Interview: How To Solve Your Early Years Nutrition Challenges

Tips from an expert paediatric dietitian.
early years nutrition
September 18, 2018
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Early years nutrition is crucial. Not only do early years settings provide the children in their care with much of the actual food that they need to grow and develop, but they teach children healthy attitudes towards food that can last a lifetime.

That’s why we sat down with qualified paediatric dietitian Lindsay Gilbert from Foodtalk.

Foodtalk is a not-for-profit organisation that helps to promote better nutrition for children of all ages, by providing training, developing programmes, and more. They’ve even produced a hugely popular board game that childcare settings can use to train their staff, without the need for an expensive away day.

So what does quality early years nutrition look like? How can you overcome some of the most common challenges to do with healthy eating? And why does it all matter so much? Well, time to find out.

Why does early years nutrition matter?

On a very simple level, it matters that we properly nourish children, so they can fulfil their potential physical and cognitive growth.

But for Lindsay and the team at Foodtalk, it’s about more than that. “96% of the three and four-year-old population in this country access some sort of pre-school care,” points out Lindsay. “What children learn about food and mealtimes in the early years, especially if they’re not learning it at home, becomes incredibly important.”

The healthy attitudes and skills that you can give to children by providing a healthy mealtime environment can last a lifetime. “My first dietetic manager used to tell me ‘what’s learnt first lasts the longest’, and that’s always stuck with me,” Lindsay recalls.

No food is bad food

“Your diet can be good or bad, but no food is good or bad by itself,” Lindsay says. Instead, the definition centres on whether a food should be enjoyed as an everyday food or a food that should be enjoyed occasionally.

“Parents and early years providers need to understand which foods children should eat every day to grow well,” explains Lindsay. “Starchy foods, iron-rich protein food, calcium-rich dairy foods, and fruit and vegetables, for example. Then we have other foods which we can enjoy but which should be eaten less frequently like sweets, chocolates, crisps and so on.”

The reason why it’s wrong to suggest that some foods are bad is that it can promote unhealthy attitudes towards food in general, Lindsay thinks.

“Our children do eat too much sugar,” she explains. “But in some instances, parents and subsequently children are worrying unnecessarily. We want children to enjoy their food without feeling guilty whilst learning about everyday foods and non-everyday foods.”

More than just what’s on the plate

Before we get stuck in, it’s important to understand a few more of these healthy attitudes that we want to promote in children.

“A lot of adults don’t have a great relationship with food themselves, and so many children grow up in households where less healthy attitudes towards food can be passed on. So we need to provide an environment that supports children to learn healthy mealtime habits and to eat well.” Lindsay explains.

Here are just some of the things we should be focusing on when it comes to promoting healthy eating attitudes:

  • The enjoyment of eating.
  • Eating as a sociable activity.
  • Eating a variety of foods.
  • The importance of sitting down to eat and drink.
  • Not feeling guilty about our food.
  • The importance of food as part of our daily routine.
  • Listening to our bodies and understanding when we’re full or hungry.
  • Eating in a pleasant environment.

How to deal with early years nutrition challenges

Now that you understand why early years nutrition is so important, let’s move onto how you can improve it at your setting. Here are 9 top tips from Lindsay on how best to approach nutrition challenges with staff, parents, or the children themselves.

1. Find a flagbearer

For Lindsay, any improvement in your team’s nutrition competency should start by asking yourself a simple question:

What skills do you have within your team already?

“The starting point is to do an audit and find out what the gaps are,” Lindsay says. ‘’By doing so, you can get an understanding of how many of your Level 2 practitioners have received any nutrition training, how recently your level 3s have updated their knowledge, and who has a passion for it in general.

Find that passion, and you’ve found your early years nutrition flagbearer.

2. Leadership counts

A flagbearer is important, but it won’t be enough without good leadership.

“I’ve worked with settings that shone because they had a passionate practitioner who was given time to work on their food policy and menus and encouraged to work closely with the chef and manager to implement them,” Lindsay explains. “In other situations that passion has been there but the proper time wasn’t given and it didn’t work out.”

Just as we explained when we talked about improving observations, giving your team the time out of ratio to work on their initiatives is key if you want to find any success with them.

3. The training you can afford

We all know nurseries don’t have endless budgets. So the next question you need to ask is:

What can I afford?

“For me, direct group face-to-face learning is the most high-impact,” Lindsay claims. “It allows you to train all your staff at the same time and have questions answered. It’s dynamic but it is more expensive.”

“On the other hand, The British Dietetic Association have The Children’s Food Trust online learning modules which are a brilliant but affordable starting point for implementing early Years Nutrition Guidelines. It means everyone in the team can be involved, looking over the training resources when it fits with their work schedule.”

And of course, as we mentioned earlier, there’s always an option to add a cost-effective board game to your staff meetings that can be used again and again.

4. Policy comes first

Time to get to the nitty-gritty. What steps can you actually take within your setting to really improve healthy eating and attitudes?

“Your healthy eating and nutrition policy should absolutely be the starting point,” Lindsay says. “That’s where you set out your setting’s whole ethos and approach, and most parents genuinely appreciate that.”

Why? It’s because it offers clarity and something to refer back to in case you have any disagreements.

“It’s so much easier if you have the conversation at the beginning because everyone knows where they stand and no-one is offended because you’ve already explained your policy and why you have that in place.” Lindsay points out.

This is particularly true for settings that don’t provide meals and want to make sure that they don’t single out any parents for providing an unhealthy packed lunch.

“The first meeting with parents is crucial. The questions that you ask on any forms are crucial too, because they are conversation starters. For example, you could ask if the children are on healthy start vitamins which the government recommends. If they aren’t, it’s a great time to get that conversation started.”

- Lindsay Gilbert, Paediatric Dietitian and Director, Foodtalk

The big ideas

5. Intolerances and allergies

One of the difficulties that many settings face is meeting the needs of children with special diets, including food allergies. Even more so when the lines are blurred between allergies, intolerances, and parents with specific nutritional wishes.

One way around this is asking about an Allergy Action Plan.

“You need to make sure that your policy has clear guidelines about how your setting manages special diets. For example, requesting an Allergy Action Plan can be particularly helpful. If a parent approaches you with various dietary requirements, you could point them towards a registered dietitian to make sure that they have the right support to ensure their child’s diet remains balanced. It’s important that foods aren’t being omitted unnecessarily.” Lindsay recommends.

“Most children grow out of their allergies by the time they reach school. Just asking those questions can sometimes prompt a helpful conversation.”

6. The right portion

One simple thing that can have a huge impact on healthy eating in the setting is a better understanding of portion control for your staff.

“Staff can often give portions that are far too big. So educating everyone on a typical portion size for a toddler can be a good starting point.” Lindsay says. “That can be a big eye-opener, because often staff are worried about children going hungry, and associate big portions with love and care.”

“However, not only do large portions lead to overeating, but they can make it even more daunting for children who are already struggling as fussy eaters.” Lindsay points out.

“Staff may not always be present at mealtimes and even if they are, they may not eat the same food as the children. Unfortunately, they can sometimes act negatively around certain foods, saying ‘I don’t like that’ or refusing to touch certain things.
It’s easy to forget that what you say and how you act can impact a lot on the children. Staff need to be positive role models too.”

- Lindsay Gilbert, Paediatric Dietitian and Director, Foodtalk

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7. Snack time

Snack time can be a surprisingly controversial issue when it comes to early years nutrition. For one thing, how do settings that favour a free-flow approach balance child-led play with an approach to healthy eating that focuses on being mindful?

“The problem with a less formal approach to snack time is that it may not encourage children to sit down to eat, which is a potential choking hazard,” Lindsay says. “Children are not taking the time to focus on the sensory aspect of eating, consider whether they are hungry or full, or appreciate the flavours and textures of the food on offer.

“I know some settings are advised not to break from snacks. But free flow snacking can be chaotic and may result in some children taking too much whilst others may miss out altogether.

So what to do? Luckily, Lindsay knows from experience the best way around this issue.

“We worked with a nursery where a specific snack table and chairs were set up at snack time. Children were aware that they could choose whether to come and sit down and eat their snack or not, leaving them in charge of their own play and appetite.”

8. Dealing with weight

There’s one looming issue that we’ve yet to discuss. And Lindsay admits it can be a tricky situation to broach due to the stigma associated with obesity.

“Excess weight in the early years is really tricky, even for health professionals to discuss,” Lindsay says. “But bearing in mind that early years practitioners are not qualified to make the diagnosis of whether a child is overweight, my advice would always be for practitioners to signpost parents back to the child’s health visitor or GP to have their growth monitored.”

With that in mind, however, there are some things that you can do to help if you are concerned about a child.

“Visual displays asking parents if they have concerns about their child’s weight can help and provide general information about healthy snacks and drinks is good, because you’re not targeting anyone in particular,” Lindsay suggests.

“If you do approach the subject, you must use incredibly sensitive language. A good way is perhaps to focus on particular eating behaviour that you may have noticed, like if the child often takes a second or third portion. I would never mention weight outright unless a parent approached you with specific concerns.” Lindsay says.

“Oral health may be a useful way to broach the issue of weight because the two often go hand-in-hand. It’s a lot easier to say you’re worried about a child’s teeth than their weight. It doesn’t create as many barriers and can open up a conversation about the child’s diet and lifestyle in general.”

9. Eating is learning

It’s not all about nutrition and healthy attitudes towards food though. Eating can be a powerful learning experience too.

“Eating in itself is a potential learning activity. It’s an opportunity to talk to children about where their food comes from, to discuss the textures, and smells, and to learn more about their likes and dislikes.” Lindsay explains.

“Some settings are great at getting children involved. For example in meal preparation, children can help chop the snacks or lay out the food, set and clear away the tables or pour the water themselves. What you’re teaching is life skills, which can boost self-esteem and confidence while you’re at it.”

Further Reading

If you want to find out more about early years nutrition, why not check out some of the brilliant resources that Lindsay has recommended?

Foodtalk is a not-for-profit organisation comprising of three paediatric dieticians passionate about reducing health inequalities relating to diet and nutrition. They specialise in community nutrition interventions designed to promote good eating habits in children, young people and their families. To find out more, head over to their website.

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Please note: here at Famly we love sharing creative activities for you to try with the children at your setting, but you know them best. Take the time to consider adaptions you might need to make so these activities are accessible and developmentally appropriate for the children you work with. Just as you ordinarily would, conduct risk assessments for your children and your setting before undertaking new activities, and ensure you and your staff are following your own health and safety guidelines.

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