Nutrition Guidance Manual - WI Child Nutrition Programs (FNS)

nurse practitioner, or registered nurse) or other health professionalspecified by the State agency.Sponsors should be aware that meal or food substitutions for nondisabilitymedical or special dietary needs that are outside the mealpattern are not reimbursable.Food Allergies and IntolerancesA food allergy is a reaction of the body’s immune system to a proteinin a food called an allergen. Food allergies can be serious, lifethreateningconditions and should be diagnosed by a licensedphysician or board-certified allergist. Symptoms of a food allergicreaction may include a skin rash, hives, itchy, watery eyes, swellingof lips, tongue, and throat, itching in the mouth or throat, nausea,vomiting, diarrhea, difficulty breathing, or loss of consciousness.More than 170 foods are known to cause an allergic reaction in somepeople, but there are eight foods that most commonly trigger suchreactions: cow’s milk, eggs, peanuts, tree nuts, fish, shellfish, soy, andwheat. When food allergies may result in severe, life-threateningreactions, a physician may assess that the child meets the definition of“having a disability” and food service personnel must make thesubstitutions prescribed by a licensed physician.Food intolerance is an adverse food-induced reaction that does notinvolve the body's immune system. Lactose intolerance is oneexample of food intolerance. A person with lactose intolerance lacksan enzyme that is needed to digest milk sugar. When that person eatsmilk and milk products, gas, bloating, and abdominal pain may occur.Gluten intolerance, also known as Celiac disease, is another foodintolerance. Sponsors are not required to make food substitutions for aperson with food intolerances as food intolerances are not considereddisabilities. However, food substitutions may be made at a sponsor’sdiscretion for a child with a non-disability medical or special dietaryneed, such as a food intolerance. See Disabilities and Medical orSpecial Dietary Needs sections above for more information on mealand food substitutions.Dietary PreferencesSponsors are not required to make food substitutions based solely on aparent or child’s personal or taste preferences. The meal patterns aredesigned to be flexible and, with advance notice, may accommodateparents concern about religious food restrictions or preference fortheir child to eat vegetarian meals.18