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CHCCN303A: Contribute to provision of nutritionally balanced food in a safe and hygienic manner

Plan food and drink provision

Contents

Within scope of own work role, ensure children are provided with food and drink consistent with current relevant dietary guidelines for infants, children and/or young people

Essential nutrients

Nutritional requirements during infancy

Nutritional requirements of toddlers

Nutritional requirements of preschool children

Nutritional requirements of school age children

Calorie intake and dietary guidelines

Ensure children’s individual needs are met to promote optimal growth and development, respecting cultural requirements, appetites, and food and drink preferences

Religious influences on food

Cultural influences on food

Accommodating children’s food and drink preferences

Encourage children to develop healthy eating habits

Helping children develop an awareness of healthy food and drink choices

Ensure meals and snacks are nutritious, attractive and an appropriate serving size for children

Making food appetising and attractive to children

Promote healthy eating through role modelling, positive food awareness and mealtime experiences

Supervising children when they are eating and drinking

Provide education and support to families and children around healthy eating, including how to foster this

Supporting healthy eating in children’s services

Plan and develop cycle menus of foods for each meal and/or snack to display for information of staff, parents and older children

2 Certificate III in Children’s Services: CHCCN303A: Reader LO 9203 © NSW DET 2010

Where should my menu planning begin?

Nutrition information panels and food labelling

Within scope of own work role, ensure nutrition policy includes identification, management and monitoring of special dietary needs related to food allergies and medical food conditions such as coeliac disease and diabetes

Addressing children’s health needs

Certificate III in Children’s Services: CHCCHILD401A: Reader LO 9203 3© NSW DET 2010

Within scope of own work role, ensure children are provided with food and drink consistent with current relevant dietary guidelines for infants, children and/or young people

Essential nutrientsFood is composed of various nutrients. Nutrients are the essential food components or elements required for healthy growth. They are the substances in food that supply energy and nourish the body.

There are approximately 50 nutrients known to be essential to humans for healthy development and growth. These essential nutrients must be provided by what we eat because the body is unable to manufacture them in adequate amounts for good health and maintenance of normal bodily functions.

There are six categories of essential nutrients required for health, growth and development. They are:

proteins fats carbohydrates vitamins minerals water

Role of nutrientsEach of these essential nutrients has an important role to play. Fats, carbohydrates and proteins provide us with our energy needs. Vitamins, minerals and water do not provide energy but help to regulate the body’s metabolic processes.

While throughout life we need all these nutrients, many things affect the amount our body needs, including:


stage and age of development gender general health activity levels lifestyle and cultural background.

Importance of nutrientsThe importance of an adequate intake of the essential nutrients in a child’s diet cannot be overemphasised. As children are still growing, they need specific nutrients to develop strong and healthy bodies. During the different stages of growth, the relative amounts of appropriate nutrients are also important. There are significant differences between the quantities of nutrients required by older children to that required by toddlers and infants. It is also necessary that children obtain the required amount and type of nutrients on a daily basis.

Nutritional requirements during infancy Nutritional requirements during infancy are particularly high as it is the period of most rapid post-natal (after birth) growth in the entire life cycle. An infant’s birth weight will triple during the first year of life and their length will increase by about 50%. Energy levels will increase rapidly as the infant becomes more active and has normal bodily functions and development. Proteins are needed for the rapid growth of hard and soft tissue. Calcium is needed for the rapid growth and hardening of bones. Infants have a high requirement for Vitamin C and iron due to their high-energy requirements and the rapid growth of muscle and blood tissue.

Breast milkBreast feeding is considered the best option for early infant feeding. Breast milk is well renowned for its high nutritional content and its unique ability to change and adapt to meet a growing baby’s needs. It carries a range of benefits for both the baby and the mother.

Breast milk is the perfect example of a well-balanced food for the following reasons:

it contains everything a baby needs (proteins, fats, minerals and carbohydrates) for the first 6 months of life, and the quantities adjust as the baby’s needs change

it is easily absorbed and digested by the immature body it protects a baby from infection as it contains important

immunological properties and is thought to protect against the early development of allergies.


Early childhood services have an opportunity to encourage and support continued breastfeeding within the local community. Staff need to be aware of safe storage and handling methods of expressed breast milk, as well as feeding and bottle cleaning techniques. Staff may also promote continued breastfeeding through maintaining a range of suitable pamphlets, posters and charts on the importance and benefits of breastfeeding within their service.

Alternatives to breast milkIron-fortified commercially prepared formulas are a good nutritional alternative to breast milk, as their composition of fats, vitamins, iron and carbohydrates closely resembles breast milk. They may be made from meat or soy products or cow’s milk.

It is crucial that we know the correct way to prepare formula. Different methods and techniques are recommended by different products. It is important for staff working in a children’s service, to be aware of the centre’s own policies and procedures for cleaning and sterilising bottle items and preparing infant formula.

Mealtimes with infantsAs mentioned earlier, breast milk or formula milk will meet all the nutritional needs of the infant in their first 6 months of life. After 6 months of age, infants are ready to start on solid foods and by 8-9 months half their nutritional intake will be from solid foods and the other half will be from breast milk or formula.

Infants will start to give signals that they are ready to be introduced to soft, solid food. The following cues may be observed:

an interest in watching food being eaten by others an increase in the number of feeds able to sit upright with support, displaying good upper body and head

and neck control. can suck small quantities of pureed food from a spoon. frequently attempts to move items towards his/her mouth

Introducing solidsWe need guidelines to know when to introduce particular foods such as fruits, vegetables, breads and cereals, meats and other dairy foods. It is highly recommended that solid foods be introduced at a very slow pace to allow the baby’s body to adjust to the new food and to be able to watch their body’s response to the food.

Where children refuse food items, it may be necessary to re-introduce them later on, to allow the taste and texture to become familiar. Each new food item will slowly build on their developing dietary intake.


The following solids, with continued feeding of breast milk or formula, will supply an infant’s nutritional needs for the first 12 months. Whilst the NHMRC National Health and Medical Research Council recommends exclusive breastfeeding , or formula until the infant is 6 months it is important for parents to seek the professional advice of their local early childhood clinic nurse before introducing solid foods into the infants diet. Current best practices recommends solids to be introduced at 6 months but each infant has individual needs and sometimes solids are offered, with professional advice, at 4 or 5 months.

http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/foodinfa.pdf

• At 6 months, introduce iron-enriched cereals• at approx 7-8 months, introduce pureed fruit and vegetables• approx 8 months, introduce coarsely mashed or minced meat or

meat-substitute products • approx 6-7 months, introduce small amounts of water from a cup • approx 10 months introduce nutritional finger foods such as hard

toast, soft cheeses, cooked vegetables (cauliflower, broccoli and carrot) and soft fruits (banana, pears and peaches).

The introduction of solid foods will progress from very smooth food, to mashed food, to bite size pieces and finger food, up until 12 months where babies are able to manage a small portion of the family meal. At approx 8 months , or as baby becomes more used to eating solids, start to offer food first followed by formula / breastmilk.

Follow this link to read the following article on introduction of solids.

http://raisingchildren.net.au/articles/when_to_introduce_solids.html

Listed below are several websites you can go to for additional information:

http://www.healthykids.nsw.gov.au/links/

http://www.cyh.sa.gov.au/Default.aspx?p=1

Infants and children under 2 years of age should not be offered low fat dairy foods or other low fat food items. Foods such as avocado, full fat milk, cheese and yoghurt contain good dietary fats which will assist their growth and development.

Nutritional requirements of toddlersA toddler’s need for nutrients is very similar to an infant’s, although a toddler usually requires more. Toddlers should be provided with small nutritious meals or snacks every 2½ to three hours. They have a small stomach capacity and may not be able to eat enough at regular meal times to meet their high-energy needs.


http://www.cyh.sa.gov.au/Default.aspx?p=1

http://www.healthykids.nsw.gov.au/links/

http://raisingchildren.net.au/articles/when_to_introduce_solids.html

http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/foodinfa.pdf

Toddlers need iron rich foods such as red meats, kidney, liver, seafood and poultry. They are particularly susceptible to iron deficiency as they are no longer having iron-fortified infant formulas and cereals. They also need plenty of water. Water is extremely important, as water loss by evaporation is high in this age range.

An example of a nutritious snack for a toddler is a pizza wheel. This is made by splitting a wholemeal muffin in half and topping it with half a diced tomato, one tablespoon of drained crushed pineapple and one tablespoon of grated cheese. It is then grilled.

Mealtimes with toddlersPlanning meals for toddlers can be a real challenge. Toddlers can often feel like they have so much to explore that eating and sitting down for mealtimes may come second. At the toddler stage of development they are striving for autonomy and control over their environment and can often reply ‘No’. This can be a difficult time as parents and carers try to maintain a balanced and nutritious diet to support their growth and development. So, the trick is how to get them to eat and eat well!

Strategies to overcome feeding challengesWhen caring for toddlers, it is important that our interactions reflect a good understanding of their stage of development and their individual personalities. Mealtimes are a great opportunity for this.

It is good advice to offer toddlers limited choices rather than leaving options open. The theory is to offer them two choices, both of which are selections that suit you. For example, ‘would you like a cheese and lettuce or an egg sandwich?’ Through offering these two choices and asking them to pick, they feel like they have control over the situation and therefore will make the choice from the selection that suits them.

If limited choice doesn’t work, it is suitable to use the strategy of informing a toddler that it’s lunchtime rather than phrasing it as a question and asking them if they would like lunch.

Toddlers may eat better if they have ‘a little often’ rather than be offered three solid meals a day. This allows you to present a variety of foods to them.

Starting each lunch meal on a small plate, with the availability of second servings, can be more welcoming and achievable for young children.

If a toddler refuses to eat, avoid making a big deal out of it. Offering small samples of a variety of foods and giving more if requested, can be a useful strategy to encourage toddlers participation in mealtimes.


It is important to make meal times relaxed and pleasant. Starting with a song or rhyme can help toddlers get in to the routine. Songs and rhymes that are linked to food, manners and mealtime experiences may be a fun and enjoyable addition to any lunchtime. As with all young children learning to enjoy mealtimes, allow plenty of time to eat.

Selecting appropriate feeding/mealtime equipmentFinger foods are often good for toddlers. They can become easily frustrated using utensils and sometimes managing a spoon or fork can be quite difficult and slow for them, especially if they are particular hungry. Introducing safe feeding equipment into role play areas can assist children’s familiarity with a range of utensils and also promote children’s fine motor development and hand-eye coordination.

http://kidshealth.chw.edu.au/fact-sheets/healthy-eating-toddlers

http://kidshealth.chw.edu.au/fact-sheets/managing-toddler-mealtimes

Activity 1

Nutritional requirements of preschool childrenDuring this period of physical growth and development, preschool children need protein for maintenance and growth, and continue to need high levels of calcium and iron.

The following vitamins are also particularly important:

Vitamin A and C—for healthy tissue growth Vitamin B group—for energy metabolism Vitamin D—for healthy bone and tooth formation.

Some food suggestions for this age range include: cheese sticks, yoghurt, vegetable pieces, spaghetti bolognaise, rice cakes with peanut butter, plain cracker biscuits with vegemite and cheese, and fruit pieces.

Mealtimes with preschool childrenPre-school children enjoy demonstrating their growing independence and enjoy making choices. Mealtimes can be an opportunity for children to express this through taking on responsibilities such as serving, cleaning up or pouring drinks.

When planning mealtimes with preschool children, it is important to consider the following:


http://kidshealth.chw.edu.au/fact-sheets/managing-toddler-mealtimes

http://kidshealth.chw.edu.au/fact-sheets/healthy-eating-toddlers

Where possible, offer opportunities for preschool children to make

choices and demonstrate their independence in the meal time routine.

Encourage children to adopt appropriate food hygiene and handling practices and make hand washing a regular part of their routine and day.

Allow small groups of children to help prepare the food e.g. wash the fruit, time the boiling of an egg, as well as watch the cook in the kitchen from afar (if there is space to do so safely).

As with toddlers, the use of songs and rhymes to help children get ready for eating, including the hand washing process can be very useful.

Creating opportunities for cooking experiences during the day will also help to increase children’s nutritional knowledge and their interest and involvement in food and mealtimes.

Packed lunchesThe basis of a healthy lunch box is to provide something from each section of the Healthy Eating Pie each day.

Here are some healthy but tasty lunch ideas from Nutrition Australia.

Pita wrap (with hommus, grated cheese, carrot, capsicum, snow pea sprouts), frozen milk, plum, raisin bread.

Homemade pasta salad (with corn, capsicum, shallots and peas), dried apricots, fresh blueberries and wholemeal pikelets.

Double decker sandwich (chicken, mayonnaise, celery and carrot) on three slices of bread, apple and kiwi combo, cheese slice and rice crackers.

Wholemeal bread roll with egg and lettuce, frozen yoghurt, bunch of grapes and scone.

Vegetable noodle salad, banana bread, frozen milk drink, dried fruit and nut mix.

Make sure you are aware of centre and service policies regarding food brought into the service, especially in regards to high allergen foods. This will ensure you are able help parents stay well informed.

We also need to consider ways to ensure that the packed lunch is safe to eat when prepared several hours before it will be eaten. In hot weather, most parents may use a frozen ice pack in an insulated lunch box to keep the food cool (under 6°C). Otherwise, they may be stored in the refrigerator at the child care service until required. Appropriate food handling and storage methods will prevent dangerous bacteria growing, making the food unsuitable for eating as it may cause children to be very ill.


http://www.nutritionaustralia.org/national/resource/kids-healthy-lunch-ideas-under-5s

Nutritional requirements of school age childrenThe actual nutritional requirements of children aged six to 12 years differ little from those of the preschool years. However, children in this age group will require portions of food larger than many adults. School age children require greater amounts of B group vitamins to assist with the release of energy, as well as calcium for bones and teeth, protein and iron. A diet low in saturated fats is recommended for children over 6 years of age.

Protein is a vital nutrient for every cell in the body including those in the muscles, liver, kidneys, heart, blood, skin, nails, bones and teeth. Protein requirements increase whenever growth is occurring. Iron is important for the blood and connective tissue. Small quantities of fat are needed in a child’s diet as it provides energy as well as vital padding around our organs.

Nutritious breakfasts are important for this age group. An inadequate amount of food causes blood glucose to fall, which can result in poor concentration. Adequate amounts of calcium, Vitamins A, C and D and phosphorus are also important in preventing dental problems.

Calorie intake and dietary guidelinesWe all require kilojoules to live and for our bodies to function. In particular, children need calories (kilojoules) for growth and activity, but it is important that they do not have an excessive intake as this can lead to childhood obesity and set poor precedents for their adolescent eating patterns and habits. Energy requirements vary greatly with the stages of physical growth and with activity levels—these are all highly individual. If energy intake is above or below what the body requires over a period of time, body weight will be gained or lost.

Many children have special food requirements for the following reasons:

some children require particular foods during temporary physical conditions, such as teething or recovering from an illness

some children require particular foods due to ongoing physical conditions, such as cerebral palsy, cleft palate or cystic fibrosis.




Australian Guide to Healthy EatingChildren should be provided with a diet based on the Australian Guide to Healthy Eating, the Healthy Eating Pie and the Dietary Guidelines for Children and Adolescents in Australia. The Australian Guide to Healthy Eating has identified five main food groups.

The Healthy Eating Piehttp://www.health.gov.au/internet/healthyactive/publishing.nsf/content/eating/$File/fdpost.pdf

A diet consistent with the Australian Guide to Healthy Eating recommends people consume fresh food and avoid foods that contain too much added fat, salt and sugar. The Guide aims to promote healthy eating habits throughout life, which will assist in reducing the risk of health problems in later life, such as heart disease, obesity and Type 2 Diabetes.


http://www.health.gov.au/internet/healthyactive/publishing.nsf/content/eating/$File/fdpost.pdf

http://www.health.gov.au/internet/healthyactive/publishing.nsf/content/eating/$File/fdpost.pdf

Australian Guide to Healthy Eating including the Healthy Eating Pie can be accessed by following the link.

http://www.health.gov.au/internet/main/publishing.nsf/Content/E384CFA588B74377CA256F190004059B/$File/fd-cons.pdf




Dietary guidelines

The National Health and Medical Research Centre (NHMRC) has issued the Dietary Guidelines for Children and Adolescents in Australia, incorporating the Infant Feeding Guidelines for Health Workers. The latter component provides recommendations specific to infants, including establishing and promoting breastfeeding, including expressing and storing breast milk. The Guidelines strongly recommend the benefits of breastfeeding and the disadvantages of using formula.

Other important elements of the Guidelines include:

Eat plenty of vegetables, legumes and fruits. Eat plenty of cereals (including breads, rice, pasta and noodles),

preferably wholegrain. Include lean meat, fish, poultry and/or alternatives. Include milks, yoghurts, cheese and/or alternatives Reduced-fat milks are not suitable for young children under 2 years,

because of their high energy needs, but reduced-fat varieties should be encouraged for older children and adolescents.

Choose water as a drink. Alcohol is not recommended for children.

Also, care should be taken to:

Limit saturated fat and moderate total fat intake. Low-fat diets are not suitable for infants. Choose foods low in salt. Consume only moderate amounts of sugars and foods containing

added sugars

Recommendations and guidelines for drink provisionThe Australian Dietary Guidelines as well as the charts and diagrams of the Australian Guide to Healthy Eating highlight the suitability of water as the recommended drink choice.


Water

It is recognised that about 55% of a child’s body weight is made up of water. For this reason, it is very important to maintain their regular intake of water and keep their bodies well hydrated.

As infants reach 9–12 months, cooled boiled water may be introduced in addition to their breast milk or bottled milk intake.

It is a requirement of all centres under the National Quality Standards (NQS) Element 2.2. that children have ready access to water which is available to them at all times throughout the day.

Good sources of water may also be found in some food items such as fruit and vegetables.

Alternative drink provisionsThere are a few other drink alternatives which may be provided to children.

Milk is a great drink choice as it provides calcium. We need to ensure children get three serves of milk a day, equivalent to one full cup. As a result of recent research on childhood obesity, it is now recommended that children over 2 years of age be offered low-fat varieties of milk and milk products such as yoghurt and cheeses. Standard milk is high in saturated fat and may contribute to obesity in young children and adolescents. This supports the Dietary Guideline ‘limit saturated fat and moderate total fat intake’. It is important to note that infants under 2 years of age should not have any low-fat versions of milk and milk products.

Juice is another source of water, though in moderation, because it often contains high amounts of added sugar, preservatives and doesn’t have other essential nutrients. Due to the lack nutrients it is recommended that juice is often as a sometimes drink and is diluted with water.

Cordials and soft drinks are high in sugar and may contain artificial flavourings, colours and preservatives. These drinks are not recommended as a healthy drink choice.


Ensure children’s individual needs are met to promote optimal growth and development, respecting cultural requirements, appetites, and food and drink preferences

It is important to remember, while the Australian Dietary Guidelines and Healthy Eating Charts should guide the decisions staff make in selecting food and drinks for infants and children, we must also recognise and respect any family food or drink preferences related to cultural, religious or lifestyle practices. The National Quality Standards (NQS) Element 2.2.1 Healthy Eating is promoted and food and drinks provided by the service are nutritious and appropriate for each child.

Religious influences on foodMany people’s religious beliefs influence the type of foods they eat and when they eat them. For example, some Hindus are vegetarian and others do not eat beef, as the cow is considered to be a sacred or holy animal which cannot be harmed or eaten. Eggs are also not eaten as they are seen as a source of life.

It is not possible to know every religion’s food restrictions, but it is important that we are aware that religious and cultural differences exist. If we are to provide quality care for children it is important that we establish relationships with the families so that we learn about the types of foods that children eat at home.

Cultural influences on food Diets based on cultural traditions have deeply enriched all of us. For many communities, food plays an important role in family, social and religious affairs and is used in rituals of healing, blessing and thanksgiving.

The cultural importance and significance of food in the development of young children should be recognised by the early childhood educator and services need to ensure that each child’s food preference are respected. Nutritious Foods from


various cultures should be incorporated into the service’s weekly menu and used to appropriately highlight and discuss similarities and differences.

A copy of The National Quality Standards (NQS), and more detail about the Standards and Elements can be accessed on the internet at www.acecqa.gov.au

Accommodating children’s food and drink preferencesWe all have different tastes when it comes to food and drink. Children are able to make up their own minds about what they prefer to eat and drink at a rather early age. In fact, children from a very young age demonstrate that they prefer some foods rather than others that are offered.

Children’s families may observe particular religious, cultural or lifestyle traditions that affect their food preferences. If we are to provide quality care for children it is important that we establish relationships with their families so that we learn about the types of food that children eat at home.

Understanding what influences food attitudesA child’s attitude to particular foods and the development of their individual preferences are influenced by many things including:

the texture and appearance of foods—’people eat with their eyes’, a comment often heard that reflects this strong influence and attitude towards foods

their individual taste preferences—sometimes these preferences are altered by past experiences and memories of these

their family’s religious and cultural food preferences—prohibition of certain foods and other restrictions where the child may never eat these foods or they must abstain from consumption of all food for a set period of time to comply with their religious or cultural beliefs, which is reinforced by parents/caregivers from birth

their emotional state and the social setting when first introduced to the food—these associated memories whether pleasant or unpleasant may continue into adult life, yet tastes for different foods and more ‘adventurous’ eating experiences may also improve with new opportunities, involving different social settings, travel and cultural exposure, environmental and financial conditions, etc

the ease with which they can manage different foods by themselves—a child may have a physical disability (eg problems with finer motor skills) or a disability that may affect their ability to swallow particular


http://www.acecqa.gov.au/

foods or forms of food without the aid of adaptive utensils or another person’s assistance.

Understanding children’s preferencesChildren in care should NEVER be forced to eat or be refused food as a punishment or consequence of their behaviour , nor should food be used as a bribe or reward. Carers need to be aware of, and aim to meet the individual needs of children within the daily routine of the service. Caregivers can get to know individual children’s preferences by:

• talking to their parents• carefully observing what they prefer to eat at meal times• asking children what foods they enjoy as you sit and enjoy a pleasant

mealtime with them

Once we understand children’s preferences we are better able to ensure that the menu accommodates these preferences. Our responsibility is to encourage the children to eat a nutritious and balanced diet.

Activity 2


Encourage children to develop healthy eating habits

The National Quality Standard (NQS) 2.2 Healthy eating and physical activity are embedded in the

program for children.

Helping children develop an awareness of healthy food and drink choices

The food and drink provided to children in care must be consistent with

The Australian Guide to Healthy Eating

National Quality Standards (NQS)

Australian Government Guidelines. Get up and Grow: Healthy Eating and Physical Activity for Early Childhood www.health.gov.au/internet/main/publishing.nsf/Content/phd-early-childhood-nutrition-resources

As well as promote healthy eating habits. The food we as adults select and provide to children will help form the eating habits that will continue throughout their life. It is therefore important to provide a good foundation of healthy choices as early as possible.

Learning to eat, eating to learnEvery meal time is an opportunity to help children learn about healthy food and drink choices and to establish good eating patterns.

Developing healthy eating habits during mealtimesSitting with children during meal times, provides us with a great opportunity to:

Role model positive healthy eating habits.


http://www.health.gov.au/internet/main/publishing.nsf/Content/phd-early-childhood-nutrition-resources


Select a balance of healthy foods from the range available or bring in

a nutritionally balanced lunch to enjoy with children as they enjoy their own packed lunches.

Discuss the food choices available, naming foods, colours, textures. Point out key nutritional aspects, at times linking this with their own

personal development, ie ‘Fish helps our brains to think’ Value and listen to children’s ideas and responses and allow them to

ask questions and talk to their peers.

Learning experiences away from the meal table are also great ways to reinforce healthy eating choices.

Eating a variety of healthy foods on a daily basis, according to recommended guidelines, will assist in the development of positive, healthy eating habits which combined with physical activity patterns, will help reduce the risk of Obesity and chronic disorders such as heart disease, some cancers, diabetes, osteoporosis and tooth decay or erosion.

Dental health and hygieneThere are direct links between dietary intake and dental health for all age groups.

It is important to be aware of the specific dental care requirements for babies. It is highly recommended that we should never prop a bottle for a baby, or leave a baby in bed with a bottle. We need to hold the baby for the bottle feed, place them in bed, then discard unused milk and wash and sterilise the bottle.

Permanent teeth are meant to last a lifetime. They need to be cared for by regular brushing, rinsing with water and by eating foods which are not sugary and sticky. Research shows that the more teeth are exposed to sugary foods, the more likely they will decay. Therefore, children need to be guided toward healthy food choices to set a pattern of healthy eating for their teeth.

We can encourage children to brush and rinse their teeth from the very first tooth. With our help, encouragement and support, they will establish good habits for cleaning their teeth. When preparing meals and snacks we need to check that our food choices promote good dental health.

Rinsing the mouth with water after eating a meal in the childcare setting is considered an acceptable alternative to brushing teeth and should be encouraged to assist in rinsing teeth of food particles, food acids and sugars.

For more information on dental health, try:

www.betterhealth.vic.gov.au/

www.ada.org.au

www.healthinsite.gov.au


http://www.healthinsite.gov.au/

http://www.ada.org.au/

http://www.betterhealth.vic.gov.au/

Ensure meals and snacks are nutritious, attractive and an appropriate serving size for children

Making food appetising and attractive to children Food is appetising to children when it is familiar to them, when it is associated with pleasant feelings, and when it looks, tastes and smells good. The majority of food presented to children should be familiar to them, with new foods being introduced in small amounts gradually. It is a good idea to provide food with a range of different textures at each snack or meal-time as this encourages the children to enjoy a range of textures at the same time but provides a choice if a particular texture is disliked. Providing a range of textures also means that children do not get too tired tackling too much of some food that is difficult for them to eat.

Adding colour and shape to foodThe colour and shape of food also seems to be important to children. Children prefer colourful and well-presented food. They are more likely to eat a plate of differently coloured food than one where all the food is mashed into a sloppy mess of one colour, texture and shape. Colour added to the presentation will also attract children (assuming they have standard vision).

Activity 3


Promote healthy eating through role modelling, positive food awareness and mealtime experiences

Supervising children when they are eating and drinking Children must be supervised during meal times. For infants, the following three rules apply to supervision:

never leave an infant alone with a propped-up bottle never leave an infant alone with a bottle or food feed infants solid food only when they are sitting up.

Sitting downToddlers, preschoolers and school-age children should be encouraged to sit down on a mat or at a table to eat. Eating food while walking around can be unhygienic and dangerous. Children could spill foods that other children might then pick up from the floor, or they could choke.

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Dropped itemsIf a child drops a piece of equipment, such as a fork, on the floor, it should be removed, and the child should be given another one. Any food which is dropped on the floor should be immediately placed in the rubbish bin, and another serve should then be offered to the child.

Role modellingAt meal times, carers should sit at a table with a small group of children. This allows carers to provide an appropriate role model for children and to meet children’s individual needs, as well as providing a more home-like environment. Meal times should be enjoyable and can be used to develop positive relationships and enhance social interaction between children and carers.


Provide education and support to families and children around healthy eating, including how to foster this

As you work in partnership with children and their families, you may find that occasionally families will ask for your support in encouraging their child to make healthy eating choices, or in dealing with such food related issues as; ‘How can I get my child to eat vegetables at home?’ or ‘My child will only eat sausages, I’m worried that’s not enough’. It can be useful to have a few handy hints up your sleeve.

Supporting healthy eating in children’s servicesImplementing some of these ideas in your workplace might provide valuable educational opportunities for increasing children and family’s awareness of healthy eating.

Display photos around the centre or run slide shows of meal times for families to view at arrival and collection times. This invites families to observe the types of foods presented to children during mealtimes as well as how mealtimes are arranged.

A copy of the service menu should always be on display for families to view as well as make amendments, recommendations or comments to add to the menu planning process.

Daily records of children’s eating patterns at the service should be maintained. We need to encourage parents to talk with their children about what they have eaten, what they enjoyed, if they were still hungry and what things they didn’t eat or didn’t like.

Providing educational pamphlets on nutritional topics as well as organising special parent and staff information evenings may also present opportunities to cover topics on healthy eating and nutrition.

Developing articles for centre newsletters as well as displaying posters and relevant newspaper articles on topics surrounding healthy eating may also raise awareness and create opportunities for families to talk with staff on these issues.


Develop a centre recipe book of healthy meal choices which is based

on recipes contributed by families at the service. The recipe book would then be reflective of the various cultural, religious and lifestyle choices of the centre’s family groups.

Where allergies and medical conditions require a change in nutritional requirements, we need to consult with parents, as well as any associated dieticians, and nutritionists so that we can plan balanced menus for these children.

The Australian Government Department of Health and Ageing has recently released the Get up and Grow: Healthy Eating and Physical Activity for Early Childhood. This initiative incorporates the Dietary Guidelines for Children and Adolescents in Australia and The National Physical Activity Recommendations for children aged 0-5 years. This should become a valuable tool for educating staff, families and children on developing and maintaining active and healthy lifestyles.

The Get up and Grow initiative is supported by a large collection of resources which are aimed for use in wide variety of early childhood settings and are available for ordering or downloading on

www.health.gov.au/internet/main/publishing.nsf/Content/phd-early-childhood-nutrition-resources

Munch & Move is a NSW Health Initiative that fits within both the National Quality Framework (NQF) and the Early Years Learning Framework (EYLF). Munch & Move is aimed at educating parents and caregivers, and supports the healthy development of children 0-5 years old through promotion of:

Physical activity Healthy eating Reduced screen time for children (eg. Television, computer, dvd, ipod,

gaming screens or hand held devices such as ds consoles)

Munch & Move also has a an extensive resource kit for use in early childhood settings and these are available for download or order via internet on

www.healthykids.nsw.gov.au/teachers-childcare/munch-and-move.aspx

Activity 4

Activity 5


http://www.healthykids.nsw.gov.au/teachers-childcare/munch-and-move.aspx



Plan and develop cycle menus of foods for each meal and/or snack to display for information of staff, parents and older children

Children do not instinctively know what food choices to make for a healthy and balanced diet. Through careful menu planning, children and families can be actively guided and supported to understand as well as experience the benefits of good nutrition and healthy food choices.

Where should my menu planning begin?When planning a menu for children in a children’s service, there are many important considerations which will influence your decisions. These include:

Using the guidelines provided by the experts, nutritionists and dieticians—eg the Five Food Groups, Get up and Grow resources, the Healthy Eating Pie and the Australian Guide to Healthy Eating.

Avoiding dangerous foods which could cause choking at various ages, high allergen foods, and foods which are known to cause health problems later.

Avoiding foods high in salts, saturated fat, sugars and artificial flavours, colours and preservatives.

Asking parents, children, other staff, as well as consulting books or discussing with experts, about ideas for meals so the menu reflects the diversity of the local and wider community.

Choosing foods which accommodate the various specific health needs of individual children in the service.

Choosing suitable drinks; water as a priority and milk as secondary option.

Using a food variety checklist to ensure the menu covers a wide variety of nutritious foods.

Ensuring adequate food is provided for children’s needs.


The Education and Care Services National Regulations (2011) clause 79 states that “ The approved provider of an education and care service that provides food or a beverage to children being educated and cared for by the service must ensure that—

The food or beverages provided are Nutritious and adequate in quantity; and Meets the requirements of individual children taking into account

each child’s growth and development needs; and Meets any specific cultural, religious or health requirements.

Knowing this, it is essential that we carefully plan menus for all meals, snacks, drinks, main meals and desserts to ensure adequate nutrition.

When you are working in a children’s service there are often lots of food issues that families are concerned about. Parents often see child care workers as experts in this area, so it is important that we understand what constitutes good food for children, what menus provide a balanced diet and where further information can be gained.

We need to also be aware that at times children will go through stages in their eating patterns and preferences. This can make menu planning quite challenging. However by communicating with children and their families, we can accommodate individual needs within a group.

How to start?Planning menus in children’s services is often a collaborative task that will involve cooks and all other staff, parents as well as children, all being encouraged to contribute their ideas and preferences. When menu planning occurs in this way, on a regular basis, it creates opportunities for a well balanced range of meals and snacks that recognise children’s nutritional needs as well as reflect the diversity of the staff, families and community.

Traditionally, menu plans are coordinated in cycles of 4–6 weeks. Menu plans are often also planned seasonally to make the best of fresh produce and availability.

When planning menus the following guidelines may be helpful:

Call a meeting to plan the menu for the next 4–6 weeks—advertise the meeting and invite all parents and staff. Ask young children what foods and drinks they like—consider breakfast, lunch, dessert, and snacks. Survey older children with a questionnaire. Look up information on the recommended daily intake (RDIs), for kilojoules—energy foods, fibre, iron and calcium


Review and comply with legislation and guidelines identified in

National Quality Standards (NQS) and The Education and Care Services National Regulations (2011

Make a copy of some blank menu formats—enough for 4–6 weeks. Get acopy of the Australian Guide to Healthy Eating, the Healthy Eating Pie and the Five Food Groups. Use a food variety checklist such as that recommended by Nutrition Australia (see http://www.nutritionaustralia.org/national/resource/food-variety

Test your food variety for a week, observe, monitor and record responses and feedback.

Look up some recipe ideas in books and websites such as those listed within this unit’s resource list.

Go to the children’s records to find any special dietary considerations for individual children (religious, cultural, preferences, any specific calorie needs and medical diets).

Nutrition information panels and food labellingAs we begin to plan meals and snacks for infants and children, we need to be aware of the nutritional value of any packaged food items we may use. In particular, we need to select food products that are low in saturated fat, low in salt and high in dietary fibre. When we start to read these information panels and compare products, we can very quickly see why some food choices are more nutritional than others.

The nutrition panels on food products will state the foods energy level in kilojoules. The panel will then include the amounts of protein, carbohydrates (including sugars), fats, and salt (sodium) in the food per serve and per 100 g, as well as information on the levels of dietary fibre, calcium, as well as vitamins.

For example, a tin of tuna will often have the amount of Omega 3 contained, and a box of cereal will often include the amounts of specific vitamins and folate.

It is important to note, that whilst food items may state they are ‘low in fat’, we should check the nutrition panel, to see the balance of all nutrients. For example a label suggesting a food is ‘low in salt’, may still be high in sugar or fat.

To learn more about food labels, visit the Food Standards website.

www. foodstandards .gov.au

Activity 6


http://www.foodstandards.gov.au/

http://www.nutritionaustralia.org/national/resource/food-variety

Within scope of own work role, ensure nutrition policy includes identification, management and monitoring of special dietary needs related to food allergies and medical food conditions such as coeliac disease and diabetes

Addressing children’s health needs It is important to consider a child’s health needs when planning meals and preparing food for young children. We need to be aware of their specific food intolerances and allergies. Some children may have medical conditions, such as diabetes, and some children may also have adopted a vegetarian diet. Cooks and food handlers have a certain level of responsibility for the children’s health and wellbeing, so must research the restrictions of diets such as these and others that children within their care may have. Providing children with foods that they should resist could lead to illness or, in serious cases, fatality.

Food allergiesFood handlers in centres need to have an understanding of food allergies so that they can answer parents’ questions and be involved in the child’s treatment. They have a responsibility to work in partnership with families and to respond to any requests to modify a menu to incorporate a child’s specific needs.

Food handlers should do their own research in order to gain a clear understanding of an individual child’s allergies/conditions. It is the centre’s responsibility to record information about an allergy in a prominent (but appropriate) position, and ensure that all staff, volunteers, and any students are aware of any allergies in children.

A food allergy can be indicated by an almost immediate appearance of symptoms such as:


breathing difficulties swelling of the face and neck vomiting diarrhoea sneezing hives eczema anaphylactic shock.

AnaphylaxisAnaphylaxis is a generalised allergic reaction, characterised by the presence of symptoms such as hives, throat swelling, acute asthma, gastrointestinal symptoms and hypotension. A severe allergic reaction usually occurs within 20 minutes of exposure to the trigger and can rapidly become life threatening.

Anaphylaxis is a preventable and treatable event. As a caregiver, you need to be educated on how to avoid food allergens and/or other triggers as well as receive professional training on how to administer an EPI-PEN, which is used to temporarily calm the allergic reaction.

Food that may typically trigger anaphylactic reactions include:

milk eggs peanuts tree nuts sesame fish and crustaceans soy.

These are the most common food triggers which cause 90% of allergic reactions; however, any food can trigger anaphylaxis. It is important to understand that even trace amounts of food can cause a life-threatening reaction. Some extremely sensitive individuals can react to skin contact or even the smell of a food (eg fish).

Accidental exposure is a reality and children and caregivers need to be able to recognise systems of anaphylaxis and be prepared for emergency treatment.

Detailed information on allergies, anaphylaxia and epi-pens can be found on www.allergy.org.au


http://www.allergy.org.au/

Food intolerances and sensitivitiesExamples of food intolerances and sensitivities include lactose intolerance and sensitivity to food colouring and monosodium glutamate (MSG). Food colourings are the additives 102, 107, 110, 120, 122, 123, 124, 127, 132, 133, 142, 150, 151, 155 and 160B. MSG occurs naturally in strong cheese, mushrooms, soy sauce, meat extracts, wines, tomato, additive 621 or yeast extract.

Lactose intolerance is not uncommon in children. Children suffering from this intolerance should avoid a sugar found in many diary products. A specific enzyme, lactase, breaks down lactose into simple sugars that the body can use. Lactose intolerance occurs when there is not enough of the lactase enzyme to break down the lactose, and as a result lactose accumulates in the gut. Therefore low lactose milk products such as calcium-fortified soy products should be substituted with items such as So-Good and soy cheese.

Vegetarian dietsThese diets can be suitable for children if they are carefully planned. Consideration must be given to protein, calcium, energy and iron intakes if children are vegetarian. Children on these diets need to consume adequate amounts of:

milk (calcium-rich soy or dairy) meat alternatives (tofu, legumes) iron and calcium-fortified cereals and grains dark, green vegetables and vitamin C sources from fruit.

Children on vegan diets need closely monitoring as their diet is often lacking in zinc, calcium, iron and Vitamin B12. It is also important to note the acceptable alternatives for special occasions such as birthdays.

Some snacks, meals or drinks suitable for children on this type of diet include:

baked beans on toast pasta with bean and tomato sauce fruit and vegetable platter with hummus dip vegetable lasagne calcium-fortified soy milk/smoothies.

DiabetesPeople with diabetes either do not produce insulin, or the insulin that they have is not effective. Children with diabetes need to manage their diet in order to prevent a hypoglycaemic attack. A hypoglycaemic attack usually occurs when a child with diabetes injects too much insulin, exercises without eating extra snacks or fails to eat at proper times. Children suffering a hypoglycaemic attack have


been known to have convulsions, to lose consciousness and even to die. The symptoms of a hypoglycaemic attack include hunger, weakness, nausea, headache, crying, shaking and perspiring, confusion and irritability.

Children with diabetes require a diet low in fat and sugar and need to eat carbohydrates throughout the day. This means providing three main meals plus snacks, containing carbohydrates, between meals. Food needs to be provided at certain times during the day to maintain blood sugar levels. Meal times should be timed with insulin injections so that the child’s body has some blood sugar to transfer to the body cells.

If a child with diabetes does have a hypoglycaemic attack while in care, staff should follow instructions given by parents on enrolment. This usually involves providing the child with glucose, such as a drink of lemonade or sweet lollies.

Children living with diabetes can suffer adverse effects on their growth if blood sugar levels fluctuate greatly. It is important to offer food and drink frequently throughout the day to stop this happening. Suitable snacks and meals include:

plenty of breads/cereals (sandwiches, cracker biscuits, pasta dishes) fruit and vegetables (frozen fruit, fresh platters with a dip) milk and dairy products (smoothies, yoghurts) meat and meat alternatives.

Coeliac diseaseIndividuals diagnosed with coeliac disease have an intolerance to the protein ‘gluten’. The protein is known to cause damage to the lining of the small bowel. It can often prevent the absorption of essential nutrients which can lead to nutritional deficiencies, diarrhoea and weight loss. Young children diagnosed with coeliac disease need to have a well managed and nutritional ‘gluten free’ diet to support their growth and development.

Gluten is found in common bread and cereal foods, including wheat, rye, oats and barley. However, gluten may also be found in items such as biscuits, sauces, crackers, cakes, pastries, salad dressings, pasta, sausages, gravy and stock cubes, the list goes on. Many of these foods may be common in childcare centres and before and after care services on a daily basis. Management of this disease not only requires a specific diet, it also requires staff to be very aware, and to always have alternative foods available.

For more information on coeliac disease, access:

http://www.healthinsite.gov.au/topics/Coeliac_Disease

There is also a factsheet from the Department of Health on coeliac disease, this is available at: http://www.health.nsw.gov.au/factsheets/general/coeliac.html


http://www.health.nsw.gov.au/factsheets/general/coeliac.html

http://www.healthinsite.gov.au/topics/Coeliac_Disease

Underweight and nutritionally-deficient childrenSome communities and family groups have higher risks of poor nutrition than others. We need to be aware of the link between poor nutrition and diet in young children and the long term effects which can lead to underweight or nutritionally deficient children.

Children who are not having a balanced healthy diet may frequently appear lethargic and tired as they may not have the energy to participate fully and concentrate for long periods of time. You may also observe patterns at mealtimes, where children may appear starving hungry or adversely not interested in food at all.

It is important to be aware of infants and children’s eating habits, play behaviour, interactions and energy levels throughout the day. Listen to parents’ comments on their child in regards to eating and mealtimes at home. Record these details and observations and talk to your supervisor or colleagues to discuss any concerns you have.

Activity 8

http://kidshealth.chw.edu.au/fact-sheets

NSW Health: Nutrition checklist for long day care menu planning:

http://www.healthykids.nsw.gov.au/teachers-childcare/food-and-nutrition/publications.aspx




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