Child Development: Nutrition

Child Development: Nutrition

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Study day 10: Nutrition Box1: Healthy eating can stabilise children’s energy, sharpen their minds, and even out their moods. While peer pressure and TV commercials for junk food can make getting kids to eat well seem impossible, there are steps parents can take to install healthy eating habits without turning mealtimes into a battle zone. By encouraging healthy eating habits now, you can make a huge impact on your children’s lifelong relationship with food and give them the best opportunity to grow into healthy, confident adults. Developing healthy eating habits

Children develop a natural preference for the foods they enjoy the most, so the challenge is to make healthy choices appealing. Of course, no matter how good your intentions, it’s always going to be difficult to convince your eight-year-old that an apple is as sweet a treat as a cookie. However, you can ensure that your children’s diet is as nutritious and wholesome as possible, even while allowing for some of their favourite treats. The childhood impulse to imitate is strong, so it’s important you act as a role model for your kids. It’s no good asking your child to eat fruit and vegetables while you gorge on potato chips and soda.

Food groups: Top tips to promote healthy childhood eating * Have regular family meals. Knowing dinner is served at approximately the same time every night and that the entire family will be sitting down together is comforting and enhances appetite. Breakfast is another great time for a family meal, especially since kids who eat breakfast tend to do better in school. * Cook more meals at home. Eating home cooked meals is healthier for the whole family and sets a great example for kids about the importance of food. Restaurant meals tend to have more fat, sugar, and salt. Save dining out for special occasions. Get kids involved. Children enjoy helping adults to shop for groceries, selecting what goes in their lunch box, and preparing dinner. It’s also a chance for you to teach them about the nutritional values of different foods, and (for older children) how to read food labels. * Make a variety of healthy snacks available instead of empty calorie snacks. Keep plenty of fruits, vegetables, whole grain snacks, and healthy beverages (water, milk, pure fruit juice) around and easily accessible so kids become used to reaching for healthy snacks instead of empty calorie snacks like soda, chips, or cookies. Limit portion sizes. Don’t insist your child cleans the plate, and never use food as a reward or bribe. How can I get my picky child to enjoy a wider variety of foods? Picky eaters are going through a normal developmental stage, exerting control over their environment and expressing concern about trusting the unfamiliar. Many picky eaters also prefer a “separate compartmented plate,” where one type of food doesn’t touch another. Just as it takes numerous repetitions for advertising to convince an adult consumer to buy, it takes most children 8-10 presentations of a new food before they will openly accept it.

Rather than simply insist your child eat a

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new food, try the following: * Offer a new food only when your child is hungry and rested. * Present only one new food at a time. * Make it fun: present the food as a game, a play-filled experience. Or cut the food into unusual shapes. * Serve new foods with favorite foods to increase acceptance. * Eat the new food yourself; children love to imitate. * Have your child help to prepare foods. Often they will be more willing to try something when they helped to make it. * Limit beverages. Picky eaters often fill up on liquids instead. * Limit snacks to two per day.

Persuading children to eat more fruit and vegetables Making mealtimes playful can mean healthier eating for your kids. Here are some fun, creative ways to add more fruit and vegetables to your child’s diet: * Top a bowl of whole grain cereal with a smiley face: banana slices for eyes, raisins for nose, peach or apple slice for mouth. * Create a food collage. Use broccoli florets for trees, carrots and celery for flowers, cauliflower for clouds, and a yellow squash for a sun. Then eat your masterpiece! * Make frozen fruit kabobs for kids using pineapple chunks, bananas, grapes, and berries. Go food shopping with your children. Let them see all the different fruits and vegetables and have them pick out new ones to try. * Try fruit smoothies for a quick healthy breakfast or afternoon snack. * Add vegetables and fruits to baked goods – blueberry pancakes, zucchini bread, carrot muffins. * Add extra veggies to soups, stews, and sauces, grated or shredded to make them blend in. * Keep lots of fresh fruit and veggies washed and available as snacks. Apples, pears, bananas, grapes, figs, carrot and celery sticks are all easy to eat on the run. Add yogurt, nut butter, or tahini for extra protein. Limit sugar and salt

One of the biggest challenges for parents is to limit the amount of sugar and salt in their children’s diets. Limiting sugar The American Heart Association recommends that sugar intake for children is limited to 3 teaspoons (12 grams) a day. Cutting back on candy and cookies is only part of the solution. Large amounts of added sugar can also be hidden in foods such as bread, canned soups and vegetables, frozen dinners, ketchup, and fast food. * Don’t ban sweets entirely. Having a no sweets rule is an invitation for cravings and overindulging when given the chance. * Give recipes a makeover. Many recipes taste just as good with less sugar. Avoid sugary drinks. One 12-oz soda has about 10 teaspoons of sugar in it, more than three times the daily recommended limit for children! Try adding a splash of fruit juice to sparkling water instead. * Cut down on processed foods, such as white bread and cakes, which cause blood sugar to go up and down, and can leave kids tired and sapped of energy. * Create your own popsicles and frozen treats. Freeze 100% fruit juice in an ice-cube tray with plastic spoons as popsicle handles. Or try freezing grapes, berries, banana pieces, or peach slices, then topping with a

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little chocolate sauce or whipped cream for an amazing treat.

Limiting salt One teaspoon of salt contains about 2,300 mg of sodium. Some guidelines for the maximum salt intake for children: If a child is…| They should eat less than…| 1 to 3 years old| 1,500 milligrams a day| 4 to 8 years old| 1,900 milligrams a day| 9 to 13 years old| 2,200 milligrams a day| 14 to 18| 2,300 milligrams a day| * Avoid processed, packaged, restaurant, and fast food. Processed foods like canned soups or frozen dinners contain hidden sodium that quickly surpasses the recommended limit. Many fast food meals are also loaded with sodium. * Opt for fresh or frozen vegetables instead of canned vegetables. Cut back on salty snacks such as potato chips, nuts, and pretzels. * Choose low-salt or reduced-sodium products. Healthy eating for toddlers and young children Toddlers can be introduced to new tastes and textures as they transition from baby food to “real” food. Keep in mind that toddlers have very small stomachs. It may be better to feed them 5-6 small meals a day, rather than three large ones. Depending on age, size, and activity level, your toddler needs between 1,000-1,400 calories a day. It is perfectly normal for your child to be ravenous one day and shun food the next.

Don’t worry if your child’s diet isn’t up to par every day—as long as he or she seems satisfied and is getting a well-rounded diet. Nutritional needs of toddlers and young children An important part of a toddler’s diet is calcium (they need about 500 mg/day), and the best source of this nutrient is milk. Until the age of two they should drink whole milk, but older toddlers can usually switch to 2% or skim milk if approved by your paediatrician. If your kids are lactose intolerant or don’t like dairy, incorporate calcium-rich foods like fortified soy products, cereals, and orange juice.

Toddlers need 7mg a day to prevent iron deficiency, which can affect growth, learning, and behavior. In infancy, breast-milk has a readily-absorbed type of iron, and baby formula and food is usually iron-fortified, so babies don’t need to worry about getting enough iron. After switching to “real” food, it’s important to ensure that your child is eating good sources of iron like fortified cereals, small amounts of red meat (like soft meatballs), or eggs. Dietary guidelines for toddlers and young children| Fruits and vegetables| Two servings each per day.

These may be given as snacks, such as apple or carrot slices. Also try adding veggies to soups. | Whole grains| Four daily servings. Can include buckwheat pancakes or multigrain toast for breakfast, a sandwich on wheat bread for lunch and brown rice or another whole grain as part of the evening meal. | Milk and dairy| Three servings, or one pint of whole milk per day. Cheeses, yogurt, and milk puddings are useful alternatives. | Protein| Two servings a day. Encourage your child to try a variety of proteins, such as turkey, eggs, fish, chicken, lamb, baked beans, and lentils. Vitamins and minerals| Check with your child’s doctor to be certain their

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diet is adequately meeting the recommended nutritional needs for this age group| Dietary guidelines for toddlers and young children| Fruits and vegetables – Two servings each per day. These may be given as snacks, such as apple or carrot slices. Also try adding veggies to soups. | Whole grains – Four daily servings. Can include buckwheat pancakes or multigrain toast for breakfast, a sandwich on wheat bread for lunch and brown rice or another whole grain as part of the evening meal. | Milk and dairy – Three servings, or one pint of whole milk per day.

Cheeses, yogurt, and milk puddings are useful alternatives. | Protein – Two servings a day. Encourage your child to try a variety of proteins, such as turkey, eggs, fish, chicken, lamb, baked beans, and lentils. | Vitamins and minerals – Check with your child’s doctor to be certain their diet is adequately meeting the recommended nutritional needs for this age group| Healthy diets for school-age children Eating becomes a social activity in this stage of life. Your kids probably spend more time in school than they do at home; eat meals at friends’ houses; and adopt eating habits from their peers.

It can be difficult to ensure they are getting adequate nutrition when you are not around to monitor their choices, so try to maintain regular family mealtimes. For kids aged 5-12, the key word is variety. Creative serving ideas will go a long way towards maintaining the healthy eating habits established in the first years of life. Not only do family meals provide an opportunity to catch up on your kids’ daily lives, they also enable you to “teach by example. ” Let your kids see you eating a wide variety of healthy foods while keeping your portions in check.

Refrain from obsessive calorie counting, though, or commenting on your own weight, so that kids don’t adopt negative associations with food. Nutrition guidelines for school-age kids As children develop, they require the same healthy foods adults eat, along with more vitamins and minerals to support growing bodies. This means whole grains (whole wheat, oats, barley, rice, millet, quinoa); a wide variety of fresh fruits and vegetables; calcium for growing bones (milk, yogurt, or substitutes if lactose intolerant); and healthy proteins (fish, eggs, poultry, lean meat, nuts, and seeds).

Healthy fats are also important: * Monounsaturated fats, from plant oils like canola oil, peanut oil, and olive oil, as well as avocados, nuts (like almonds, hazelnuts, and pecans), and seeds (such as pumpkin, sesame). * Polyunsaturated fats, including Omega-3 and Omega-6 fatty acids, found in fatty fish, such as salmon, herring, mackerel, anchovies, and sardines, or in unheated sunflower, corn, soybean, and flaxseed oils, and walnuts. Kids, like the rest of us, should limit: Trans fats, found in vegetable shortenings, some margarines, crackers, candies, cookies, snack foods, fried foods, baked goods, and other processed foods made with partially hydrogenated vegetable oils. Dietary guidelines for school age children| Vegetables| 3-5 servings per day. A serving might be one cup of raw leafy vegetables, 3/4 cup of vegetable juice, or 1/2 cup of other vegetables, raw or cooked. | Fruits| 2-4

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servings per day. A serving may consist of 1/2 cup of sliced fruit, 3/4 cup of fruit juice, or a medium-size whole fruit, such as an apple, banana or pear. Whole Grains| 6-11 servings per day. Each serving should equal one slice of bread, 1/2 cup of rice or 1 ounce of cereal. | Protein| 2-3 servings of 2-3 ounces of cooked lean meat, poultry, or fish per day. A serving in this group may also consist of 1/2 cup of cooked dry beans, one egg, or 2 tablespoons of peanut butter for each ounce of lean meat. | Dairy products| 2-3 servings (cups) per day of low-fat milk or yogurt, or natural cheese (1. 5 ounces=one serving). | Zinc| Studies indicate that zinc may improve memory and school performance, especially in boys.

Good sources of zinc are oysters, beef, pork, liver, dried beans and peas, whole grains, fortified cereals, nuts, milk, cocoa, and poultry. | Dietary guidelines for school age children| Vegetables – 3-5 servings per day. A serving might be one cup of raw leafy vegetables, 3/4 cup of vegetable juice, or 1/2 cup of other vegetables, raw or cooked. | Fruits – 2-4 servings per day. A serving may consist of 1/2 cup of sliced fruit, 3/4 cup of fruit juice, or a medium-size whole fruit, such as an apple, banana or pear. | Whole Grains – 6-11 servings per day.

Each serving should equal one slice of bread, 1/2 cup of rice or 1 ounce of cereal. | Protein – 2-3 servings of 2-3 ounces of cooked lean meat, poultry, or fish per day. A serving in this group may also consist of 1/2 cup of cooked dry beans, one egg, or 2 tablespoons of peanut butter for each ounce of lean meat. | Dairy products – 2-3 servings (cups) per day of low-fat milk or yogurt, or natural cheese (1. 5 ounces=one serving). | Zinc – Studies indicate that zinc may improve memory and school performance, especially in boys.

Good sources of zinc are oysters, beef, pork, liver, dried beans and peas, whole grains, fortified cereals, nuts, milk, cocoa, and poultry. | The special nutritional needs of teenagers This is growth spurt time: kids gain about 20% of adult height and 50% of adult weight during adolescence. Because growth and change is so rapid during this period, the requirements for all nutrients increase. This is especially true of calcium and iron. Eating disorders in teens Adolescents and teens are at a high risk of developing anorexia, bulimia, or binge eating disorder.

Eating habits, however, are pretty well set by now, and if your child’s choices are less than ideal, it can be a challenging time for a course correction. The best way to make teen dietary changes is to present information about short-term consequences of a poor diet: appearance, athletic ability, energy, and enjoyment of life. These are more important to most teens than long-term health. For example, “Calcium will help you grow taller. ” “Iron will help you do better on tests and stay up later. ” Special nutritional needs for teens|

Calories | Due to all the growth and activity, adolescent boys need 2,500-2,800 per day, while girls need around 2,200 per day. It’s best to get these calories from lean protein, low-fat dairy, whole grains, and fruits

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and veggies. | Protein| In order for the body to grow and maintain muscle, teens need 45-60 grams per day. Most teenagers easily meet this need from eating meat, fish, and dairy, but vegetarians may need to increase their protein intake from non-animal sources like soy foods, beans, and nuts. | Calcium| Many teens do not get sufficient amounts of calcium, leading to weak bones and osteoporosis later in life.

Encourage teens to cut back on soda and other overly-sugary foods, which suck calcium from bones. The 1,200 mg of calcium needed per day should come from dairy, calcium-fortified juice and cereal, and other calcium-rich foods such as sesame seeds and leafy greens like spinach. | Iron| Iron deficiency can lead to anemia, fatigue, and weakness. Boys need 12 mg each day, and teen girls, who often lose iron during menstruation, need 15 mg. Iron-rich foods include red meat, chicken, beans, nuts, enriched whole grains, and leafy greens like spinach and kale. Special nutritional needs for teens| Calories – Due to all the growth and activity, adolescent boys need 2,500-2,800 per day, while girls need around 2,200 per day. It’s best to get these calories from lean protein, low-fat dairy, whole grains, and fruits and veggies. | Protein – In order for the body to grow and maintain muscle, teens need 45-60 grams per day. Most teenagers easily meet this need from eating meat, fish, and dairy, but vegetarians may need to increase their protein intake from non-animal sources like soy foods, beans, and nuts. Calcium – Many teens do not get sufficient amounts of calcium, leading to weak bones and osteoporosis later in life. Encourage teens to cut back on soda and other overly-sugary foods, which suck calcium from bones. The 1,200 mg of calcium needed per day should come from dairy, calcium-fortified juice and cereal, and other calcium-rich foods such as sesame seeds and leafy greens like spinach. | Iron – Iron deficiency can lead to anemia, fatigue, and weakness. Boys need 12 mg each day, and teen girls, who often lose iron during menstruation, need 15 mg.

Iron-rich foods include red meat, chicken, beans, nuts, enriched whole grains, and leafy greens like spinach and kale. | A “weighty” problem: children, weight and self esteem Children who are substantially overweight or obese are at greater risk for cardiovascular disease, bone and joint problems, sleep apnea, and poor self-esteem, as well as long-term health problems in adulthood. While childhood obesity doesn’t always lead to obesity in adulthood, it does raise the risks dramatically. The majority of children who are overweight during preschool or elementary school are still overweight as they enter their teens.

Most kids do not outgrow the problem. Addressing weight problems in children requires a coordinated plan of physical activity and healthy nutrition. Unless directed by your child’s doctor, though, the treatment for childhood obesity is not weight loss. The goal should be to slow or halt weight gain, thereby allowing your child to grow into his or her ideal weight. Think of exercise as a food group in your kid’s diet Add physical activity to your child’s day, just as you would add fruit or veggies.

To encourage

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physical activity, play with your kids – throw around a football; go cycling, skating, or swimming; take family walks and hikes; and help your kids find activities they enjoy by showing them different possibilities. The benefits of lifelong exercise are abundant and regular exercise can even help motivate your kids to make healthy food choices. Kids and junk food No matter how well parents promote healthy eating, it can be difficult for any kid to avoid the temptation of junk food. Instead of eliminating junk food entirely, which tends to increase cravings even more, try substituting some healthier alternatives.

Kid-friendly junk food alternatives| Instead of…| Try…| * French fries * Ice cream * Fried chicken * Doughnuts or pastries * Chocolate-chip cookies * Potato chips | * “Baked fries” grilled in the oven and salted lightly * Low-fat frozen yogurt; sorbet; fresh fruit smoothies * Baked or grilled chicken * Bagels; English muffins; home baked goods with less sugar/fat * Graham crackers, fig bars, vanilla wafers, fruit and caramel dip * Pretzels, unbuttered popcorn, baked potato chips, soy crisps | Kid-friendly junk food alternatives| Instead of…| Try…|

French fries| “Baked fries” grilled in the oven and salted lightly| Ice cream| Low-fat frozen yogurt; sorbet; fresh fruit smoothies| Fried chicken| Baked or grilled chicken| Doughnuts or pastries| Bagels; English muffins; home baked goods with less sugar/fat| Chocolate-chip cookies| Graham crackers, fig bars, vanilla wafers, fruit and caramel dip| Potato chips| Pretzels, unbuttered popcorn, baked potato chips, soy crisps| Eating out with kids: fast food and restaurant nutrition for children It might be challenging to persuade your youngster to order a salad instead of a cheeseburger, but you can steer them towards healthier options.

Some important tips to remember about fast food and restaurant dining for kids: * Avoid sodas – Kids should drink water or milk instead. * Avoid chicken nuggets – Unhealthy imposters of real chicken. * Skip the fries – Consider taking along a bag of mini carrots, grapes, or other fruits and vegetables to have instead. This will add vitamins and fiber to the meal. * Order the kid’s meal with some substitutions – Children often love the kid’s meal more for the fun box and toys than for the food. Ask to substitute healthier choices for the soda and the fries if possible. Opt for chicken and vegetables or spaghetti with tomato sauce in a sit-down restaurant, rather than a big plate of macaroni and cheese. At our nursery each child also has a laminated placemat with their photo and a list of any food they cannot have. The nursery will probably be providing a veggie option each day but they will probably be trying to make it look as close to the meat option. eg. Spag bol/lentil bol, as children (older, babies aren’t so fussy) like to eat food that looks the same as everyone else’s. Fruits is always an option for dessert.

World religions, foods practices and restrictions, and rationale for behavior Type of religion Practice or restriction Buddhism •Refrain from meat, vegetarian diet is desirable •Moderation in all foods •Fasting required of monks •Natural foods of the earth are considered most pure •Monks avoid all solid food after noon Eastern Orthodox Christianity •Restrictions on Meat and Fish •Fasting Selectively •Observance of Holy Days includes fasting and restrictions to increase spiritual progress Hinduism •Beef prohibited •All other meat and fish restricted or avoided •Alcohol avoided •Numerous fasting days Cow is sacred and can’t be eaten, but products of the “sacred” cow are pure and desirable •Fasting promotes spiritual growth Islam •Pork and certain birds prohibited •Alcohol prohibited •Coffee/tea/stimulants avoided •Fasting from all food and drink during specific periods Eating is for good health •Failure to eat correctly minimizes spiritual awareness •Fasting has a cleansing effect of evil elements Judaism •Pork and shellfish prohibited •Meat and dairy at same meal prohibited •Leavened food restrictedFasting practiced •Land animals that do not have cloven hooves and that do not chew their cud are forbidden as unclean (e.., hare, pig, camel) •Kosher process is based upon the Torah Mormonism •Alcohol and beverages containing caffeine prohibited •Moderation in all foods Fasting practiced •Caffeine is addictive and leads to poor physical and emotional health •Fasting is the discipline of self-control and honoring to God Protestantism •Few restrictions of food or fasting observations •Moderation in eating, drinking, and exercise is promoted God made all animal and natural products for humans’enjoyment •Gluttony and drunkenness are sins to be controlled Rastafarianism •Meat and fish restricted Vegetarian diets only, with salts, preservatives, and condiments prohibited •Herbal drinks permitted; alcohol, coffee, and soft drinksprohibited •Marijuana used extensively for religious and medicinalpurposes •Pigs and shellfish are scavengers and are unclean •Foods grown with chemicals are unnatural and prohibited •Biblical texts support use of herbs (marijuana and other herbs) Roman Catholicism •Meat restricted on certain days •Fasting practiced •Restrictions are consistent with specified days of the church year Seventh-day Adventist •Pork prohibited and meat and fish avoided Vegetarian diet is encouraged •Alcohol, coffee, and tea prohibited •Diet satisfies practice to “honor and glorify God” Box 2: Duty to care is a legal obligation that we all have. Professionals working in registered early years settings are expected to maintain a set of standards that reflect the government’s aim of improving the quality of life for children through the 5 positive outcomes of Every child matters (children’s act 2004) Why protect children during care routines * Depending on the nature of the routine there are times when children can be made vulnerable eg. uring examination, observation, nappy changing, soiling; cleaning, toileting, undressing and dressing. * Protection during these times ensures children are not victims of abuse or discrimination, experiences of this can damage lives and prevent what a setting aims to provide in terms of children achieving their potential and securing positive outcomes for themselves – 5 outcomes of ECM every child matters. Protection may involve practitioners not putting themselves into situations that can result in allegations of abuse, have changing areas that are staffed by 2

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and are not closed off from others.

Use of technology is monitored in the setting and regulated appropriately: video, cameras, phones. Report and log books are kept and filled in as policy; procedure guide. * Everyone has a legal obligation that involves a duty to care. * Policies and procedures will guide practice through appropriate recording processes where concern is present or daily logbooks completed eg. nappy changing, regulate against mobile phone and video use, ensure that everyone in contact with children has the correct clearance to be tending for children alone, or work in partnership that supports witness testimony. It helps to prevent allegations of abuse and inappropriate behaviour. * It helps everyone to be aware of allegations and what that may mean. * It can reassure parents and carers that child protection is an area the setting takes most seriously. * All children have the right to live life free from emotional and physical harm UNCRC 19 * All children have the right to protection from harmful drugs 33 * All children have the right to privacy 16 Children have the right to be live life free from sexual harm 34 * Children have the right to be protected from all forms of negative exploitation 36 * All Children have the right for adults to do the best they can for them 3 * Article 37 states no one is allowed to punish or degrade a child. * Article 39 would suggest it is a responsibility of settings to have policies, procedures, practices and an environment in place that assists children in exercising their right to help if hurt, neglected or mistreated. * All children are protected by law – as a right under the UNCRC and Children’s act 1989 Box 3: 0-1years

Nutrition for 0-1 year olds Most mothers know that breast milk remains a baby’s healthiest food choice. Breast milk is is a food and drink all in one, which also contains special substances to protect against infection and disease and help the baby to grow. Health and nutrition experts recommend breast milk as the best food choice in the first six months of life, but most mothers know that exclusive breastfeedingisn’t always possible, in which case formula is an adequate substitute. A child’s early years are a critical time for physical and mental development. It is also the time when the eating habits of a lifetime are formed.

Fluids for babies Cow’s milk is not recommended for babies less than 12 months old because it is a poor source of iron and may place an infant at risk of iron deficiency. It also has high levels of protein, sodium, potassium, phosphorous and calcium potentially causing strain on young kidneys. The best fluids for babies 0-1 years include * Breast milk and infant formula * Cooled boiled water * (Soy formula only under medical advice) Introducing solid foods from 6 months The first solid foods for baby are best introduced slowly and methodically, with one food at a time introduced a couple of days apart. Baby recipe apple juice

Baby yoghurt Baby rice pudding Hot corn cereal Homemade teething rusks Pear and apricot puree Baby crisp bread Homemade rice cereal Vegetable puree Stewed prunes Weetabix custard 1-3 years

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Banana teething biscuits French toast soldiers Fruit jelly Healthy eating for 1-2 year olds Healthy recipes 1-2 Lemony fish bites Mini quiches with hidden veg Potato fritters Pumpkin custard Pumpkin fritters Red egg Savoury teddy scones with beef and mash Spotty berry pancakes Wholemeal teething sticks Baby trifle Banana biscuits Healthy eating for 2-3 year olds Healthy recipes 2-3 Incy mincy fried rice Lollipop lamb Macaroni cheese Marvellous meatloaf

Mary May’s crunchy on toast Simple chicken soup Vegetable pasties Veggie fritters Watermelon fangs 4-7 years Ants on a log Baby sushi DIY tuna sushi hand roll Egg-free yoghurt cupcakes Hand-wrapped little sushi Healthy chicken nuggets Healthy recipes 3-4 Ice cube sushi Mighty patties Mini banana muffins with yoghurt topping Pikelets Rainbow jellies Rice pudding recipe Sneaky pumpkin muffins Apricot topping Basic omelette Basic pancakes Creamy mango ice blocks Damper Delicious cheese pizza just for me French toast Fruit juice Fruit kebabs with yoghurt dip Fruity salsa tortillas Games to encourage healthy eating Healthy recipes

Healthy yoghurt and oat muffins Lulu’s cheese puffs One ingredient ice-cream Strawberry frozen yoghurt Strawberry topping 8-12years Cheese and bacon rolls Cook up a kid that loves learning Gluten-free pikelets Healthy eating Healthy recipes Kids’ nachos Lemonade scones Mini hot dogs Mini pita pizzas Mini UFOs Pizza pops Sunday night tomato bruschetta 2 ingredient pizza dough Apple and pear pudding Apricot balls Banana cake Banana damper Bull’s eye egg Cereal balls Cheese and vegemite scrolls Cheese sticks Cheesy potato bake Choc coconut balls Choc packed cookies Chocolate crackles Corn fritters Edible mud pies Fruit skewers

Ginger star biscuits Healthy cooking Healthy recipes Honey popcorn Impossible quiche Marshmallow and fruit kebabs Masterchefs in the making Muesli cookies Oaty raisin biscuits Strawberry yogurt with crunchy bits Yo-yo biscuits Varied and nutritious diet and regular physical activity are very important to ensure healthy growth and development in young children. In the short term, they not only improve growth but also improve concentration and support children’s learning. There are longer term health benefits as well, as poor eating habits in childhood can lead to the development of obesity and anaemia as a result of iron deficiency.

Even more importantly, a good diet in childhood can help to prevent the risk of serious diseases common in later in life, such as cancer, cardiovascular disease, diabetes and osteoporosis. Developing good eating habits National Care Standard requires that children and young people have the opportunity to learn about healthy lifestyles, including a healthy diet. This covers a number of points: Encourage children to experiment: offering a variety of foods and repeatedly introducing new foods from an early age encourages children to experiment and accept different tastes and textures. 7 Plan snack and meal times: we already know that young children need to have structure to their day and this applies to planning times for eating and drinking. Children differ in their responses to food being made available: most children enjoy food and usually welcome an opportunity to take a snack or drink when they are hungry or thirsty. However some children are less interested, may be distracted while playing

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and can ‘forget’ or be ‘too busy’ to choose to eat or drink. This can result in children becoming ‘over’ hungry or thirsty, leading to difficult behaviour.

Therefore, it is important to organise snack time so that every child has a chance to eat and drink. Snack time provides an excellent opportunity for children to: practise personal hygiene by washing their hands before eating/drinking; learn about healthy snacks and drinks; and learn to try new foods and chat to staff about their likes and dislikes. Children are more likely to try new foods if they see other children eating them. For all these reasons, a timetabled snack time, supervised by staff to ensure that every child’s needs are met, is regarded as current best practice.

Allow plenty of time: give children enough time to finish eating and drinking – once they have started to eat, this may take around 15 minutes for a snack and 30 minutes for a meal. Children need to eat regularly and it is recommended that they be offered something to eat at least every 3 hours. Snacks are best given well before or after meal times to avoid spoiling the appetite for the next meal. Develop social skills: when children sit down together to eat and drink this provides an excellent opportunity for them to learn good social skills and behaviours associated with eating and drinking.

For example: chatting to other children and adults, developing good table manners, offering and sharing food, learning to respect others, tasting and trying foods from different cultures. Try to avoid distractions such as television and lots of noise. Provide good role models: children often model their behaviour on others. Therefore, encouraging good food choices and eating habits in the adults, brothers and sisters, and friends around children is important in reinforcing the right messages. Snacking Together

Our nursery used to run an ‘open snack’ system, however staff were concerned that some children were not keen to have a snack while others were limited in the foods they would try. Issues around hygiene, e. g. children washing their hands properly and the use of utensils to serve food, were also raised. It was decided that, for a trial period, snack time would be a group activity with an early years worker sitting with each group of children. Snack items were set on a tray which was taken to the group table where the children helped to prepare and serve the snack.

This new way of approaching snack time was so successful that it has now been adopted as permanent practice and staff have highlighted a range of benefits: Development of social skills through interaction and co-operation with others, e. g. taking turns. Development of language skills as children and adults talk together about what they are eating, foods they like to eat and health issues including toothbrushing and handwashing. Children are more easily encouraged to try new foods and can see what the whole food looks like before helping an adult to prepare and serve it.

Staff are more aware of what children are eating and can share this information with parents.

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Children can make suggestions for foods to be included in the snack menu. Staff can observe children closely, gathering information for their profiles in several areas of development. Overall, snack time is now less stressful for the children and both children and adults enjoy it! Foods and nutrients Energy needs: getting the balance right Children need energy to enable them to grow and develop and be active. Essentially, energy from food and drink provides ‘fuel’ for the body.

Energy comes from foods containing carbohydrate, fat and protein. The precise amount of energy required for an individual child depends on their age, size, gender, rate of growth and level of activity. For good health and optimal growth, it is important to get the balance right between energy consumed in food and energy expenditure. 14 Children who are regularly active (see section 3. 4) are able to achieve a better energy balance than children who are less physically active. 14 Dietary fibre Dietary fibre as part of a varied, balanced diet is essential for good health at all ages.

Although there are no specific dietary recommendations for children aged 1 to 5 years, children who follow the ‘five-a-day’ guidance on fruit and vegetable intake and who have some wholegrain foods, e. g. wholegrain bread, cereals and pulses (e. g. peas, beans, lentils), incorporated into their daily diets will have an adequate intake of dietary fibre to maintain good health as they grow. Vitamins, minerals and bioactive components These are essential for growth, development and normal body functions. Some vitamins and minerals are important for the immune system to protect against ill health and disease.

Children aged 1 to 5 have a high requirement for vitamins and minerals because of the rapid rate of growth and bone development during these years. An adequate intake of vitamins and minerals will be provided by a varied well-balanced diet, as described in the guidance. Vitamin D is the one exception to this: obtaining adequate vitamin D depends on getting enough sunlight and/or taking supplements. There are some compounds in foods (bioactive components) that do not fall into the categories of vitamins and minerals or nutrients, e. g. lycopene and flavonoids. Some of these compounds help to protect against ill health and disease.

Vegetables, some fruits and other plant foods such as fresh herbs are particularly good sources of these. Menu planning and nutrient guidance Menu planning Menu planning is very important in achieving a well-balanced and healthy diet for the children in your care. It will also help you to work towards providing the quality of service described in National Care Standard Menu planning should be done by a member of staff with the knowledge and skills and an understanding of children’s differing nutritional needs. The menu planning guidance set out below should be used to help produce a written menu covering all food provided, i. e. eals, snacks and drinks. Young children have changing likes and dislikes and their appetite and willingness to try new foods varies. Different foods and portion sizes may need to be interchanged as breakfast, snacks, light meals or main meals. This need for flexibility to allow for

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changing eating habits has been taken into account in the guidance on food groups and menu planning. Children’s cultural background should also be acknowledged and any special dietary requirements included in planning meals and snacks, as reflected in National Care Standards – Early Education and Childcare up to the Age of 16; Health and Wellbeing Standard

In planning a menu it is important to include a variety of sensory qualities, e. g. taste, texture, flavours, colours and temperature. This will help children’s learning and enjoyment of food. Early and repeated exposure to a food also helps children to accept it and learn to like it in the long term. In the food groups and sample menus that follow, descriptions of foods and the frequency of serving are given only as a guide towards meeting the nutritional guidance. A flexible approach, building on catering experience, skills and local tastes, will allow a wide range of food and menu options to be used.

The menu planning guidance is based on the five food groups (see Adventures in Foodland4 for further information). It is important to ensure that all food is stored and prepared safely. For the most up-to-date information on food safety and hygiene for the early years see the Food Standards Agency’s Eatwell website (www. eatwell. gov. uk). It is packed with reliable and practical advice about healthy eating, understanding food labels and how what we eat can affect our health.

The Food Standards Agency has also developed specifications for the quality of processed foods to be used in school meals, which may be useful for foods used in catering for the early years sector. Box 4: The Ofsted publication, Starting Early (July 2004) notes that having a policy on healthy eating increases the chances of children developing good eating habits. A policy helps all the staff in the setting to understand the objectives of a healthy eating approach and to appreciate the reasons why snacks and meal times are run as they are.

In addition, parents are aware of the setting’s goals and approach to promoting a healthy lifestyle. A good healthy eating policy will include: * The reasons that underpin healthy eating in the setting. * Key aims focusing on health and wellbeing. * Key messages about food and nutrition. * How these messages will be coordinated and conveyed. * How everyone, including parents and carers, will know how to contribute to the promotion of healthy eating. * How staff will be trained, so that knowledge and skills are developed to ensure consistent messages are given to the children. How the setting’s practice will be monitored and reviewed. What constitutes a healthy diet for young children? (The word ‘diet’ in this context is used to refer to general nutritional needs rather than a ‘specialised diet’ in order to lose weight.) A healthy diet is one with variety including plenty of water, enough protein for growth and repair, sufficient carbohydrates to provide the energy young children use, small amounts of fat as a source of essential fatty acids for cell growth, iron and calcium for blood and bones to grow

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strong, vitamin D for healthy bones and zinc and magnesium to support the immune system. Variety of food’ refers not to how much you consume of one food type or how often you eat it, but to the range of foods that are eaten. Encouraging children to try a variety of different vegetables, meats and fruits will not only ensure a balance of nutrition, but also means they consume enough fibre to keep the digestive system healthy. Key points to remember when thinking about a healthy diet for young children: * Young children should not be placed on low-fat diets, but need to be encouraged to eat a variety of foods. * They should be encouraged to drink plenty of water rather than drinks high in sugar and additives. It is important for children to begin the day with a nutritious breakfast, as their bodies continue to use up energy for growing even when they are asleep. A nutritious breakfast ensures that the child has enough energy for all the activities of the day, including growing and learning. * Young children have small stomachs but use up large amounts of energy – they may need to eat little and often. * The nutritional value of food will be affected by how it is grown, stored and prepared. Simple baking, boiling and grilling of either fresh or frozen food will help to retain the best nutritional content.

Maintaining a balance of good health The nutritional advice produced by the Food Standards Agency entitled The Balance of Good Health is applicable to children of five and over. This also provides a good guideline for younger children, although they may need more calcium and fat in their diet. The Balance of Good Health is a pictorial guide that groups foods together into five categories. These are: * fruit and vegetables * breads, other cereals and potatoes * milk and dairy foods * meat, fish, eggs, soya, beans and pulses * foods containing sugars and foods containing fats.

A healthy balanced diet contains more foods from the first two groups and a smaller number of foods from the next two groups. Foods from the fifth group – those containing fats and/or sugar – should be eaten sparingly and not as a substitute for foods from the other four groups. The Balance of Good Health also provides eight general guidelines on healthy eating which are applicable to all of us: * Enjoy your food. * Eat a variety of different foods. * Eat the right amount to be a healthy weight. * Eat plenty of foods rich in starch and fibre. * Eat plenty of fruit and vegetables. Don’t eat too many foods that contain a lot of fat. * Don’t have sugary foods and drinks too often. * If you drink alcohol, drink sensibly (no alcohol for young children!). Eating fruit and vegetables as an alternative to crisps and sweets as a snack between meals is a good way to start introducing young children to a healthy, balanced diet. Fruit, vegetables and salads are rich sources of vitamins, minerals and other components which boost the immune system. They also provide

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an excellent combination of fluid and fibre to help prevent constipation in young children.

How you can help young children to develop healthy eating habits Early years settings have an important role to play in encouraging young children to develop healthy eating habits. They are naturally social places, where children can learn from other children as well as from adults, and the staff have daily contact with parents and other carers. Acting as a role model Children learn much about the world through watching and imitating others – they need to see adults demonstrating healthy eating and drinking habits in order to develop their own. Most settings now have water freely available to he children, but how often do the adults drink the water? Drinking plenty of water is vital for a healthy lifestyle and if the adults are seen drinking the children will drink more. Some children never access water at all during the course of a session, so a system for monitoring who has accessed it and who needs some encouragement is a good idea. It could be that when a child has had a drink he puts his name on a board or puts a picture of a water drop next to his name/photo. The child can see how many drops he has by the end of a session and the adults can quickly see who is not drinking enough.

The adults will of course have their names and water drops recorded too! Snack and meal times need adults acting as good role models, not practitioners hurrying around sorting out the room, or passing plates of food around, but instead sitting, eating and talking with the children. To appreciate the importance of acting as a good role model think about the messages you are giving if you do not participate. If no adults are eating the food some children may feel apprehensive and wonder what is wrong with it. If children see others, particularly adults, eating new and unusual foods they will feel it is safe to try the food themselves.

Making eating an enjoyable social event In the busy lives many families lead, children may be eating alone while an adult prepares a meal for other members of the family to have later, or may be eating in front of the television. The early years setting is an ideal place for redressing the balance – it is a social place, everyone is present and children can experience eating with others. They will be more likely to try new foods if they and see their friends trying them in a relaxed and happy atmosphere. There will be opportunities to talk about food, their likes and dislikes and the texture, colour and smell of different foods.

The organisation of snack time often depends on how many children there are in the room at any one time and the times the children arrive and leave. Snack time can be set up either at a specific time when everyone sits down together, or as a snack bar where children are encouraged go when they are hungry. As snack time is a

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social event it should not be hurried – it is important to give children time to explore and talk. Their talk does not have to be about the food – general chit-chat about their play and their homes is very valuable too. It is amazing what you can find out about hildren’s lives when you have the time to listen. Remember some children will not have eaten breakfast when they arrive at the setting in the morning. This is such an important meal, especially for young children who are growing rapidly and who need a boost after fasting all night. Some settings offer a breakfast table until 9. 30 in the mornings, with small jugs of cereal and milk for children to help themselves. Providing variety Careful planning of snack and meal times means that a wide range of food can be presented to the children in a variety of different ways.

Some children will eat grated carrot for example but not sliced; or dried raisins but not grapes. Planning for variety ensures children have the opportunity to experience food that they may not have at home, such as exotic fruits or unusual vegetables. When introducing children to new foods it is important that they have the chance to try the same food on more than one occasion. The first time they try a food it can be the fact that it is new or that they do not like the texture that makes them not want to eat it. The second time they try it, it is not so unfamiliar and their preferences may change.

Remember, there are many different ways of presenting the same type of food, for example looking at and tasting fruit and talking about the colours, looking at the seeds, comparing dried and fresh fruits, comparing sizes, juicing the fruit. Encouraging play and involvement Playing is the main way children learn and this is no different when learning about food – children need time to explore and play with different foods. Playing involving foodstuffs can conjure up a vision of food mess and hygiene problems, but food play that has been carefully planned is very beneficial.

A variety of fruits and vegetables in a bowl for children to investigate provides opportunities to handle, explore and discuss. Using real fruit and vegetables for transactional play is far more interesting than plastic food that all feels, smells and weighs the same. Being involved in the preparation of meals and snacks can remove some of the unfamiliarity, so that when a child sits down to eat she feels that she knows the food and that it is safe to try. Having the opportunity to decide what fruit pieces are going into her bowl gives the child a feeling of control.

She can be encouraged to talk about what she has chosen and her developing tastes can be supported by comments such as ‘Well if you like that because of … then you will probably like …, would you like to try a piece? ’ When trying new foods children need to know that they do not have to swallow the food. If

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they know they can spit it into a tissue they are less likely to be worried about putting a new type of food into their mouth. Developing language and learning A group snack time is an ideal opportunity for developing social and language skills.

Encouraging children to talk about where a food comes from, what country it is grown in and how it is harvested can remove some of the mystery and fear of trying new food. Taking children shopping and looking at the range of food that can be bought, or taking children to visit a dairy or a bakery is an exciting way to help them to understand about food and to realise that it will not harm them to try something different. In the process children can learn in a relaxed way about different food types, for example, which ones make the blood strong, which food contains calcium to make teeth and bones grow strong.

No food is a ‘bad’ food or a ‘good’ food, and it is important that children are not encouraged to label food as good or bad. The idea of bad food tends to promote phobias and eating disorders as well as rebellion – what is denied is desired. Involving parents It is vital to keep parents informed of the setting’s policy on, and approach to, healthy eating. It is important that parents are not made to feel that they are giving their children ‘wrong’ or ‘bad’ food habits at home. A healthy eating policy is a way of explaining the importance of healthy eating and can be looked on as part of the setting’s responsibility for nsuring the best standard of care for all children. A noticeboard displaying the types of food on offer for snack time, along with photos of the children enjoyingdifferent foods, will enable parents to talk about these foods with their children. A letter sent home at the beginning of the week describing the food on offer, and how it will be presented that week, also gives parents the opportunity to talk with their child about food. Do not expect young children to remember the names of the new foods or to tell their parents about them unprompted. Tips for parents * Be a good role model – it will help your health and weight too. Make sure you have a good basic knowledge of what a healthy diet is, and of ways to be more active. * Ensure your child understands how their body changes as it develops, and that healthy lifestyle changes are to help their skin and health and are not about appearance (relevant for older children). * Recognise that we’re all different shapes and sizes and examine your own feelings and comments about your weight and shape, and other people’s. * Help your child find something they’re good at and enjoy to boost their self-worth. * Encourage the whole family to follow the same flexible healthy behaviours, rather than single one child out.

Eat together whenever you can – eating is social as well as nourishing. Watch portion sizes for the whole family. * Try not

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to let food become a power struggle, nor a means of reward or punishment. Box5: There are three different types of formula: * cow’s milk-based formula * hydrolysed protein formula * soya-based formula It’s most likely your baby can have cow’s milk-based formula, unless there’s a health or dietary reason why she can’t. Read on to find out more about these types of formula milk. Cow’s milk-based formula Most baby formula milks are based on cow’s milk, which is modified to resemble breastmilk as closely as possible.

Manufacturers modify cow’s milk for babies by adjusting carbohydrate, protein, and fat levels and adding vitamins and minerals. There are also special types of formula manufactured for premature babies. The protein in milk can be broken down into curds (casein) and whey. The ratio of casein to whey can vary according to the type of baby formula milk. There are two main types: * First-stage formula. These milks consist of mostly whey, with a casein:whey ratio of 40:60, which is about the same as breastmilk. They are suitable for your baby from birth up to about a year, and are thought to be easier to digest. Second-stage formula. These milks consist of mostly casein, with a casein:whey ratio of 80:20. They take longer to digest and are often promoted as being for hungrier babies. Nutritionally, your baby will only need first-stage formula, although you may decide to move your baby onto second-stage formula as she grows. Hydrolysed-protein formula This is a formula milk which is specially designed for babies with an allergy or intolerance to cow’s milk. If your baby has a cow’s milk allergy, the protein in the milk will cause an allergic reaction.

And if she has an intolerance to cow’s milk, she will have difficulty digesting the lactose, or sugar, in the milk. Hydrolysed-protein formula milks are based on cow’s milk and have the same nutritional value as standard formula milk. But the protein in the milk is hydrolysed, which means it is broken down so your baby is less likely to react to it. These milks are also generally lactose-free, so babies with an intolerance to cow’s milk can digest them easily. If you think your baby has a cow’s milk allergy or intolerance, see your doctor or health visitor. Your doctor will be able to prescribe a hydrolysed-protein formula for your baby.

You can buy these from your pharmacy, too. You can also buy special lactose-free formulas, which your doctor may suggest is your baby has a lactose intolerance. Soya-based formula Soya-based formula is made from soya beans. It is modified with vitamins, minerals and nutrients to make it suitable for formula milk. Only give your baby soya-based formula on the advice of your doctor, health visitor or paediatrician. Even though manufacturers market their soya formulas as suitable for babies from birth, health professionals don’t recommend them for babies under six months.

It’s not recommended that your baby has soya formula if she has a cow’s milk allergy. Babies who are allergic to cow’s milk are often

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allergic to soya, too. There is also no evidence that changing to a soya-based formula can help to soothe your baby if she is unsettled or colicky. Your baby may be colicky because she’s intolerant to lactose, and so a lactose-free formula is best if this is the case. Ask your doctor or health visitor for advice if you think your baby has an allergy or intolerance to cow’s milk. There are no particular health benefits that your baby would get from soya formula compared to other formula milks.

In fact, soya formula milks can actually damage your baby’s teeth over time, because they contain glucose syrup. If you do give your baby soya milk, you’ll have to take extra special care of her teeth. Box 6: Children are able to control their bladder and bowels when they’re physically ready, and when they want to be dry and clean. Every child is different, so it’s best not to compare your child with others. Bear in mind the following: * Most children can control their bowel before their bladder. * By the age of two, some children will be dry during the day, but this is still quite early. By the age of three, 9 out of 10 children are dry most days. Even then, all children have the odd accident, especially when they’re excited, upset or absorbed in something else. * By the age of four most children are reliably dry. It usually takes a little longer to learn to stay dry throughout the night. Although most children learn this between the ages of three and five, it is estimated that a quarter of three-year-olds and one in six five-year-olds wet the bed. When to start potty training It helps to remember that you can’t force your child to use a potty. If they’re not ready, you won’t be able to make them use it.

In time they will want to use it; your child won’t want to go to school in nappies any more than you would want them to. In the meantime, the best thing you can do is to encourage the behaviour you want. Most parents start thinking about potty training when their child is around 18 to 24 months old, but there’s no perfect time. It’s probably easier to start in the summer, when washed nappies dry more quickly and there are fewer clothes to take off. Do it over a period of time when there are no great disruptions or changes to your child’s or your family’s routine. You can try to work out when your child is ready.

There are a number of signs that your child is starting to develop bladder control: * They know when they’ve got a wet or dirty nappy. * They get to know when they’re passing urine, and may tell you they’re doing it. * The gap between wettings is at least an hour. (If it’s less, potty training may fail and at the very least will be extremely hard work for you.) *

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They know when they need to pee, and may say so in advance. Potty training is usually fastest if your child is at the last stage before you start the training. If you start earlier, be prepared for a lot of accidents as your child learns.

How to start potty training * Leave a potty where your child can see it and can get to know what it’s for. If you’ve got an older child, your younger child may see them using it, which will be a great help. It helps to let your child see you using the toilet and explain what you’re doing. * If your child regularly has a bowel movement at the same time each day, leave their nappy off and suggest that they go in the potty. If your child is even the slightest bit upset by the idea, just put the nappy back on and leave it a few more weeks before trying again. As soon as you see that your child knows when they’re going to pee, encourage them to use their potty. If your child slips up, just mop it up and wait for next time. It takes a while to get the hang of it. If you don’t make a fuss when they have an accident then they won’t feel anxious and worried and are more likely to be successful the next time. * Your child will be delighted when he or she succeeds. A little praise from you will help a lot. It can be quite tricky to get the balance right between giving praise and making a big deal out of it, which you don’t want to do.

Don’t give sweets as a reward, as that can end up causing more problems. When the time is right, your child will want to use the potty and they will just be happy to get it right. Everyone who looks after your child know about the start potty training as grandparents, nursery staff or childminders all need to use the same, consistent approach (ERIC 2010a). Coping with a disabled child Some children with illnesses or disabilities find it more difficult to learn functions such as sleeping through the night or using a toilet. This might be linked to their medical condition or disability, and it can be challenging for them and for you.

Common potty-training problems My child isn’t interested in using the potty at all. Try not to worry. Remind yourself that, sooner or later, your child will want to be dry for their own sake. If they start to see potty training as a battle of wills with you, it’ll be much harder. My child keeps wetting himself. You’ve got two options: you could go back to nappies for a while and try again in a few weeks, or you can keep trying now but be prepared to change and wash clothes a lot. Whatever you decide, don’t let it get you or your child down, and don’t put pressure on them.

Talk to other parents about how they

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coped. You also don’t want to confuse your child by stopping and starting too often. So if you do stop, leave it for a few weeks before you start again. Just when I think things are going well, there’s an accident. Accidents will happen for a while so when your child does use the potty or manage to stay dry, even if it’s just for a short time, let them know how pleased you are. Even though accidents can be very frustrating, try not to show your child your frustration. Explain that you want them to use the potty or toilet next time.

If your child starts to worry, the problem could get worse. My child was dry for a while, but now they’ve started wetting themselves again. If your child has been dry for a while, either at night, during the day or both, and then starts wetting themselves again, it can mean they have a bladder infection, constipation or threadworms. Ask your GP for more advice. Alternatively, there may be an emo

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