To help meet targets on childhood obesity, Bromley Primary Care Trust was awarded a grant to design and deliver training on food and nutrition in nurseries and pre-schools. Bromley is the largest London borough, with 18,000 children under five - at least half of whom are in full-time or part-time childcare. There are 43 registered nurseries, including 29 which take babies under 12 months, and 132 registered pre-schools in Bromley.
I am a registered dietician with 15 years experience in nutrition and education, and I was recruited to carry out this project. After researching relevant literature, standards and existing training packs on food and nutrition, I came up with a set of standards, recommendations and guidelines used to audit practice in four nurseries across the borough, at the start and end of the project.
I assessed the training needs of the nurseries and pre-schools through a questionnaire and used the results to plan three training strands.
On-site nursery support
A total of 38 training and support sessions were held in 24 local nurseries. Topics covered during the visits included menu planning, healthy eating, allergies, and infant feeding. Numbers of staff ranged from one (usually the manager) to 17. The larger nurseries were usually able to release staff from the rooms to come together for a training session. In the smaller nurseries, I moved around the rooms, talking to staff in each.
Barriers to change include time, cost and food preparation facilities, so the focus of discussion was often quick- and-easy dishes using inexpensive ingredients.
Staff from more than half of the nurseries visited also chose to attend one or more of the central workshops. In addition, 13 other nurseries which did not request on-site support participated in the central workshops.
I also facilitated three workshops for parents on-site at their child's nurseries.
This left only six nurseries which did not engage in the project at all.
These nurseries were offered an 'open door' to contact me should the need arise.
Off-site workshops
Some 13 workshops were facilitated during the project, covering:
* Healthy eating for the under-fives
* Menu planning
* Special diets
* Food and festivals
* Healthy snacks
* Packing a healthy lunch
An additional five cluster groups involving staff from nurseries, pre-schools and infants schools in a locality were facilitated, plus one session for parents.
In order for the advisers to continue supporting settings after the end of the project, I ran training sessions on promoting food and health-related activities in settings.
Resource pack
A comprehensive resource pack, 'Full of Beans', was produced using materials developed for training sessions, alongside examples of good practice, including:
* Multi-cultural menus
* Cooking every week with the children
* Growing herbs and vegetables
* Building relationships with local greengrocers and butchers
* Pre-school packed lunch club
* Snack bars and milk bar
* Staff eating with the children
Packs were provided to all nurseries, pre-schools and childminders and they were launched at a 'Full of Beans' event in Bromley Central Library. The highlight of the event was cookery demonstrations by five chefs/cooks from local nurseries, who demonstrated stir-fried vegetables, Irish stew and soda bread, Jamaican rice and peas, risotto, vegetable curry, and pasta with hidden vegetables. People attending had the opportunity to taste these dishes, to take away recipes and to talk to the cooks about their menus.
In addition to the cooking, there were stalls with food and health-related toys, games and books; a stand on oral health promotion; and a parents'
resource stall, staffed by community dieticians. Photographs and examples of good practice from the resource pack were laminated and displayed in the hall and there was also an ongoing slideshow including photos from the pack. The event was attended by 92 people and was featured in the local press.
People attending the event planned to make changes on their return to their setting:
* Trying out new recipes and ideas for snacks, including from other cultures
* Feeding back to colleagues
* Being more adventurous with snacks
* New ideas for projects and involving children in cooking, food preparation and serving food.
Changes made
When the key nurseries were re-audited at the end of the project, and a parent survey was repeated, the results were positive. Some of the changes made by the nurseries were:
* Introducing food policies
* More multicultural choices
* Carers eating with the children
* Better feedback to parents
* Supporting mothers in breastfeeding and weaning
* Involving parents through surveys and events like Mothers' Day tea and Big Breakfasts
* Cutting out milkshakes and cordials from the menu
* Cooking dishes from scratch to lower their salt content.
Healthy results After the project, comments from parents included:
* 'He seems happy, so I am happy'
* ' I like that there is lots of fruit given'
* 'It's different to the food provided at home and it is varied'
* 'They enjoy as well as learn about what they eat'
* 'I am happy with what my child eats at nursery and have noticed that she eats more now too, and her table etiquette has improved as she copies others. Meals and kitchen staff are good.'
The project as a whole was assessed and also received many positive comments, with similar changes being made in settings across the borough. I had contact with a total of 554 people working in childcare.
Nutrition is a current 'hot topic', which helped the project to be successful. However, the survey showed that not all settings had heard of the project, which highlights the importance of a variety of marketing tools in initiatives of this kind.
Some pre-schools reported that they did not respond to the needs assessment questionnaire as they 'only' provide milk/water and fruit at snack times.
However, those pre-schools who were involved found it useful to share ideas for a greater variety of snacks and, crucially, the importance of snack time as a development opportunity for skills, knowledge and awareness.
Although the project has ended, there is clearly a need for ongoing support through training, resource pack updates and professional visits to settings. Future work will be targeted at areas of deprivation through the children's centre network, and will target childminders as well as nurseries and pre-schools.
Meanwhile, settings should be urged to continue to share good practice, and to develop relationships with local producers and suppliers.
Further information
* The pack can be downloaded from http://www.bromley.gov.uk/education/childcare/full_of_beans_food_and_nutriti on_in_nurseries_and_pre_schools.htm
Chicken nuggets
Little Elliott's Day Nursery in Bromley has a popular recipe for homemade chicken nuggets
Ingredients
Skinless chicken breast, plain flour, breadcrumbs, grated cheese, dried chives, mustard powder, milk
* Cut the fresh chicken into small nugget shapes.
* Make a thin paste with the mustard and milk.
* Mix the flour, breadcrumbs, grated cheese and dried chives.
* Coat the chicken pieces with the paste, followed by the flour and breadcrumbs mixture.
* Place on a lightly greased baking tray. Put in the oven at 190xC/375xF/gas mark 5 for 20 minutes or until lightly browned.
* Test temperature with a probe.
