One Four Nutrition

FAMILY CHILD CARE TRAINING PROGRAM

LEVEL ONE - UNIT FOUR

NUTRITION

LEARNING OBJECTIVES:
1. Understanding the importance of good nutrition in children’s growth and development.
2. Reviewing Canada’s food guide and recommended daily servings.
3. Planning meals and snacks that meet children’s nutritional, cultural, and personal, preferences and needs.
4. Identifying strategies to encourage children’s interest in good nutrition.

CHATTER BOX

"Even though we had two children of our own, I had worked outside the home for almost five years before I started providing care and we had gotten pretty accustomed to meals on the run, lots of take-out and not a lot of cooking. I worked it out the other night and between my own family and the children in care I am now preparing 144 meals and snacks a week! I’ve had to get a lot better about meal and menu planning, and food budgeting. I have to admit we are all eating a lot healthier now but the biggest surprise is that I am really enjoying cooking, especially cooking with all the kids. It’s messy, it’s noisy and it’s great fun."

THE BASICS Good nutrition is important for all of us. It is especially important for children because they are still growing and developing as well as establishing life-long eating habits. A healthy diet provides the energy and essential nutrients that children need to grow, develop and be active. It also develops the children’s sense of taste, acceptance and enjoyment of a variety of foods. Good nutrition can even have a positive impact on children’s behaviour!

ABOUT NUTRIENTS Children need food to satisfy hunger, to stay healthy, to grow and to have energy for daily activities. Foods contain nutrients that keep bodies healthy. Because no one food supplies all the necessary nutrients it is important to eat a variety of foods each day. Each nutrient has a basic purpose.

· Carbohydrates and fats provide the energy the body needs to perform its’ daily functions.
· Proteins provide the "building blocks" for growth and repair. Proteins are necessary for proper growth and development.
· Vitamins and minerals help the body to use other nutrients.
· Water is used in every chemical activity that takes place within the body. It also satisfies thirst and removes waste. Although water provides no energy to the body, it is essential for proper bodily functions.

Nutrients are found in a variety of foods which are classified into four main food groups.

THE FOUR FOOD GROUPS Canada’s Food Guide divides food into four basic groups as a convenient way to achieve a balanced diet. These four groups are: grain products, fruits and vegetables, milk products and meat and alternatives. Each of the four groups contain nutrients. The basic nutrient in each of the four groups, and some of the foods included in the groups are:

· Grain Products provide carbohydrates, minerals and some vitamins. Whole grain and enriched products are especially nutritious choices.
· Vegetables & Fruits provide carbohydrates, vitamins, some minerals and water. Dark green and orange vegetables and orange fruit are especially nutritious choices. A vegetable or fruit containing Vitamin C, such as broccoli, oranges, grapefruit, orange or other vitamin-fortified juices, kiwi fruit, cantaloupe or strawberries, should be eaten each day.
· Milk Products provide proteins, fats, minerals and vitamins. Milk products include milk, cheese and yogurt. Two cups of milk should be consumed each day because it is our main dietary source of Vitamin D. In Canada, only fluid milk is fortified with Vitamin D, other milk products are not.
· Meat & Alternatives provide proteins, fats and some minerals.

Eating the recommended amount of a variety of foods from each of these four food groups will ensure an adequate intake of essential nutrients. Each of the four basic food groups provides certain nutrients but not all foods within a group contain the same nutrients or the same amounts of nutrients. That is why enjoying a variety of foods within each food group is an important recommendation of the Guide.

Other Foods is another category identified by Canada’s Food Guide which includes foods that are not part of the four basic food groups. These foods, while providing taste and enjoyment, are not nutritious and are usually higher in fat and/or calories and they should be used in moderation. Examples of these "other foods" include: soft drinks, butter, margarine and other fats, tea and coffee; ketchup and mustard; salad dressings; pickles; honey; and snack foods such as cookies, cakes, pies, and potato chips.

ACTIVITY

Make a list of what you served for breakfast, morning snack, lunch, afternoon snack and supper today. How well did your menu plan measure up to the Food Guide? Were you under in some food groups and over in others? How many ‘extras’ appeared on your list? Is that something you would want to change? Indicate on your list, changes that you would have to make to ensure the children are receiving the required number of servings in each of the food groups.

NUMBER AND SIZE OF SERVINGS CHILDREN NEED Everyone has the same nutritional needs, but the amounts vary according to each person’s age, size, sex, activity level, appetite and growth rate. The following chart shows the number of servings and some examples of the size of serving recommended by Canada’s Food Guide for children.

	# of servings daily	Serving size for under 4 years old	Serving size for children 4 years and over
Grain Products	5 - 12 servings*	½ - 1 slice bread ½ - 1 cup flaked cereal 2 tbs. or 1/3 cup granola 1/4 - ½ bagel, pita or bun 1/4 - ½ cup pasta or rice	1 slice bread 1 cup flaked cereal 1/3 cup granola ½ bagel, pita or bun ½ cup pasta or rice
Fruits and Vegetables	5 - 10 servings*	½ - 1 medium sized fresh fruit or vegetable 1/4 - ½ cup fresh, frozen or canned fruit or vegetable	1 medium sized fresh fruit or vegetable ½ cup fresh, frozen or canned fruit or vegetable
Milk Products	2 -3 servings* (3 - 4 servings for 10-16 years old)	½ - 1 cup milk** 25 - 50 g cheese 1 - 2 slices cheese 1/3 - 3/4 cup yogurt	1 cup milk 50 g cheese 2 slices cheese 3/4 cup yogurt
Meat and Alternatives	2 - 3 servings*	25 - 50 g meat, fish or poultry 50 - 125 g beans 1 - 2 tbsp. peanut butter 1/4 - 1/3 cup tofu 1 egg	50 - 100 g meat, fish or poultry 125 - 250 g beans 2 tbsp. peanut butter 1/3 cup tofu 1 - 2 eggs

Children’s nutritional needs vary depending on their age, sex, body size, activity level, growth rate and appetite. Very young children may eat the lower number of servings for the four food groups (for example 5 servings of grains), while older more active children may eat the high number of servings (12 servings of grains).

HEALTHY FOOD CHOICES

GRAIN PRODUCTS

Breads
Whole wheat, multi-grain, rye, orenriched white breads, rolls or bunsRaisin or cheese breadBagels, pita bread, flour tortillas, muffins

Cereals
Cold cereals without sugar coatingHot cereals, plain, no sugar

Crackers
"Low salt" varietiesPlain bread sticksRice cakesGraham wafers"Animal" crackersArrowroot cookies

Pasta, couscous, or rice

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VEGETABLES & FRUIT

Any and all kinds of vegetables
Fresh, frozen, or canned.Vegetable juice

Any and all kinds of fruit
Fresh,Frozen, unsweetenedCanned, unsweetened or in fruit juice

Juice, unsweetened 100% real fruit juice

MILK PRODUCTS

Milk
Fluid milk, whole (homogenized) or 2%Low-fat milk for those over 2 years of ageButtermilk

Cheese
Cheddar, mozzarella, brickCottage cheese
**Cream cheese is considered a fat serving, not a part of the "Milk Product" Group.

Yoghurt

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MEAT & ALTERNATIVES

Meat, Fish, Poultry
Beef, pork, organ meats, lambWhite fish, tuna fish and salmonChicken, turkey, Canned ham, chicken or turkey

Alternatives

Eggs, scrambled, poached, boiled, ...Egg Salad SandwichesEggs in French toast, Pancakes...Brown beans, vegetarian chili, lentils, peasTofu Tofu products such as tofu wieners or burgers

Peanut butter

USING CANADA’S FOOD GUIDE Canada’s Food Guide, with its’ range of servings and portion size, may seem complicated at first. Is it just more information to consider when deciding on the foods to serve your day care children? Not at all! Actually, the Guide is a valuable tool that will help streamline your choices when it comes to meals and snacks.
The Food Guide was organized for everyday use. All the choices that you have to make are right there: the selection of foods to be offered; the serving size of each food; and the number of servings needed each day. By organizing your meals and snacks around the Guide’s recommendations, you will achieve a balanced, healthy diet.
As a rule of thumb, preschoolers in care for more than six hours should receive the following number of servings from the four food groups.

    Grain Products........................at least 3-5 child size servings
    Vegetables & Fruit.................at least 4-5 child size servings
    Milk Products.........................at least 2-3 child size servings
    Meat & Alternatives...............at least 2-3 child size servings.

Energy needs, and therefore the amount of food eaten, will vary from child to child and from day to day. Never force a child to eat. As long as they are growing adequately and are energetic, they are likely getting enough. A good rule of thumb is that you decide what the child will eat, and that the child decides how much he or she will eat. Always be alert to any known food allergies and post a list of known allergies in a prominent place in the kitchen. When introducing new foods to children, talk to parents first, and watch closely for any indication of an allergic reaction. (Any new food that an infant is given should be introduced at home first.)
Morning and afternoon snacks should contain foods from at least two of the four food groups. Yoghurt and sliced banana, toast and peanut butter or carrot sticks and cheddar cheese would all make healthy snacks containing foods from two of the four food groups.

Breakfast, lunch and supper should contain a minimum of one food from each of the four groups. Ham or tuna sandwiches, carrot sticks, an apple and a glass of milk make up a balanced lunch.
Planning meals that satisfy the children’s nutritional needs as well as their preferences can be challenging. Here are some suggestions:
Learn all you can about nutrition. Depend on reliable sources such as Canada’s Food Guide when making food choices.
Let the children and the parents know that you care about good health and nutrition and you are serving foods that meet recommended standards. Include both children and parents in discussing food preferences, allergies, menus and meal planning.
If a child care family’s diet is very different from your own, ask parents to share ideas for new foods that you could incorporate into your meal planning. If there are foods you are unfamiliar with, ask for advice from parents about preparation and serving. They will appreciate your interest and their child will be much more comfortable with some familiar foods.
Popular choices such as pizza, hamburgers, peanut butter, cheese, milk, cookies and muffins are all part of good eating, as long as they are prepared in a healthy way. Topping these choices up with vegetables and fruits will also increase their nutritive value.
Try foods new to you along with old favourites. Learn about and incorporate foods of other cultures and countries into your menu planning. Young children are at an ideal stage for learning to accept and enjoy a varied menu.
Encourage the children’s interest in good foods by letting them help prepare some of their meals and snacks. Cooking activities are very enjoyable for the kids, even if it’s just preparing a muffin mix or arranging apple and cheese slices on a plate. Children will especially enjoy an opportunity to help prepare and share some of the foods that their families enjoy. Let children help out with preparing meals and snacks, setting the table, passing food and clearing the table.
A warm, social atmosphere encourages children to enjoy snacks and meals. Provide comfortable seating and maintain a relaxed pace.
Children are happier with predictable routines. Let the children know when lunch or snack is a few minutes away. "Tidy up, visit the bathroom and wash your hands" might signal that mealtime is coming.
Get things organized before the children are seated for a meal or snack. Organize beverages and provide a plate of vegetable and fruit pieces to keep children settled while you serve the rest of the meal. Have your bibs and damp face cloths ready!
Prepare and freeze some favourites ahead of time for those really hectic days.
Avoid adding too much sugar or salt to foods.
Avoid serving highly seasoned foods to children not accustomed to seasoning.
Be a good role model. Join children for meals and snacks.
Present food in appealing ways, combining different colour, textures and shapes of food.
Talk about healthy food in a positive and enthusiastic way. "Look at those crunchy, orange carrots."

CHATTER BOX

"One of my families was having a difficult time with their two year old. While he was eating very well here, he was refusing to eat at home. The parents were really becoming concerned and we talked about it at length. We went over everything, routines, foods, portion sizes, etc. but the only difference we could find was that at home he was still in a high chair, while here he sat on a normal chair with a booster at the table with all of us. They decided to try that at home and to their surprise (and mine), it worked. Now it might have been coincidental and his appetite may have been going through the usual ebbs and flows, but I still think it’s a valuable lesson - often when there is a problem, we overlook the easiest solutions."

Meeting Infant’s Nutritional Needs

Feeding infants requires the cooperation and guidance of the parents. They will have decided on the foods, including breast milk or formula and the feeding schedule that their baby is following. Parents are an important source of information around their infant’s eating habits, including how much they eat and how often. As the caregiver, you’ll play an important role in meshing the baby’s usual routines at home with those in your child care home in order to meet the infant’s needs while satisfying those of the other children in your care.

About Bottle Feeding Ask the parents to supply their infant’s bottles ready for the feedings, and labelled with their infant’s names.
Put the bottles in the refrigerator as soon as they arrive.
Warm the bottle just to take the chill off. Shake a few drops on to the back of your hand. It should feel cool to the touch.
Pour any liquid remaining in the bottle down the drain.
Hold and cuddle the baby while feeding. Never lay the baby down and "prop" the bottle.
    Breast milk or formula is an infant’s main source of nutrition for the first four to six months. Around this time parents may wish to start introducing solid foods especially if the baby seems hungrier (finishing the bottle and looking for more). This is the time in a baby’s development when he or she is ready to try new tastes and textures but the main part of his or her diet is still the bottle. Introduce foods one at a time and one teaspoon at a time. Any foods that the infant is given should be introduced at home first.
    Feed babies in a sitting or almost sitting position to reduce the possibility of choking. Use a small spoon gently and talk and smile at the baby to create a pleasant eating experience for both of you. Never lay babies on their backs after feeding.
When introducing a cup, try one with a spout or straw since both are closer to sucking than drinking. Water is a good choice to quench children’s thirst.
    Most babies are ready for mashed family foods between nine and ten months. This introduces coarser textures and encourages chewing. They will also enjoy low-sugar cereals such as "Cheerios," toast fingers, and pieces of soft fruits such as bananas to encourage self-feeding.
Between ten and twelve months, children are ready for chewier finger foods which will promote chewing, coordination and independence. Try diced fruits, grated vegetables, fruits and vegetables that have been lightly steamed or microwaved, pieces of cheese, small meatballs or diced chicken,   small squares of banana, pumpkin, or zucchini bread or muffins (without nuts) and whole wheat bread and crackers. Children should be encouraged to drink from a spill-proof cup.
    The feeding pattern for toddlers, one year to eighteen to twenty-four months, is to gradually increase the texture and variety of the foods served until the children are being served all of the foods on the regular child care menu.

PREVENT CHOKING Choking is a serious concern, especially for young children under five years of age. Here are some guidelines which will help prevent this danger.
• Avoid giving children large pieces of food. Provide child size pieces.
• Insist that all food should be eaten sitting down.
• Encourage children to chew their foods slowly and thoroughly. Make sure that they aren’t laughing or crying with food in their mouths.
• Keep a close eye on all the children while they’re eating, particularly those who seem to choke or gag easily.
• Avoid foam cups and plastic forks and spoons which can be easily bitten by children.
• Do not give cough drops, fish with bones, gum, hard candy, popcorn, peanuts or other nuts, raisins, or snacks served with toothpicks, to children under four.
• Develop an awareness of the foods that are most likely to cause choking as well as the preparation required to reduce this likelihood.

Some common foods that require extra caution when being served to young children:
Weiners/Hot Dogs: Because of their round shape, weiners can get stuck in the throat. To eliminate this problem, slice lengthwise, and dice for children under four.
Peanut Butter: Because of it’s thick consistency, peanut butter can mass together and stick in the child’s throat. Spread it thinly between bread or crackers.
Carrots: Because of their cylindrical shape, carrots can become stuck in the throat. Grate raw carrots or slice thinly.
Grapes: Because of their circular shape, grapes can become stuck in a child’s throat. Slice grapes into four pieces.

NOTEWORTHY
Fussy Eaters? Children can be turned off by large amounts of food on the plate. Serve smaller portions with an offer of seconds.
If children show a real dislike for a particular food - accept their preferences - we all have some foods that we just don’t like.
Offer small quantities of a new or less favoured food alongside a familiar one, without pressure to eat the new food.
Encourage children to become familiar with foods by having them help to grow, buy, prepare or serve them.
Avoid showing distress if a child is not eating. Many children experience variations in appetite, but children will not actually starve themselves. Offer a variety of foods in small sized servings and remain calm.
Avoid using food as reward or punishment. For example offering desert as a bribe for finishing vegetables reinforces the notion that desert is more desirable and vegetables less so.

ACTIVITY

What are some of the methods you have used to help overcome eating difficulties? To encourage children’s interest in good nutrition, what are some of the activities that you might do with toddlers, preschoolers and school-aged children?

for more information Canada’s Food Guide to Healthy Eating was developed to provide information about the kinds of foods to choose for healthy eating as well as the number and serving size of these foods needed each day. It was designed for everyone over the age of four.

Canada’s Food Guide to Healthy Eating for Preschoolers, designed for two to five year old children, follows a similar pattern, but takes into account the smaller amounts of food that preschoolers eat.

You can obtain copies of both of these guides by contacting:

Publications, Health Canada
Ottawa, Ontario K1A 0K9
Telephone: (613) 954-5995

There are many other sources of information that you can access including:

· The Canadian Paediatric Society has several helpful publications including Little Well Beings: A Handbook on Health in Family Day care. This book contains practical information on promoting children’s health in family day care homes. Another booklet which is available is called Starting Right. It is a nutritional guide for a child’s first three years of life and contains valuable information on feeding infants, toddlers and preschoolers. To enquire about either of these books or any other publications write to The Canadian Paediatric Society, Children’s Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario, K1H 8L1. Some of the publications are available free of charge and others are available at a minimal cost.

· Provincial Milk Marketing and other Agriculture Boards
· Family Child Care Associations
· Libraries, books and magazines
· Doctor’s offices, Medical Clinics
· Public/Provincial Health Departments
· Provincial/Territorial Government Child Care Offices
· There are many health and nutrition sites available on the Web. One example is a Health Canada site at www.hc-sc.gc.ca.

EVALUATION

OPTIONS FOR EVALUATION
13) ASSIGNMENT
14) QUIZ

ASSIGNMENT

Using the Canada Food Guides, and your own knowledge of the children’s preferences, develop a menu plan for meals and snacks for a two week period. On your menu plan, include any meals or snacks that you will be serving to the day care children including, for example breakfast, morning snack, lunch, afternoon snack, dinner and evening snacks.

QUIZ

1. What do carbohydrates and fats provide to the body?

2. Why is water so important to the body’s function?

3. What are the four food groups?

4. Name at least three foods in the grain group.

5. Name at least three foods in the meat and alternatives group.

6. Children’s nutritional needs vary. What are three of the factors that affect a child’s nutritional needs?

7. Name at least three finger foods appropriate for a 10 - 12 month old infant.

8. Name at least four foods that could cause choking in children under four years of age.

9. Saba, an active three year old, has just started in care. Her parents inform you that all she will eat are noodles (not for religious or cultural reasons, it is simply all they have been able to get her to eat lately). What are some of the strategies you might use to encourage more balanced eating?

10. What information regarding meals and snacks should you be providing to and receiving from parents?