Nutritional Guidance for Early Years: food choices for children aged 1-5 years in early education and childcare settings

4 Putting nutritional guidance into practice

Putting the nutritional guidance into practice is the responsibility of everyone involved with children in the early years setting.

4.1 Working in partnership

Working in partnership with all those involved in caring for children, in particular parents and guardians, to encourage and support them to provide a balanced, nutritious diet will get the best results.

Developing and maintaining good relationships with parents, guardians, staff who support the early years sector, and, most importantly, the children themselves is essential to ensure that the nutritional guidance is given the support and endorsement it needs.

It is also worthwhile exploring other partnerships with individuals and organisations that may be able to help put the nutritional guidance into practice at a local level, e.g. activity groups for children, voluntary sector groups for children, summer clubs, etc.

CASE STUDY

Lanarkshire's Health Promoting Nursery Award Scheme ( HPNAS)

NHS Lanarkshire has worked with education partners in North and South Lanarkshire Councils to create an award scheme for Lanarkshire nurseries. This scheme mirrors the successful Lanarkshire Health Promoting School Award Scheme.

The HPNAS will co-ordinate health promotion activity in nurseries in Lanarkshire, in both the public and private sector. The scheme has three levels: bronze, silver and gold. At bronze level, nurseries will audit themselves and identify three priority areas for action, two priority areas at silver and one at gold. Early evidence shows that nutrition and promoting healthy eating will be identified as one of the priority areas. The HPNAS team will support nurseries with personal contact and resources, including a sample healthy eating policy. The team will promote Lanarkshire's Nutrition and Oral Health Pack, distributed to all nurseries in 2003. The award scheme will also link with other local activities such as the free fruit in nursery scheme, joint training for early years staff, and support for parents through practical cooking skills courses. The scheme will have a positive impact on the health of children, staff, parents and carers in Lanarkshire.

4.2 Working alongside parents and guardians

As an early years carer, it is important to recognise that parents and guardians play a vital role in supporting your work, and together you have the potential to influence the eating habits of young children. There are a number of ways that you can involve parents and guardians to take an interest in food and healthy eating. These could include:

• Early engagement with parents/guardians about individual needs which may impact on food choices and intake during induction.
• Regular informal contact to let them know what their child has eaten and if he or she has eaten well.
• Involving parents/guardians in developing and updating your policy (see section 4.3) on food and health lets them know that you are committed to providing healthy, varied and enjoyable food as part of childcare; it also lets them know what to expect and asks for their input.
• Making menus available to parents in advance so they can see what the child will receive that day and plan other food in the day accordingly.
• Giving parents/guardians notice of changes to meals and food provision, allowing them to comment on menus.
• Inviting parents to share special recipes with you.
• Providing storybooks with a food theme that parents can read at home with their child.

CASE STUDY

Food for Tot

The Food for Tot project in Edinburgh provides parents and carers with information, knowledge and practical skills to help them make informed choices for their family's diet. Food for Tot is a joint initiative between education, social work and health services to deliver nutrition courses through a resource pack for groups of parents with children under the age of 5. Courses are delivered in a variety of outreach settings, although support is also offered to parents on a one-to-one basis.

The project is funded by Sure Start and aims to:

• Develop dietary knowledge to help parents to make healthy food choices for themselves and their children.
• Address parental concerns around how diet and health affect growth and development of babies and young children.
• Build strategies to transfer what has been learned into the home environment.
• Develop parents' self-esteem and confidence.

The Food for Tot project works in partnership with other professionals and projects including the infant feeding advisor, Edinburgh Community Food Initiative, community dental team, health visitors, Books for Babies and the Early Communications Project.

4.3 Developing a food and nutrition policy

The recommendations and advice on food and nutrition should be understood and accepted by the staff, carers, parents/guardians and those who provide food for the children. The best way to achieve this is to write down what the staff and carers aim to do with regard to food and drink. This helps by allowing everyone a chance to discuss and agree the aims and add to or change what is decided, and it can be given out to new parents as information on the approach to healthy eating. This written information (or policy) can then be updated as new information becomes available.

Here are some ideas for the sort of information you may wish to consider when developing a policy:

What types of food will you provide for the children?
At meal and snack times …	Healthy food items, low in sugar and salt, and including plenty of fruits and vegetables. You could explain that a menu will be planned by a member of staff with the knowledge and skills to do so and will be made available to parents (for example by placing on the nursery notice board). The menu plan will include all meals, snacks and drinks to be offered. You could refer to the fact that you have used this Nutritional Guidance and Adventures in Foodland 4to develop your menu.
What types of drinks will you provide for the children?
Throughout the day … At snack and meal times …	Plain, still water will be available throughout the day. Fresh fruit juice diluted with water will be offered only at meal times. Milk and plain still water will be offered with snacks and meals.
Who should see the policy? How will it be communicated to them?
New parents and guardians, new staff, carers and caterers … Ongoing …	You may decide to give a copy of the policy to all staff including new members of staff and parents. The policy should contain a copy of the menu cycle. Thereafter you might display weekly menus on a notice board. Encourage feedback from staff and parents. Any changes to the policy could also be posted on the notice board.
What are you going to say about developing good eating habits?
Staff and carers …	Will encourage children to enjoy sitting and eating and drinking with others and helping each other with their food and drink (e.g. at snack time pouring the drinks). Children will not be expected to finish everything on their plate and will be allowed seconds of fruits, bread or milk if still hungry.
What will you do if a child does not eat?
If a child does not like the food … If it is a continuing problem …	Children who do not eat the food will be offered an acceptable alternative, e.g. plain crackers, cheese, fruit, milk-based desserts. Regular informal contact with parents will let them know how their child has been eating and make them aware of any difficulties.
What advice will you give to parents about bringing food into the pre-school setting?
Bringing sweets and chocolates into the early years setting …	Sweets and chocolates are not given to children. We ask parents not to give children sweets or chocolates to bring into the nursery, including treats such as party bags containing sweets. For the occasional very special celebration children may receive these as part of the pre-school activities.

A sample food and nutrition policy is set out in Appendix 7.

4.4 Staff development and training

Effective early education and childcare requires a well-qualified workforce, all of whom should be properly trained. ²⁹ Staff and carers will have differing training needs. All staff handling food will need training in food safety and hygiene ¹⁸ and some will need to develop the knowledge and skills for menu planning, purchasing and preparation of food to ensure that the nursery meets National Care Standard 3. ¹

A staff development programme should assess the training needs of all staff and carers and offer appropriate training. Healthy eating should be an integral part of this training to support the implementation of this guidance, enabling staff to develop an understanding of the nutritional needs of pre-school children and how the guidance can be applied practically in their setting.

Qualifications such as Scottish Vocational Qualifications ( SVQs) and the Higher National Certificate ( HNC) in Childcare and Education provide training opportunities for early years staff.

4.5 Monitoring and evaluation

Early education and child care settings are regulated by the Scottish Commission for the Regulation of Care, (the Care Commission) and Her Majesty's Inspectorate of Education ( HMIe). The National Care Standards for Early Education and Childcare up to the Age of 16 provide the framework for regulation and the Care Commission takes the lead role in inspection against Standard 3, which includes nutrition. Standard 3.4 requires that:

"Children and young people have access to a well-balanced and healthy diet (where food is provided) which takes account of ethnic, cultural and dietary requirements, including food allergies. Staff make sure that help with feeding is given in a way that best meets the needs of the child or young person."

The Care Commission inspects the provision of food in early years settings as part of its inspection programme. The standards will remain the tool that the Care Commission uses to monitor the quality of services. This guidance will contribute to this process by setting out what the Scottish Executive considers to be a well-balanced and healthy diet.

The Scottish Executive and the Care Commission will continue to work together to raise the standard of food provision for young children in care and education settings.

4.6 Areas for further consideration

During the consultation period, a number of areas were identified by respondents for further consideration and development. These include assessing the nutritional status and intake of pre-school children in Scotland; the need to review evidence and current practice with regard to vitamin supplementation, in particular, the need to review the vitamin D status of pre-school children in Scotland; developing staff training to support implementation of this guidance; and developing further resources such as advice for parents on packed lunches and physical activity.