Nutrition matters for the early years

Nutrition matters for the early years
Nutrition
matters for
the early years
Guidance for feeding under fives in the
childcare setting
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Introduction
What we eat can play a critical role in
determining our health, whatever our age.
The eating patterns established in the first
few years of life influence our health during
childhood and adulthood. Encouraging good
nutrition during the early years of life is
therefore an investment in the health of our
population for years to come.
With more parents working, increasing numbers
of children are spending long periods of time
in childcare outside their own homes. This has
implications for their dietary intake, as a large
proportion of meals and snacks is now eaten away
from home. Childminders and the staff in nurseries
and playgroups therefore have a crucial role to play
in promoting healthy nutrition among young children.
In recognition of this, the Public Health Agency
has revised and updated this publication, Nutrition
matters for the early years, which was originally
developed by the former Health Promotion Agency
for Northern Ireland (HPA) in partnership with
the former Health and Social Services Trusts, the
Early Years organisation and the Northern Ireland
Childminding Association (NICMA).
This updated version outlines straightforward
practical advice and information on a range of
nutritional issues relating to children up to the age
of five, based on current government guidelines.
Information about the importance of encouraging
physical activity and ensuring the safe handling and
storage of food is also included.
Nutrition matters for the early years is a valuable
resource for all staff within day nurseries, playgroups
and crèches and for childminders providing childcare
within the home setting.
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Contents
Page
Why good nutrition is important 6
A guide to weaning
8
- Foods to avoid giving to babies..................................................................................8
- Weaning before six months...................................................................................... 10
- Weaning: from 6 months........................................................................................... 11
- Weaning: from about 7 months............................................................................... 12
- Weaning: from 9 months........................................................................................... 13
- Drinks for babies up to 12 months old................................................................... 14
A varied balanced diet for children aged one to five
15
- Bread, rice, potatoes, pasta and other starchy foods........................................ 17
- Fruit and vegetables................................................................................................... 19
- Milk and dairy foods.................................................................................................... 21
- Meat, fish, eggs, beans and other non-dairy sources of protein...................... 23
- Foods and drinks high in fat and/or sugar............................................................. 25
Planning meals and snacks for children
26
- Meal and snack suggestions.................................................................................... 27
- Sample menu for a full day........................................................................................ 31
Children with individual dietary needs
32
- Children following a vegetarian diet........................................................................ 32
- Children from ethnic communities following a traditional diet.......................... 33
- Children with special dietary needs........................................................................ 33
- Fussy eaters.................................................................................................................34
Food safety
35
Rewards and celebrations
36
- Encouraging good behaviour...................................................................................36
Physical activity for children
37
Preparing a nutrition policy
39
Nutrition checklist
41
Contacts for more information
45
5
Why good
nutrition is
important
Good nutrition is essential during childhood, as
it is a time of rapid growth, development and
activity. This is also a vital time for healthy tooth
development and prevention of decay. General
eating habits and patterns are formed in the first
few years of life. Poor nutrition during these years
is associated with an increased risk of obesity,
hypertension, diabetes and coronary heart
disease. Childcare providers therefore have a
key role to play in introducing children to a wide
variety of foods and establishing a pattern of
regular meals and healthy snacks.
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The arrangements for children’s meals and
snacks will of course vary considerably between
different childcare providers. Some nurseries and
childminders may provide all meals, snacks and
drinks. This document offers them straightforward
guidelines on how to ensure they are giving
the children in their care a healthy diet. In other
cases, where parents provide drinks and snacks,
or all foods and drinks for their child, childcare
providers can use the document to help in any
discussions they may have with parents about the
food that they are providing.
When providing food for young children,
consideration must be given to the following
points:
• Children’s appetites may vary, not only from
day to day, but also from one meal to the
next.
• Young children are very active and have
high energy (calorie) and nutrient needs in
proportion to their small body size.
• Children have small stomachs and may be
physically unable to eat large meals.
• Every day, children need three meals plus
snacks. Use the ideas given in this document
to provide nutritious meals and snacks.
• Children should be encouraged to drink
adequate amounts of fluids.
• A frequent intake of sugar and sugary foods
and drinks between meals causes tooth
decay. Snacks and drinks taken between
meals should be sugar-free.
• Foods and drinks containing sugar should
only be given occasionally and should be
limited to mealtimes. Sugar may also appear
on labels as sucrose, glucose, syrup, fructose
or dextrose.
• Puddings offered each day should be
nutritious and based on milk and/or fruit
(fresh, stewed or tinned).
• Avoid low fat or diet products, as young
children need the extra calories from fat
to grow and develop properly. Full fat
spreads and whole milk dairy products are
recommended.
• A diet high in fibre is not suitable for young
children. It can fill them up without providing
all the nutrients they require. Foods of varying
fibre content should be offered, eg both
white and wholemeal breads and pasta; a
variety of breakfast cereals, eg Corn Flakes,
Rice Krispies, Weetabix, porridge, etc.
Children between the ages of two and five
should gradually be encouraged to increase
their intake of higher fibre foods.
• Dry, unprocessed bran should never be used
as it can reduce the absorption of important
nutrients and can cause bloating, wind and
loss of appetite.
• Do not add salt to food either in cooking
or at the table, as babies’ kidneys are not
fully developed. Too much salt is linked
with high blood pressure later in life and
may encourage a preference for salty food,
which is difficult to change. Salty snacks
such as crisps should be avoided for babies
and young children, and given only very
occasionally for older children.
• Whole nuts are unsuitable for children under
the age of five years because of the risk of
choking. It is recommended that peanuts and
products containing them, eg peanut butter,
are not provided within the childcare setting.
This is to protect children who may be at risk
of nut allergy.
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A guide
to weaning
All the nourishment a baby needs during the first
six months comes from either breastmilk or infant
formula milk. Based on current research, health
experts recommend that babies should begin to
take solid foods from six months in addition to
breastmilk (or the baby’s usual formula milk) to
allow them to grow and develop.† This process
is called weaning (sometimes referred to as
complementary feeding). Solid foods should be
offered initially 2–3 times a day, increasing to 3–4
times daily between 9–11 months.
Weaning before six months is not recommended
as babies’ digestive systems and kidneys are still
developing. Weaning too soon may increase the
risk of infections and allergies.
The tables on the following pages outline the
current recommendations for weaning.
Foods to avoid giving to babies
• Salt. Do not add any salt to foods for babies
as their kidneys are not fully developed. You
should also avoid foods that contain a lot of
salt, eg packet soups, stock cubes, crisps,
bacon, smoked meats.
• Sugar. Do not add sugar to the foods
or drinks you give a baby. Sugar could
encourage a sweet tooth and lead to tooth
decay when the first teeth start to come
through.
• Honey. Don’t give honey to a child under
the age of one year, as it can contain a kind
of bacteria which can produce toxins in
the baby’s intestines and can cause a very
serious illness (infant botulism).
• Nuts. It is recommended that peanuts and
products containing them are not provided
within the childcare setting. This is to protect
children who may be at risk of peanut allergy.
Whole nuts should never be given to children
under the age of five because of the risk of
choking.
†
Kramer MS, Kakuma R. Optimal duration of exclusive
breastfeeding. Cochrane Database of Systematic
Reviews 2002, Issue 1. (Updated in 2009)
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Weaning before six months
Baby led weaning
Weaning before six months is not recommended;
however, childcare providers will obviously have
to follow the parents’ wishes about introducing
complementary feeds. If the parents of a baby
in your care are determined to wean before six
months, there are a number of extra foods that
should be avoided in addition to the list above.
These are:
Baby led weaning is becoming an increasingly
popular way of introducing foods to children. It
does not use the conventional weaning methods
of purees and mashed foods; instead the child is
offered bite sized pieces of food to suck, chew
and explore. There are pros and cons to this style
of weaning. If you would like more information
please visit: www.rapleyweaning.com
• Foods which contain gluten, eg wheat flour,
bread, breakfast cereals made from wheat,
rusks, spaghetti or other pastas (eg tinned
pasta in tomato sauce).
• Nuts and seeds.
• Eggs.
• Cow’s milk, either as a drink or mixed with
food.
• Fish and shellfish.
• Citrus fruits, including citrus fruit juices, eg
orange juice.
• Soft and unpasteurised cheeses.
• Tofu, Quorn, soya protein.
More detailed guidance on weaning can be found
in the Public Health Agency’s leaflet Weaning
made easy: moving from milk to family meals.
This leaflet is aimed at parents but childcare
providers working with young babies will also find
the information useful.
You can download the leaflet from the
publications section of our website
www.publichhealth.hscni.net/publications or ask
for a copy from your community midwife or health
visitor.
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Weaning: from 6 months
First foods should be smooth or well mashed.
At this stage the food doesn’t need to be quite so
runny – you can start to leave a few soft lumps.
Suitable first foods are:
Notes
Texture
• plain baby rice mixed with baby’s usual milk;
• smooth or well-mashed cooked potato, carrot,
parsnip, turnip, cauliflower;
• smooth or well-mashed banana, stewed fruits,
eg apple, pear, apricots;
• unsweetened custard (made using custard
powder);
• plain/natural yogurt.
As babies get used to spoon feeds
After a couple of weeks begin to add different
foods and different tastes:
• mashed or minced meat, chicken, fish (with bones
removed), lentils, hard boiled egg (serve these with
well-mashed potatoes, rice or pasta and veg);
• foods made from wheat, eg bread, pasta, semolina;
• breakfast cereals such as plain Ready Brek,
Weetabix, porridge.
Finger foods
Finger foods encourage babies to feed
themselves. Try:
• soft fresh fruit, eg banana, melon, peeled pear;
• pieces of cooked vegetables, eg green
beans, cauliflower, carrot;
Vitamin D
Vitamin D is an essential vitamin for bone
development. Our body creates most of our vitamin
D from moderate exposure to the sun, however, a
significant proportion of the UK population have
low levels of vitamin D. Those at risk of deficiency
include young children and it is therefore
recommended that all children between the ages
of 6 months and 5 years should be given vitamin
drops or tablets which contain vitamins A, C and
D, unless they are consuming 500ml (a pint) or
• Cook vegetables or fruit (without added salt
or sugar) until they are soft, then mash well.
• Breastmilk or infant formula milk can be used to
mix with cereals, potatoes etc to give a
smooth consistency. Pasteurised whole cow’s
milk can be used to mix into foods, such as
mashed potato and breakfast cereal, but should
not be given as a main drink until after 1 year.
• At this stage the baby will continue to receive the
usual amount of breastmilk (this may need to be
expressed for use within the childcare setting)
or infant formula milk each day. This should be
provided in accordance with the parent’s guidance.
• Cooled boiled water can be offered between
feeds if the baby seems thirsty.
• Use a cup for drinks of infant formula or water.
• Introduce finger foods.
• fingers of toast (with unsalted butter),
unsalted breadsticks, pitta bread;
• fingers of hard cheese;
• low-sugar rusks (these should only be used
occasionally, as even low-sugar varieties still
contain a lot of sugar).
more of infant formula a day at any time during this
age range. Ordinary cow’s milk does not contain
sufficient vitamin D. More detailed guidance
on Vitamin D can be found in the Public Health
Agency’s leaflet Vitamin D and you which can be
downloaded from the publications section of our
website www.publichealth.hscni.net/publications.
The UK Chief Medical Officers’ advice on Vitamin
D supplementation can be accessed at
www.gov.uk/government/publications/vitamin-dadvice-on-supplements-for-at-risk-groups
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Weaning: from about 7 months
Texture
From about 7 months just mash food with a fork.
This will encourage the baby to learn how to
chew.
Suitable foods
All family foods can be offered at this stage –
remember not to add salt while cooking or at
the table.
Notes
• By this age the baby should be having three
meals a day and eating more at each spoon
feed.
• The amount of milk can be gradually reduced
as the baby eats more solid food. The baby
should continue to have breastmilk (this may
need to be expressed for use in the childcare
setting), or at least 500–600mls (16–20fl oz)
of infant formula each day.
• Encourage babies to hold spoons.
Menu ideas
Main meal ideas:
• mashed baked beans with fingers of toast;
• tuna and pasta bake with broccoli;
• macaroni cheese with peas;
• shepherd’s pie with carrots;
• minced chicken with mashed potato and
Brussels sprouts;
• corned beef hash with sliced green beans;
Dessert ideas:
• pieces of fresh soft fruit, eg pear, banana,
melon;
• stewed fruit, eg apples, apricots, prunes
(with stones removed);
• tinned soft fruit in its own juice, eg
strawberries, peaches, pears;
• milk pudding, yogurt or fromage frais (do not
use ‘diet’ varieties).
• meat or lentil stew with mashed potato;
• fish pie with peas.
“Pieces of fresh soft fruit,
eg pear, banana or melon”
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Weaning: from 9 months
Texture
During this stage babies will move on from
mashed to chopped foods.
Suitable foods
Continue to offer all family foods at this stage.
Notes
• Continue to give three meals a day plus 1–2
snacks.
or about 500–600mls (16–20fl oz) of infant
formula) each day.
• Water or very diluted pure fruit juice (one
part juice to 10 parts water) can be given
as a drink at mealtimes. By now, most drinks
(including the baby’s usual milk) should be
given from a cup. From 12 months, the use of
a bottle should be discouraged.
• Encourage babies to eat a wide variety of foods.
• For suitable drinks refer to page 14.
• At this stage babies will continue to receive
3–4 breastfeeds each day (this may need to
be expressed for use in the childcare setting)
Menu ideas
Some meal ideas to try
Breakfast:
Dinner:
• unsweetened breakfast cereal with whole
cow’s milk;
• minced or chopped meat, mashed potatoes
and carrots;
• toast with well-cooked egg, either scrambled,
poached or boiled.
• fish fingers, peas and mashed potatoes;
Lunch:
• chicken casserole and rice;
• lasagne with broccoli;
• baked beans with fingers of toast;
• vegetable risotto with grated cheese;
• sandwiches filled with, for example, tuna,
chicken, egg, hummus;
• beef or lentil burgers, courgettes, sliced
tomato and boiled potatoes;
• soup, for example vegetable or lentil, with a
sandwich;
• cauliflower cheese, boiled potatoes and
green beans.
• pasta with tomato sauce and grated cheese.
Snack ideas
Healthy snacks to use between meals include:
• chopped fruit and vegetables, eg peeled apple,
pear, peach, banana, orange, carrot, cucumber;
• bread, toast, scones, pancakes;
• natural yogurt or plain fromage frais – add
your own fruit for extra flavour;
• cheese.
Snacks that contain quite a lot of sugar are
safest for teeth if taken at mealtimes and
should be given as snacks only occasionally.
These include:
• flavoured yogurt, flavoured fromage frais;
• low-sugar rusks;
• plain biscuits, eg Rich Tea, Marie, Digestives.
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Drinks for babies up to 12 months old
Breastmilk or infant formula milk
Breastmilk or infant formula milk should be the
main drink during the first year.
If a mother wishes to express breastmilk for her
child to drink while in childcare, it should be stored
in the fridge and brought up to room temperature
in a jug of hot water before it is given to the baby.
It is now recommended that powdered infant
formula is freshly prepared for each feed. Use
bottles that have been sterilised and always
reconstitute the formula in water which has been
boiled and is still hot (above 70ºC). Cool this
rapidly to room temperature, then use immediately.
Always discard any formula left over after the feed.
If formula cannot be made up by childcare providers,
parents could supply cartons of ready-to-feed
liquid formula. If parents choose to make up formula
at home, feeds should be made up and cooled in
the fridge for at least one hour before transporting
to the childcare facility. The feeds should be labelled
and transported in a cool bag with an ice pack and
on arrival transferred immediately to the fridge.
They can then be used for up to 24 hours.
Note: If the feeds are not cooled in the fridge or
are transported without an icepack they must be
used within two hours.
Follow-on formula
Follow-on formula is unsuitable for babies under
six months and is unnecessary for older babies.
Cow’s milk
Whole cow’s milk should not be used as the main
drink until after one year. If a child is eating a
varied diet, semi-skimmed milk may be given from
two years. Do not give skimmed milk to under fives.
Other drinks
A little cooled boiled tap water can be given if a
baby seems very thirsty (after six months, water
straight from the mains tap is suitable). Very dilute
fruit juice (one part pure fruit juice to ten parts water)
from a cup may be given occasionally with meals.
Drinks that are not recommended
Baby juices, herbal drinks and sugary
diluting juices
These contain sugar and can damage developing
teeth if they are used frequently or given from a
Drinks that should not be given
Colas, lemonades and fizzy drinks including ‘diet’
drinks and sugar-free squashes.
bottle. Squashes should be very well diluted (one
part squash to ten parts water). All of these drinks
should be given from a cup at main meals.
sugar and present a risk to dental health so it is
advisable to choose low sugar varieties if possible.
Tea and coffee
These are acidic and can cause damage to teeth.
These may reduce the absorption of iron.
‘Diet’ drinks are also high in artificial sweeteners
which are unsuitable for babies and young children. Bottled mineral waters, still and sparkling
Soya drinks
Soya drinks (previously known as soya milk), which
are not formula, should not be given to children
under the age of 1 year. After this, choose
fortified drinks to ensure an adequate vitamin and
mineral intake. Many of these drinks also contain
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These may contain high levels of minerals which
make them unsuitable for babies under one year.
Goats’ and sheep’s milk
These lack essential vitamins and minerals needed
for babies’ growth and development.
A varied balanced
diet for children
aged one to five
Growing children need plenty of
energy (calories) and nutrients,
eg protein, fat, carbohydrates,
vitamins and minerals. These
needs can be met by including a
variety of foods from each of the
main food groups. The following
tables outline the recommended
number of servings, per child,
from each of the four food groups
for a whole day. The actual
number of servings provided will
depend on the length of time the
child is in childcare.
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Food group: Bread, rice, potatoes, pasta and other starchy foods
What’s included
This group includes:
• all types of bread, eg wholemeal, wheaten, granary, multigrain, white, brown, soda bread, potato
bread, rolls, baps, chapattis;
• crispbreads, savoury crackers, crumpets, pancakes;
• breakfast cereals without added sugar, honey or chocolate, eg Weetabix, Ready Brek, porridge
oats, Corn Flakes, Rice Krispies;
• boiled, mashed or baked potatoes (chips should be limited to once a week);
• pasta, noodles, rice and couscous.
Recommended servings
Offer a minimum of one portion per child with each meal. Examples of one portion are:
• 1 slice of bread;
• 1 small potato;
• 8 oven chips;
• 3 tbsp cooked pasta or 2 heaped tbsp cooked rice;
• 2 tbsp breakfast cereal.
Portion sizes should be increased according to appetite.
Key nutrients
The main nutrients provided are:
• energy (calories);
• B vitamins (needed for growth and activity);
• fibre (needed for healthy bowels).
Some breakfast cereals are fortified with iron (needed for healthy blood).
Notes
These foods should also be offered as snacks.
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18
Food group: Fruit and vegetables
What’s included
This group includes:
• all types of fresh, frozen and canned vegetables, eg broccoli*, Brussels sprouts*, cabbage*,
carrots, cauliflower*, mushrooms, parsnips, frozen peas, peppers*, swede, sweetcorn, turnip;
• all types of salad vegetables, eg lettuce, cucumber, tomato;
• all types of fresh fruit, eg apples, bananas, grapes, kiwi fruit*, oranges*, strawberries* blueberries;
• all types of tinned fruit in juice, eg peaches, pears, pineapple, prunes;
• stewed fruit;
• dried fruit.
* All these are good sources of vitamin C.
Recommended servings
Five child-sized portions should be offered each day.
Examples of one child-sized portion are:
• ½ apple, ½ pear, ½ banana or ½ orange;
• 1 tbsp fruit salad, tinned or stewed fruit;
• ½ cup of strawberries or grapes;
• 1 tbsp cooked vegetables;
To reduce
the risk of choking,
cut up small fruits and
vegetables like grapes and
cherry tomatoes, remove any
stones and pips and cut
large fruits into smaller
pieces.
• 1 tbsp chopped or raw salad vegetables.
Key nutrients
The main nutrients provided are:
• vitamins, especially vitamin C (needed for general good health and to help absorb iron);
• fibre;
• iron (from dark green vegetables, eg broccoli and spinach).
Notes
• Fruits and vegetables make good snacks and are ideal as finger foods.
• Dried fruits such as raisins or dates can be included in main meals but are not recommended as
snacks between meals because they are concentrated sources of sugar, which may cause tooth
decay.
• Frozen vegetables are high in vitamins.
• Vegetables can be added to soups, casseroles and stews.
• Do not overcook fruit and vegetables, as this will reduce the vitamin content.
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Food group: Milk and dairy foods
What’s included
This group includes:
• milk;
• cheese;
• yogurt.
Recommended servings
Each day allow 350–600mls (½–1 pint) of milk from one year of age onwards
or
2–3 servings of foods from this group should be provided, for example:
• 25g (1oz) of hard cheese;
• 125g carton of yogurt – avoid ‘diet’ varieties;
• a bowl of milk pudding.
Each of these provides equivalent amounts of calcium.
Key nutrients
The main nutrients provided are:
• calcium (needed to build strong bones and for nerve and muscle function);
• protein (for growth);
• fat (for calories);
• vitamin A (needed for growth, healthy skin and eyes, a healthy respiratory system (lungs and
breathing tubes) and a healthy digestive tract (including mouth, stomach and bowel);
• vitamin D (needed to help absorb calcium and to build strong bones).
Notes
• Children aged one to two years should have whole cow’s milk as their main drink. From two years
children can have semi-skimmed milk if they are eating a varied diet.
• Skimmed milk should not be given to children under five years.
• Milk can be used in drinks, on breakfast cereals, in milk puddings or sauces.
• Cheese can be added to jacket potatoes, spaghetti or toast. Grated cheese, cottage cheese,
cheese portions or spreads can be used as sandwich fillers or on toast.
• The length of time the child is cared for will determine how much of the daily requirements should
be provided within the childcare setting.
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Food group: Meat, fish, eggs, beans and other non-dairy sources of protein
What’s included
This group includes:
• all types of meat including beef, lamb, pork, bacon, ham, liver, chicken and turkey;
• white fish, oily fish (eg tuna and sardines), fish cakes, fish fingers;
• baked beans, mushy peas, butter beans, kidney beans, chickpeas;
• eggs including boiled, scrambled, poached, omelette;
• meat alternatives, eg soya mince, textured vegetable protein (TVP);
• bean curd, Quorn;
• processed meats/meat products, eg chicken nuggets, sausages, sausage rolls and burgers.
Recommended servings
Two servings of these foods should be taken every day, ie at lunch and evening meal.
Examples of one serving include:
• 40–50g (1½–2oz) beef, pork, lamb, chicken or fish;
• 2 fish fingers;
• 1 egg;
• 2–3 tbsp baked beans.
Processed meat products should be given no more than once a week in the childcare setting.
Examples of one serving are:
• 4 chicken nuggets;
• 4 fish bites;
• 2 sausages;
• 1 junior (50g/2oz) burger.
Key nutrients
The main nutrients provided are:
• protein;
• iron (to prevent anaemia);
• vitamins, especially B vitamins.
• Omega 3 fatty acids in oily fish.
Notes
• Whole nuts are unsuitable for children under the age of five years because of risk of choking.
• It is recommended that peanuts and products containing them, eg peanut butter, are not provided
within the childcare setting. This is to protect children who may be at risk of peanut allergy.
• Ensure that all meat and fish dishes are free from bones to prevent choking. Be aware that chicken
nuggets can sometimes contain small bones.
• Red meat should be included as it is a good source of iron. Mince is acceptable as a red meat.
Minced meat may be used for shepherd’s pie, meatballs and spaghetti bolognaise. Where possible
use leaner cuts of meat and trim off visible fat. Processed meat products contain less protein and iron.
• All eggs must be well cooked. Foods rich in vitamin C (eg tomatoes or orange juice) taken at the
same meal, help the body absorb the iron in eggs.
• Vegetarian choices could include omelette, cheese quiche, bean and pasta bake, macaroni
cheese, vegetable lasagne.
• It is important to include good sources of iron regularly, eg beef, lamb, pork, eggs, sardines, baked
beans, mushy peas. Soya mince is a good source of iron for those who want to avoid meat.
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24
Food groups: Foods and drinks high in fat and/or sugar
Foods in this group taste good and add extra interest to what we eat, but should not replace foods
from the four main food groups outlined earlier. They should form the smallest part of the overall diet.
What’s included
This group includes:
• spreading fats, such as butter, margarine and spreads;
• cooking fats, such as olive, rapeseed, sunflower, corn oils;
• cream, sour cream and crème fraîche;
• cakes, biscuits, pastries;
• crisps, corn snacks, roasted nuts;
• chocolate, sweets, cereal bars;
• puddings, jelly, ice cream;
• sugar, jam, honey;
• sugary squash and fizzy drinks, ice lollies.
Key nutrients
• Energy (calories) provided by the fat and sugar in these foods.
• Fat soluble vitamins (provided by the foods rich in fat):
-- Vitamin A (needed for growth, healthy eyes, a healthy respiratory tract (lungs and breathing
tubes), and digestive tract and maintenance of skin);
-- Vitamin D (needed to help absorb calcium and to build strong bones);
-- Vitamin E (to protect body cells from damage and reduce the risk of some cancers);
-- Vitamin K (for healthy blood).
• Essential fatty acids – necessary for brain development, retinal (eye) development and heart health
in later life.
Notes
Many of the foods in this group are high in sugar (eg sweets, chocolate, biscuits, cakes, puddings,
sugary drinks) and can cause tooth decay. Try not to offer these foods too often, and especially not
between meals, as this is when they are most damaging to teeth.
Many of the foods in this group are also high in fat, eg cooking and spreading fats, biscuits, cakes,
fried foods etc. Some fat is essential for everyone, but it is important to remember that too much fat (for
example by eating foods such as biscuits, cakes, fried food and chips frequently or in high amounts), can
lead to unwanted weight gain and increases the risk of health problems such as obesity and diabetes.
Young children under five years have high energy (calorie) needs in proportion to their small body size.
This means they need concentrated sources of calories, so the healthy eating advice for adults (for a
diet that is low in fat and high in fibre), is unsuitable for this age group.
Children under two years should be given the full-fat versions of foods such as spreads and butter
(from this food group) and full fat milk products such as whole milk and yogurts (from the food group:
milk and dairy foods). From two years onwards children can begin to move towards the healthy eating
guidelines, by having some of the lower-fat versions, eg semi-skimmed milk.
From five years onwards, children should follow the healthy eating guidelines set out for adults.
25
Planning meals and
snacks for children
The following points will be helpful when planning
meals for children.
• Children need to eat regularly and it
is recommended that they are offered
something to eat at least every three hours.
• All children need a breakfast – either at home
or provided in childcare.
• Children cared for all day will receive most
of their food whilst in childcare. The number
of meals and snacks provided will vary
depending on the length of time the child is
cared for. In general it is recommended that
children being cared for over a normal working
day receive at least one main meal and two
snacks. In some instances childcare providers
may also need to offer breakfast and/or an
evening meal.
• A variety of foods from the four main food
groups should be provided daily.
• A main meal must include a portion of food
from the following food groups:
• Choose combinations of colours to make
food look attractive. Three or four defined
areas of colour look good on a plate.
• A combination of different textures increases
appeal. Children will appreciate crispy,
crunchy, chewy, smooth and soft foods.
• Taste should be varied but meals containing
too many new flavours may not be
acceptable to children.
• Providing finger foods, as well as foods that
require cutlery, allows variation at mealtimes.
This is also a good way to encourage
children less than two years of age to eat
independently and to try new foods.
• Child-sized cutlery and crockery, and being
able to sit comfortably and safely at mealtimes
may make it easier for children to serve
themselves and learn to eat independently.
-- bread, rice, potatoes, pasta and other
starchy foods;
• Encourage children to try all the foods
offered but never force a child to eat.
-- fruit and vegetables
• Meals are social occasions, so try to sit with
children when they are eating and talk with
them. If possible, eat with them. This can be
used to help encourage good table manners
and if you are eating healthily it sets a good
example to the children.
-- meat, fish, eggs, beans and other non-dairy
sources of protein (see information on food
groups, pages 15–25)
• It is important to include 2–3 portions of
foods from the milk and dairy foods food
group, which can be given at either main
meals, snack times or a mixture of the two.
• Wherever possible healthier cooking
methods should be used, eg baking, boiling,
steaming, grilling, microwaving, etc.
26
• It is recommended that parents/guardians are
given the opportunity to discuss their child’s
food preferences and are kept informed
about meals and snacks offered.
• Some children eat slowly. It is important to
ensure that they are given enough time to eat.
• Avoid distractions such as television during
meals and snacks.
• Encourage children to try foods from other
cultures to promote a respect for other
cultures and traditions.
Meal and snack suggestions
Children need to eat a variety of foods every day
to ensure that they get all the nutrients they need
for healthy growth and development. This section
outlines a number of ideas for meals including hot
main meals, lighter meals, vegetarian choices and
desserts. Suggestions for between-meal snacks
and drinks are also included.
Main meal ideas include:
• Chicken casserole with leeks, carrots and
mashed potatoes.
• Chicken kebab with salad vegetables and
pitta bread.
• Chicken curry with rice/naan bread.
• Beef casserole with carrots and turnip, plus
boiled potatoes.
• Spaghetti bolognese* (add extra vegetables
into the bolognese sauce, eg mushrooms,
tomatoes, peppers, onions etc).
• Shepherd’s pie* (add onions and carrots to
the pie) served with cauliflower, broccoli or
green beans.
• Mince lasagne* with salad vegetables (add
grated vegetables eg onion, carrot, courgette
to the sauce).
• Beef stir-fry with noodles.
• Potato topped steak pie and turnip.
• Irish stew.
• Chicken and broccoli bake.
• Lamb casserole with baked potatoes and
peas or sweetcorn.
• Chicken fried rice (use a mixture of white and
brown rice).
• Pork, pineapple and pepper casserole served
with boiled rice.
• Chicken fajitas.
• Boiled ham with cabbage and boiled
potatoes.
• Tuna, sweetcorn and pasta bake with sliced
or cherry tomatoes.
• Grilled fish fingers with baked beans and
boiled potatoes.
• Fish in white sauce or oven-baked fish in
breadcrumbs with mashed potato and mixed
frozen vegetables.
• Roast pork or oven-baked pork steaks with
roast potatoes, broad beans or peas plus
gravy.
• Sausages, mashed potatoes, peas and onion
gravy.
• Fish pie (potato topping) with peas.
• Chickpea and vegetable casserole with
pasta.
• Oily fish (e.g. salmon) with champ and
broccoli or spinach.
• Vegetable lasagne with salad or vegetable
sticks.
• Kedgeree.
• Vegetable risotto (add onions, peas,
mushrooms, tinned tomatoes) topped with
grated cheese.
• Baked breaded fish with oven chips and
mushy peas.
• Roast chicken with carrots/parsnips and
roast potatoes.
• Savoury mince* with mashed potatoes,
frozen peas and sweetcorn.
• Homemade beef burgers* (grilled or oven
baked) with a wholemeal or white bap,
lettuce and tomato.
• Vegetable curry with rice/naan bread.
• Quiche with tomato and baked potato.
• Pizza with extra vegetable topping (eg
peppers, mushrooms, sweetcorn, onion).
*Soya mince or textured vegetable protein (TVP) may be used to
replace minced meat in these dishes.
27
Lighter meal ideas include:
• Sandwiches, paninis or tortilla wraps with
a variety of fillings, (for example egg and
onion, cheese and tomato, cold chicken,
beef or pork with salad vegetables, tuna and
sweetcorn) served with vegetable sticks and/
or slices of fruit.
• Baked potatoes with baked beans.
• Scrambled eggs on toast with tomatoes.
• Macaroni cheese with chopped fresh tomato.
• Omelette with added mixed vegetables
served with white, wholemeal bread or
wheaten bread.
• Homemade vegetable or lentil soup with
bread or rolls.
• Hummus on toast with sliced tomatoes and
cucumber and carrot sticks.
28
• Slice of tortilla (Spanish omelette) made with
egg, potato, mixed vegetables and chopped
ham, served with salad vegetables.
• Mini-pizza using a soda farl sliced in half and
topped with chopped tomato and cheese.
• Tuna melt made with tuna, chopped pepper,
sweetcorn and grated cheese.
• Couscous with roasted vegetables.
Note: These, or similar ideas, can be used as
substantial afternoon snacks if a child is not
picked up until late in the evening and their
evening meal is delayed.
Dessert ideas include:
• Chopped fresh or tinned fruit on its own or
with natural yogurt or fromage frais.
• Baked apple with custard.
• Ice cream with tinned fruit.
• Fruit crumble with custard.
• Fruit salad.
• Rice pudding and tinned peaches.
• Milk-based instant dessert with banana.
• Kiwi fruit served in an egg cup.
• Sponge pudding topped with tinned fruit and
fromage frais.
• Bread and butter pudding.
• Fruit jelly.
Snacks
Young children need snacks between meals, as
they are not usually able to eat enough at mealtimes
to meet their needs for energy (calories). The best
snacks are those which are sugar-free or low in
added sugar and packed with nutrients. However,
it is important to ensure that children are not
allowed to snack freely throughout the day as this
can reduce the amount that they eat at mealtimes
and also increase the risk of tooth decay. A variety
of snacks should be offered, for example:
• Toast or bread: offer wheaten, wholemeal,
white, granary, potato bread, soda bread,
scones, crumpets, bread muffins or pancakes
with a little butter or spread. Avoid using
sugary spreads, such as jam, honey or
chocolate spread.
• Sandwiches: suitable fillings include sliced
banana, spreading cheese, egg, tomato, tuna
and lean meat such as ham, chicken or turkey.
• Pieces of fresh fruit: try sliced or chopped
apples, bananas, pears, kiwi fruit, grapes,
tomato and other seasonal fruits. Dried fruit
is not recommended as a snack between
meals as it contains concentrated sugar and
may cause tooth decay. However, it can be
included in main meals.
29
• Raw vegetables: carrot, cucumber, peppers,
celery can all be sliced up or cut into sticks.
• Natural yogurt or plain fromage frais –
chopped fruit (eg banana, apple or mandarin
orange) can be added to plain unsweetened
yogurt. Fruit tinned in its own juice rather
than syrup can also be used.
• Cereal and milk: offer unsweetened varieties,
eg Weetabix, Cornflakes, Ready Brek, Puffed
Wheat.
Foods and drinks which are high in sugar, eg
sweets, biscuits, sweetened yogurts and
desserts, are most damaging to teeth when they
are taken between meals. This doesn’t mean that
they should never be taken, but they are less
damaging to teeth if they are taken at the end of
meals.
If you choose to offer biscuits occasionally, eg
once or twice a week, these should be plain
without chocolate or cream, eg Rich Tea, cream
crackers or Digestives.
Drinks
• Milk or water is the recommended drink for
young children.
• Pure unsweetened fruit juice, well diluted
(one part juice to ten parts water) can be
given at main meals.
• Sweetened juices, squashes and minerals/
fizzy drinks are not recommended. If used,
they should be confined to main meals
and squashes and juices should be well
diluted. Sugar-free drinks contain artificial
sweeteners, which are not recommended for
young children.
• Children should be introduced to a cup from
six months to protect their developing teeth.
From one year, all drinks should be from a
cup and the use of a feeding bottle should be
discontinued.
30
Note: It is recommended that these snacks and
drinks should also be provided to any
older children who are cared for after school.
For guidance on suitable snacks and drinks for
infants up to 12 months refer to pages 13 and 14.
Sample menu for a full day
The sample menu below shows an example of how a child’s daily nutritional requirements could be met.
Monday
Breakfast
Porridge with
sultanas and milk
Glass of pure
orange juice, well
diluted
Mid morning
snack, eg at
10.00am
Tuesday
Weetabix with
sliced banana
and milk
Glass of pure
orange juice, well
diluted
Wednesday
Thursday
Friday
Rice Krispies with
milk
Ready Brek with
chopped apricots
and milk
Corn Flakes with
milk
Slices of apple
Glass of pure
apple juice well
diluted
Glass of pure
orange juice, well
diluted
Mandarin orange
Glass of pure
orange juice, well
diluted
Milk
Milk
Milk
Milk
Milk
Wholemeal toast
Tinned fruit (in its
own juice)
Whole milk
yogurt
Pancakes
Whole milk
yogurt
Kiwi fruit
Finger food
selection eg
slices of grapes,
celery, red
pepper, tomatoes
Fish pie
Roast chicken
Irish stew
Vegetable curry
Lasagne
Peas
Mashed potatoes
Mixed vegetables
Sweetcorn
Salad vegetables
Rice pudding
Cabbage
Milk fruit jelly
Naan bread/rice
Apple purée
Fruit crumble and
custard
Stewed fruit and
custard
Midafternoon
snack, eg at
3.00pm
Milk
Milk
Milk
Milk
Milk
Vegetable sticks
Plain popcorn
bread muffin
toasted
Breadsticks
Fruit
Cheese sticks
Whole milk
yogurt
Tea, eg at
5.00pm
Sandwiches, eg
egg, onion and
tomato
Spanish omlette
(onions, tomatoes
and potatoes)
Baked beans
Sweetcorn
Cheddar cheese
Couscous
salad (salad
vegetables, mixed
beans)
Semolina and
tinned pears (in
their own juice)
Dried fruit
Sliced hardboiled
egg
Whole milk
yogurt
Jelly and tinned
mandarins
Banana
Lunch, eg at
12 noon –
1.00pm
Water
and milk
available to
drink
Water
and milk
available to
drink
Sliced pear
Fruit salad
Banana
Banana and
custard
Tuna and
sweetcorn pasta
Vegetable sticks
Fromage frais
and raisins
Toast
Apple slices
31
Children with
individual
dietary needs
Childcare providers may care for children with a variety of dietary requirements. The most common
are outlined below. You should discuss each child’s particular needs with the parents. More detailed
information and advice is available from either the child’s health visitor or local registered dietitian. The
Early Years Team or the child’s health visitor can put you in contact with a registered dietitian.
Children following a vegetarian diet
People who follow vegetarian diets may eat or exclude a variety of different types of food. If you are
caring for a child who is following a vegetarian diet it is essential to discuss with a parent what foods
the child can eat. For example, some children may avoid only red meat, but eat chicken, fish, eggs, milk
and dairy products such as cheese or yogurt, whereas strict vegans exclude all foods of animal origin.
A vegetarian diet is a healthy diet providing that a wide variety of foods from all main food groups are
eaten. When meat and animal products are excluded from meals it is important that the nutrients they
provide are obtained from other foods. Vegetarian sources of protein should be provided at each meal.
For more information and meal suggestions, refer to the notes on pages 22 (Meat, fish, eggs, beans
and non-dairy sources of protein) and 27 (main meal ideas).
To ensure that all nutrients are provided by vegetarian choices, a vegetable source of protein (eg
pulses such as dried peas, beans and lentils) should always be eaten with a grain/cereal food (eg
bread, rice, pasta), for example, chickpea casserole with pasta, lentil stew with rice or beans on
wholemeal toast.
Note: Nuts are also a vegetable source of protein. However whole nuts should not be given to under
fives because of the risk of choking. It is also advised that peanuts and products containing them are
not used within the childcare setting – refer to the section on peanut allergy on page 33.
32
Children from ethnic communities following a traditional diet
When planning menus, childcare providers must accommodate the traditions and customs of ethnic
communities. Childcare providers should take parental guidance on special dietary requirements as
some families follow these traditions more strictly than others. Details of the foods traditionally avoided
by particular groups are shown below:
• Hindus do not eat beef and most are vegetarian. Periods of fasting are common.
• Sikhs do not eat beef and many are vegetarian. Meat must come from other animals killed by ‘one
blow to the head’.
• Muslims do not eat pork, pork products or shellfish. Meat from other animals must be halal (killed
in accordance with Islamic law). Uncertainty about the content of other foods would mean their
exclusion from the diet, eg pastries and puddings which may contain pig fat. Many savoury baby
products contain meat which is not halal, and these products are unacceptable to Muslims.
Muslims observe regular periods of fasting, including the month of Ramadan.
• Jews do not eat pork. All other meat must be kosher (ie slaughtered according to Jewish law).
Meat and dairy foods must not be consumed together. Only fish with scales and fins are eaten.
Products from animals that have not been prepared by the kosher method are also avoided, eg
gelatine, animal fats. Jewish children should not be offered cheese that contains rennet or biscuits
that contain animal fat.
• Rastafarians do not consume any animal products except milk. No canned or processed foods
may be eaten and no salt may be added to food. Food should be organic.
• Chinese people generally exclude dairy produce. The Chinese community also believes that good
health depends on a balance of two opposite elements in the body: yin (referred to as ‘cold’) and
yang (referred to as ‘hot’). Infant formula milk is regarded as ‘very hot’. Where a mother has chosen
to bottlefeed her baby, she may want to give her baby ‘cooling’ drinks such as cooled boiled water.
Children with special dietary needs
Providing special diets
Special diets for children with coeliac disease (a gluten-free diet), diabetes or those who need to avoid
milk or nuts and all products made from them can be quite complex. Parents should be able to provide
a diet sheet about their child’s specific dietary needs which has been prepared by a registered dietitian.
Food allergy
Many parents believe that their child is sensitive to certain foods. However the true incidence of food
allergy is likely to be much lower than reported. Parents requesting special diets for their children
because of food allergy should be encouraged to seek medical advice. It is unwise to restrict food
choice among young children without professional help and advice.
Peanut allergy
Peanut allergy is usually severe – sensitive individuals may even react to peanut dust. All nuts and nut
products must be avoided, including peanut butter. Care should also be taken to prevent accidental
consumption of food containing nuts or nut products or food that has come into contact with them.
As a precautionary measure, it is recommended that childcare providers should not provide
peanuts or foods containing them, eg peanut butter, to any child in their care.
33
Children with peanut allergy are advised to carry identification and may require a pre-filled syringe of
adrenaline (eg epipen) which can be administered if they have a reaction.
Recent advice from the Department of Health states that if there is a family history among parents,
brothers or sisters of conditions such as asthma, eczema or hay fever, parents should speak to their
GP, health visitor or medical allergy specialist before introducing peanuts to the child for the first
time.† It has also been advised that those children who are breastfed should be breastfed throughout
weaning and that high-allergen foods* should be introduced one at a time so that if a reaction occurs
the specific food causing the response can easily be identified.
* High-allergen foods include; milk, eggs, fish, shellfish, wheat, soya, peanuts, tree nuts, sesame seeds, celery and mustard.
Fussy eaters
It is quite normal for an infant or child to refuse a food occasionally. However, if a child continually
refuses food, the parent or guardian should be informed. If a child refuses a snack or meal, gently
encourage them to eat. If they refuse to eat even after gentle encouragement, the following
suggestions may be helpful.
• Remove the food without making a fuss or passing judgement and offer food at the next meal or
snack time.
• Keeping your attitude friendly and relaxed will help children to feel that eating is a pleasurable way
to satisfy hunger rather than a battleground.
• Small helpings may be better accepted. Second helpings can then be offered if appropriate.
• Do not try to bribe children to eat food they do not want with the reward of a pudding or sweet snack.
• It may be useful to adopt the approach that a food refused is ‘not liked today’. If a food is refused,
try it again a few days later; changing the form a food is given in may make it more acceptable (eg
offering tinned tomato in bolognese sauce instead of tomato sauce on a pizza).
• Consider possible reasons for the food refusal, such as drinking continually throughout the day, or
frequent large snacks between meals, as both of these can reduce the appetite for main meals.
• Never force a child to eat.
†
Statement of the review of the 1998 COT recommendations on peanut
avoidance last accessed 25.6.2012
http://cot.food.gov.uk/pdfs/cotstatement200807peanut.pdf
34
Food safety
Food safety is an important issue when caring for the under fives. The areas where food is stored,
prepared and served should be safe, clean and hygienic. Extra care is needed for babies and young
children as they may have a lower resistance to food poisoning.
Listed below are some general points on food safety:
• Always wash hands (yours and the children’s) with soap and warm water before and after
handling food and always after touching the dustbin, pets, changing nappies or going to the toilet.
• Keep your kitchen clean and dry.
• Don’t use the same knife or chopping boards for raw meat, cooked food and fresh vegetables
without washing them between times. Ideally, keep a separate chopping board for raw meat.
• When shopping, take chilled or frozen food home as quickly as possible.
• Keep your fridge/freezer at the correct temperature – get a fridge thermometer. Fridges should be
kept at 5°C or below and freezers at –18°C or below.
• If parents are supplying food for their children, make sure anything perishable is stored in the
fridge straight away.
• Cook food thoroughly.
• Do not eat or serve raw eggs.
• Store raw and cooked food separately.
• Check use-by dates and always use food within the recommended time.
• Reheat food thoroughly and do not reheat it more than once.
• Keep pets and their feeding bowls out of the kitchen.
Note: More detailed information and advice on food hygiene is available from the environmental health
department of your local district council.
See page 14 for information on breast and formula milk. Further advice and information on bottle
feeding including preparing feeds safely, sterilising equipment and practical tips can be obtained
from either the child’s health visitor, the Early Years Team or the Public Health Agency’s leaflet,
Bottlefeeding which can be accessed at:
http://publichealthagency.org/sites/default/files/Bottlefeeding_2_2014.pdf
35
Rewards and
celebrations
Rewards for good behaviour and the celebration of special occasions,
such as birthdays, often involve sugary foods and drinks. The frequent
consumption of sugary foods and drinks can adversely affect dental
and general health; therefore they should be limited.
Encouraging good behaviour
Children should be given encouragement for good behaviour. This can be in the
form of smiles or praise, or simply giving the child attention. This form of positive
encouragement is preferable to the practice of giving items such as sweets,
chocolates, small toys etc.
Parties and special occasions
Depending on how frequently these are celebrated you may want to try some of the following:
• Discuss with parents what foods and drinks are appropriate for them to provide – encourage
healthier choices.
• Offer some ideas for healthier party food, for example:
- sandwiches cut into fancy shapes;
- finger sized pieces of pizza and quiche;
- cocktail sausages (oven-bake on a rack to allow fat to drain away);
- plain, unsalted popcorn;
- birthday cake (a plain sponge cake decorated with fruit by the birthday child);
- fruit punch (diluted pure fruit juice – 1 part juice to 10 parts water – with chopped fruit added);
- fruit and raw vegetables cut into fingers or fancy shapes.
• Focus on the sense of occasion rather than simply the supply of party food.
• Hold a theme party and encourage children to dress up. Theme days can also be used to
encourage children to try foods from other cultures, and to promote a respect for other cultures
and traditions, eg St Patrick’s Day, American Independence Day (4th July) , Pancake Tuesday,
Indian festival of lights (Diwali), Chinese New Year etc.
• Encourage children to play active party games, eg musical statues; blind man’s bluff; musical
chairs; have a mini disco.
36
Physical activity
for children
There is good scientific evidence that being physically active is good for our health. For children and
young people, being active has a wide range of benefits, for example it:
• helps to develop physical skills such as agility, balance and coordination;
• builds up muscle strength and overall fitness;
• helps them develop social skills;
• helps them to avoid becoming overweight or obese;
• improves concentration in school;
• contributes to a healthy appetite;
• helps to reduce the risk of ill health in later life.
New UK-wide Chief Medical Officer guidelines were published in 2011, which set out
recommendations for physical activity for all age groups. These recommend that:
• children should be encouraged to be active from birth, particularly through floor-based play and
water-based activities in a safe environment;
• all children of pre-school age, who are able to walk without help, should be active for at least
180 minutes each day, spread throughout the day;
• the amount of time that young children are inactive, either restrained (eg in a high chair or car
seat) or sitting (except time spent sleeping) should be kept to a minimum.
37
It has been shown that children who develop an
active lifestyle when they are young are more likely
to maintain a healthy active lifestyle as they get
older. They should be encouraged to be active all
year round and not just in the summer months. Visits
to parks and play areas, going for walks and playing
games both outdoors and indoors should all be
encouraged.
Outdoor play provides great opportunities for
learning, for example children can learn about
the environment around them. Playing with other
children can develop their social skills and help
build their confidence. Childcare providers
should ensure that children have access to
outdoor play every day.
Exposure to summer sunlight in outdoor play helps
to ensure an adequate supply of vitamin D, which is
essential for healthy bone development. Childcare
providers should agree guidelines with parents on
how long children can remain outdoors and on the
use of sunscreens and protective clothing such as
sun hats. Babies under one year should be kept
out of the sun. Older children should be kept in the
shade during the hottest part of the day, between
11.00am and 3.00pm.
38
Preparing a
nutrition policy
Developing a nutrition policy is an excellent way to demonstrate your commitment to the children in
your care. It also provides an opportunity to ensure that the recommendations and advice about healthy
eating are agreed between you and the children’s parents or guardians.
Writing a nutrition policy is not as difficult as it may sound. Most childcare providers will have a number
of unwritten ‘rules’ about eating and drinking. Developing a policy is just a way of recording these
‘rules’ and provides an opportunity for you to discuss healthy eating with parents and how it will apply
to their child/children.
A policy may also be useful in cases where parents are providing their own food. It could, for example,
be used to agree suitable alternatives should a child refuse the food the parent has provided. A policy
should not be seen as fixed, but open to regular review.
Some suggestions about the type of information that could be included in such a policy are outlined
below.
Introductory statement
I aim to offer a high quality service to the children I care for and their parents.
I recognise the need to encourage healthy eating habits from an early age to help children to reach
their full potential in terms of growth and development.
Meals
• Well-balanced and nutritious meals are provided for the children.
• All puddings provided are based on fruit and/or milk.
• Fresh fruit is always available.
• Processed meat products such as sausages, chicken nuggets, burgers and fish bites, if provided,
are limited to once a week.
• Healthier cooking methods are used, eg boiling, grilling, steaming, microwaving, stewing, rather
than frying.
• Special diets are respected. Parents will be asked to provide a copy of the diet sheet from a
registered dietitian or specific guidance in agreement with the child’s doctor.
• Cultural dietary habits are respected. Parents should provide details of these.
• Mealtimes are used as an opportunity to encourage good table manners. For example, whenever
possible children and adults eat together.
39
Snacks and drinks
• Snacks provided are healthy and nutritious.
• Sweets and fizzy drinks are not routinely offered.
• Where possible, snacks are sugar-free to avoid causing damage to teeth.
• Fresh fruit is regularly offered as a healthy snack.
• Whole milk or water is provided for children as a drink between meals.
• If juices and squashes are given, these are well-diluted and only given at mealtimes to avoid
causing damage to teeth.
For more ideas of what could be included see sections on Snacks and drinks on pages 13–14 and
29–30.
Rewards and special occasions
• Praise and attention are used to help develop children’s self-esteem and to act as a positive
reward for good behaviour.
• If other forms of reward are used, they do not conflict with the healthy eating principles that are in
everyday use. For example, sweets and sugary drinks are not given as rewards.
• On special occasions the focus will be on the occasion rather than providing fatty or sugary foods
or drinks.
For more ideas of what could be included see Rewards and celebrations, page 36.
Activities
A healthy lifestyle is promoted through a variety of activities including active play, outings, cookery,
stories, music, etc.
40
Nutrition
checklist
This checklist has been provided to help childcare providers see at a glance that they are providing
a healthy diet for the children in their care. As there is a great variation in the number of meals and
snacks that children receive while in childcare, the checklist covers meals and snacks provided over a
full day – select the ones which are relevant to you.
This can also be used on its own or with a nutrition policy, to show parents what food/meals are
provided, or as an agreement for an individual child which could include likes and dislikes or any other
relevant information about the child’s eating habits. It is important to vary the meals and snacks served
over the week, and between weeks, to ensure that children get the opportunity to try a variety of foods.
Yes
No
Comments
Breakfast
Bread or toast is always available.
Cereals are always available (unsweetened
breakfast cereals are preferred, eg porridge,
Weetabix, Cornflakes, Rice Krispies).
Suitable choices are provided for babies
and infants.
Midday meal
One portion of food from the Meat, fish,
eggs, beans and other non-dairy sources of
protein group is provided.
At least one portion from the Fruit and
vegetables group is provided.
At least one portion is provided from the
Bread, rice, potatoes, pasta and other
starchy foods group.
Desserts are based on fruit and/or milk.
(See pages 43 and 44 for details of food groups)
41
Yes
Evening meal (if provided)
One portion of food from the Meat, fish,
eggs, beans and other non-dairy sources of
protein group is provided.
At least one portion from the fruit and
vegetables group is provided.
At least one portion is provided from the
Bread, rice, potatoes, pasta and other
starchy foods group.
Desserts are based on fruit and/or milk.
(See pages 43 and 44 for details of food groups)
Snacks between meals
Morning and afternoon snacks are served at
regular times.
Recommended snacks include:
- bread*, toast*, scone*, pancake*, crumpet*,
bread muffin*;
- sandwiches (eg meat, cheese, egg, fish);
- fresh fruit;
- raw vegetables;
- cheese;
- natural yogurt, unsweetened fromage frais;
- low-sugar cereal and milk.
(*all served without jam, honey, marmalade, chocolate
spread).
Children are not encouraged to snack freely.
Suitable snacks are served for infants.
Drinks
These are sugar free.
Water and milk are the most suitable drinks
at all times.
Unsweetened pure fruit juices and squashes,
if used, are well diluted (1 part juice to 10
parts water) and only given at mealtimes.
42
No
Comments
Yes
No
Comments
Milk and dairy foods
300–600ml (½–1 pt) of milk per day is
provided for each child
or
2–3 portions of milk-based foods are
provided each day. One portion is 25g (1oz)
of hard cheese or 125g carton of yogurt or a
bowl of milk pudding.
Breastmilk or infant formula is provided as
the main drink for infants under 12 months.
Meat, fish, eggs, beans and other
non-dairy sources of protein
One portion of food from the Meat, fish, eggs,
beans and other non-dairy sources of protein
group is provided at each main meal, eg: beef,
lamb, pork, liver, kidney, ham, poultry, fish,
fish fingers, egg*, cheese*, beans*, lentils*,
Quorn*, Tofu*, TVP* (*suitable for vegetarians).
Red meat should be included at least twice
a week as it is a good source of iron.
Mince is acceptable as red meat.
Processed meat products, eg sausages,
burgers, sausage rolls, fish/chicken nuggets
are served no more than once each week.
Cultural and religious preferences are
catered for where appropriate.
Bread, rice, potatoes, pasta and other
starchy foods
A variety of these foods is offered, eg bread,
pasta, rice and potatoes.
At least one portion is included at each meal.
Extra servings are available if the child is hungry.
Mashed potatoes are made with fresh
potatoes and milk rather than instant potato.
Chips or roast potatoes are served a
maximum of once a week.
43
Yes
Fruit and vegetables
A total of five child-sized portions should be
provided over the day, three of which should
be provided in childcare.
A child’s portion is smaller than an adult’s,
eg ½ piece of fresh fruit, 1 tablespoon
cooked vegetables.
A variety of types is included.
A vitamin C rich fruit is included daily, eg
orange, kiwi fruit or strawberries.
Desserts
Desserts served at main meals are milk or
fruit based (preferably both).
Milk pudding is provided at least three
days per week, eg custard, semolina, rice
pudding, instant whipped dessert, yogurt.
‘Ready to eat’ custard or rice are suitable
choices.
Fruit is also included in the dessert at least
three days per week.
Fruit-based desserts include fruit crumble,
fruit sponge, fruit tart, fruit jelly, stewed fruit.
A variety of desserts is included over the
menu cycle.
Spreads
Low fat spreads are not used.
Salt
No salt is added at the table.
The minimum possible amount of salt is
used in cooking. If stock cubes are used,
salt is not added in cooking.
44
No
Comments
Contacts for
more information
Enquiries should, in the first instance, be directed to the Early Years Team in your local area. They can
put you in touch with other health professionals such as community dietitians and dental staff. Health
visitors can be contacted directly with the parent’s permission. The Northern Ireland Childminding
Association is another source of information, training and support for childminders.
Belfast Health and Social Care Trust
Early Years Team
124 Stewartstown Road
Belfast
BT11 9JQ
Tel: 028 9504 2811
Northern Health and Social Care Trust
Causeway Early Years Team
1st Floor
Route House
8e Coleraine Road
Ballymoney
BT53 6BP
028 2766 1340
Ballymena Early Years Team
Raphael House
11B Fenaghy Road
Galgorm
Ballymena
BT42 1HW
Tel: 028 2563 5110
Magherafelt/Cookstown Early Years Team
Magherafelt Community Health Clinic
44 King Street
Magherafelt
BT45 6AH
Tel: 028 7930 2628
Carrickfergus Early Years Team
Ellis Street
Carrickfergus
BT38 8AZ
Tel: 028 9331 5112
Southern Health and Social Care Trust
Early Years Team
Lisanally House
87 Lisanally Lane
Armagh
BT61 7HW
Tel: 028 3752 0616
Early Years Team
The Bungalow
Lurgan Hospital
100 Sloan Street
Lurgan
BT66 8NT
Tel: 028 3831 6691
Early Years Team
Drumalane House
Drumalane Road
Newry
BT35 8AP
Tel: 028 3082 5098
45
South Eastern Health and Social Care Trust
Early Years Team
Ward 25
Downshire Hospitals
Ardglass Road
BT30 6RA
Tel: 028 4451 3807
Western Health and Social Care Trust
Early Years Services
Clooney Hall Centre
36 Clooney Terrace
Londonderry
BT47 6AR
Tel: 028 7132 0950
Early Years Team
Tyrone and Fermanagh Hospital
Omagh
BT79 ONS
Tel: 028 8283 5108
Early Years Team
2 Coleshill Road
Enniskillen
BT74 7HG
Tel: 028 6634 4000
Northern Ireland Childminding Association
(NICMA)
16–18 Mill Street
Newtownards
BT23 4LU
Tel: 028 9181 1015
www.nicma.org
46
Early Years – the organisation for young
children
6c Wildflower Way
Apollo Road
Boucher Road
Belfast
BT12 6TA
Tel: 028 9066 2825
ww.early-years.org
47
Tel: 0300 555 0114 (local rate). www.publichealth.hscni.net
06/16
Produced by the Public Health Agency, 12–22 Linenhall Street, Belfast BT2 8BS.
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