'Nugget' Lunch Incident Spurs Debate on Preschool Nutrition | Eastern North Carolina Now

   Publisher's note: The author of this fine report is Barry Smith, who is a contributor for the Carolina Journal, John Hood Publisher.

Lawmakers, regulators discuss need to make accommodations for parents

    RALEIGH     The substitution of a chicken nugget lunch at a Hoke County pre-kindergarten program in January has done more than raise a few eyebrows. It has raised the ire of many who believe that government is overstepping its regulatory bounds.

    It also has focused attention on proper nutrition and while raising awareness of childhood obesity.

    Some, like state Rep. Justin Burr, R-Stanly, who oversees the budget subcommittee overseeing health and human services programs, suggest that a change in rules might be in order. "We certainly don't need a bunch of food Nazis running around in the schools and private facilities and forcing kids to eat foods that their parents do not want them to eat," Burr said.

    Others suggest that the Hoke County incident was an overreaction and that no revision in the rules is needed.

    The nutrition rules, many of which have been in effect for decades, require pre-kindergarten and child care centers to offer healthy snacks and lunches, going as far as to specify how many servings a child must have in all of the food groups.

    Those rules apply to both public and private centers. They even apply to boxed or bagged lunches packed by parents and brought from home. Centers are supposed to monitor lunches brought from home and offer to supplement those lunches if they're found lacking.

    The scrutiny over enforcement of child nutrition rules has been ramped up since mid-February when Carolina Journal reported on what has become known as the Hoke County "chicken nuggets" story. A girl in a Hoke County pre-kindergarten program brought a bag lunch to school that didn't meet the standards. It included a turkey-and-cheese sandwich, banana, potato chips, and apple juice. It didn't include milk, which is required to meet U.S. Department of Agriculture nutrition guidelines.

    Instead of being offered the missing milk to supplement the youngster's lunch, she was offered a cafeteria tray, from which she ate three chicken nuggets. Her family members say her bag lunch was brought home untouched. The girl is a picky eater, and everything else on the cafeteria tray went to waste.

    State and federal nutritional guidelines promote healthy eating habits at schools, child care centers, and other preschool programs. It's part of the government's mission to fight childhood obesity, which officials remind us can lead to serious health problems later on in life.

    "We are all aware of our lifestyles in this country," said Deborah Cassidy, director of the Division of Child Development and Early Education, which oversees and regulates pre-kindergarten and child care centers in North Carolina.

    USDA guidelines require lunches to include one serving of a meat or meat substitute, one serving of fluid milk, one serving of grain, and two servings of fruit or vegetables.

    State rules for pre-kindergarten programs require sites to provide meals meeting USDA requirements during the regular school day. Partial or full costs of meals may be charged if families do not qualify for free or reduced price meals.

    The rules continue: "When children bring their own food for meals and snacks to the center, if the food does not meet the specified nutritional requirements, the center must provide additional food necessary to meet those requirements."

    Similar rules apply to child care centers: "When children bring their own food for meals or snacks to the center, if the food does not meet the nutritional requirements ... the center must provide additional food necessary to meet those requirements."

    Federal guidelines, state regulations

    While the nutritional guidelines flow down from USDA, the rules and regulations don't.

    "We, at the federal level, do not check meals coming from home," said Aaron Wiley, a spokesman for the USDA's Food and Nutrition Service. "This is not part of the [2010] Healthy, Hunger-Free Kids Act."

    Nor do USDA regulations cover meals served at pre-kindergarten and child care centers.

    According to the USDA, the nutritional rules are adopted to set minimum standards for meals served in its programs. They apply only to meals served to school-aged children in the National School Lunch and School Breakfast programs.

    While there are federal incentives to monitor compliance of nutritional standards in schools, such incentives are not available to pre-kindergarten programs and child care centers, the USDA says.

    There is, however, a Child and Adult Care Food Program, which is operated independently of the school lunch program. Revised nutrition standards for meals served to infants, toddlers, and children in pre-kindergarten programs and in child care centers are currently under development by the CACFP, the USDA says.

    States have the flexibility to institute additional requirements, with USDA approval. The USDA offers Delaware and Florida as examples. Their new nutrition standards for meals served at licensed child care centers are more restrictive than the USDA regulations.

    The USDA says it does not suggest the type of practice that would require teachers at schools, pre-kindergarten, or child care centers to inspect lunch boxes brought from home. "But that does not mean that we are not concerned about what children are eating," the USDA says.

    "It is at our discretion to pass rules that we think are appropriate to meet the USDA food guidelines," said Cassidy, the division director. "It's the health and safety and well-being that's at stake here for some pretty young children."

    She notes that the rules applied to the Hoke County incident have been in place for decades.

    Cassidy said that consultants, working directly for the division, make visits to the approximately 7,900 licensed pre-kindergarten facilities, child care centers, and family child care homes to monitor their operations. The consultants like to visit the centers at least once a year, Cassidy said. They are based throughout the state and carry caseloads of about 80 to 85 centers apiece, she said.

    On-site visits

    The 107 consultants across the state look at a number of things when making their annual visits, said Tammy Barnes, the division's regulatory section chief.

    As far as nutritional standards are concerned, the consultant will look to see if menus are posted. "We try to be there at a time when a meal is being served," Barnes said. She said meal monitoring by teachers could be done in various ways, depending on the facility.

    In some facilities, a teacher sitting at a table with children may observe what they're eating, Barnes said. In facilities where meals are prepared on-site, cooks may take a look around and see what is needed, she said.

    The division also contracts with University of North Carolina at Greensboro to provide assessors, who go to centers and grade them, giving them star ratings signifying the educational quality of their center, Cassidy said.

    Assessors generally make visits once every three years, where they check on the center's educational quality.

    Officials overseeing the program at UNC-G could not be reached for comment.

Licensed providers in North Carolina are covered by the rules. While rules apply to pre-kindergarten programs, child care centers, and family child care homes, they do not apply to homes where people care for fewer than three children, Cassidy said. Nor do they apply to gymnasiums or YMCAs, where parents may drop their kids off briefly while they work out and use exercise equipment.

    Hoke County incident

    The Hoke County incident occurred on Jan. 30, four days after a Jan. 26 visit by a division consultant. An assessor had been at the facility the previous fall.

    "There was an assessment visit," said Claire Tate, who chairs the Child Care Commission. "This program scored very well. There was a low score on a nutrition-related item."

    "The consultant came out on Jan. 26 to meet with the teachers and principal to discuss their scores," Cassidy said. "One of the items that was in question, where they can do better, was the home lunches doing better meeting the guidelines from the USDA."

    State officials say that the teacher misapplied the rule in providing an entire cafeteria lunch for the 4-year-old. The teacher and school system have since parted ways.

    "It wasn't necessary to give the child an entire lunch," Cassidy said. Milk would have sufficed.

    "One teacher just went over the line, took extreme measures which were not appropriate," Tate said, adding if she'd been the teacher, "I probably would have said, here's a carton of milk."

    New rules forthcoming?

    The rules could get more detailed. The Child Care Commission is set to take up a revision in nutrition rules at its May 8 meeting. Those rules include:

    • Requiring children ages 2 and older to be served either skim milk or low fat milk.

    • Allowing food brought from home to reflect cultural and ethnic preferences, including providing a vegetarian diet.

    • Prohibiting children from being served flavored milk or sugary drinks. Those include Kool-Aid, fruit drinks, sports drinks, sweet tea, and soda. The rules provide that no more than 6 ounces of 100 percent fruit juice be served in one day.

    • Requiring a center's staff to be nutritional role models. Staff members would be asked to refrain from consuming foods or beverages with little or no nutritional value when in the presence of children.

    • Keeping infants from being served a bottle without a prescription or written statement on file from a health care or nutritional professional.

    Do the rules need revising to try to avoid another "chicken nugget" incident from occurring?

    "I can't answer that," Tate said. "We certainly will look at it with this in mind."

    "I think it's something we need to look at," Burr said. "If we're going to have instances like this occur, then, yes, we need to change the rules."