Food and Nutrition Programs

Update: Choking Prevention Policy: Nutrition for Young Children (Under the age of four)

This updated Choking Prevention Policy is being distributed due to the issuance of United States Department of Agriculture (USDA) Memorandum "Update of Food Crediting in the Child Nutrition Program" SP 08-2019, CACFP 02-2019, SFSP 02-2019 dated December 4, 2018. In this memorandum, Food and Nutrition Service (FNS) allows the following items to credit towards a reimbursable meal in Child Nutrition Programs (CNPS)

• Shelf stable, dried and semi-dried meat, poultry, and seafood snacks (such as beef jerky or summer sausage)
• Coconut, hominy, popcorn, surimi seafood, and tempeh

Due to their shape and texture, shelf stable, dried and semi-dried meat, poultry, and seafood snacks (such as beef jerky or summer sausage) as well as popcorn have been added to the list of foods that are not to be served to children under the age of four.

This FNP policy supersedes "Choking Prevention Policy: Nutrition for Young Children (Under the age of four)" issued May 10, 2018.

CNP Operators participating in the Child and Adult Care Food Program (CACFP), National School Lunch Program (NSLP), School Breakfast Program (SBP), and Summer Food Service Program (SFSP) must not offer to children under four years of age foods that pose the highest risk for choking.

FNP's policy applies to CACFP Centers, Day Care Homes (DCH), School Food Authorities (SFA), and SFSP sites serving children under four years of age.

Choking Prevention: Nutrition for Young Children

Based on guidance from the USDA*, foods that pose the highest risk for choking are foods that possess the following characteristics: "round, tube-shaped, small, hard, thick and sticky, smooth, slippery, or easily molded to stick to the airway." In order to align with Massachusetts state licensing and USDA's recommendations, FNP's policy restricts the serving of the following foods to children under four years of age:

• Hot dogs, sausages, sausage links or similar processed food items
• Grapes, cherries, melon balls, or cherry and grape tomatoes
• Specific berries - kiwi, raspberries, blackberries, goji berries
• Peanuts, nuts, and seeds (for example sunflower or pumpkin seeds)
• Peanut butter and nut butters
• Dried fruit such as raisins or cranberries
• Shelf Stable, dried and semi-dried meat, poultry, and seafood snacks (such as beef jerky or Summer sausage)
• Popcorn

There are many items that are not included in the above list, which may still pose a choking hazard due to their shape or texture. FNP asks CNP operators to consider the aforementioned characteristics when feeding children under the age of four; and alter any food items that may pose a risk. CNP operators shall alter food items so that they can be served in manageable bites, no larger than a nickel in size, to pre-school age, toddlers and infant age groups.

* 

Supplement A: Practice Choking Prevention

To clarify, the foods listed in the bulleted list, are not to be served to children under the age of four, even using alternate food preparation methods. The information about alternate food preparation methods relates only to other foods not specifically identified.

Vended Meals or Contracts

Operators that enter into a contract to purchase meals from a food service vendor are responsible for ensuring that meals and snacks comply with FNP choking prevention policy.

Please share FNP's policy guidance ensuring that meals received meet the requirements for serving children under the age of four years old.

Implementation timeframe:

CACFP to implement in FY2018, NSLP and SBP to implement in FY2019 (July 1, 2018), and SFSP to implement in FY2018.

The list of foods not to be served to young children will continue to be expanded as FNS issues additional guidance. As new foods are added to the list, implementation of restrictions should be immediate.

If you have any questions or need further assistance, please contact FNP at 781-338-6480 or email nutrition@doe.mass.edu.

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