Superintendent's Memo #267-09

State seal, Commonwealth of Virginia

Department of Education

September 25, 2009

TO: Division Superintendents

FROM: Patricia I. Wright, Superintendent of Public Instruction

SUBJECT: Milk Substitution for Children with Medical or Special Dietary Needs (Non-Disability), Questions and Answers

Schools in the National School Lunch Program and School Breakfast Program have the option to offer a nondairy milk substitute to a student with a medical or special dietary need other than a disability. The final rule Fluid Milk Substitutions in the School Nutrition Programs (73 FR 52903, September 12, 2008) addresses the substitution of fluid milk for children whose non-disabling allergies, culture, religion, or ethical beliefs preclude the consumption of cow's milk.

This rule recognizes the valuable contributions of milk to a child's diet and, therefore, does not allow a school to offer other beverages, such as juice, as milk substitutes. The only milk substitutes allowed under this rule for students without disabilities are nondairy beverages that meet the established nutrient standards. However, this rule has no effect on a school's ability to offer lactose-free milk to a student with a medical or special dietary need such as lactose intolerance. Lactose-free milk continues to be allowed as part of the reimbursable meal. Schools that elect to offer milk substitutes for students without disabilities can accept a statement from a parent/legal guardian or from a medical authority identifying the student's need.

Please note that a statement from a medical authority is still required for any meal variations, other than milk substitution for a student with medical or other special dietary needs.

This rule does not apply in cases of disability. For a student with a recognized disability who cannot consume cow's milk, the school must omit or substitute fluid milk based on the written statement from a licensed physician.

The key requirements of the rule are:

The attached Questions and Answers clarify various issues concerning the substitution of fluid milk in nondisability cases.

If you have any questions, please contact the school nutrition program specialist assigned to your division, or Catherine Digilio Grimes, director of school nutrition programs, by e-mail at or by phone at (804) 225-2074.



a. Question and Answers: Fluid Milk Substitutions in the School Nutrition Programs (Word)