Setting the Table Guidance

1 Why this guidance is important

1.1 Who this guidance is for

Childcare services providing food (including snacks) and/or drinks, and are registered with the Care Inspectorate, will be responsible for the implementation of this guidance.

This guidance will apply to a wide range of providers, including local authority and PVI (private, voluntary, or independent) settings, family centres, childminders, playgroups, and caterers who provide food for early years settings, regardless of the length of time that children are being cared for.

Regulated childcare providers should supply appropriate healthy food and drinks for babies and young children in their care. Children should also have opportunities to try a variety of different foods, and food should be seen as part of the learning experience and be an integral part of the caring environment.

It will also be of interest to:

• Non-regulated settings such as parent and toddler groups and play/activity groups, who can use it when planning and providing food and drinks for children.
• Practitioners who have an interest in the health and welfare of young children. For example, NHS and social work staff who support families, a range of voluntary organisations working with families in community settings and those delivering training to early years practitioners.
• Parents and carers as a guide to give them some insight into the importance of a healthy, balanced diet for young children.

It is important for childcare providers to work alongside parents and carers when implementing this guidance. Working in partnership will mean that children receive care that is consistent and supports the best outcomes. Both childcare providers and parents and carers must be actively involved in decisions around food and drink provision, and share key information about an individual child’s needs.

Not only can the childcare setting provide healthy food for the children in its care, but it also has a unique opportunity to act as a role model and potentially influence food in the home too.

1.2 How this guidance supports the health and wellbeing of young children

Eating well is essential for healthy growth and development in childhood. Children’s early experiences with food, including the foods they are offered and the eating patterns they are exposed to, both at home and outside the home, can shape future eating habits. This paves the way for long-term health including maintaining a healthy weight, positive mental health and the foundations for good oral health. A varied diet and a regular eating pattern in early childhood can also have a positive impact on mood, attention, behaviour and learning.

A poor diet is one of the main causes of ill-health and premature death in Scotland. A poor diet can also affect brain development, impacting learning and social development.

Evidence suggests that a healthy diet, being physically active and maintaining a healthy weight may substantially reduce the risk of chronic diseases such as cardiovascular disease, type 2 diabetes and some cancers. There is evidence to show that good nutrition in the early years can have a positive effect on long-term health, and can influence the risk of these chronic diseases in later life.

What we eat and drink also has an impact on our oral health, particularly in early childhood. Dental extractions (under general anaesthetic) remain the most common reason for children to have an elective hospital admission in Scotland. Childcare settings can support Childsmile, which is a national programme to improve the oral health of children in Scotland and to reduce inequalities, through the distribution of free dental packs and supervised toothbrushing programmes in childcare settings. Supporting healthy smiles provides further information on approaches to implementing toothbrushing programmes.

Health inequalities are the unfair and avoidable differences in people’s health across the population and between specific population groups, for example how long they are likely to live, the health conditions they may experience and the care that is available to them. They are socially determined by circumstances largely beyond an individual’s control. These circumstances disadvantage people and limit their chance to live longer, healthier lives.

The early years are considered a crucial time to reduce health inequalities. Providing healthy and nutritious meals and snacks in childcare settings is important, particularly in meeting the needs of families who could benefit the most.

It is important for childcare providers to recognise that some families face a lot of challenges in their lives, and individual needs must be considered when planning food provision and activities within the childcare setting.

The World Health Organization recommends that babies should be exclusively breastfed for around the first 6 months of life and the Scottish Government has adopted this recommendation. Breastfeeding should then continue beyond the age of 6 months, alongside the introduction of solid foods, for up to 2 years of age or for as long as mother and baby wish. The support offered by childcare settings to mothers who wish to continue breastfeeding is crucial in providing a positive impact on early nutrition, chronic disease and reducing health inequalities. NHS Scotland’s Breastfeeding Friendly Scotland Early Learning Scheme is aimed at promoting breastfeeding as the cultural norm.

Childcare settings may have the opportunity to promote Best Start Foods. This initiative provides financial support to purchase healthy foods and milk to pregnant people and families with children under the age of 3 years who receive certain benefits. It is also helpful to be able to signpost parents and carers who are experiencing food insecurity to where they can access emergency infant formula milk and local food banks.The infant food insecurity guide provides further information to support parents and carers.

Childcare settings can also register for the Scottish Milk and Healthy Snack Scheme (SMHSS) via their local authority. The scheme is a universal pre-school policy which supports healthy growth and development in children by promoting and establishing healthy eating habits from an early age that can last into later life. SMHSS also aims to reduce the impacts of health inequalities, malnutrition and child poverty, and improve access to healthier food.

Vitamin D supplements are recommended all year round for infants and children under five years old as well as pregnant and breastfeeding mothers. Vitamin D drops are available free for infants and children from birth until their third birthday. Families can usually access Vitamin D drops from local universal services, such as their health visitors.

1.3 How this guidance helps childcare providers meet regulatory requirements

This guidance has been written to support the practice of those working in registered childcare services within the public, private and voluntary sectors.

It supports childcare providers to meet their regulatory responsibilities in relation to the following:

• UN Convention on the Rights of the Child (Article 3 and 24)
• The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011
• Health and Social Care Standards: my support, my life (2017) (HSCS)
• Public Services Reform (Scotland) Act 2010
• Children and Young People (Scotland) Act 2014
• Funding Follows the Child and The National Standard for Early Learning and Childcare Providers: Operating Guidance

This resource also supports the implementation of several national policies aimed at providing young children with the best possible start in life, such as Getting it right for every child (GIRFEC). The guidance also addresses aspects of Curriculum for Excellence, and national practice guidance for early years in Scotland Realising the Ambition: Being Me.

Appendix 4 provides further information on relevant national policies.

1.4 Development and implementation of this guidance

This updated guidance has been developed by a Scottish Government led multi-partner working group consisting of national statutory bodies, clinical and nutrition experts, and sector representatives. Membership included Public Health Scotland, Food Standards Scotland, Care Inspectorate, Education Scotland, NHS Greater Glasgow and Clyde dietetics, The Children and Young People’s Allergy Network Scotland (CYANS), Early Years Scotland, National Day Nurseries Association, Scottish Childminding Association and Assist Scotland (representing Local Authority catering leads).

The guidance has been endorsed by Professor Sir Gregor Smith, Scotland’s Chief Medical Officer, and Professor Marion Bain, Deputy Chief Medical Officer with responsibility for public health.

The expectation is that the guidance will be implemented by 1 August 2025 in order to provide time for settings to familiarise themselves with its contents and make changes where necessary.

The Care Inspectorate is a scrutiny body that supports improvement. When they carry out their scrutiny work, Care Inspectorate will expect registered childcare providers to be able to demonstrate how they are meeting this guidance within their individual settings.