Special Diets in CACFP Adult Day Care Centers

Milk Substitutes

The U.S. Department of Agriculture (USDA) allows CACFP adult day care centers to offer two types of optional fluid milk substitutions for participants who do not consume regular cow’s milk due to non-disability reasons. These include lactose-free or lactose-reduced milk and fluid milk substitutes that meet the USDA’s nutrition standards for fluid milk substitutes. These requirements do not apply to fluid milk substitutes for participants whose disability restricts their diet. For detailed guidance on the meal modification requirements for disability reasons, refer to the CSDE's Guide to Meal Modifications in CACFP Adult Day Care Centers.

Lactose-free/reduced Milk

Lactose-free and lactose-reduced milk are fluid milk and credit the same as regular milk in the milk component for the CACFP adult meal patterns. These types of milk are processed by adding lactase enzymes to reduce or eliminate the lactose (naturally occurring milk sugar) found in regular milk. Children who cannot digest the lactose found in regular milk may be able to drink lactose-free/reduced milk. The USDA recommends these types of milk as the first choice for children with lactose intolerance. Lactose-free/reduced milk must be low-fat or fat-free milk, either unflavored or flavored.

Fluid Milk Substitutes that Meet USDA’s Nutrition Standards

Section 7 CFR 226.20(g)(3) of the CACFP regulations allows CACFP adult day care centers to choose to offer one or more fluid milk substitutes (plant-based beverages designed to replace cow's milk) that meet the USDA’s nutrition standards for fluid milk substitutes. Only certain brands of fluid milk substitutes meet these standards.

Identifying Acceptable Fluid Milk Substitute Products

Before purchasing any type of fluid milk substitute, CACFP adult day care centers must ensure it complies with the USDA’s nutrition standards for fluid milk substitutes. Commercial products that meet the USDA’s nutrition standards for fluid milk substitutes are identified in table 3 of the CSDE's Allowable Fluid Milk Substitutes for Non-disability Reasons for Adult Participants in the CACFP. If a commercial product is not listed, CACFP facilities must contact the manufacturer to obtain documentation that 1 cup provides the minimum amount of each required nutrient. 

Certain brands of soy milk and oat milk are the only currently available commercial products that meet these requirements. Almond milk, cashew milk, rice milk, some brands of soy milk, most brands of oat milk, and other nondairy milk products do not comply with the USDA’s nutrition standards and cannot be offered as fluid milk substitutes for non-disability reasons in the CACFP. 

Guidance