Q: The Government has launched a review into standards of nursery food by a panel of experts and nutritionists. It will consider whether the quality of food in early years settings should be regulated. Do you think there is a need for new regulations or guidelines this area?
'I think that regulations would be too dictatorial. However, I do think that there should be guidelines. The School Food Trust should include early years settings and have specific guidelines for the early years. I think that the Schools Food Trust does a good job for schools and it's a shame that it does not recognise that eating habits are formed a long time before children start school.'
'It concerns me that some settings are still serving processed food. I think that regulations might be necessary for nurseries that are still serving bad food to children, but for nurseries that already offer good food it might make things more difficult. We consult regularly with parents and all of our food is cooked from scratch.'
'It really depends how stern or how prescriptive the regulations would be. For example, if we have to start noting all of the salt that we use, then it could just end up being another expense that nurseries have to cope with.'
'I don't think regulations are necessary, as some settings already make it a priority to serve good-quality food to children. We have healthy menus at our setting, which last year we won an award for. We have taster evenings where parents can sample the food that we offer to the children and a lot of parents request the recipes that we use.'
'Our setting is run by a health visitor, so we are very conscious about healthy food and things like salt content. I think it would be good for the Government to publish guidelines for nurseries. However, regulations would probably lead to extra costs for nurseries, and unless they are going to provide some sort of funding, nurseries might have to increase their fees or buy lower-quality food, which would defeat the purpose of bringing in the regulations. For example, we provide wholemeal rice and pasta because it is healthier, but this is more expensive than buying white pasta and rice.'
Q: Is there a lack of information for nurseries on what sort of meals and snacks that they should be providing to their children?
'There are definitely gaps in the information available around what to feed young children. Unless you are very pro-active, it is difficult to find the information. Parents are always asking me about portion sizes. Again, I think that it should be part of the School Food Trust's remit. One area where there is definitely a need for more information is with weaning. A lot of parents are reluctant to reduce their child's milk intake. However, keeping their milk intake high can encourage faddy eating.'
'Having one central point of information like the School Food Trust would be useful.'
'I don't think there is enough information for nurseries. Even for the parents of young children the information is limited. Parents often ask me for advice on healthy eating for young children, and all I can give them is my interpretation of what this means.
'I also think that childcare qualifications should include modules on healthy eating for children. If practitioners are aware of what children should be eating, then they are in a position to challenge or try to make changes in a setting that serves junk food.'
'There just isn't enough information out there on what to serve young children.'
'I think there is a real lack of information out there. I don't know of any websites that give advice for nurseries on providing healthy food. I think it would be a good idea for there to be a quality assurance scheme which would look at the standard of food served in nurseries, and if there is a scheme like this already, it should be more heavily promoted.'
Q: Who do you think should monitor the quality of food provided by early years settings?
'That is a difficult question. Perhaps there could be an overlap with the local authorities' environmental agencies, which monitor hygiene in early years settings. I would worry about Ofsted being given responsibility for this, because there could be a lack of knowledge from inspectors about healthy eating and it could just make things worse. Perhaps local authorities could delegate a dietitian who could visit early years settings and offer advice. At the moment settings can get this advice, but they have to pay for it.'
'I don't think it should be Ofsted's responsibility to monitor the standard of food in nurseries, because the inspectors would not be qualified to make judgements on this. It would just come down to each inspector's personal interpretation and that could do more harm than good. It would be more logical for the local authority's environmental agency to do it, or someone who is an expert on food.'
'Ofsted could monitor the standards of food, but the inspectors would need the right knowledge or have enough information to be able to monitor food quality fairly and objectively.'
'I think nurseries should take responsibility themselves for the monitoring of healthy food, but I also think local authorities should have some involvement via their early years teams.'
Q: What do you think the barriers are for nurseries not providing balanced meals to children?
'Providing healthy food is one of the main philosophies of our setting, but it takes up a lot of time. It takes someone with a lot of knowledge and passion for healthy eating to instill it at a setting. It's not easy and it is very labour-intensive.
'In our setting we provide organic meat from the local butcher, which is very expensive, so providing healthy food has a financial impact. There is also a lack of parental knowledge and parents need a lot of support. It would be easier if childcare settings could get some funding to provide healthy food in the same way that schools do.'
'I think that it all comes down to money. It is expensive to provide good food, which at our setting means fresh food that is preferably organic. Seventy per cent of the food that we provide is organic and we are trying to get to the 100 per cent mark. However, it is punitively expensive. I am sure, or at least I would like to believe, that all of those nurseries who do not provide healthy food would do so if they could afford to.'
'There is definitely a cost factor involved. Other possible barriers are the knowledge of the person who is responsible for preparing the food. Our nursery chef is excellent and he puts all the menus together himself.'
'I think cost and a lack of knowledge is the major issue preventing some nurseries from providing good-quality food to children.'
NURSERY FOOD STANDARDS
By Priya Tew, freelance dietitian (www.dietitianuk.com, www.dietitiansunlimited.co.uk)
Children under five are highly vulnerable to malnourishment, whether this be overor under-nourishment. They depend on 
their caregivers to provide them with well-balanced, highly nutritious food. Good eating habits are learned early on in life and they are the foundation block.
Early nutrition can impact on children's growth, development and their ability to achieve and learn, so it's vitally important to get it right. With the rise of children under five attending nurseries, alongside the rise in obesity, it seems imperative that these nurseries are providing healthy, balanced food throughout the day, and a comprehensive set of guidelines would seem to help with this.
The current standards are quite brief and do not cover all nursery and childcare situations. The review being carried out by the School Food Trust seems to be very timely and will provide an invaluable overview of what information is currently available, along with what is needed.
The initial review has shown there is a lack of knowledge and there are gaps in the current guidelines. Obvious gaps seem to be guidance on portion sizes. This is a subjective matter and highly important, as young children have different nutritional needs to adults, so just giving smaller portions of adult food is not always suitable.
The Caroline Walker Trust is currently trialling a photo-based portion size resource, which sounds fantastic. There also appears to be a large gap in guidelines on special diets, allergies and cultural needs, which is not helpful in a time when these diets are on the rise. Training and guidance on these issues as well as support for nursery caterers on how to balance a menu would be a good step forward.
For years, dietitians have been the champions of good nutrition, quietly working with groups when there is funding, being the source of reliable, credible expertise. They are well placed to offer guidance on menu planning, recipe analysis, special diets and nutritional standards, as well as to provide education to staff, parents and children.
The Caroline Walker Trust has also produced an excellent set of guidelines, Eating well for under-fives in childcare: practical and nutritional guidelines (Crawley 2006) that I would highly recommend.
