Government Guidelines for Nutrition

Sarah Slack

Unit Four

Health Promotion and Development

It is important that the under-5s get enough energy (calories) for growth and development. Childcare workers should therefore be sensitive to the needs of children who are fussy eaters or small eaters and ensure that these children are offered a good variety of food that they will accept.

Age Average energy requirements in kcals (calories) per day:

• 1 year 935kcals
• 2 years 1,160kcals
• 3 years 1,430kcals
• 4 years 1,530kcals

(Gregory JR, Collins DL, Davies PSW, Hughes

JM, Clarke PC. 1995. National Diet and

Nutrition Survey: Children Aged 11/2 to 41/2

Years. Volume 1. Report of the Diet)

Children in a childcare setting should always be encouraged to eat a varied diet. They should eat foods from each of the four main food groups every day. The four main food groups are:

• Bread, cereals and potatoes
• Fruit and vegetables
• Milk and dairy foods,
• Meat, fish and alternatives such as eggs, pulses (peas, beans and lentils) and soya.

Vitamin C is important in maintaining good health and may have a role in helping the body to absorb iron if both nutrients are present in the same meal. Children should be encouraged to eat foods containing vitamin C at meals like fruit and fruit juices.

Children who do not eat meat should have a varied diet containing foods such as cereals, pulses (peas, beans and lentils), vegetables and fruits.

Children need nutritious snacks between meals. The best snacks are those which are low in sugar. A variety of snacks should be offered including fruit, vegetables, milk, yoghurt, any type of bread, and sandwiches with savoury fillings.

When planning menus in a childcare setting you must consider children who have special needs. Some children may have particular dietary requirements or may need specific help with eating.

Sarah Slack

Food unsuitable for young children and babies

There are many different foods which are unsuitable for young children and babies, such as:

Salt

Salt can be dangerous for babies as it can damage their kidneys. Salt should never be added to babies food. Stock cubes or gravy are high in salt so they should be avoided when making homemade food for babies. Pre-packaged food can contain high amounts of salt so the packaging should always be checked to ensure the salt intake isn’t too high.

The table below shows the guidelines provided by the Food Standards Agency for salt consumption:

Sugar

Sugar is the leading cause of tooth decay in young children. Milk teeth which start to ‘come through’ when a child reaches the age of around 6 months are very susceptible to acid erosion from sugars. Research suggests that children are more sugar sensitive than adults, and the effects are more pronounced in younger children, according to Dr. Keith Conners, author of Feeding the Brain. This could be related to the fact that the brain grows rapidly in the preschool years, exaggerating the effects of sugar on behavior and learning.

Honey

Honey can contain a bacteria called Clostridium botulinum which can produce toxins in a baby’s intestines, leading to infant botulism, which is a very serious illness. The symptoms include:

• Constipation
• The child not wanting to feed or eat
• Suffering from lethargy

These symptoms can take several months to appear after the spores have been consumed as the spores grow in the infant’s gastro-intestinal tract and as they grow the toxins are released into the blood stream. Once an infant reaches the age of one the intestines begin to develop ‘good’ bacteria which are able to fight off the bacteria.

Nuts

Whole nuts, including peanuts, should never be given to children under five as they can choke on them. As long as there's no history of food allergies or other allergies in a family a baby can be given peanuts once they're six months old as long as they are crushed or ground into peanut butter.

1% of the population are affected by a peanut allergy and children that have a sibling which is affected have a greater risk of being affected themselves.

Low fat foods

Fat is an important source of calories and some vitamins for babies and young children. Until the age of two years children should be given whole fat milk, cheese, oily fish, yogurt and fromage frais. After the age of two the amount of fat in a child’s diet can gradually be decreased.

Eggs

Eggs should never be given to babies under 6 months old. Babies have a delicate intestinal system and they can react to the protein found in eggs. They can be given to babies over six months old, but they must be cooked until both the white and yolk are solid to prevent salmonella which can be very dangerous for young children.

Saturated fat

A child should never be given too many foods that are high in saturated fat such as crisps, chips, cheap burgers and cakes.

Raw shellfish

Raw shellfish can increase the risk of food poisoning so it’s should never be given to young babies and young children. They can contain salmonella bacteria which causes food poisoning.

Swordfish, shark and marlin

The amount of mercury in these fish can affect a baby’s growing nervous system so they should never be given to babies and children. Regular consumption above the recommended limits of fish containing high amounts of mercury can lead to a toxic build up and it can have a devastating effect on the central nervous system of babies and children, causing impairments with movements and cognitive brain function by displacement of essential neurons.

Sarah Slack

Record form for Dietary Requirements

Child’s full name: ……………………………….................

Start date :………………….

Address :…………………………………………………………………………………….

Home telephone number:………………………………….Mobile:...................................

D.O.B……………………Male/Female Age…...

Please give any details of your child’s dietary requirements including any food allergies:

Please give a detailed list of any food or drink which your child CAN NOT have:

In the unlikely case that your child consumes any of these items please give details of any treatment that should be given:

I confirm that I will keep the nursery staff informed if any of the needs or allergies detailed on this form change or are no longer applicable.

Signed…………….ParentPrint Name……………….

Signed…………….Child care providerPrint Name……………….

Sarah Slack

Coeliac Disease

Coeliac disease is intolerance to gluten and it is thought to affect around 1 in 100 people in the United Kingdom. It can affect people of all ages.

Eating foods containing gluten can cause symptoms such as:

• Diarrhoea
• Bloating
• Feelingtired all the time, this is due to notgetting enough nutrients from food. Gluten can damage the lining of the intestines which prevents the absorption of nutrients from food. If this happens, a child can become malnourished and grow at a poor rate
• Flatulence
• Abdominal pain
• Weight loss

Gluten is found in any food that contains wheat, rye and barley cereals, including:

• Pasta
• Cakes
• Breakfast cereals
• Most types of bread
• Certain types of sauces
• Some types of ready meals

Any children with this condition should never be given these foods and the food they do eat should be well documented and checked for any gluten products.

Potential long-term complications include:

• Osteoporosis(weakening of the bones)
• Iron deficiency (anaemia)
• Vitamin B12 and folate deficiency anaemia

Sarah Slack

Chronic Childhood Diseases

There are various chronic diseases suffered by children which can have an effect on their mental and physical development.

Some chronic childhood diseases that can effect development are:

• Diabetes
• Asthma
• Cerebral palsy
• Cystic Fibrosis

Diabetes

Diabetes is a condition that prevents the body from properly using energy from food. It affects around 3.2 Million people in the UK.

It occurs when the pancreas does not produce insulin, or when the pancreas produces insulin, but it is resisted by the body. It is a lifelong condition that causes a person's blood sugar level to become too high.

There are two types of diabetes, type 1 and type 2. In type 1 diabetes, the body's immune system attacks and destroys the cells that produce insulin. As no insulin is produced, glucose levels increase, which canseriously damage the body's organs.

Type 1 diabetes is often knownas insulin-dependent diabetes. It's also sometimesknown asjuvenile diabetes because it usually develops before during theteenage years.

If you are diagnosed withtype 1 diabetes, you will needinsulin injections for the rest of your life.

Type 2 diabetes is where the body doesn't produce enough insulin, or the body's cells don't react to insulin. This is known asinsulin resistance.

Type 2 diabetes is more common than type 1 diabetes.

If you're diagnosed withtype 2 diabetes, you may be able to control your symptoms by simply eating a healthy diet, exercising regularly,and monitoring your blood glucose levels.

Type 2 diabetes is often associated with obesity. Obesity related diabetes is more common in older people.

Diabetes can have various complications that can hamper development in children. These include diabetic retinopathy and diabetic neuropathy.

Diabetic retinopathy is a complication of diabetes that affects the eyes. It's caused by damage to the blood vessels of the light-sensitive tissue at the back of the eye. It can impair a child’s vision which can have a knock-on effect with their development, both physically and intellectually.

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Diabetic neuropathy can affect nerves in many different parts of the body. The most common early symptoms of the condition are numbness, tingling, or sharp pains in the feet or lower legs. Because nerve damage can happen anywhere in the body, problems can occur in almost any organ system, including the digestive tract, urinary system, eyes, and heart.

Asthma

Asthma is a common long-term condition that can cause coughing, wheezing, chest tightness and breathlessness. Asthma typically appears in childhood and around 1 in 10 children are affected.

Asthma symptoms can get gradually or suddenly worse. This is known as an asthma attack. During an attack the airways become inflammed and narrow which constricts the child’s breathing. Some allergies such as pet hair and pollen cause trigger an attack.

Asthma can hamper emotional and intellectual development depending on the severity of the disease. If a child has to miss time off school due to frequent asthma attacks this could cause the child to fall behind on school work and also important socialising. The attacks may also be frightening for the child which can affect them emotionally. This could lead to anxiety and stress which in turn could impact on a child’s life when growing up.

Cerebral Palsy

Cerebral palsy is caused by a problem in the parts of the brain responsible for controlling muscles. The conditioncan occur if the brain develops abnormally or is damaged before, during or shortly after birth.

Causes of cerebral palsy include:

• An infection caught by the mother during pregnancy
• Bleeding in the baby’s brain
• Changes in the genes that affect the brain's development
• A difficult or premature birth

Many can children suffer visually and may have hearing impairment. It may also affect learning and delay growth. A child with cerebral palsy may be slower in achieving important developmental goals, such as learning to crawl, walk or speak.

Cystic fibrosis

Cystic fibrosis is a hereditary disorder affecting the exocrine glands. It causes the production of abnormally thick mucus, leading to the blockage of the pancreatic ducts, intestines, and bronchi and often resulting in respiratory infection. It can lead to inadequate growth due to poor digestion which is a result of malnutrition.

Symptoms usually begin in early childhood and include persistent cough, wheeze, repeated chest infections, malabsorption of food and general ill health. Treatments include antibiotics, physiotherapy, and mucus thinning medicines, pancreatic enzyme replacements and other therapies. It is a life threatening condition.

Bibliography

References

• Department of Health. 1991. Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. Report on Health and Social Subjects No. 41. London: HMSO.

• Scientific Advisory Committee on Nutrition. 2003. Salt and

Health. London: TSO.

• Gregory JR, Collins DL, Davies PSW, Hughes JM, Clarke PC. 1995. National Diet and Nutrition Survey: Children Aged 11/2 to 41/2 Years. Volume 1. Report of the Diet
• www.gdalabel.co.uk
• www.diabetes.co.uk
• Practical and Nutritional guidelines, Dr Helen Crawley
• www.kon.org.uk
• www.asthma.org.uk
• www.patient.co.uk