Nutrition Policy Institute
Nutrition Policy Institute
Nutrition Policy Institute
University of California
Nutrition Policy Institute

Information on CACFP Rule

NPI's recommendation for water in childcare facilities

Water for Children

 

“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:

The rule on drinking water should be strengthened on the basis of the following:
  • Young children consume inadequate amounts of plain water and excessive sugary drinks;[1]
  • Modeling water as the first for thirst beverage is critical for the early establishment of healthy beverage behavior, obesity prevention[2][3],[4] and optimal cognitive function; [5], [6]
  • There is no evidence that normal water consumption with meals will displace other foods; [7]
  • 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; [8] if tap water is consumed in lieu of sugary drinks and 100% juice, cost savings may be achieved.[9]
  • Strengthened policies have been shown to result in improved beverages in childcare settings. [10]

 

The following guidance should also be provided to CACFP sites:[11]

  1. 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;
  2. Bottled water should not contain any added vitamins, minerals, carbonation, sweeteners (natural or artificial) or other supplements;
  3. Adding fresh fruit, vegetable or herbs for flavoring is allowable, but children should primarily be given plain tap water;
  4. Childcare staff should not drink any other beverages in front of children besides plain water, unflavored low- or nonfat milk, and 100% juice;
  5. 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);
  6. Standards for water testing and water quality issues should be provided;
  7. Training for staff and parents on the importance of hydration and drinking plain water should be emphasized.

 

Citations

[1] 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.

[2]  Arch Pediatr Adolesc Med. 2009;163:336-43.

[3] 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.

[4]  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.

[5] 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.

[6] Masento NA, Golightly M, Field DT, et al. Effects of hydration status on cognitive performance and mood. Br J Nutr. 2014;111:1841-52.

[7] 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.

[8] 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.

[9] 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.

[10] 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

[11] 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.

 

 

NPI's recommendations on proposed CACFP standards

Whole Grains

Flavored Milk

100% Juice

Drinking Water

Overall Comments

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