August 8th, 2011
12:01 AM ET

Secret for a safe kid's lunch: Extra ice

When you're packing your kid's lunchbox in the morning, the ice pack is just as important as the fruit and the sandwich. And new research finds you might need more than one to keep your little one healthy.

Looking at the lunches of preschool age children, Texas researchers found that 98% of the time the food was not as cold or as hot as it should be for safe eating, even if packed in an insulated lunch box or stored in a hot thermos. This means your child may be more likely to come home with a stomach ache.

"This is a red flag. This means that the recommendations for food safety are not being followed," said Dr. Steve Abrams, member of the American Academy of Pediatrics Committee on Nutrition.

Food science experts at the University of Texas in Austin tested the temperature of foods in more than 700 packed lunches of 3- to 5-year-olds attending day care.

The scientists were surprised by what they found. The results appear in the current issue of the journal Pediatrics.

"I was shocked to discover that almost 40% of the time, parents had not packed an ice pack in their child's lunch," said study author Fawaz Almansour with the Department of Nutrition at the University of Texas at Austin.

But even when several ice packs arrived in the lunch, more than 90% of the perishable foods had entered the temperature danger zone. When foods that should stay chilled, such as milk, meat and sliced fruits, reach temperatures above 40 degrees Fahrenheit, it's  risky to eat them, especially if they've sat longer than two hours.

For hot items such as a thermos of soup, the temperature needs to stay at 140 degrees or above. When temperatures deviate from the safe zone, this gives bacteria a fertile playground, potentially spoiling food and sickening people who consume it. If your child complains of a stomach ache or is vomiting or has diarrhea, it's not necessarily a bug caught from another child. It may be from the food he ate that day. According to the study, children younger than 3 or younger are four and a half times more likely than adults who are 49 or younger to suffer from a foodborne illness .

The Texas researchers found that the average temperature for perishable foods had climbed to 62 degrees by lunchtime, more than 20 degrees  higher than recommended.

"Parents want to do the right thing for their child ,and I think that sometimes there is not an awareness that some foods need to stay cold," says Diane Van, deputy director of food safety education at the U.S. Department of Agriculture.

Van says that there are several practical things that parents can do when packing their child's lunch and they don't have to take a lot of time.


– When you can, freeze it

Before you head to bed, take your child's milk, juice or water and put it in the freezer. It can then serve as a second ice pack and help keep other foods cold. You can also do this with other foods as such as yogurt or soft cheeses. When making a chicken sandwich or other perishable mainstay, put it in the freezer as well, leaving the lettuce and tomato in the refrigerator to be added later.

– Keep it cold

If you're sending a whole apple or an orange,  which normally don't need to be refrigerated, put it in anyway to get cold. This will help keep the overall temperature of the lunch box lower.

– Make sure it's insulated

When shopping for a lunch box, choose one that's insulated. Van says that  there are many more of these available than in years past and that they can really make a difference.

– Double up on the ice packs

Always use an ice pack or cold source. If you have room, try to use more than one. Remember that a frozen beverage can help.

– Use the day care refrigerator

If your child's day care has a refrigerator, ask to use it.

If you'd like to test the temperature of your child's lunch, you can use a refrigerator thermometer to get a reading. You can find them at your hardware store or where appliances are sold.


– When cold weather hits, children sometimes like hot soup as part of their lunch. The best way to ensure that it stays at 140 degrees or higher is to pour boiling water into the thermos in the morning, letting it sit for several minutes. Then pour the hot soup into the container.

And the rules for packaging lunches don't just apply to children. When taking leftovers and other items to work, don't forget your own ice packs. You may need to schedule a trip to the store to buy some extras so that everyone in the family can eat safe healthy meals.

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soundoff (301 Responses)
  1. MomOf12Cats

    This is a bunch of caca- I never had an ice pack in my lunch, nor did my mother, brother, cousins or friends. We got a buck twenty-five for the hot plate of the day or else we brown-bagged it. I grew up healthy and fine. This article must be written by polar bears who are trying to export their products. DISLIKE 🙂

    August 8, 2011 at 09:23 | Report abuse | Reply
    • San

      It's clear to me in the article the pediatricians were looking ONLY at children three and younger, who are by far the most susceptible to food borne illness. Kindergarten and older children are a lot more resistant and unless they're immune-compromised - or food hygiene in the home is exceptionally poor - will usually tolerate food outside the storage temperature range for a few hours.

      We put an icepack in our son's lunches, but only because warm mayonnaise, juice and yogurt don't taste very good. People also need to remember that popular lunch items like deli meats are not only refrigerated until the sandwich is packed, but they're also loaded with preservatives and salt, which inhibits bacterial growth. Mayonnaise can be a culprit, but mayonnaise is completely shelf stable and is only refrigerated after opening because it becomes contaminated in routine use. It takes a lot of contamination in some pretty warm mayo to cause a problem.

      We used to worry about polio. Then we had had polio vaccinations, so we worried about bacterial meningitis. Now we have vaccinations for most organism that cause that. So we worry about flu pandemics. But now we can vaccinate for that. We have to have SOMETHING to worry about.

      We're too polarized in our parents. I see three-year-olds allowed to wander the neighborhood without supervision. Then I see moms make their third-graders use hand sanitizer RIGHT AFTER washing their hands with soap and water. But we should remember that the high school dropout rate is such a concern these days because the overwhelming majority of our children are healthy enough to stop going to class. 😉

      August 8, 2011 at 10:01 | Report abuse |
    • Jamie C. Baker

      If it was "a bunch of caca" I'm fairly certain that refrigerators and freezers wouldn't exist. Even if your claim that it's not harmful allowing food and certain beverages to reach unsafe temperatures is true, what about the preference of the child? Yes, the study was on toddlers, but the advice is for any person, regardless of age, who brings lunch to work, school, or another outing. Maybe I'm the idiot here, but I don't want to drink warm orange juice or serve my son a sandwich on soggy bread resulting from his ham and cheese sandwich rising to room temperature. I'd much rather play it safe and take the extra 2 seconds to throw an ice pack in than I would to laugh the article off and risk the health of myself and my child.

      August 8, 2011 at 13:17 | Report abuse |
    • Kris

      When I put a frozen ice pack in my son's insulated lunch box with his turkey sandwich, the sandwich froze and he was unable to eat it. Since then I have used nothing but the insulated lunch box and he's had no issues. And freezing the drinks – guess what they don't thaw by lunch time!

      August 8, 2011 at 13:20 | Report abuse |
    • Ley

      I imagine you're one of the thousands who didnt get a head injury for not wearing a bike helmet or a worse injury, from not wearing required seat belts.. just because you ddint suffer, doesnt mean others haven't or won't...

      August 8, 2011 at 15:53 | Report abuse |
    • Shane

      You didn't get sick because you ate the "hot plate" which is prepared by the school in a kitchen at the appropriate temperature! Brown bagging it is also fine, as long as you have items which aren't temperature sensitive. The article states 2 hours off the recommened temp as being unacceptable, but general food safety guidlines say 4 hours. Depending on when school starts and how cool the food is when sent it should still be fine at lunch time.

      August 9, 2011 at 07:59 | Report abuse |
  2. Joe in Colorado

    I always use two ice packs, one under the sandwich and one on top of it. But probably his sandwiches are above 40F by the time he eats them... especially during summer camp, when they keep their backpacks outdoors.

    He's never came home with a stomach ache or suffered diarrhea since he was a baby though. He takes a probiotic every single day, which likely helps in that regard. Hopefully.

    August 8, 2011 at 09:30 | Report abuse | Reply
    • Matt

      The point of the probiotic is to encourage healthy digestive bacteria in the digestive tract. It really has nothing to do with preventing food-bourne illness.

      August 8, 2011 at 17:03 | Report abuse |
  3. sam

    children younger than three... or younger!

    kids in the womb are such picky eaters, too

    August 8, 2011 at 10:14 | Report abuse | Reply
  4. emailnotrequired

    In my opinion, poor food preparation is to blame. Icing it is just a preventive measure and does not quite eliminate the threat.

    August 8, 2011 at 10:54 | Report abuse | Reply
  5. erich2112x

    Use dry ice so after lunch your kids can do a fog machine magic show for their friends.

    August 8, 2011 at 11:05 | Report abuse | Reply
  6. amg

    My mom ALWAYS packed an ice pack in my lunch box because I would complain if my drink was warm.

    August 8, 2011 at 11:10 | Report abuse | Reply
  7. lhh

    We brown bagged it all through elementary school and ate bologna and cheese sandwiches and cottage cheese that sat unrefrigerated for 4-5 hours–no one ever got sick from eating lunch.

    August 8, 2011 at 12:13 | Report abuse | Reply
    • Andreia

      idk how healthy this is but its rlaley good.2 cans cream of mushroom soup2 boxes macaroni and cheese1 lb hamburger meatcook hamburger meat and macaroni mix everything together___________________________________________or1 chicken breast1 med. potato1 can asparagus or green beansOne hour before time to eat, wash and remove skin from chicken breast. Season with Tony's creole seasoning and wrap in foil. Cut potato in half and season with Tony's. Then, wrap in foil. Bake in oven at 350 degrees for 1 hour. Heat vegetables and you have a good healthy lunch. Was this answer helpful?

      August 2, 2012 at 05:35 | Report abuse |
  8. anemone

    For as long as I can remember, we've never refrigerated any of our leftovers. We just cover them or pack them and let them sit on the counter. Never has anyone in my family gotten sick from eating them (even 2 days after) so far 30 years. And we're not exactly known for our hardy immune systems. We just keep our kitchen clean. I don't understand how everyone here gets food poisoning so often. Not even any of our friends have gotten sick from our unrefrigerated leftovers. Hmmmm...

    August 8, 2011 at 12:28 | Report abuse | Reply
    • Sandy

      Ewww....I'd never eat at your house. Do you not have a fridge? Why would you chose to not refrigerate leftovers?

      August 9, 2011 at 11:52 | Report abuse |
    • Brad

      Probably because your friends and you have built up immunity to the bacteria after eating it so many times. The rest of us, if we came over and ate the leftovers, would probably have a real interesting 24-48 hours ahead of us.

      August 9, 2011 at 16:49 | Report abuse |
  9. lols finnisher




    August 8, 2011 at 12:31 | Report abuse | Reply
  10. Razor

    What's funny is that the more care and preperation we take in keeping bacteria and viruses away from our children, the more immuno-compromised they become. Your immune system is a muscle much like your brain. It doesn't become good at its job by being protected from the outside world. Bacteria are everywhere, many are good/do not affect humans, others are bad and can cause harm to the child. Perhaps little children, atleast until their immune systems become stronger, cannot handle bad food, and personally I do not wish bad food on anyone. However we can only protect children from so much before we cause more harm than good.

    August 8, 2011 at 12:55 | Report abuse | Reply
  11. dom625

    I don't understand who day care kids bring a lunch anyway. Both of my sons' day cares provided lunch; it was part of the fee each month. They were also given breakfast and a snack.

    What this article fails to mention is how ice packs melt and cause puddles in the lunch box...nothing is worse than water-soaked bread!

    August 8, 2011 at 13:25 | Report abuse | Reply
  12. WellnessDrive

    Our oldest son was born with a week immune system so we always say "Better safe than sorry." 🙂 We use the insulated lunch box with 2 compartments and add ice-pack(s) when needed.

    But we start the morning out with his Vitamin juice. This has helped his immune system GREATLY. Hence one reason why we started up WellnessDrive.com to share the best Natural Supplements that you can get – Isotonix. Even our 3yr old loves them. 🙂

    August 8, 2011 at 13:44 | Report abuse | Reply
  13. Count Iblis

    Did CNN mix up the advice for school lunches with the one for survival camp where perishable foods need to stay fresh for several days?

    August 8, 2011 at 14:09 | Report abuse | Reply
  14. HealthyMom

    Try Gudernoobs made by WooHoo Foods for a nutritious snack!

    August 8, 2011 at 15:44 | Report abuse | Reply
  15. ieat

    how many times have you let the food sit on the counter for 3 hours before putting it away? I know we have done it countless times. I have never gotten sick from food sitting out for a few hours. I don't see how is lunch that is packed different either. Unless you put cheese or mayo on the sandwiches, it shouldn't be much of an issue.
    Besides frozen sandwiches taste nasty.

    August 8, 2011 at 16:19 | Report abuse | Reply
  16. Sandy

    My guess is that study author Fawaz Almansour has zero experience providing her kids with brown bag/sack lunches. If she had tried it, she would realize the odds of a freezer pack actually returning with the lunch box are low, as most young kids simply dump their boxes over the trash can. Her shock might vanish at the potential cost in blue ice over the school year. As for the "freeze it" advice in the article, I guess we must invest in extra plastic to protect everything else in the lunch from condensation when all that frozen stuff starts to melt. Maybe preschoolers are at risk, but who packs food for a preschooler? Snacks are part of most programs. I don't believe the few hours outside the fridge will harm most kids or adults, most of whom attended school before blue ice had even been invented. It's fear mongering to suggest that childhood illnesses are really the result of undiagnosed food poisoning. Food poisoning doesn't spread from person to person, the hallmark of classroom contagion. CNN is scraping the bottom of the Back to School barrel here.

    August 8, 2011 at 19:22 | Report abuse | Reply
  17. CLA

    Thirty years ago I never had an ice pack and I never had an issue. In fact, I can't recall anyone getting sick from their bag lunch. This is why I am against anything labelled "anti" bacteria.

    August 8, 2011 at 20:14 | Report abuse | Reply
  18. PreschoolAChoiceForAReason

    Yet another reason, I guess, to stay at home with kids under 5 years old, rather than sending them to preschool. I have a fridge at home, ha. I agree with other commenters, though...this is simply fear mongering. The articles that get the clicks are the ones that give us parents additional things to worry about, as if we didn't have enough to worry about...how about an article that states everything is OK and we're doing a good job and let's be happy for each other and enjoy the special moments. Nah, that won't get any clicks.

    August 8, 2011 at 22:52 | Report abuse | Reply
  19. Ta-da

    DId people who wrote this article ever heard about physics? When liquid is frozen, it turns into ice. Ice takes up more space than liquid. What will happen to a carton of milk left in the freezer overnight? Right, it will explode! Go back to school, folk.

    August 8, 2011 at 23:05 | Report abuse | Reply
    • nurse

      Frozen Milk does not explode. We have froze milk in cans, bottle and cartons with NO explosion!

      August 9, 2011 at 14:56 | Report abuse |
  20. julianpenrod

    A typical example of deceitful New World Order rhetoric.

    "98% of the time, the food was not as cold or as hot as it should be for safe eating", the article claims. But it's a matter of time. Germs don't suddenly appear in hordes, they need time to grow from tiny colonies! Yes, left at an unwise temperature for long enough will cause microbes to grow to be dangerous, but if something is even at a "dangerous" temperature for only a short time, it is not a problem! But the crooks of the New World Orde carefully don't mention the crucial part that time plays in this!

    "Yous child may be more likely to come home with a stomach acyhe", the article says. The people who fell for the craven NWO advertising dodge of "this can improve mileage" or "you may pay less with us" will also be easy prey for this! But, consider, if 98% of the lunches were at bad temperatures, why is it only "maybe" that a child could have a stomach ache?

    It's "risky" to eat foods that need to be cold if they've sat above 40 degrees for "longer than two hours", the crooks behgind the article insist. Much longer than two hours, though, is what should be said! If something has sat at 41 degrees Fahrenheit, something the NWO thugs don't admit to be possible for standard ice bags, they could still stand a large part of a day and be safe.

    THe NWO crooks are careful to try to cover the issue of why kids who didnt' even carry cold packs before got sick by saying it was "erroneously misdiagnozed" as being something caught from othe kids! Those who fall for "you can see better mileage" will certainly fall for this. But what of adults who got sick from being near kids, even though the adults were careful about their food? What about kids who got sick at home, when food could be carefully handled? And do the New World Order liars behind this article really think a kid would be unable to tell if food smelled bad?

    BUt they want to force the public to buy more garbage. Ice packs. Insulated containers/ Thermoses. And they want to push for refreigerators in evey classroom!

    August 9, 2011 at 00:56 | Report abuse | Reply
  21. DJP

    A refrigerator in every classroom would be money well spent.

    August 9, 2011 at 01:02 | Report abuse | Reply
  22. PopiRed

    I've been packing my son's lunch for 5 years now, and have done so in a thermal box with freezer packs and tuperware boxes for his food items, also using a food thermos for hot items. I keep his lunch cold, or hot, out of love. It makes for a more enjoyable lunch for him, as well. It is no big deal and makes sense. I knew food health perameters before, and they make sense too. You would not accept less from a restaurant, or even fast food drive thru...so why pole vault over mouse poo by scathing the article, or purposfully packing a lame lunch for your child. Has everyone lost their minds?!

    August 9, 2011 at 04:28 | Report abuse | Reply
  23. deb

    PopiRed-Thank you! I posted what you said yesterday on another news site. I am a preschool teacher-and I suggested a cold pack is a good idea for perishables for my preschoolers-mainly because the food would taste better-yogurt, cheese, etc. I was called a loser, retarded, not educated. I couldn't believe it. Thanks for being the voice of reason!!!

    August 9, 2011 at 08:07 | Report abuse | Reply
  24. melina

    Hmm... Why would we pack our kids lunches instead of letting the preschools feed our kids? Really? Uh... Maybe because we want our kids to have taste buds that recognize things besides salt,sugar,and fat. Maybe we want our kids to appreciate a home-made special meal. Maybe we want our kids to consume less than 300ingredients in one sitting. This just saddens me. Regarding the subject matter presented: I use drink "pouches" frozen overnight and give them a quick rinse to begin the thawing process otherwise even here in west texas they won't thaw by lunchtime. It seems cruel to send my son to school with an awesome lunch and a rock hard drink pouch. But a quick rinse helps it get to the perfect slushy icy drinkable consistancy by 11:30 and the food is still cold.I also keep food items in the refrigerator until right before I take him to school. Why didn't they also remind numskull, illogical parents to not pack fresh fish, raw eggs, undercooked meats, hot milk, and lukewarm mayo while they were at it? And for all the grandpas out there who responded with the "this is bogus! I walked ten miles in the snow and ate raw hamburger for lunch and never got sick" that's nice... But food, especially meats passed through fewer contaminating surfaces back in your day. Meat was ground up at the butcher shop then sold. Nowadays, cows are killed, their parts sometimes shipped, then cut, passed through conveyor belts separated and ground then shipped again, then made into smaller packages and sold for a higher price after repackaging. There's a more chance for contamination from surfaces than their used to be and more hands touching your meat. I envy the wholesomeness foods once had but unfortunately its just not there. Unless your like rural and eat venison that you've prepared yourself, which is what I do, city people don't usually have that choice though and they have to rely on 'the system' which requires a higher need for careful lunchbox assembly. its pretty common sense, don't you think?

    August 9, 2011 at 09:58 | Report abuse | Reply
  25. melina

    The part about why didn't they remind parents about not packing raw meats and fish was a example of sarcasm by the way... For those of us who take things a little too literally. If the kids food is cold to the touch and not lukewarm its probablly ok! Bacteria hasn't had time to grow in epic porportions between 10:30am when it was still 40 degrees and 11:30 when it has raised to 45-50 degrees. However if it is already lukewarm and was never refrigerated and contains meats that don't have a zillion preservatives it may cause disentary. So beware. Of hot raw foods. In case you missed that part back in the 50's when refrigeration started.

    August 9, 2011 at 10:07 | Report abuse | Reply
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  30. Emma

    Its great! My son is 6 yrs old. I keep his lunch cold, or hot, out of love its depends. It makes for a more enjoyable lunch for him, as well. hot and cold gel packs are very usable.

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      I seen these ice packs first at https://www.cryolux.com.au/

      June 13, 2017 at 02:27 | Report abuse |
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.