Institute of Medicine Recommendations for the Child Meal Pattern

Ann McCormack, MPH, RDMissouri Department of Health and Senior ServicesBureau of Community Food and Nutrition Assistance

Age Groups1 year oldsAge 2 through age 4Age 5 through age 13Age 14 through age 18

Lean meat or meat alternates must be served at breakfast 3 days per week.

On the days without meat or meat alternates, must serve an additional ½ ounce equivalent grain/bread for 1 year old children, and an additional 1 ounce grain/bread equivalent for all other ages.

Breakfast

Lunch/Supper Meal Pattern

One fruit and two vegetables must be served at each lunch/supper meal◦Dark green vegetables at least twice per

week◦Orange vegetables at least twice per

week◦Legumes at least once per week◦Starchy vegetables no more than twice

per week◦Other vegetables at least three times per

week

FruitFruit, rather than juice is to be

served at most meals100% fruit juice is allowed only

once per day in a serving size tailored to the child’s age

Grains/BreadOver the course of the week and

day, at least half of the grains/breads served in meals and snacks must be whole grain rich◦Whole grain rich food must meet at

least one of the following two specifications: The product contains the FDA approved

health claim on its packaging The product ingredient listing lists whole

grain first, in both mixed and non-mixed dishes

MilkFat free on low fatRestrict flavored milk to children

5 years of age and above. Restrict sugars in flavored milk to

22 g. per 8 fluid ounces.

SnacksEach snack will provide two

different food components◦Over the course of a five day week,

the food components provided will include: Two servings of fruit One serving of an orange vegetable One serving of a non-starchy vegetable Two servings of grain/bread Two servings of lean meat Two servings of low fat or non-fat milk

Fat, Sugar and SodiumThe amount of solid fat, trans fat,

sugar, and sodium are to be limited in all meals and snacks.

Enhanced SnacksProviders should have the option

of offering an enhanced snack in both the morning and afternoon◦The enhanced snack would have the

same requirements as two smaller snacks

Weekly Meal Pattern-Breakfast

1 year 2-4 years 5-13 years 14-18 yearsFruit or non-starchy vegetables

¼ cup ½ cup ½ cup ½ cup

Grain/bread (ounce equiv)

½ ounce 1 ounce 1 ½ ounce 2 ounces

ANDLean Meat or Meat Alternate

½ ounce 1 ounce 1 ounce 2 ounces

ORGrain/bread 1 ounce 2 ounce 2 ½ ounce 3 ounces

Milk ½ cup ½ cup ¾ cup 1 cup

Weekly Meal Pattern – Lunch/Supper

1 year 2-4 years 5-13 years 14-18 years

Fruit ¼ cup ½ cup ½ cup ½ cup

Vegetable (offer two different)

¼ cup ½ cup 1 cup 1 cup

Grain/Bread ½ ounce 1 ounce 2 ounces 2 ½ ounces

Lean meat or meat alternate

½ ounce 1 ounce 2 ounces 2 ½ ounces

Milk ½ cup ½ cup 1 cup 1 cup

Weekly Meal Pattern - Snack1 year 2-4 years 5-13 years 14-18 years

Fruit (2 X per week)

½ cup ½ cup ½ cup 1 cup

Orange vegetable(1 x per week)

1/8 cup ¼ cup ½ cup ½ cup

Non-starchy vegetable(1 x per week)

1/8 cup ¼ cup ½ cup 1 cup

Grain/Bread (2 x per week)

½ ounce equiv.

1 ounce 1 ounce 2 ounces

Meat or meat alternate (2 x per week)

½ ounce 1 ounce 1 ounce 1 ounce

Milk(2 X per week)

½ cup ½ cup ½ cup ½ cup

Enhanced Snack5-13 years 14-18 years

Fruit (4 X per week)

½ cup 1 cup

Orange vegetable(2 x per week)

½ cup ½ cup

Non-starchy vegetable(2 x per week)

½ cup 1 cup

Grain/Bread (4 x per week)

1 ounce 2 ounces

Meat or meat alternate (4 x per week)

1 ounce 1 ounce

Milk(4 X per week)

½ cup ½ cup

Enhanced SnacksRecommended as an option for

children 5 years of age and olderFor each age group, the snack

will include four servingsRecommended as an option for

the afternoon snack onlyNot recommended for children

under age 5

Orange VegetablesAcorn squashButternut squashCarrotsHubbard squashPumpkinSweet potatoes

Starchy VegetablesCornGreen peasLima beansPotatoes

Dark Green VegetablesBok choy Turnip greensBroccoli Mustard greensCollard greens WatercressDark green leafy lettuce Spinach KaleMesclunRomaine lettuce

Additional RecommendationsLimit grains/breads that high in

added sugars to one time per weekReady to eat and hot cereals must

have less than or equal to 21.2 grams of sugar per 100 grams dry weight of cereal (WIC food package) which is equal to 6 grams or less sugar per 1 ounce cereal dry weight.

Additional RecommendationsBaked or fried grain

products high in solid fat and added sugars are limited to one serving per week across all eating occasions.

Limit highly processed meat, poultry, and fish to one time per week across all eating occasions. This includes breaded and fried products.