Information on CACFP Rule
NPI's recommendation for water in childcare facilities
“Plain water should be available and encouraged for self-serve at all times throughout the day, both inside the site and in outdoor play areas, including with meals and snacks, regardless of whether milk or 100% juice is also served. Further, there should be no caution expressed with regard to serving water at or before meals.”
How to Comment: Click to learn how to submit a powerful comment on drinking water in CACFP.
Submit your Comment: Click here to access the USDA online comment submission form. The CACFP public comment period closes on April 15.
Our rationale for this modified language:
- Young children consume inadequate amounts of plain water and excessive sugary drinks;
- Modeling water as the first for thirst beverage is critical for the early establishment of healthy beverage behavior, obesity prevention, and optimal cognitive function; , 
- There is no evidence that normal water consumption with meals will displace other foods; 
- It is unrealistic and unreasonable to expect young children to request a drink of water when they are thirsty and for busy childcare providers to comply with individual requests; young children may not recognize thirst or have the wherewithal to make the request.
- It is expected that this recommendation can be implemented with no or very little cost;  if tap water is consumed in lieu of sugary drinks and 100% juice, cost savings may be achieved.
- Strengthened policies have been shown to result in improved beverages in childcare settings. 
The following guidance should also be provided to CACFP sites:
- Bottled water should be provided only if safe tap water is not readily available; when bottles are necessary, they should be 5-gallon reusable containers when possible;
- Bottled water should not contain any added vitamins, minerals, carbonation, sweeteners (natural or artificial) or other supplements;
- Adding fresh fruit, vegetable or herbs for flavoring is allowable, but children should primarily be given plain tap water;
- Childcare staff should not drink any other beverages in front of children besides plain water, unflavored low- or nonfat milk, and 100% juice;
- Best practices for provision of self-serve water should be offered (e.g., water pitchers and cups at the table during meals and snacks a well as inside and outdoor at non-meal times);
- Standards for water testing and water quality issues should be provided;
- Training for staff and parents on the importance of hydration and drinking plain water should be emphasized.
 Drewnowski A, Rehm CD, Constant F. Water and beverage consumption among children age 4-13y in the United States: analyses of 2005--2010 NHANES data. Nutr J. 2013;12:85.
 Arch Pediatr Adolesc Med. 2009;163:336-43.
 Sonneville KR, Long MW, Rifas-Shiman SL, et al. Juice and water intake in infancy and later beverage intake and adiposity: Could juice be a gateway drink? Obes. 2014;23;1:170-6.
 Muckelbauer R, Barbosa CL, Mittag T, et al. Association between water consumption and body weight outcomes in children and adolescents: a systematic review. Obesity. 2014;22(12):2462-75.
 Edmonds CJ, Jeffes B. Does having a drink help you think? 6-7-Year-old children show improvements in cognitive performance from baseline to test after having a drink of water. Appetite. 2009;53: 469-72.
 Masento NA, Golightly M, Field DT, et al. Effects of hydration status on cognitive performance and mood. Br J Nutr. 2014;111:1841-52.
 Ritchie L, Rausa J, Patel A, et al. Providing water with meals is not a concern for young children: Summary of the literature & best practice recommendations. RWJF Commissioned Analysis. May 2012. www.rwjf.org.
 While drinking water is not typically a reimbursable CACFP cost, if safe drinking water is not available at a site, purchasing water for children (but not adults) is an allowable cost.
 Giles CM, Kenney EL, Gortmaker SL, et al. Increasing water availability during afterschool snack: evidence, strategies, and partnerships from a group randomized trial. Am J Prev Med. 2012;43:S136-42.
 Ritchie LD, Sharma S, Gildengorin G, et al. Policy Improves What Beverages Are Served to Young Children in Child Care. J Acad Nutr Diet. 2014; doi:10.1016/j.jand.2014.07.019
 Patel AI, Hampton KE. Encouraging consumption of water in school and child care settings: access, challenges, and strategies for improvement. Am J Public Health. 2011;101:1370-9.