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nutritional guidance for early years:
food choices for children aged 1-5 years in early education
and childcare settings
3 additional information
3.1 Physical activity
Physical development and movement is a key aspect of a
child's development and learning (Scottish Office, 1999).
All children, including children with disabilities, should
have the opportunity to be physically active and the pre-5
setting plays a key role in contributing to the minimum
recommendation for at least one hour a day. Young children,
given the chance, will be physically active as part of
spontaneous play - this play allows them to have fun as
well as to develop/enhance physical and social health.
Children should be encouraged to be physically active
and carers should plan opportunities for structured
activity and unstructured active play. Having access and
opportunity to a range of physical activities encourages
young children to develop positive attitudes to the
benefits of physical activity.
Staff and carers should ensure that activities are
developmentally appropriate to the age and stage of a child
and ensure that links are made with the
Curriculum Framework for Children 3 to 5.
3.2 Drinks
It is important for infants and young children to have
plenty of fluids to drink to help their body to function
properly, keep cool and prevent constipation.
- Children should be encouraged to drink water if
they are thirsty. Water quenches thirst, replenishes
body fluid, does not spoil the appetite and is safe for
their teeth. Milk and water can be taken between meals
and cool drinking water should be made available to all
children, at any time throughout the day.
- After 1 year of age whole cows milk should be the
main drink until the child is at least
2 years old. After age 2, semi-skimmed can be
introduced gradually as a main drink, provided the
child is eating well, with enough energy and nutrients
from a varied diet. Fully skimmed milk is low in energy
and low in some nutrients and for this reason is not
suitable as a drink for children under the age of
5. - Remember that cows and goats milk are unsuitable as
the
main milk drink for children under one
year. However, cows milk can be given as part of
milk-based dishes, e.g. yoghurt, custard, rice pudding
and white sauce.
- Fresh fruit juice is a good source of Vitamin C and
is best given with breakfast or a main meal to help
with the absorption of iron. Fresh fruit juices are
quite acidic so can be harmful to teeth and should be
diluted with water (1 part juice to a minimum of 5
parts water). Juice should be served in a cup rather
than a bottle and preferably taken with other food, to
minimise the risk of tooth decay.
- Children should be discouraged from frequent
consumption of sugared or fizzy drinks. Unsuitable
drinks include: fizzy (carbonated) drinks, still sugary
drinks, squashes, sugared and fizzy waters. These
contribute to dental problems, are a poor source of
nutrition, tend to displace other more nutritious foods
and can result in poor energy balance. If children have
these drinks they should be diluted one part to ten of
water.
- Tea and coffee are not recommended for children
under 5 as the tannin present can interfere with the
absorption of iron.
3.3 Snacks
Children need a varied diet to ensure they get all the
nutrients they require for growth and development. Nursery
aged children often have small appetites and need regular
meals with snacks in between. Snacks should be as
nutritious as possible and low in free sugars to prevent
tooth decay. Chocolate bars, sweets, cereal bars and sweet
biscuits should be saved for after mealtimes and as treats
rather than offered between meals.
Here are some suggestions for nutritious snacks:
- Fruit - mouth size chunks, cubes or slices of
apple, pear, satsuma, orange, banana, kiwi, melon,
strawberries, grapes, peaches and plums.
- Raw vegetables - carrot, pepper, celery, cucumber,
cherry tomato, red cabbage, turnip, radish, courgette,
broccoli.
- Toast, breads, rolls, baps, french bread with a
small amount of butter or spread. Mini sandwiches with
marmite, cheese, tuna or thin slices of meat. Pitta
bread pockets - cut into small slices; plain or with
fat spread high in monounsaturated or polyunsaturated
fat, e.g. sunflower or olive spread.
- Bread sticks - on their own or with a dip or soft
cheeses, home-made pizza triangles.
- Oatcakes, rice cakes, crackers, crispbreads, melba
toast; plain or with butter or spread high in
monounsaturated or polyunsaturated fat, e.g. sunflower
or olive spread.
- Natural yoghurt with fruit or fromage frais - on
its own or as a dip.
- Muffins, plain, potato or cheese scones, crumpets,
pancake, plain buns, plain popcorn, low sugar breakfast
cereal.
Note: Crisps or corn snacks, e.g. Quavers, Golden
Lights, Wheat Crunchies, Tortilla Chips or Twiglets - these
can be offered as part of a snack or meal option as an
alternative texture and taste, e.g. beside a filled
sandwich or salad dish. However, they are high in salt and
fat and young children should only be given a small portion
(e.g. 15-20g) about twice in the week.
3.4 Vegetarian and vegan diets
Vegetarians don't eat fish or meat, but most will eat
animal products, such as eggs, milk and dairy products.
Using the menu guidance provide food from the main food
groups. Choose alternatives to meat such as eggs, soya
products such as tofu and humous, lentils, beans including
baked beans, chopped nut and nut pastes, seed pastes such
as in humous, meat substitutes such as soya mince or Quorn,
chick peas, e.g. falafel.
Vegetarian meals and snacks are suitable for all
children.
- Vegan diets do not include any food from animal
sources, therefore in addition to meat and fish they
exclude dairy produce, eggs and honey. In this
situation meeting the nutritional needs of the child is
more complex and should be discussed with the parents
and guardian.
Meeting iron requirements on a vegetarian
diet
As meat is one of the main sources of iron it is
important that vegetarian and vegan children eat other iron
rich foods such as wholemeal bread, breakfast cereals,
pulses, beans, peas, dried fruits, fortified cereals and
dark green vegetables, broccoli, tinned sweetcorn, baked
sweet potato. Tea and coffee reduce the uptake of iron in
the body and for this reason are not suitable for young
children. Fresh fruit and fresh fruit juice are rich in
Vitamin C. Vitamin C enhances the uptake of iron in the
body when taken along with iron rich foods.
3.5 Food choices and religious faiths and
beliefs
Families and children may choose to exclude, include or
prepare foods in a particular way according to their
religious faith and belief. There may be individual
differences in food choices between families of a similar
faith and these should be checked for each child with his
or her parent or guardian from the outset.
3.6 Children with special needs or therapeutic
diets
Children with special needs may have a particular
problems associated with eating. It is important that
anyone involved in caring for children with eating
difficulties is trained to give the most appropriate
assistance. These problems should not be a barrier to
enjoyment and learning about healthy eating.
For a special or therapeutic diet, a parent/guardian or
Registered Dietician will supply the staff or carer with
details of the child's dietary needs. Early years staff,
carers and caterers should be appropriately advised of the
specific nature of the dietary requirements, including
suitable food choices for meals and snacks and any foods,
which should be excluded.
Food allergies are not uncommon in pre-school age
children. There are foods which are more commonly
associated with allergy in children: these are milk, wheat,
peanuts, fish, soya, eggs, shellfish and citrus fruits. A
wide range of symptoms can occur if a child is exposed to
an allergen in food, ranging from a mild reaction to a very
rapid and severe response.
Allergy to some foods for some children, e.g. peanuts,
peanut products, other nuts and shellfish can be
particularly serious. Children who are known to suffer from
a severe food allergy need to know the exact ingredients in
their food to avoid an acute, potentially fatal reaction.
When a child has a severe allergy to a particular food the
staff or carer may decide to minimise the risk of exposure
in the child's environment, as far as is possible, e.g.
avoid having the food/ingredient in the nursery at snack or
meal times, incorporating information into the local policy
with regard to food brought into nursery. In this situation
it is important that advice is taken from a Registered
Dietician.
3.7 Oral and dental health for toddlers and
pre-school children
Staff and carers can work with young children and
parents to help develop good oral and dental health
habits.
The three most important points in promoting healthy
dental habits are:
- choosing foods low in added sugar - if choosing
sugary foods or drinks have them as part of a
meal.
- Tooth brushing - teach children to use a toothbrush
as early as possible.
- having check-ups with a dentist - parents should
register their child with a dentist providing NHS care,
where treatment is free up to the age of 18 years.
Tooth brushing
Parents and carers should begin tooth brushing as soon
as teeth appear. Twice daily tooth brushing with a soft
'baby' toothbrush and fluoride toothpaste is important to
prevent tooth decay. A smear of toothpaste should be used
for babies and a small pea-sized amount for toddlers and
older children. Help children with tooth brushing until
they are around
6-8 years old.
Registering with a dentist
If parents have not registered their child with a
dentist before leaving them in your care, ask them to do
so. If they cannot register with a NHS dentist, then the
Community Dental Service may be able to help. Children
should visit a dentist for regular check-ups as early as
possible and certainly before the age of 2 years.
3.8 Vitamin supplementation
Some children may receive vitamin drops, containing
Vitamins A, D and C. This is the responsibility of parents
and guardians and can be discussed with them. However, it
may be helpful for early years staff and carers to be aware
of current advice on children who may benefit from vitamin
drops.
For children aged 1-5 the current advice for vitamin
supplementation is to take Vitamins A, D and C.
10,11 Children at risk of vitamin deficiency include: those
who are persistent poor eaters and those who consume a very
limited number of foods; children on restricted diets of
choice, e.g. vegan or exclude food items for management of
allergy or intolerance.
Children at risk of Vitamin D deficiency specifically
are those living in northern latitudes (Scotland) and those
from traditional Asian or Islamic communities (this is
particularly important in Scotland in the winter months
12 (see Annex 2)).
There is no recommendation to give young children aged
1-5 years other more complex multi vitamin and/or mineral
preparations unless they are on a special or therapeutic
diet and then should be advised by a Registered
Dietician.
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