Three weeks ago, a teacher reached out to me because her six-year-old student decided he should stop eating; other kids were teasing the 130 pound boy, let’s call him Andres. For context, the average six-year-old boy weighs closer to 45 lbs.

What his teacher didn’t know was that I had been made aware of Andres several months before, when he was referred to our Pediatric Pre-Operative Board over concerns regarding the safety of performing a tonsillectomy to relieve his sleep apnea. Sleep apnea was interfering with the quality of his sleep such that that he was falling asleep in class everyday. We – pediatric anesthesia, pediatric head and neck surgeons, pediatric pulmonologists, pediatric cardiologists, and pediatric hospitalists — were concerned that he was at significant risk of postoperative complications because of his weight. Cautiously, we proceeded with the operation, which was successful. Andres is no longer falling asleep in class, but now he is refusing to eat.

More than 30 percent of the population in Sacramento lives at or below 185 percent of the federal poverty level. Children living in poverty are more likely to have chronic diseases, and are more likely to be hospitalized for their illnesses. Many of these diseases are tied to poor nutrition. Children who experience food scarcity miss more school then other students and suffer academically – it’s hard to learn when you are hungry or undernourished.

Just try taking the food stamp challenge, which invites participants to live on the average SNAP food benefit of $4.18 per day, and find out for yourself how hard it is to concentrate on a food-stamp-diet. Eating healthy is hard enough without worrying if your limited budget should go to rent or food. Anyone who has been to the grocery store recently knows that healthy and nutritious food is more expensive and less accessible than low-quality and processed junk food.

Andes’ parents both work full time, and he is often cared for in child care. His parents try to provide him nutritious meals, but it is difficult and expensive. Unfortunately, many child care providers also face hardships when it comes to consistently providing healthy meals for children in their care. Andres doesn’t have regular access to healthy food, and the food he does have access to in child care is high calorie, nutrient-poor food that contributes to obesity.

That was not always the case. In 1978, the federal government permanently implemented the Child and Adult Care Food Program (CACFP), which provides a reimbursment to child care providers who serve healthy meals to low-income children. Since the federal reimbursement was the same for all states, California added a subsidy to offset the state’s high cost of living.

From 1978 to 2012, California supplemented the cost of serving healthy meals to low-income children in child care through CACFP, but it came to an end in 2012. With that budget cut, thousands of California’s children lost access to healthy meals in child care — 98 percent of whom are from low-income homes.

Child care providers are required to feed children in their care. Without assistance from the state, it is almost impossible for providers in low-income communities to keep up with the cost of healthy meals that meet federal nutrition standards – forcing many providers to drop from the federal program entirely.

Reallocating funds to CACFP would improve the quality of food our children receive in child care, and our state can afford this allocation. What’s more, California cannot afford to raise a generation of children who do not have the academic skills to be successful, and who have chronic, preventable diseases that started in childhood. Unfortunately, Andres is an example.

We know that high-quality early childhood education works to create academic, social, and emotional gains for disadvantaged children. It make sense that these and other programs aimed at giving California’s children a better chance should serve healthy, nutritious food.

Providing healthy food to children in our state should not be viewed as optional — they are our foundation, and they are worth the investment; the legislature should budget accordingly.