A Unique Child: Nutrition - Course of action

Mention the words 'children' and 'healthy eating', and a whole series of associations will probably come up, perhaps including the 'war on obesity', Jamie Oliver, and reports that more than a quarter of English children are overweight or obese. It feels like all of us working with young children must respond, and urgently. But matters are not really as simple as they seem.

That is certainly what we found out at Kate Greenaway Nursery School and Children's Centre, in London's Kings Cross neighbourhood, when we started off a chain of actions which led us to rethink nursery food, build a new kitchen, work with a local restaurant and, finally, seek a specialist cook to work with young children.

Our starting point was a parent satisfaction survey, which found that parents were mostly very pleased with Kate Greenaway. But there was a big exception: the meals were almost universally criticised. We were in a contract with a large provider - I'm not able to name the company for legal reasons, but many attempts to suggest improvements got us almost nowhere.

As a nursery school headteacher, I think that every stage of providing meals for the children is important. But, despite the changes in recent years, it still seems to me that most school meals are characterised by not very well prepared food being slopped or placed into nasty plastic trays for children to accept as passive consumers, knowing little of what they are eating or where it comes from.

Thornhill Primary School, just up the road from us, opted out of its school meals contract and was working with a local restaurant, the Duke of Cambridge, to develop and implement a menu based around seasonal, fresh produce that was mostly organic and locally sourced. Geetie Singh, the founder of the Duke of Cambridge, is a member of the Government's Council of Food Policy Advisors, and believes that 'children are the future of our food industry'. How, she wonders, will children 'make informed choices as teenagers and young adults if we don't supply them with the information, experience and habits they need from a young age?'

Baby-led weaning

Thornhill Primary School's work brewed up excitement in the local community. A group of parents came together at Kate Greenaway to help us do fundraising for our own kitchen, which was built last year. Feeling both excited and somewhat daunted by the fast pace of events, I set about trying to learn more about what children in a nursery school like Kate Greenaway should be eating.

Despite the current focus on healthy eating for the youngest children, and the seemingly endless news stories and other sources of information that come to me as a headteacher, I found that I knew much less than I had thought. Our school meals start with the youngest babies during the process of weaning. A quick discussion with the baby team found that we lacked a clear approach to weaning, and simply followed what parents were doing at home.

I spent some time working with colleagues in the local primary care trust who were eager for children's centres like Kate Greenaway to promote healthier eating for babies, rather than just follow custom and practice. We decided to experiment with changing the organisation of baby lunch, reducing substantially the amount of food that was offered to babies in blended form or already cut into very small pieces.

Instead, drawing on the approach called 'baby-led weaning', we increasingly presented babies with chunks of food cut like chunky chips, so they can be held in a little fist. Staff still spoon-feed babies mashed and blended food if necessary, but only after they have had enough time to feed themselves.

This fits well with our ethos of encouraging babies and young children to make choices in the presence of caring and trusted adults, and feels a long way from the horrors I saw years ago of babies in nurseries being practically force-fed by over-eager staff.

The next question was how our approach to healthy eating should respond to the needs of two-year-olds. Again, I was surprised by what I learned. Although toddlers are much more active than babies, and bigger, their need for food is not correspondingly greater because their rate of growth and brain development has slowed. This explains in part how the baby with a good appetite can seem to become a picky, fussy toddler.

Additionally, toddlers' biological development may make them more wary about unfamiliar foods, reducing the chances of the more mobile toddler picking up and eating poisonous or harmful substances. We felt confident about giving children more choice at mealtimes, rather than worrying unduly if they did not choose to eat much.

Nutrition research

We are not seeing many signs of the 'childhood obesity epidemic' among children on roll in the nursery. I assumed that this was because children at Kate Greenaway are very active all day, both inside and outside. It may be so - but I was surprised to find that the evidence suggests that many children are not being fed enough in English nurseries.

The most thorough piece of research whose findings point that way was undertaken by Sarah Almond, a consultant specialist paediatric dietician, who analysed samples from one week's worth of breakfast, snacks, lunch and supper from every nursery in East Sussex. Her study found that most nursery meals were too low in calories to provide adequate nutrition, and that portions were generally too small.

Sarah Almond told The Observer newspaper, 'We expected the study to show nurseries were serving children food that was too high in calories, fat, saturated fat and salt, and low in vegetables and fruit. Instead, we found that the majority of nurseries had gone to the other extreme and appeared to be providing food that was too low in calories, fat and saturated fat and too high in fruit and vegetables.'

It seems as if nutrition in early childhood is being driven by a desire to promote adult-style healthy eating, replacing all those crumpets and English muffins that used to be served at snack times with cucumbers and carrots, and leaving children hungry and potentially malnourished.

For help, we have turned to the excellent Caroline Walker Trust for specialist advice on healthy eating for the under-fives, and have continued to work with the Duke of Cambridge restaurant, which is sourcing ingredients and devising seasonal menu plans for us.

As we are just about to take our next big step - advertising for a nursery cook - we imagine a kitchen that will be properly connected to the nursery, involving children in vegetable and herb growing and helping with some of the preparation, so that dinner does not simply arrive on a plate by completely hidden processes.

We want our approach to nutrition to fit with everything else that we do: to be adapted to the specific needs of children under five, to involve them, and to promote their autonomy and skills.

FURTHER INFORMATION

- Caroline Walker Trust: www.cwt.org.uk/

- Duke of Cambridge: www.dukeorganic.co.uk/

- 'Fruit and veg diet "danger for toddlers"' by Amelia Hill, www.guardian.co.uk/society/2008/apr/13/children.health

- Islington Primary Care Trust's leaflet on weaning www.islington.nhs.uk/Services-Breastfeeding/MilkAndMore.pdf