Childcare nutrition programs improve health outcomes, food security but are underfunded, researchers argue

In the latest issue of the Journal of the Academy of Nutrition and Dietetics, a survey​ of more than 3,000 1- to 4-year-olds from low-income households that receive a childcare subsidy and who attended childcare found those who received meals and snacks onsite – versus brought from home – were 30% less likely to live in food-insecure households, 39% less likely to be in fair or poor health and 41% less likely to be admitted to the hospital from the emergency department.

While associations between child food insecurity, developmental risk and risk of obesity were not statistically significant, the researchers found “all were in the expected direction.” They added child food insecurity might not have reached the threshold of statistical significance because providers prioritize feeding children.

Most of the programs in the five US cities where the research was conducted were able to provide meals to the children thanks to funding from CACFP, which is a federal program administered by states that gives nutritious meals and snacks to children from families participating in Head Start programs, family childcare, childcare centers and afterschool programs or who are living in emergency shelters. All the meals and snacks must meet National Academy of Medicine standards for nutrition and follow age-appropriate meal patterns.

Strengthening CACFP ‘offers a vitally important pathway to ensuring both children and their families can flourish’​

“These findings have several clinical and policy implications,”​ argued the researchers, lead by Stephanie Ettinger de Cuba, executive director of Children’s HealthWatch and a research associate professor at Boston University.

“Household and child food insecurity are known risk factors for young children’s developmental delays and poor health. Moreover, food insecurity is associated with increased hospitalizations among young children and greater hospital charges for infants once hospitalized, due to longer lengths of stay,” they explain in the study.

They add the benefits of childcare-provided meals demonstrated in the study have expand beyond the children to include their families and society as a whole.

They explain: “Excellent/good child health status has been linked to decreased avoidable inpatient and outpatient health care services and costs. In addition to children being less severely ill and not needing to be admitted from the ED, families benefit from reductions in stress and avoiding the expenses associated with inpatient care and society benefits from potentially significant health care cost savings.”

Given these benefits, Ettinger de Cuba argues for strengthening and improving access to programs like CACFP, which she says in a statement “offers a vitally important pathway to ensuring both children and their families can flourish.”

In the study, the researchers argue that current CACP funding levels are inadequate for full implementation of the program and that current reimbursement rates are insufficient “to meet the real cost of healthy foods (especially in light of recent inflation in food prices) and support for provider training and technical assistance.”

They also advocate for simplifying paperwork and administrative burdens associated with the program, noting they act as a barrier for childcare provider participation in CACFP.

‘Work at the federal and state levels is warranted to expand participation’​

This sentiment is echoed in another recent study​ published in the American Journal of Preventive Medicine that found current CACFP participation rates among licensed child care centers “point to program under-utilization and unequal access.”

Researchers based their conclusion on finding of all licensed childcare centers, only 36.5% participated in CACFP, ranging from 15.2% to 65.3% across states. The rates increased to 57.5% when restricted to low-income areas.

“Work at the federal and state levels is warranted to expand participation in the program, above all in low-income areas, so that more young children could eat healthfully with CACFP,” conclude the researchers led by Tatiana Andreyeva at the Rudd Center for Food Policy and Health at the University of Connecticut.