It is undeniable the importance of an adequate nutrition to ensure growth and development, especially during childhood and its role in promoting and maintaining health and well-being of the individual.

The Child Care Setting while feeding children should devote attention to encourage the consumption of various foods offered on the menu, guiding them to eat in moderation, how to do and not do, repressing when pouring or spreading food.
Never punish, embarrass or force children when refuse to eat, never used children even as a baby receiving food as a reward or distraction.
The act of eating alone is a feeling new to the child and should be performed with pleasure; teach them that they need to eat not to fast or too slow.
Encourage children to eat new foods: like fruits and vegetables, the introduction of other foods than breast milk or formula should be done after 6 months.
Juices, water, fruits, vegetables, cereals, meats, eggs, derivatives of milk introduced progressively lead to a healthy diet.
The Child Care Setting can help parents with children’s food consumption, vitamins and minerals their bodies need, with an incredible range of colour combinations and flavours providing rich, healthy and tasty food.
We can use fairy tales in Child Care Settings as a way to teach healthy food habits, such as Hansel and Gretel explaining that we cannot eat so many sweets or chocolates; Little Red Riding Wood who was taking a basket full of healthy food to her grandmother; Ratatouille who dreamed being a head master and follow the footsteps of the chef who he idolized, etc.

Baby/ Toddler age

Kcal per day:
Boy/ Girl

Portions per day

6 months

760kcal/ 710 kcal*

Carbohydrates-3
Vegetables-3
Fruits-3
Breast milk/ formula
Meat/eggs-2
Beans-1
Oil/ Fat-2
Sugar- 0

9 months

880kcal/820kcal*

1 year

960 kcal/910 kcal*

2 years

1190kcal/ 1130kcal*

Carbohydrates-5
Vegetables-3
Fruits-4
Milk/ dairy-4
Meat/eggs-2
Beans-1
Oil/ Fat-2
Sugar-1

3 years

1280kcal/1230kcal*

4 years

1490kcal/1370kcal*

Carbohydrates-5
Vegetables-3
Fruits-3
Milk/Dairy-3
Meat/eggs-2
Beans-1
Oil/ Fat-1
Sugar-1

5 years

1600kcal/1460kcal*

*estimated

There are many types of food that are unsuitable for babies and toddlers and we as carers and parents need to have extra care, for example: we should avoid cooking with salt because it is associated to hypertension and their kidneys have difficulty in eliminate the excess.

When cooking for babies and toddlers with salt we should be in attention the guideline salt intake, where babies from birth to age of 6months should be less than 1 g/d because breast milk or formula already has enough salt for their bodies. Babies from 7months to 1 year 1g/d; 1 to 3 years 2 g/d; 4 to 6 years3g/d (…)
Always have extra care when cooking with salt for babies or toddlers.
It is recommended that children up to 1 year do not consume honey; it can be contaminated with spores of Clostridium botulinum bacteria responsible for transmitting the intestinal botulism.
In the first year of life, the intestinal flora is still in development and cannot stop the action of these bacteria.
Sugar or refined sugar, are high calories foods, poor in nutrients and in overconsumption can cause a number of diseases.
Excessive sugars intake while increasing the concentration of insulin in the blood also increases the amount of adrenaline causing irritation, anxiety, arousal, and difficulty concentrating.
Sugar is not only present in sweets, but also in frizzy juices and some types of yogurts.
One well known disease of children and adults are tooth decay and gum inflation caused by habitual intake of sweets and frizzy juices.
Nuts are foods at higher risk of causing allergies and should be only introduced to children after age of 5.
The probability of a potentially allergic reaction increases with the presence of allergic parents and with early or late introduction of a new food.
It is also important, the amount and the frequency with which the food will be offered to children.
Eggs are also an allergenic food and it should be given only on babies by the age of 6 months and never before.
When cooking eggs, they must be firstly thoroughly washed and cooked well to reduce the risk of salmonella infection.
The symptoms of salmonella infection may vary of intensity but in general are strong diarrhoea, vomiting, nausea, high fever.
The treatment is drink fluids to avoid dehydration and in sometimes antibiotic medicines.
It is not recommended introduce more than one new food at a time, because if an allergic reaction occurs the possible cause will be difficult to identify.
It should be introduced in small quantities and observe the following 48 hours if they have any allergic reaction.
Everybody knows that fish is very good for babies and adults because they have plenty of protein. But we need to have extra care when giving to babies swordfish, shark and marlin, because they contain high levels of mercury which can be prejudicial to the development of the baby nervous system.
Shellfish can trigger serious allergies and food poisoning, therefore should not be eaten by children until they are older.

The ingress of a child is a period of flexible transition between leaving their comfort zone and the entrance to a Child Care Setting.

In this period, children and family experience a series of feelings, such as fears, hopes, expectations, etc.
Apart from the adaption required in this new environment, children need to adapt to other factors like feeding and various types of stimulation and also any health problems they might have, like food allergies or food intolerances.
Child cares must have special attention and promote a safe environment to these demands recording a daily routine.
Family need to be present at all the times participating together with children, and child cares to the resolution of any problems or concerns that may emerge, even when cooking the meals and snacks to children with special dietary requirements.
Trust, respect, affection, understand, partnership between the family, the child care and the Child Care Setting are extremely important for the safety of a Child.
The difference between food allergy and food intolerance is the kind of response the body gives you when it is in contact with the food. There is an immediate immune response and intolerance cannot digest or metabolize the food.
The most typical food allergies in children are cow’s milk, nuts, strawberries, fish, shellfish, egg, etc.
The food fights the ingested food as if it was an offending agent, and immediately responds in an exaggerated way, and even in contact with small amounts of food it can emerge symptoms like spots on the skin, cough, nasal or eye irritation, swelling or asthma larynx.
Some food intolerance in children is lactose, wheat and gluten, soya, etc.
In food intolerance the body lacks an ability to digest food causing the accumulation inside the body.
The undigested substance can cause symptoms such as abdominal pain, gas, diarrhoea or constipation, nausea or vomiting.
But both treatments consist of removing the food and all the recipes, which are prepared with the foods that cause the symptoms.
When preparing the menus in a Child Care Setting, we should be aware of being a balanced and varied menu, rich in nutrients, proteins and vitamins respecting the socio-cultural context of children and their religion (Judaism, Hinduism, Islam, Buddhism, Sikhism, Rastafarianism, Seventh Day Adventist, Jainism), respecting parents believes.
Menus should be diverse and be in accordance with the development of children intended; respect individuals preferences of each child; in situations of need have special diets, and parents should be informed about the menus and changes on it.
Always read the food composition on labels, avoiding inadvertent consumption the substance in question. Be aware of the utilization of certain utensils that may have come into contact with the allergen (e.g.: cheese knife should not be used to cut ham or the other way around), find out the ingredients with which the meal was done and has been prepared in the Child Care Setting or in a catering service.

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And that is why is so important to involve all workers in a Child Care Setting, child carers, kitchen staff, cleaners and discuss what is the best for the safety of the child and in case of allergic reactions have an Epi-pen if is the case, normally prescribed to the child by their doctor, and other medications prescribed to the child in case an emergency occur.
Keeping these records up to date and documented accurately is crucial in a way to familiarise parents or guardians about the daily routine activities and the specific dietary of the child requirements given by them are being followed.
Example:
Child Record Form for a Child with a specific dietary requirement
Childminder’s name:­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­ Start date:
Child’s name
Religion: Age:
Address:
Parent/ Guardian: Mobile: Work ph. no:
Emergency contact information:
Medical details
Child’s doctor name:
Telephone:
Record of immunization attached:
List of food allergies:
Emergency plan needed in case of an allergic food occur:
Food intolerances:
Emergency plan needed in case of food intolerance occurs:
Specific dietary require? Details:
Consequence of the dietary requirement not being followed:
Necessary medications and times:
Parents/Guardian:
Child Care Provider Signature:

Few Childhood chronic diseases, among others are asthma, diabetes, cystic fibrosis and cerebral palsy.

Asthma is a respiratory chronic disease in childhood, where the most common symptoms are breathiness, cough, tightness and wheezing in the chest.
It can affect children differently, they can have from mild symptoms to strong attacks that require care in hospital to get the disease under control and consequently failure to school and poor school performance, impaired sleep, interference in the relationship with siblings and friends, etc.
The treatment for asthma is the inhaler and steroid medication.
Diabetes: there are two types, diabetes type 1 is more common in children and can occur in the first week of birth to 30 years of age. It is related to the lack or low insulin production, unable to control the rate of ingested glucose and it is controlled with insulin injections.
The type 2 is hereditary and it happens when the cells resist to insulin action, even if its production is normal, and we can control through diet and medication.
Cystic Fibrosis is caused by an inoperative gene, which causes the body to produce odd thick and sticky mucus. The mucus builds up in the breathing passages of the lungs and in the pancreas, an organ that helps to break down and absorb food, and the result can be lung infection that are life-threatening and serious digestive problems.
The treatments are tablets, diet, exercise and physiotherapy to eliminate the mucus from the lungs.
Cerebral Palsy is a brain injury, induced by the lack of oxygenation in the brain and it can develop during pregnancy, childbirth or during childhood.
It is a disorder that involves the brain and the functions of the nervous system, such as movement, hearing, learning, seeing and thinking forever.
Children with chronic diseases might share similar experiences despite differences in symptoms and severity; they tend to be pain and discomfort, insufficient growth and development, frequent trips to doctors and hospitals, daily care and sometimes with painful treatments, or medical care, and fewer opportunities to play with other children.
It can frustrate the dreams the parents had for their child, the increased spending of the treatment to do, a complex system of care, the loss of opportunities (e.g. when a parent cannot return to work), social isolation, the parent’s distress trying to deal and live with a child with chronic disease can interfere with the bond between parents and between the child and his family.
Parents might feel distress to learn that the child as an abnormality, they might also feel a great impact of sadness, depression, guilty, anxiety, etc and these feelings can occur at any time during the development of the child and each parent can react differently, which can cause inconsistencies disciplinary and behavioural problems.
A parent working, where cannot support the other in the visits to the doctor or hospital. Parents should be completely familiar with the illness of their child.
The collaboration between physicians, social workers, chid cares and others can be very beneficial for the child, parents and their family.
There are groups that can help them to find a family that has already faced a similar problem and who is willing to talk to new parents and offers them their support.
If necessary the family can seek from financial and physical support.
Reference List
http://www.cwt.org.uk/pdfs/Under5s.pdf
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Mercury Levels in Fish – Safe Fish for Pregnancy

http://www.acaai.org/allergist/allergies/Types/food-allergies/types/Pages/shellfish-allergy.aspx
http://www.babycenter.com/0_foods-that-can-be-unsafe-for-your-child_1491465.bc
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http://www.rnib.org.uk/eye-health-eye-conditions-z-eye-conditions/understanding-eye-conditions-related-diabetes?gclid=COCsi8emn8ECFSbmwgodszoAcg
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http://www.aboutkidshealth.ca/en/resourcecentres/diabetes/aboutdiabetes/SignsandSymptomsofDiabetes/Pages/default.aspx
http://www.nhlbi.nih.gov/health/health-topics/topics/cf/
http://www.nhs.uk/conditions/Cystic-fibrosis/Pages/Introduction.aspx
http://www.nhs.uk/conditions/cerebral-palsy/pages/introduction.aspx
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