff rarely eat less healthy foods in front of the children. We provide visible support for good nutrition in 2-to 5-year old classrooms and common areas through use of posters, pictures, and displayed books. Our staff often talk informally with the children about trying and enjoying healthy foods. Nutrition Education for Staff, Children, and Parents We provide training opportunities for staff on nutrition (other than food safety and food programs guidelines) 2X per year or more. We provide teacher-directed nutrition education to the children, through a standardized curriculum, 1X per week or more. We provide nutrition education to parents 2X per year or more.

Physical Activity: Active Play and Inactive Time We provide at least 120 minutes of active play time to all children each day. We provide opportunities for outdoor play 2 or more times per day. We ensure that children are rarely seated for periods of more than 30 minutes. We do not withhold active play time for children who misbehave. Instead, we provide additional active play time for good behavior. We rarely show television and videos.

Play Environment We provide fixed play equipment (tunnels, climbing and balancing equipment) that is extensive and varied for all children. We provide portable play equipment (wheeled toys, balls, hoops, ribbons) that is diverse and available for children to use at the same time. We make outdoor portable play equipment freely available to all children all of the time. Outdoor play space includes an open, grassy area and a track/path for wheeled toys. Indoor play space is available for all activities, including running, when weather does not permit outdoor play. Supporting Physical Activity Our staff often encourage children to be active and often join children in active play. We provide visible support for physical activity in 2-to 5-year old classrooms and common areas through use of posters, pictures, and displayed books. Physical Activity Education We provide training opportunities for staff on physical activity (other than playground safety) 2X per year or more. We provide teacher-directed physical activity education for children, through a standardized curriculum, 1X per week or more. We offer physical activity education to parents 2X per year or more.

Healthy Guidelines for Celebrations Please help us encourage life long healthy habits among our children. We encourage parents to join us for their child’s birthday or other special occasion and bring food to help celebrate. Please select or prepare healthier food options that your child enjoys. Suggestions include: ¾ favorite fruits ¾ lower fat baked goods (ex. mini muffins with icing) ¾ favorite dishes that aren’t necessarily desserts ¾ foods with special family or cultural significance ¾ healthy foods in fun shapes Also, consider celebrating with favorite stories, music, games, or activities. Often the most important thing to your child is that you took the time to help plan something special. Please talk with the Director if you have questions or need ideas. We know that it’s hard to break old habits like cake, ice cream, and candy, but give it a try!

Resources for Free Promotional Materials Check out these websites for free materials (posters, stickers, coloring sheets, etc.) that promote health, nutrition, and physical activity while supplies last:

Eat Smart. Play Hard. A USDA campaign to motivate children and their caregivers to eat healthy and be active using their character, the Power Panther. Stickers, tattoos, activity sheets, window stickers, and more are all available at no charge. www.fns.usda.gov/eatsmartplayhardhealthylifestyle

Fruits and Veggies - More Matters Produce for Better Health Foundation offers the Fruits & Veggies—More Matters™ health initiative. In simple, user-friendly ways, this health initiative offers expert cooking advice, nutrition information, and shopping tips. Refer to the “Get Kids Involved” section for downloadable coloring pages, tracking and shopping planners, and other activity pages. www.fruitsandveggiesmorematters.org

Leafy Greens Council Promotes consumption of leafy greens for the nutritional benefits and cancer-fighting elements of leafy greens. Offers free posters and lesson plans. http://www.leafy-greens.org/

PE Central Web site for health and physical education teachers, parents, and students to provide the latest information about physical education programs for children and youth. This site offers free posters on a variety of topics (smoking, nutrition, sports, etc.), booklets, and activities: www.pecentral.org/websites/freeresources.html

The Wheat Food Council Promotes awareness of dietary grains as part of a healthy diet. They offer a variety of free posters. www.wheatfoods.org

Developed by the Children in Balance initiative at the Friedman School of Nutrition Science and Policy of Tufts University

07/11 R06/13

Select Resources MAINE RESOURCES Bicycle Coalition of Maine: www.bikemaine.org Healthy Maine Partnerships: The Healthy Maine Partnerships is an initiative that was established to link aspects of four Maine Center for Disease Control and Prevention programs. The coordination of the state and local intervention activities are funded by the tobacco settlement and assures linkages with related program activities. Visit www.healthymainepartnerships.org to find your local HMP. Healthy Maine Walks & Sites: www.healthymainewalks.org Healthy Policy Partners of Maine: www.mcd.org/HPP Let’s Go! Maine information for kids, teens, parents, childcare, healthcare providers, schools and workplaces: www.letsgo.org MaineHealth Learning Resource Centers: The MaineHealth Learning Resource Centers are health information and education resources for patients, families and communities. Each center has an extensive library of books, periodicals and videos on a wide variety of healthcare topics. www.mainehealth.org/lrc Maine Bureau of Parks and Lands: www.maine.gov/doc/parks Maine Census Data: www.state.me.us/newsletter/may2001/maine_census_data.htm Maine Chapter of the American Academy of Pediatrics: www.maineaap.org Maine Children’s Alliance: The Maine Children's Alliance is a strong, powerful voice for children, youth and families and provides leadership to create or change policy on their behalf. The Maine Children's Alliance collects the voices and data of various organizations, develops, promotes and advocates a substantive strategic plan including desired outcomes to insure positive change for children and their families. www.mainechildrensalliance.org Maine Children’s Alliance/Maine Kids Count Data Book: www.mekids.org Maine Department of Education: www.maine.gov/education Maine Governor’s Council on Physical Activity: www.maineinmotion.org Maine Prevention Research Center: http://www.une.edu/mhprc/ Maine Physical Activity & Nutrition [PAN] Program: www.maine.gov/dhhs/boh/hmp/panp Maine WIC Program: www.maine.gov/dhhs/wic

WinterKids: WinterKids is a nonprofit organization committed to helping children develop lifelong habits of health, education, and physical fitness through participation in outdoor winter activities. www.winterkids.org

NATIONAL RESOURCES Academy of Nutrition and Dietetics is the largest organization of Food and Nutrition Professionals in the United States. The ADA offers reliable, objective food and nutrition information. www.eatright.org American Alliance for Health, Physical Education, Recreation, and Dance: This professional alliance seeks to support and assist those involved in physical education, leisure, fitness, dance, health promotion, and education and all specialties related to achieving a healthy lifestyle. www.aahperd.org American Council on Exercise: This nonprofit group’s mission is to serve as an education and certification provider by setting standards and protecting the public against unqualified fitness professionals and unsafe or ineffective fitness products, programs, and trends. www.acefitness.org America on the Move is a national initiative dedicated to helping individuals and communities across our nation make positive changes to improve health and quality of life. www.americaonthemove.org CDC Body Mass Index (BMI) Calculator: This simple tool calculates weight adjusted for height, which can be used to approximate whether someone is underweight, normal weight, overweight, or obese. www.cdc.gov/nccdphp/dnpa/bmi Centers for Disease Control, Healthy Youth: This website offers information, resources, and strategies for encouraging physical activity in youth. www.cdc.gov/HealthyYouth/PhysicalActivity Center on Media and Child Health: The Center on Media and Child Health at Children’s Hospital Boston, Harvard Medical School, and Harvard School of Public Health is dedicated to understanding and responding to the effects of media on the physical, mental, and social health of children through research, production, and education. www.cmch.tv ChooseMyPlate: ChooseMyPlate is the nutrition guide published by the United States Department of Agriculture (USDA). It was produced in 2011 and replaces MyPyramid with a new focus on encouraging fruits and vegetables to be 50% of every meal. For more information and tips check out www.choosemyplate.gov The Citizenship Through Sports Alliance: This coalition of athletic organizations focuses on character in sport. CTSA promotes fair play at all levels—youth leagues to professional sport—to reinforce the value of sport as a test of character. Since 1997, CTSA has been building a sports culture that encourages respect for self, respect for others, and respect for the game. www.sportsmanship.org

Food and Nutrition Information Center serves to provide “credible, accurate, and practical resources for consumers, nutrition and health professionals, educators, and government personnel.” The “Consumer Corner” contains information about popular food and nutrition topics. The Food and Nutrition Service offers free, downloadable posters and activity sheets as well as other materials. www.nal.usda.gov/fnic Healthy Hearts 4 Kids is a web-based intervention that encourages children to participate in physical activity regularly, eat nutritiously, and avoid the use of tobacco products. The web-based instructional module is designed to impact children’s knowledge, attitudes, and behaviors related to these risk factors associated with cardiovascular health. It encourages youngsters to read, write, and problem solve, while learning to make wise decisions that will impact them throughout their lifetimes. In addition, children are encouraged to complete daily logs of their physical activity and diet intake for which they receive immediate feedback to applaud their reports or to help them make wiser decisions the following day. Incentives are provided to encourage students to complete online tasks, take quizzes, and complete physical activity and diet logs. www.healthyhearts4kids.com Healthy People 2020: This framework is a statement of national objectives to identify and reduce threats to the health of the nation. www.healthypeople.gov HeartPower! is the American Heart Association’s curriculum-based program for teaching about the heart and how to keep it healthy for a lifetime. http://www.heart.org/HEARTORG/Educator/ FortheClassroom/ElementaryLessonPlans/ Elementary-Lesson-Plans_UCM_001258_Article.jsp International Health, Racquet and Sportsclub Association: IHRSA’s mission is “to grow protect and promote the health and fitness industry, and to provide its members with benefits that will help them be more successful.” www.ihrsa.org/ KidsHealth: KidsHealth, a partner with the Barbara Bush Children’s Hospital in Maine, is the largest and most- visited site on the Web providing doctor-approved health information about children from before birth through adolescence. It has separate sections for kids, teens, and parents. www.kidshealth.org Let’s Move: This campaign, headed by Michelle Obama, seeks to end childhood obesity in the United States. It’s focus is to promote increased physical activity by appealing to not only children but their families, schools, and communities. www.letsmove.org National Association for Health & Fitness: This nonprofit organization “exists to improve the quality of life for individuals in the United States through the promotion of physical fitness, sports and healthy lifestyles and by the fostering and supporting of Governor’s and State Councils on physical fitness and sports in every state and U.S. territory.” www.physicalfitness.org National Center on Physical Activity and Disability: This group serves as an information center on physical activity and disability. www.ncpad.org

National Institute for Fitness and Sports: NIFS is a nonprofit organization committed to enhancing human health, physical fitness, and athletic performance through research, education, and service by encouraging the adoption of appropriate healthy behaviors. www.nifs.org The President’s Council on Physical Fitness and Sports: This organization promotes physical activity, fitness, and sports through various partnerships and activities. The President’s Challenge is a program that awards children and adults for participating in physical activities. www.fitness.gov State Agriculture Departments: Your state agriculture department can help you find local farmers’ markets, state fairs and other resources and events that may align with your program’s mission. www.usda.gov Sustainable Table: This consumer campaign was “launched to help fill in the gaps in the sustainable food movement, and to help direct consumers to the leading organizations who are working on the issue.” www.sustainabletable.org USDA Center for Nutrition Policy & Promotion: CNPP works to improve the health and well-being of Americans by developing and promoting dietary guidance that links scientific research to the nutrition needs of consumers. www.usda.gov/cnpp US Food and Drug Administration: The FDA is the federal agency responsible for protecting the public health by assuring the safety of our food supplies as well as various drugs, medical devices, and other products. It also serves to educate the public on nutrition and other health topics. www.fda.gov We Can! (Ways to Enhance Children’s Activity & Nutrition): This National Institutes of Health developed program focuses on children ages 8 to 13. Research has shown that children these ages are highly influenced by the habits and activities of their parents and caregivers. We Can! seeks to provide information on increasing physical activity, eating healthier, and reducing screen time. www.nhlbi.nih.gov/health/public/heart/obesity/wecan/about-wecan/index.htm

RESOURCES FOR PARENTS AND KIDS

(Some of the websites listed below are great for computer classes or free computer time.)

Body and Mind: A CDC website that focuses on topics that kids say are important to them— such as stress and physical fitness—using kid-friendly lingo, games, quizzes, and other interactive features. www.bam.gov CDC Physical Activity: www.cdc.gov/physicalactivity Children and Nature Network: www.childrenandnature.org ChooseMyPlate: www.choosemyplate.gov Dole 5 A Day: Dole’s SuperKids website is designed educate and encourage elementary school children to eat 5 to 9 servings of fruits and vegetables a day to promote better health. www.dole5aday.com/ Eat Smart, Play Hard Kids: Interactive website with lots of materials, geared to elementary age students. www.fns.usda.gov/eatsmartplayhardkids Go Healthy Challenge: An Alliance for a Healthier Generations website that addresses nutrition and physical activity for children. www.igohugo.org Kidnetic.com: This interactive website offers nutrition and physical activity games, information, and resources for 9-12 year old children and their parents. www.kidnetic.com KidsHealth: www.kidshealth.org Make Your Calories Count: http://www.fda.gov/Food/IngredientsPackagingLabeling/LabelingNutrition/ucm275438.htm Meals for You: www.mealsforyou.com Nutrition Explorations Kids: A Dairy Council Website designed to promote nutritious eating. www.nutritionexplorations.com/kids Overview of the VERB Campaign: www.cdc.gov/youthcampaign

RESOURCES FOR EARLY CHILDHOOD Color Me Healthy: This program is a North Carolina based initiative focused on children ages 4 and 5. It includes teacher’s guides, original songs, parent newsletters (available in English and Spanish), posters, and more. www.colormehealthy.com Colorado Physical Activity and Nutrition Program: Developed in Colorado, this program is composed of 8 task forces that concentrate on topics like breastfeeding, early childhood, school-aged children, worksite wellness programs, and active community involvement. www.cdphe.state.co.us/pp/COPAN/COPAN.html Healthy Start: This is a preschool health education curriculum that promotes positive healthy behaviors to help prevent childhood obesity and other risk factors for longterm illnesses later in life. www.healthy-start.com Let’s Move! Child Care: This program is a collaboration between Michelle Obama’s Let’s Move! program and several nationwide child-focused programs like KidsHealth and Nemours. The program has five goals involving increasing physical activity, reducing or eliminating screen time, healthy food, healthy beverages, and infant feeding. www.healthykidshealthyfuture.org National Association for Family Child Care (NAFCC): The NAFCC is a non-profit organization dedicated to promoting quality child care by strengthening the profession of family child care. www.nafcc.org National Association for the Education of Young Children (NAEYC): The NAEYC is dedicated to improving the well-being of all young children, with particular focus on the quality of education and developmental services for all children from birth through age 8. www.naeyc.org National Association of Child Care Resource & Referral Agencies (NACCRRA): NACCRRA’s mission is to promote national policies and partnerships to advance the development and learning of all children and to provide vision, leadership, and support to community Child Care Resource & Referral. www.naccrra.org Nutrition and Physical Activity in Child Care (NAP SACC): www.napsacc.org Team Nutrition: This is a program of the USDA aimed at improving children’s lifelong eating and physical activity habits by using the principles of the Dietary Guidelines for Americans and MyPlate. www.fns.usda.gov/tn/childcare.html

RESOURCES FOR AFTER SCHOOL Afterschool Alliance: The nation's leading voice for afterschool, the Afterschool Alliance is the only organization dedicated to raising awareness of the importance of afterschool programs and advocating for more afterschool investments. www.afterschoolalliance.org CATCH Kids Club: The Child and Adolescent Trial for Cardiovascular Health (CATCH), an NHLBI-funded study, created a school health education curriculum designed to motivate heart-healthy behavior in children in grades K-5 in after-school and summer camp settings. For more information, please visit www.catchusa.org/ ckc.htm. The HEAT Club: The HEAT Club curriculum was developed as part of the Shape Up Somerville: Eat Smart. Play Hardâ&#x201E;˘ project of Tufts University and revised in 2005 and 2007 for broader dissemination through the Children in Balance initiative. This health curriculum, called The HEAT (Healthy Eating and Active Time) Club, includes hands-on activities to use with elementary school children in after school programs in order to improve eating habits and increase physical activity levels. For more information, please visit http://www.childreninbalance.org. Maine Afterschool Network: The purpose of the Maine Afterschool Network is to enable every child to have access to quality, inclusive, affordable after school programming that meets the needs of the child, the family and the community. www.maineafterschool.net National AfterSchool Association: The National AfterSchool Association is the leading voice of the afterschool profession dedicated to the development, education and care of children and youth during their out-of-school hours. www.naaweb.org

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Healthy Activity Booklist Row, Row, Row Your Boat by Kubler, Annie

Board Book $4.99 Age 9 mo-2 yr ISBN: 0859536580 In this traditional nursery rhyme, a group of babies and their toy animal friends row merrily down the stream.

Wiggle Waggle by London, Jonathan

Board Book $5.95 Age 9 mo-2 yr ISBN: 0152165886 Describes how various animals walk, from the wiggle waggle of a duck to the boing, boing, boing of a kangaroo to the bumble roll, bumble roll of a bear.

On the Go! by Stockham, Jess

Board Book $6.99 Age 9 mo-2 yr ISBN: 1846430496 Animals move by stretching, jumping, and climbing, and readers can flip the page to see babies doing the same action.

Head, Shoulders, Knees and Toes by Kubler, Annie Board Book

$4.99 An illustrated version of the song which identifies parts of the body.

Age 9 mo-2 yr

ISBN: 0859537285

Eyes, Nose, Fingers, and Toes by Hindley, Judy

Board Book $6.99 Age 9 mo-2 yr ISBN: 0763623830 A group of toddlers demonstrate all the fun things that they can do with their eyes, ears, mouths, hands, legs, feetâ&#x20AC;&#x201D;and everything in between.

Bear About Town by Blackstone, Stella

Board Book $6.99 Age 1-3 ISBN: 1841483737 The big, friendly bear goes on his daily walk through his neighborhood, meeting the people who live and work nearby.

I Went Walking by Williams, Sue

Board Book $11.99 Age 1-3 During the course of a walk, a young boy identifies animals of different colors.

ISBN: 0152056262

Skippyjon Jones Shape Up by Schachner, Judy

Board Book $6.99 Age 1-3 ISBN: 0525479570 Skippyjon Jones, a Siamese cat who thinks he is a Chihuahua dog, exercises using objects of different shapes.

Jumping Day by Esbensen, Barbara Juster

Paperback $8.95 Age 2-4 ISBN: 1563978539 The pleasures of jumping, running, skipping, and hopping are celebrated as a little girl starts her day, goes to school, and comes home to play.

Doing the Animal Bop by Ormerod, Jan

Paperback $9.99 Age 2-4 ISBN: 0764178997 Various animals dance to the animal bop, including ostriches, elephants, and monkeys; includes read-along compact disc.

I'm as Quick as a Cricket by Wood, Audrey

Board Book $6.99 Age 2-4 ISBN: 0859536645 A young boy describes himself as loud as a lion, quiet as a clam, tough as a rhino, and gentle as a lamb. (continued on other side)

Healthy Activity Booklist (continued) Get Moving with Grover by Tabby, Abigail

Hardcover $6.99 Age 2-4 ISBN: 0375830464 Grover and Elmo show young readers that being fit can be fun, encouraging exercises involving jumping over, running around, and dancing around the book itself.

Duck on a Bike by Shannon, David

Hardcover $16.99 Age 2-4 ISBN: 0439050235 A duck decides to ride a bike and soon influences all the other animals on the farm to ride bikes too.

From Head to Toe by Carle, Eric

Big Paperback $24.99 Age 2-6 Encourages the reader to exercise by following the movements of various animals.

ISBN: 0061119725

Froggy Learns to Swim by London, Jonathan

Paperback $5.99 Age 3-6 ISBN: 0140553126 Froggy is afraid of the water until his mother, along with his flippers, snorkle, and mask, help him learn to swim.

Hop Jump by Walsh, Ellen Stoll

Paperback $6.99 Bored with just hopping and jumping, a frog discovers dancing.

Age 4-6

ISBN: 015201375X

Froggy Plays Soccer by London, Jonathan

Paperback $5.99 Age 5-6 ISBN: 0140568093 Although Froggy is very excited when his Dream Team plays for the city soccer championship, he makes a mistake on the field that almost costs the team the game.

Puddles by London, Jonathan

Paperback $6.99 Age 5-6 ISBN: 0140561757 When the rain stops falling and the skies clear up, it's time to put on boots and go outside to play in the puddles.

Get Up and Go! by Carlson, Nancy L.

Paperback $5.99 Age 5-6 ISBN: 0142410640 Text and illustrations encourage readers, regardless of shape or size, to turn off the television and play games, walk, dance, and engage in sports and other forms of exercise.

Animal Exercises by Ross, Mandy

Paperback $7.99 A collection of poems describes how familiar animals keep in shape.

Age 5-6

ISBN: 1846430445

I Love Yoga by Chryssicas, Mary Kaye

Hardcover Need to buy used Age 5-8 ISBN: 0756614007 Presents young readers with simple instructions for the practice of yoga, discussing how to relax, focus, and have fun through basic poses explained in step-by-step sequences.

The Busy Body Book by Rockwell, Lizzy

Paperback $6.99 Age 6-8 ISBN: 0553113747 Exploring all the many moves, twists, and turns a human body can do, this book is designed to encourage kids to move around, use their bodies, and learn the importance of staying actively fit.

Anna Banana by Cole, Joanna

Paperback $7.99 Age 6-9 ISBN: 0688088090 An illustrated collection of jump rope rhymes arranged according to the type of jumping they are meant to accompany.

Spriggles: Activity & Exercise by Gottlieb, Jeff

Paperback $8.95 Age 3-5 ISBN:1930439024 Motivates children in the areas of physical fitness and activity with animal rhymes such as “Go for a walk, Hawk”, “Play in the park, Shark”, “Ride your bike, Pike”, and many more.

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Healthy Eating Booklist Baby Signs for Mealtime by Acredolo, Linda

Board Book

$6.99

Age 6 mo-1 yr

ISBN: 0060090731

Through baby signing that parents can teach to their children, youngsters can communicate when they want more, when something is too hot, or even to let everyone know the food is all gone!

Eat by Intrater, Roberta Grobel

Board Book $4.95 Age 9 mo-2 yr ISBN: 0439420067 A group of babies enjoys some favorite foods—along with making as big as mess on their faces as possible while they eat.

My Food/Mi Comida by Emberley, Rebecca

Hardcover $6.99 Age 9 mo-2 yr Labeled illustrations introduce various familiar foods and their names in English and Spanish.

ISBN: 0316177180

Tucking In! by Stockham, Jess

Board Book $6.99 Age 9 mo-2 yr ISBN: 1846430461 Animals and young children enjoy the same types of foods, including oats, oranges, and fish, in a book with pictures hidden beneath the flaps.

Yum-Yum, Baby!

By Harwood, Beht Board Book $5.95 Age 9 mo-2 yr ISBN: 1592238033 Rhyming text describes which meals of the day a baby is hungry for, while labeled illustrations introduce related words, such as banana, cup, and peas.

The Carrot Seed by Krauss, Ruth

Board Book $6.99 Age 1-2 ISBN: 0694004928 A young boy plants and cares for a carrot seed that everyone says will not grow, but he lovingly tends to his seed, and he eventually grows a large carrot.

Crunch Munch by London, Jonathan

Board Book $5.95 Age 1-3 ISBN: 0152166009 Shows how different animals eat, from the nibble bibble of the chipmunk to the zap! zap! zap! of the frog, and reveals the tasty morsels that each animal loves, from the yummy ants for the aardvark to the green leaves for the giraffe.

Lunch by Fleming, Denise

Board Book $7.99 Age 1-3 ISBN: 0805056963 A sturdy board-book format follows a hungry little mouse as he munches his way through a variety of colorful fruits and vegetables.

My Very First Book of Food by Carle, Eric

Board Book $5.99 Age 1-3 ISBN: 0399247475 A split-page board book provides a simple introduction to the foods animals eat as preschoolers are challenged to match up the image of the food with the animal presented.

Bread, Bread, Bread by Morris, Ann

Paperback $6.99 Age 2-4 ISBN: 0688122752 Celebrates the many different kinds of bread and how it may be enjoyed all over the world.

Spriggles: Healthy & Nutrition by Gottlieb, Jeff

Paperback $8.95 Age 3-6 ISBN:1930439016 Motivates children in the areas of nutrition, hygiene, and general well-being with animal rhymes such as “Eat a balanced meal, Seal”, “Limit the fat, Cat”, “Have a carrot, Parrot” and many more. (continued on other side)

Healthy Eating Booklist (continued) Bread Is for Eating by Gershator, David

Paperback $8.99 Age 2-4 Mamita explains how bread is created in a song sung in both English and Spanish.

ISBN: 0805057986

Give Me My Yam by Blake, Jan

Paperback $3.99 Age 2-4 ISBN: 0763608734 When Jordan loses the yam he just dug up in the river, he keeps asking to get it back, only to get something else instead, in a repetitive story set on a Caribbean island.

Growing Vegetable Soup by Ehlert, Lois

Board Book $ 6.95 A father and child grow vegetables and then make them into a soup.

Age 2-4

ISBN: 0152061762

Orange Pear Apple Bear by Gravett, Emily

Hardcover $12.99 Age 2-4 ISBN: 1416939997 Explores concepts of color, shape, and food using only five simple words, as a bear juggles and plays.

The Little Mouse, the Red Ripe Strawberry, and the Big Hungry Bear by Wood, Don Board Book $6.99 Age 2-4

ISBN: 0859536599 Little Mouse worries that the big, hungry bear will take his freshly picked, ripe, red strawberry for himself.

World Snacks: A Little Bit of Soul Food by Sanger, Amy Wilson Board Book

$6.99 Age 2-4 ISBN: 1582461090 Easy-to-read rhyming text introduces a variety of soul food dishes, including grits, fried chicken, collard greens, yams, and sweet tea.

World Snacks: Chaat and Sweets by Sanger, Amy Wilson Board Book

$6.99 Age 2-4 ISBN: 1582461937 Through the authorâ&#x20AC;&#x2122;s trademark collage art, introduces toddlers to the Indian finger foods known as chaat, including phel puri, tandoori chicken, and sweet coconut cham-cham.

World Snacks: First Book of Sushi by Sanger, Amy Wilson Board Book

$6.99 Illustrations and rhyming text introduce a variety of Japanese foods.

Age 2-4

ISBN: 1582460507

World Snacks: Hola Jalapeno by Sanger, Amy Wilson

Board Book $6.99 Age 2-4 ISBN: 1582460728 Illustrations and rhyming text, sprinkled with some Spanish words, introduce a variety of Mexican foods.

World Snacks: Letâ&#x20AC;&#x2122;s Nosh by Sanger, Amy Wilson

Board Book $6.99 Age 2-4 ISBN: 1582460817 Illustrations and rhyming text introduce the variety of Jewish foods, from gefilte fish to challah bread, chicken soup to matzoh.

World Snacks: Mangia! Mangia! by Sanger, Amy Wilson Board Book

$6.99 Age 2-4 ISBN: 1582461449 The sixth book in the World Snacks series pays tribute to dishes from the Italian table, from hearty minestrone and risotto to sweet, cool gelato.

World Snacks: Yum Yum Dim Sum by Sanger, Amy Wilson Board Book

$6.99 Age 2-4 ISBN: 1582461082 Easy-to-read rhyming text introduces children to the varied Chinese foods called dim sum, which means a little bit of heart.

Eating the Alphabet by Ehlert, Lois

Board Book $6.95 Age 2-5 ISBN: 015201036X An alphabetical tour of the world of fruits and vegetables, from apricot and artichoke to yam and zucchini. (continued on next page)

Healthy Eating Booklist (continued) Market Day by Ehlert, Lois

Paperback $6.95 Age 2-6 ISBN: 0152168206 On market day, a farm family experiences all the fun and excitement of going to and from the farmers’ market.

The Little Red Hen (Hen Makes a Pizza) by Sturges, Philemon Paperback

$6.99 Age 2-6 ISBN: 0142301892 In this version of the traditional tale, the duck, the dog, and the cat refuse to help the Little Red Hen make a pizza but do get to participate when the time comes to eat it.

An Island in Soup by Levert, Mireille

Paperback Need to buy used. Age 3-6 ISBN: 0888995059 Staring at the fish soup he doesn’t want to eat, Victor imagines that he is on an island of overgrown celery where he conquers a fierce pepper dragon only to be barraged by a wealth of terrifying ingredients, and soon Victor unexpectedly discovers that the dreaded fish soup is quite delicious.

Feast for 10 by Falwell, Cathryn

Paperback $6.95 Age 3-6 ISBN: 0395720818 Numbers from one to ten are used to tell how members of a family shop and work together to prepare a meal.

Grover’s Guide to Good Eating by Kleinberg, Naomi Hardcover

$6.99 Age 3-6 ISBN: 037584063X Little ones can join their host Grover and his assistant Elmo in the Good Eats Cafe where they will learn all about good nutrition and healthy eating!

Little Pea by Rosenthal, Amy Krouse

Hardcover $14.99 Age 3-6 ISBN: 081184658X Little Pea hates eating candy for dinner, but his parents will not let him have his spinach dessert until he cleans his plate, in a story that many children can relate to!

Good for Me and You by Mayer, Mercer

Paperback $3.99 Age 5-6 Little Critter learns that a healthy lifestyle includes a balanced diet and exercise.

ISBN: 0060539488

Muncha! Muncha! Muncha! by Fleming, Candace

Hardcover $17.99 Age 5-6 ISBN: 0689831528 After planting the garden he has dreamed of for years, Mr. McGreely tries to find a way to keep some persistent bunnies from eating all his vegetables.

Two Eggs, Please by Weeks, Sarah

Paperback $7.99 Age 5-7 ISBN: 141692714X A harried waitress at the local diner tries to keep up with an abundance of orders from demanding patrons—all of whom want eggs, in a lively introduction to similarities and differences.

An Orange in January by Aston, Dianna Hutts

Hardcover $16.99 Age 6-7 ISBN: 0803731469 An orange begins its life as a blossom where bees feast on the nectar, and reaches the end of its journey, bursting with the seasons inside it, in the hands of a child. (continued on other side)

Healthy Eating Booklist (continued) Blueberries for Sal by McCloskey, Robert

Paperback $7.99 Age 6-7 ISBN: 014050169X Little Bear and Sal both go berrying with their mothers, but after sitting down to rest, they each end up following the other one’s mother.

I Will Never Not Ever Eat a Tomato by Child, Lauren Paperback

$6.99 Age 6-7 ISBN: 0763621803 Fussy eater Lola makes it perfectly clear that she will not eat anything she doesn’t want until her brother shows her that carrots are really orange twiglets from Jupiter and mashed potatoes are actually Mount Fuji cloud fluff.

The Edible Pyramid by Leedy, Loreen

Paperback $6.95 Age 6-7 ISBN: 0823420752 Animal characters learn about good eating every day in a restaurant called The Edible Pyramid, where the waiter offers the foods grouped in sections of the Food Guide Pyramid and customers learn how many servings they need each day.

The Seven Silly Eaters by Hoberman, Mary Ann

Paperback Seven fussy eaters find a way to surprise their mother.

$7.00

Age 6-7

ISBN: 0152024409

How to Make an Apple Pie and See the World by Priceman, Marjorie Paperback

$6.99 Age 6-8 ISBN: 0679880836 Since the market is closed, the reader is led around the world to gather the ingredients for making an apple pie.

The Sweet Tooth by Platini, Margie

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Hardcover $16.95 Age 6-8 ISBN: 0689851596 Stewart’s loud, obnoxious sweet tooth constantly gets him into trouble, until Stewart uses a healthy diet to take control of the situation.

Cloudy With a Chance of Meatballs by Barrett, Judi Paperback

$6.99 Age 7-10 ISBN: 0689707495 Life is delicious in the town of Chewandswallow where it rains soup and juice, snows mashed potatoes, and blows storms of hamburgers—until the weather takes a turn for the worse.

Gregory, the Terrible Eater by Sharmat, Mitchell

Paperback $4.99 Age 7-8 ISBN: 0590433504 Mother Goat, alarmed by Gregory’s bizarre dietary preferences—he prefers toast and scrambled eggs to shoe boxes and tin cans—consults Dr. Ram, who devises an appetizing transitional diet for little Gregory.

Sun Bread by Kleven, Elisa

Paperback $6.99 Age 7-8 ISBN: 0142400734 During the dreary winter, a baker decides to bring warmth to her town by baking bread as golden and glorious as the sun itself.

Everybody Cooks Rice by Dooley, Norah

Paperback $6.95 Age 7-9 ISBN: 0876145918 A child is sent to find a younger brother at dinnertime and is introduced to a variety of cultures through encountering the many different ways rice is prepared at the different households visited.

Good Enough to Eat by Rockwell, Lizzy

Paperback $6.99 Age 7-9 ISBN: 0064451747 Describes the six categories of nutrients needed for good health, how they work in the body, and what foods provide each.

Why Do People Eat? by Needham, Kate

Paperback $4.99 Age 7-9 ISBN: 0794516238 Using simple text and illustrations, explains why people need food, where food comes from, and how the body uses it.

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Here are some great tips to help make reading to your very young child a joy for everyone involved!  If your child tends to be squirmy when you're reading,

try not reading the text and using your own words instead. Try pointing to the objects on the page while you or the text "talks" about them.  Put life into the reading with your voice. Be

expressive. Give different voices to different characters. Make the sounds of the animals pictured.  Move your fingers across the page to show

that movement is taking place.  You might find that your child enjoys book-time more

the words after you, or by simply adding sound effects!  Just talk about the pictures, and don't stay on one page too long. Don’t even

expect to finish the book!

 Start with "easy-to-read," bright, simple and maybe even aesthetically

Even if you don't feel like reading, remember: many requests for book-time are merely indications that your child wants to sit and cuddle.

Adapted from a list compiled by Anita West/http://www.chinaberry.com/service/musings.cfm?qid=29

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or more fruits and vegetables!

hours or less recreational screen time! Circle the activities that make your body strong!

Every Day!

hour or more of physical activity!

How many of the activities listed can you find in the puzzle below?

BASKETBALL

RUNNING

BIKE

SKIING

DANCING

SLEDDING

GARDENING

SNEAKERS

HIKING

SNOWSHOES

JUMPING

SOCCER

JUMPROPE

SWIM

PLAY

TAG

RECESS

WALKING

REDY

WATER

C Y I O R D F Y W A L K I N G

F N B J S C R A F Q E U A J W

G W I A X Q O L L A G E S I A

J U Y B U E G P R N H Q J G T

B N R M L U K A R U I R P W E

X P W H N C W Q T Q B Z C C R

S R E K A E N S L N C Q B V S

V G Q L M W P F T F G E Z B E

B A S K E T B A L L L N H V I

D G Z H P A J E Z Q K N J G Y

Q N W G U Z K K Z R P E U G Q

R I N S Q I P P P W S J M G G

A N C F B V W R X R I X P N V

R E C C O S Z L U S V O I G P

Y D I J Z D H P U N C C N J P

Y R Q H Q I H S F H N S G Y F

P A Y Y K A L E M A E I R I M

G G V I E E W U D O X P N W K

Y N N M D P C I H W R T S G W

O G I D H U O S X P H E S J N

L U I I P G W R A Q N S E W N

R N J R K O R L P V Q J C Y X

G H F G N S M E C M C Y E B D

M I N S C Q K G D I U F R Z W

S W I M S J A X G Y Q J M R D

sugary drinks, more water and low fat milk!

Redy is the spokesperson for the 5-2-1-0 message. Redyâ&#x20AC;&#x2122;s favorite foods are apples, blueberries, and green peppers. He loves doing cartwheels, but is also very good at jumping rope and playing Frisbee. He likes to cool down with a nice refreshing bottle of water after a long day of play!

5-2-1-0 in the First Year Booklet This booklet is designed to guide both children’s and caregiver’s journey to good health! The tips and suggestions contained here will give them the tools to get started today!

Click on the image above to access the complete ‘5-2-1-0 in the First Year’ Booklet.

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Healthy Favorites Recipe Booklet This booklet is designed to help guide you on your journey to good health. The tips, suggestions, and recipes it provides will give you the tools to get started today!

Click on the image above to download a copy!

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