Nutrition Education
Accommodating Children with
Special Dietary Needs
The United Stated Department of Agriculture’s (USDA’s) nondiscrimination regulation (7 CFR 15b) applies to any site participating in federally-funded meal programs such as the National School Lunch Program (NSLP), School Breakfast Program (SBP), Special Milk Program (SMP), Child and Adult Care Food Program (CACFP), and Summer Food Service Program (SFSP).
Food and beverage substitutions must be made to the regular meal for children with disabilities when directed by a licensed physician.
Food substitutions must be available for a child with a disability when a statement signed by a licensed physician* supports the need. The physician's statement must identify:
- Child's disability,
- Explanation of why the disability restricts the child's diet,
- Major life activity affected by the disability,
- Food(s) to omit from the child's diet, and
- Food(s) to substitute.
*A physician is a person licensed by the State to practice medicine. The term includes physicians or doctors of osteopathic medicine. These fully trained physicians are licensed by the State to prescribe medication or to perform surgery.
The document Guidance for School Food Service Staff contains a sample form schools can provide to a family for the physician to complete.
For children with disabilities only requiring modifications in food texture (such as chopped, ground, or pureed), a licensed physician’s written instructions indicating the appropriate texture is recommended, but not required.
Food and beverage substitutions may be made for individual children who do not have a disability, but who are medically certified as having a special medical or dietary need.
These determinations are made on a case-by-case basis and cover children who have food intolerances or allergies that do not substantially limit major life activities or cause them to have anaphylactic reaction when exposed to the food(s) to which they have problems. Food substitutions may be made at the SFA’s discretion when a statement signed by a recognized medical authority* supports the need. The medical statement must include:
- Identification of the medical or other special dietary condition which restricts the child’s diet,
- Food(s) to omit from the child’s diet, and
- Food(s) to substitute.
*A recognized medical authority is a licensed physician, physician assistant, nurse practitioner or other health professional specified by the State agency. Click here for a sample form that school food service staff can use in the kitchen to prepare meals for children with special dietary or medical needs.
