Nursery Food: Two-year-olds - All the essentials

The funded-places programme for disadvantaged two-year-olds provides early years settings with valuable opportunities to engage these children and their families in learning about a healthy diet and good eating habits. So, what are the nutritional needs of this age group and what messages can settings pass on to parents and carers?

STARTING POINTS

Starting points for understanding nutritional needs of twos are:

• Voluntary Food and Drink Guidelines for Early Years Settings in England - this provides detailed information on the types and amounts of foods that meet the nutritional needs of children from one to five years.
  
  
• Your Guide to Eatwell Plate: helping you eat a healthier diet - produced by Public Health England in association with the Welsh Government, the Scottish Government and the Food Standards Agency in Northern Ireland, the plate shows the four essential food groups within a balanced diet, plus a fifth category that should be kept to a minimum, 'Food and drinks high in fat and/or sugar'. 'Fruit and vegetables' and 'Starchy foods' should each make up one third of the daily diet, while 'Milk and dairy' (or non-dairy alternatives containing the same nutrients) and 'Meat, fish, eggs, beans and other non-dairy sources of protein' should be eaten daily in moderate amounts (see diagram).

There are important points to remember when using the Eatwell Plate. These include the following:

• The plate represents the balance required for a healthy diet, rather than any one specific meal or a particular timescale. However, all meals and snacks should contain all four essential food groups.
  
  
• A person's intake of nutrients varies according to stage of life and gender. Given young children's rapid growth and development, they need more nutrient-dense foods relative to their size - that is, more foods from the 'dairy' and 'protein' groups. So, between the ages of two and five, children should gradually move to eating the same foods as the rest of the family, in the proportions shown on the Eatwell Plate.
  
  
• Two-year-olds who do not have a balanced diet are at risk of becoming deficient in some essential nutrients, notably iron and vitamins A and C. Iron is essential to healthy living and a deficiency can cause anaemia and, in turn, lead to physical and mental impairment. To ensure an adequate intake of iron, a two-year-old's diet must include the recommended amounts of easily absorbed sources of iron, such as meat and fish, and/or less easily absorbed sources, such as fortified breakfast cereals, dark green vegetables, broad beans, lentils and dhal, and dried fruit such as apricots, figs and prunes. All children aged one to four years should be given vitamin A, C and D drops as a nutritional safety net. 'Disadvantaged' families within the two-year-old programme may qualify for the means-tested Healthy Start scheme, which provides vouchers to cover the cost of the vitamin drops.

MAIN MEALS

Meals for twos should include the four essential food groups:

Fruit and vegetables, which contain lots of vitamins, minerals and fibre, should be included in every meal. Different varieties of fruit and vegetables contain different vitamins and minerals, so the more types that families and children eat, the better.

Introduce lots of kinds from an early age, whether fresh, frozen, canned or dried. However, don't worry if a child eats only one or two varieties as they can be encouraged to include more as they grow older. Also keep offering small amounts of other fruits and vegetables over time, so the child gets accustomed to the taste.

Some children don't like cooked vegetables but may be willing to eat 'fingers' of raw vegetables on a separate plate. Add vegetables to casseroles and sauces and use them to decorate savoury items such as scrambled egg on toast or eggy bread. A portion of fruit and vegetables is 40g for under-fives and 80g for portions for children aged five and over.

Starchy foods provide energy, nutrients and some fibre. Food from this group include bread, breakfast cereals, potatoes or yams, pasta or chapattis, rice or couscous, and are popular foods for most children.

While eating wholegrain varieties exclusively is advisable for adults and older children, it is not appropriate for young children as they can fill children up before they have eaten the calories they need. However, foods such as wholemeal bread, pasta and brown rice can be included in their diets.

Milk and dairy products, good sources of calcium, help build strong bones and teeth. They also contain vitamin A, which helps the body resist infections and is needed for healthy skin and eyes. Semi-skimmed milk can be introduced from the age of two, provided a child is eating well and growing well for their age - 1 per cent fat or skimmed milk contains insufficient fat and isn't recommended for under-fives.

Meat, fish, eggs, beans, and other non-dairy sources of protein are rich in vitamins and/or minerals as well as protein. It is recommended that children have one or two portions from this group each day.

Meat, fish, eggs and vegetable sources of protein such as pulses (beans, lentils and peas) and foods made from pulses (tofu, houmous and soya mince) are excellent sources of both protein and iron. Nuts also contain protein and nut butters are excellent nutrient-rich foods to serve to children. However, whole nuts, including peanuts, should be avoided for under-fives in case they choke.

Aim for at least two portions of fish a week, including a portion of oily fish. There are recommended limits for oily fish, crab and some types of white fish. See www.nhs.uk for more information about these limits and for choosing fish from sustainable sources.

PACKED LUNCHES

Practitioners are well placed to advise parents and carers on what makes a good packed lunch. Emphasise that these should contain the four essential food groups.

• One or two portions of starchy food: white or wholegrain bread or rolls, bagel, baguette, tortilla or wrap, pitta bread, cooked pasta, potato, noodles, rice, couscous, fruit or raisin bread, malt loaf.
  
  
• A portion of protein food: meat, fish, eggs, beans, lentils and other alternatives such as chicken, turkey, beef, lamb, sardines, tuna, egg, houmous, dahl, falafel, tofu, nut butters, and seed spreads.
  
  
• At least one portion of vegetables and at least one portion of fruits: cucumber, tomato, pepper, sweetcorn, sugar snap peas, runner beans, broccoli, carrots; apple, pear, banana, grapes, berries, kiwi, mango, canned fruit in juice and dried fruits.
  
  
• Milk and dairy or suitable alternatives: semi-skimmed milk, unsweetened calcium fortified soya milk, plain yoghurt, plain fromage frais, plain calcium-fortified soya yoghurt, cheese, rice pudding, semolina pudding, custard.

SUITABLE SNACKS

One- to four-year-olds should eat every three hours throughout the day, so when planning snacks within the setting or advising parents and carers, remember:

• - As with main meals and packed lunches, aim to provide snacks that incorporate the four essential food groups (see also page 14).
• - Avoid snacks with added sugar.
• - Don't serve fruit juice or dried fruit, as these are particularly damaging to children's teeth (see also page 9).
• - Offer only milk or water to drink.
• - Offer a range of tastes and textures, so include cooked and raw foods.

HEALTHY EATING: MAIN MESSAGES

To pass on 'healthy eating' messages to families and to encourage good eating habits among the two-year-olds in your care, you can:

- organise family workshops or fundraising activities, as these are great ways to engage families and promote consistent messages about healthy living

- emphasise to families that a child's early years provide a crucial time to encourage them to taste, experience, enjoy and eat a wide variety of foods and to develop healthy eating patterns. The more varied a child's diet in early life, the greater their chances of eating a rich and nutritious diet in later life

- remember food activities can help excite children's curiosity and enthusiasm for learning as well as helping to establish good eating habits.

Two-year-olds should:

- drink semi-skimmed milk and don't need fortified milks - they should get all the nutrients they need from eating a variety of foods

- be encouraged to drink from a cup

- be encouraged to learn how to use cutlery

- enjoy the social aspects of mealtimes by eating with others

- see adults and other children involved in food preparation and preparing for meals, such as chopping vegetables and helping set tables. They should be encouraged to help as soon as they are able to participate

- have a variety of flavours and textures in their diets, including food from different cultures.

Diana Hawdon is a registered dietitian and nutritionist (public health) and early years project manager for Food For Life Partnership, Soil Association

Download the PDF