SAFE HEALTHY CHILDREN A Health and Safety Manual for Childcare Providers

Transcription

1 TABLE OF CONTENTS Chapter 6: Nutritious Menu Planning I m Hungry: Nutritious Menu Planning. 6.1 Infant Feeding Requirements of the Day Nurseries Act 6.2 Infant Feeding Recommendations of the Medical Officer of Health. 6.2 Meals for Older Children - Requirements of the Day Nurseries Act Meals for Older Children - Requirements of the Medical Officer of Health Schedule 1 and Schedule Menu Planning Requirements of the Day Nurseries Act Menu Planning Recommendations of the Medical Officer of Health 6.5 Allergies Requirements of the Day Nurseries Act. 6.7 Allergies Recommendations of the Medical Officer of Health Guidelines For Special Dietary Needs

2 We all recognize the importance of good nutrition for young children. Good nutrition promotes healthy growth and development and a feeling of well-being. We want kids to grow up healthy and feeling good about themselves. There is more and more evidence that creating an environment for children where the norm is to be physically active and eat healthy, leads to life-long healthy habits and healthier body weights. As a childcare provider, your role is to ensure that the children in your facility are in an environment where they receive nutritious meals, learn good eating habits, and develop healthy attitudes toward food. Planning and offering healthy menus that provide variety can be challenging. Some children are naturally fussy about what they eat and mealtimes can sometimes be hectic. This section reviews standard practices and gives you some ideas for addressing these concerns. Bon appetit! 6.1

3 39 Every operator shall ensure that: INFANT FEEDING (a) each infant under one year of age... is fed in accordance with written instructions from a parent (b) where food or drink is supplied by a parent... the container... is labelled with the child s name (c) all food or drink is stored, prepared and served so as to retain maximum nutritive value and prevent contamination. INFANT FEEDING Remember: Feeding infants improperly can have serious consequences. You and your staff must follow the written instructions of parents concerning the type, amount, and schedule of feedings for their infants. 1. Feeding Your Baby is a booklet which offers detailed guidelines for infant feeding. Review relevant details with each infant s parents to confirm their instructions. 2. Parents may bring breast milk, commercial infant formula, whole cow s milk, and/or baby food from home. Ensure that they are labelled with name and date, and stored in the refrigerator. Note that soy, rice and almond beverages are generally not recommended for children under the age of 24 months because they may not be nutritionally adequate. 3. Use extreme caution with microwave reheating. Ensure that containers are microwavesafe. Use low temperatures and short heating times. Stir food once heated and always test the temperature of the food before serving. 6.2

4 MEALS FOR OLDER CHILDREN 40(1) Every operator shall ensure that each child one year of age or over is provided with: (a) a meal consisting of at least 1 serving of milk products, 1 serving from meat and alternatives, 1 serving from grain products, and 2 servings from vegetables and fruit within the range set out in... Schedule 1... (b) nutritious between-meal snacks consisting of foods that will promote good dental health at times that will not interfere with a child s appetite for mealtimes. 40(2) Where a child... is in attendance for 6 hours or more, the operator shall ensure that the total food offered to the child... for each food group... is within the range set out... in Schedule 2. MEALS FOR OLDER CHILDREN Healthy food choices meet a child s energy needs to grow, develop and keep active. Children aged 2 and up can meet their energy needs by following Canada s Food Guide. The amount of food young children need depends on their age, body size, activity level, growth rate and appetite. It s no wonder that mealtime for young children is a challenge! For toddlers under 24 months, there is no recommended number of servings for each food group but Schedule 1 of the DNA provides a range of servings to offer 1-6 year old. Vegetables and Fruit: Offer whole, fresh or frozen vegetables and fruit. Limit or avoid fruit juice. Grain Products: Ensure at least half of the grains served are whole grains. Milk and Alternatives: Serve whole (homo) milk to children up to 24 months of age. Serve 1% or 2% to children over the age of 2. Meat and Alternatives: Offer fish and meat alternatives such as beans and lentils weekly. Limit foods and beverages high in calories, fat, sugar or salt such as fruit drinks, fruit beverages, store-bought pastries, cakes, cookies, granola bars, donuts and chips, Many parents and caregivers are concerned about how much or how little preschoolers eat. Children know best how much they need. Children's appetites will vary from meal to meal and day to day. Allow children to choose from a variety of healthy foods provided by the caregiver. Never force children to eat. 6.3

5 Food Group SCHEDULE 1 Range of serving size Children under 6 years of age but more than 1 year of age Range of serving size Children 6 years of age and over 1. Milk Products ml ml 2. Meat & Alternatives g g 3. Grain Products 1/2-1 slice or ml 1 slice or ml 4. Vegetables & Fruit 1/4-1 whole fruit or ml 1 whole fruit or 125 ml SCHEDULE 2 Food Group Amounts provided each child in attendance for 6 hours or more 1. Milk Products ml 2. Meat & Alternatives g 3. Grain Products 1 1/2-2 1/2 slices or ml 4. Vegetables & Fruit 2-2 1/2 whole fruits or ml METRIC CONVERSION Volume Weight 50 ml = 1/4 c. 30 g = 1 oz. 125 ml = 1/2 c. 90 g = 3 oz. 175 ml = 3/4 c. 250 ml = 1 c. 375 ml = 1 1/2 c. 450 ml = 1 3/4 c. 6.4

6 MENU PLANNING 41(1) Every operator of a day nursery shall post planned menus for the current and following week in a conspicuous place... with any substitutions noted on the posted menus. 41(2) A menu... shall be retained by the operator for 30 days after the last day for which it is applicable. Every operator of a private home day care agency shall ensure that each person in charge of the child in each location where private home day care is provided... plans menus in consultation with the child s parents, and a private home day care visitor. MENU PLANNING Make healthy meals and snacks your goal every day. Consult Canada s Food Guide (included in the Appendix). Foods other than those in the 4 food groups are also part of healthy eating. They add to the taste and enjoyment of eating. When choosing Other Foods, centres should: include them in amounts that do not displace foods from the 4 food groups use moderate amounts of foods such as margarine, butter and salad dressing encourage the natural flavour of foods, only add high salt seasonings and condiments in moderation. Preschoolers tend to eat a large part of their day s food from snacks so make sure that snacking does not increase chances of tooth decay. Whenever possible, encourage your children to brush their teeth after eating. Serve snacks which include choices from 2 food groups such as crackers and cheese or yogurt and fruit. Reserve sticky foods like dried fruit for mealtimes when children can brush their teeth afterwards. Make sure that children eat sitting upright and supervise eating to prevent choking incidents. For children under 4 years, avoid foods like hard candies, gum and gummy bears, peanuts, sunflower seeds, popcorn, fish with bones, snacks on toothpicks or skewers. Food that require preparation for children under 4 years include: grapes, hot dogs, raw carrots, peanut butter (spread thinly), celery and pineapple. Slice or chop these finely. 6.5

7 MENU PLANNING Put variety into your menu by contrasting the colors, textures, sizes, shapes, temperatures, and flavours of foods. Serve foods in forms that young children can manage easily. Include some finger foods such as vegetable sticks and fruit sections. Introduce new foods in small quantities. Encourage children to try them. Consult the guidelines in section of the Day Nurseries Act for more good suggestions for menu planning, food purchasing, and controlling waste. For infants, use the menu only as a guide and modify it according to each baby s needs and parental instructions. Follow these steps for easy, worry-free menu planning 1. Use the Child Care Menu Planning form as your guide. The form includes the minimum number of food guide servings recommended according to Ministry requirements. 2. Select the meat and alternatives for the whole week. Choose a different protein source for each day. Include beef, pork, chicken, fish, legumes, cheese, eggs etc. Include fish on the menu 1-2 times per week. 3. Next, select the vegetables. Remember to include both cooked and raw choices. Make the most of the colours and variety available in season. 4. Select fruit more often than juice. Consider not serving 100% juice at all. 5. Add a variety of breads, cereals and grain products like bagels, pitas, muffins, pasta, and rice. Concentrate on whole grain choices. 6. Add milk products. Remember to follow parental instructions, and serve whole (homo) milk for children under Select the snacks for the week, including foods from at least 2 food groups. 8. Add Other Foods in moderation. These include jam, honey, mayonnaise, syrup, ketchup, salad dressing, pretzels, etc. 9. Do not serve low nutrient, high sugar, salt and/or fat food such as popsicles, fruitflavoured drinks, hot dogs, cake, cupcakes and chips. 6.6

8 ALLERGIES 42 Every operator... shall ensure that a list is posted in each cooking and serving area... that sets out the names of the children... that have food allergies and their respective allergies (1),(2),(3) (1) Every operator shall ensure that each day nursery operated by the operator and that each location where private-home day care is provided by the operator has an anaphylactic policy that includes the following: 1. A strategy to reduce the risk of exposure to anaphylactic causative agents. 2. A communication plan for the dissemination of information on life-threatening allergies, including anaphylactic allergies. 3. Development of an individual plan, with input from the child s parent or guardian and the child s physician, for each child with an anaphylactic allergy that includes emergency procedures in respect of the child. 4. Training from a physician or a parent on procedures to be followed in the event of a child having an anaphylactic reaction. (2) The individual plan for a child with anaphylaxis and the emergency procedures in respect of the child shall be reviewed as follows: 1. By all employees before they begin their employment and at least annually afterwards. 2. By volunteers and students who will be providing care or guidance at the day nursery before they begin providing that care or guidance and at least annually afterwards. 3. By the person in charge of a location where private-home day care is provided before the child is placed at that location and at least annually afterwards. 4. By volunteers and students who will be providing care or guidance at a premises where private-home day care is provided before they begin providing that care or guidance and at least annually afterwards. 5. By persons who are ordinarily residents of the premises where private-home day care is provided before the child is placed at that location and at least annually afterwards. (3) In this section, anaphylaxis means a severe systemic allergic reaction which can be fatal; resulting in circulatory collapse or shock, and anaphylactic has a corresponding meaning. 6.7

9 ALLERGIES Food allergies can have serious consequences. Be prepared to care for food allergic children in your centre. 1. Refer to Anaphylaxis in Schools & Other Settings (2011) available at to help your centre reduce the risk of accidentally exposing allergic children to allergens and to respond appropriately in an emergency. Use the Checklist for Dealing with Allergies (see Appendix) Establish a written allergy/anaphylaxis plan with the child s parent(s) or guardian Ensure each child s allergy/anaphylaxis plan is signed by their physician Work with the child s parent(s) and other personnel involved with the child s meals and snacks Inform other parents of the presence of food allergies and request their cooperation Take steps to create safe conditions on and off-site 2. Keep individual children s allergy/anaphylaxis plans up-to-date, in visible places, and made known to all staff. SPECIAL DIETARY ARRANGEMENTS 43 Every operator shall ensure that where special dietary and feeding arrangements have been made with the operator... that the arrangements are carried out in accordance with the written instructions of the parents of the child. SPECIAL DIETARY ARRANGEMENTS Improper feeding of children with special needs can lead to severe consequences. Be sure to adhere strictly to parental instructions. Discuss any concerns you have with the parents. Suggest that they consult further with the Registered Dietitian at the Middlesex- London Health Unit by calling , ext or ginette.blake@mlhu.on.ca. 6.8