Nutrtion

Nutrition recommendations

Pre-school nutrition

Nutrition recommendations for pre-school children

The eat well guide

The eatwell guide is aimed at children aged over five years old and adults and represents the overall balance of a healthy diet and how much of what is eaten should come from each food group. 

Using the eatwell guide with pre-school children

Under 2 years – children of this age have different nutritional needs therefore the eatwell guide should not be used.

Children aged 2-4 years - the eatwell guide doesn’t apply in full but a flexible approach can be used to gradually start working towards the recommendations set by the eatwell guide, but remember the following points:

  • The calorie requirements shown on the eatwell guide apply to adults and not children. The focus for young children should be to offer 3 main meals and 2-3 nutritious snacks each day, including a good balance of food from all the food groups.
  • Foods offered to this age group should be less strict on fat. Young children need a more energy dense diet so skimmed milk and products that are aimed at older children and adults aren’t suitable for this age group.  If the child is a good eater and they are growing well, semi skimmed milk and lower fat dairy products can start to be introduced from the age of two, so that by the time they are five years old they can be following a healthy low fat diet suitable for older children and adults. 
  • Children in this age group need a mixture of both white and wholemeal/wholegrain starchy foods. High fibre foods can fill a child up before they have taken in all the energy they need and can also result in poor absorption of some minerals.

Which foods? And how much?

Children should be offered food in the right proportions from the four main food groups each day to ensure they are getting a good balance of food and all the nutrients they need. The portions for the main food groups are outlined below. For more information on what each of the food groups contain see the drop down boxes.

For more information on portion sizes of a range of food for 2-4 year olds see the good food choices and portion size PDF. 

  • Potatoes, bread, rice, pasta and other starchy carbohydrates: Offered at each meal and as some healthy snacks, they should make up a third of the food served each day
  • Fruit and vegetables: at least 5 different fruits and vegetables each day (approx. 40g per portion)
  • Dairy (and alternatives): Offered at 2-3 meals and snacks each day
  • Beans, pulses, fish, eggs, meat and and other proteins: 2 portions of meat and fish, 2-3 portions of vegetarian alternatives.

What do each of the food groups contain?

Potatoes, bread, rice, pasta and other starchy foods

                                               

What? This age group needs a mixture of white, wholegrain and wholemeal varieties to ensure their diet is not too high in fibre. From the age of five years old wholegrain varieties are the best option for both children and adults. 

Good choices from this food group include all types of bread, pasta, rice, noodles, potatoes and sweet potatoes, breakfast cereals, couscous, yam, plantain, cocoyam and cassava. For more information on good choices and foods to avoid see the first steps nutrition resources

How much? These foods should make up a third of the food that young children are served each day. They should be the base of every main meal and some healthy snacks.

Good for - good source of starchy carbohydrate and contain fibre, iron and B vitamins. 

Top Tips

  • Try and limit processed potato products as they can be high in salt (e.g. crisps, chips)
  • Try and avoid flavoured rice, noodle and pasta products as these can be high in salt
  • Avoid sugary and chocolate coated breakfast cereals (good choices include Ready Brek, Weetabix, crisped rice, flaked wheat)
  • Fortified breakfast cereals can be a good source of iron

Fruit and vegetables

                                              

What? Children should be offered a variety of fruit and vegetables at mealtimes and as healthy snacks, this includes all fresh, frozen, tinned and dried types.

How much?  Children should be encouraged to try at least five different fruit and vegetables each day.  The recommended portion size for young children is approximately 40g or the amount that a child can hold in one hand.

Good for - vitamins, minerals and fibre.

Top Tips

  • Keep dried fruit and fruit juice for mealtimes only due to the effect on dental health
  • Choose tinned fruit in juice instead of syrup
  • Different fruit and vegetables contain different vitamins and minerals so try and provide plenty of variety from this food group
  • Fruit juice can only count as one portion of fruit however much you drink throughout the day, it should be kept for mealtimes only and for this age group served as half pure juice/half water.

Dairy and alternatives

                                                

What? This food group includes milk, cheese, yoghurt and fromage frais. Up until the age of two years old children need full fat dairy products. From the age of two if a child is a good eater and they are growing well they can be offered semi skimmed milk but skimmed milk and 1% milk isn’t suitable until after the age of five.

How much milk do 2-4 year olds need each day? It is suggested that children of 2-4 years old probably need about 300-350ml of milk a day as they will eat bigger portions of foods at meals, may need fewer or shorter daytime naps, or not need a drink before bed2.

Good for - a rich source of calcium and good source of protein.

Top tips

  • Butter and cream don’t belong in this food group, they are high in saturated  fat and are placed with other foods and drinks high in fat, salt and sugars outside the eatwell guide as they are not essential in the diet
  • Milks aimed at toddlers and growing children are not needed unless advised by a health professional
  • Non-dairy alternatives such as soya milk can be given, the British Dietetic Association recommend that ‘ready made soya, hemp, oat, coconut or other milk alternatives may be used as a main drink after two years of age, but the choice may depend on your child’s nutritional status’3.
  • Rice milk should not be given to children under five  years old
  • Avoid unpasteurised milk and cheese and also mould-ripened cheeses
  • Watch out for added sugar in yoghurts.  If possible choose plain unsweetened natural yoghurt and add natural sweetness from fresh, tinned or dried fruit

Beans, pulses, fish, eggs, meat and other proteins

                                                  

What? This food group includes beans, pulses (e.g. lentils), fish (cod, haddock, salmon, tuna, etc), eggs, meat (lean chicken, turkey, beef, pork, lamb etc) and other proteins (e.g. vegetarian substitutes such as soya mince).

How much? Children should be offered two portions of meat and fish or up to three  portions of vegetarian alternatives (beans, pulses, nut butters, soya mince) from this food group each day.  It is important that main meals contain something from this food group. 

Good for - a good source of protein and high in iron and zinc (important nutrients in a young child’s diet)

Top Tips

  • All eggs should be well cooked
  • Try and limit processed meat and fish products as they can be high in salt (burgers, sausages, ham, chicken nuggets, fish fingers, bacon, sausage rolls)
  • Try and include one portion of oily fish into a child’s diet each week as they are good sources of omega 3 fatty acids and vitamins A and D, e.g.  mackerel, salmon, sardines, pilchards and fresh tuna (tinned tuna doesn’t count as a portion of oily fish as the omega three fatty acids are removed during the canning process).  It is recommended that boys have no more than four portions of oily fish a week and girls have no more than two portions a week as they can contain low levels of pollutants that can build up in the body4
  • Smooth nut butters are good sources of protein and unsaturated fats but whole nuts shouldn’t be given until after five years old as they are a choking hazard
  • Meat alternatives such as soya mince, tofu and Quorn can be included into the diet
  • Children under the age of 16 should avoid shark, swordfish and marlin because of the levels of mercury which can have an effect on a child’s nervous system
  • Babies and children should also avoid raw shellfish as there is a chance of food poisoning

Nutrients in young children's diets

There are a number of other nutrients that are important for pre-school children:

Iron

Iron is needed to form healthy red blood cells which carry oxygen around the body. There are two types of iron. One is found in animal sources such as red meat, dark poultry meat, eggs and oily fish like sardines and pilchards.  The other type of iron comes from plant sources and includes beans, lentils and other pulses, dark green vegetables, fortified breakfast cereals, dried fruit and some breads. The iron from animal sources is more easily absorbed in the body than the iron from plant sources.  However, absorption can be improved if these plant sources are eaten with foods and drinks containing vitamin C (oranges, red peppers, strawberries, broccoli). Some breakfast cereals are fortified with iron and can make a useful contribution to a young child’s diet.  Anaemia (iron deficiency) can be a risk factor for some children especially if they are not eating enough iron rich foods in their diet. In addition if they fill up on lots of milk this can make it difficult for them to get all the nutrients they need from food. 

Fats

The energy that is provided by fat is important for young children and especially those under 2 years of age.  Fats contain important vitamins that are needed for this age group (vitamins A and D) and essential fatty acids such as omega three fats (found in salmon, sardines, mackerel and pilchards)

‘Between the ages of two and five, children should gradually move towards the diet recommended for older children and adults, with less energy provided from fat, and more fibre’5. As with older children and adults it is important to try and limit saturated fat in a young child’s diet.  Saturated fat can be found in butter and lard, meat, pastries, cakes and biscuits.  Try and offer instead unsaturated fats from olive and rapeseed oils and their spreads, nut butters and oily fish.

Top Tips

  • Try and avoid giving high fat foods like crisps, cakes, biscuits, pastries, sausage rolls and pies too often
  • Instead of frying foods try grilling or baking them
  • Buy leaner cuts of meat
  • Remove the skin from poultry
  • Drain the fat from mincemeat once it is cooked
  • Use unsaturated fats for cooking such as olive and rapeseed oils
  • Use fat spreads made from vegetable oils rather than butter

Foods and drinks high in added sugars

Added sugars are also referred to as free sugars and include sucrose (table sugar) and those found naturally in syrups, honey and unsweetened fruit juices.  Free sugars don’t include the sugars found naturally in milk and whole fruits.

Foods that are high in added sugar such as chocolate, cake, sweets, ice-cream, biscuits and full sugar fizzy drinks are not needed in a young child’s diet.  If they are included in the diet they should be offered only occasionally, in small amounts and at mealtimes. Consuming sugary foods and drinks too often can lead to tooth decay, so restricting them to mealtimes can help to protect teeth. Too much added sugar can also be a risk factor for obesity.  Be cautious of foods and drinks containing artificial sweeteners as these can encourage children to prefer the taste of sweet foods and drinks.

Top Tips

  • Trying adding fruit (instead of sugar) to deserts like rice pudding or treats like cakes
  • Provide water and plain milk as the only drinks especially in between meals
  • Limit the amount of foods that are high in added sugars such as cakes, biscuits, sweets, chocolate and ice cream.  Try and replace these with some healthier snacks like fruit, vegetables, plain rice cakes, toast.
  • Watch out for sugar-coated cereals.  Choose low sugar versions such as plain porridge and wholewheat  biscuit  cereals. Try adding some fruit to the top of cereal
  • Choose tinned fruit in fruit juice as a healthy pudding.  Serve this with some plain natural yoghurt
  • Jam is high in added sugar
  • Check the ingredients list for hidden sugars (some names for sugars include glucose, molasses, maltose, dextrose, corn syrup, honey, fructose)

salt

Salt should not be added to children’s food and meals and snacks offered should be low in salt.  High intakes of salt can contribute to high blood pressure later in life.  The recommended maximum amount of salt a child should be having daily is less than older children and adults.  

The recommended maximum salt intake per day is:

  • 1-3 years old – 2g/day
  • 4-6 years old – 3g/day

Top Tips

  • The whole family will benefit from reducing salt in cooking and removing it from the table
  • Limit the use of stock cubes in cooking
  • Use herbs and spices to add flavour instead of salt
  • Choose tinned vegetables with no added salt
  • Limit processed foods and readymade meals as much as possible
  • Limit high salt snack foods like crisps and offer healthy snacks such as fruit and vegetables instead
  • Limit ready made sauces in jars and packets
  • Sauces like ketchup can be high in salt so limit these also
  • Watch out for packet and tinned soups as these can be high in salt
  • Choose tinned tuna in spring water or oil instead of brine and other tinned fish in oil rather than brine

Drinks - what is recommended and how much?

Children should be offered a drink at each meal and snack and water should be available in between these times. .  Drinks should be offered in an open cup or free flowing beaker.  The British Dietetic Association recommend that ‘an open cup should fully replace a bottle at around 1 year of age, a free-flow, lidded beaker (that lets the liquid run out when held upside down) is also suitable, but the lid should be removed to make an open cup as soon as the infant has learnt how to drink’6. Water and plain milk are the best drinks to offer children as they will not damage teeth.  Fizzy drinks and energy drinks are not suitable for this age group.  Squash should also be avoided as this can also be damaging to teeth (even the low sugar varieties).  Sugary and fizzy drinks offered before mealtimes can fill children up and reduce their appetite at mealtimes. Tea and coffee are not suitable drinks for children aged 2-4 years as they contain tannins which can inhibit the absorption of iron from foods.  Pure fruit juice can be offered at mealtimes only and for this age group it should be served as half pure juice/half water. From the age of 5 children can be given undiluted pure fruit juice but make sure this is still at mealtimes only and a small glass once a day (150ml) Avoid ‘fruit juice drinks’ as these contain only a small amount of fruit juice and have added sugar.

The amount of fluid that a child needs can depend on a number of factors such as age, gender, activity levels and the weather.  How much they drink will be individual to the child but as a guide adequate fluid intake from drinks should be for 2-3 year olds 1040ml/day and for 4-8 year olds 1280ml/day7.

Vitamin supplements

The Department of Health recommends that all children aged 6 months to five years are given a vitamin supplement containing vitamins A, C and D every day (unless they are drinking more than 500ml (1 pint) of infant formula per day as formula is already fortified with certain nutrients). 

Some parents are eligible to receive free vitamin supplements as part of the Healthy Start Scheme (Under 18 and pregnant, or in receipt of certain allowances/credit).  Parents who are eligible for Healthy Start can also receive vouchers each week to spend on milk, plain fresh and frozen fruit and vegetables and infant formula.  Many shops accept these vouchers.

For more information visit the Healthy Start Scheme.   

Those who are not eligible to receive Healthy Start vitamins should speak to a pharmacist for advice on which supplement is best for their child.

References

2. First Steps Nutrition Trust, Good food choices and portion sizes for 1-4 year olds, 2016.

3. British Dietetic Association, Food Fact sheet; Suitable milks for children with cow’s milk allergy, August 2017, (last accessed 21.09.17)

4. NHS Choices, What to feed young children (last accessed 24.07.17)

5Children’s Food Trust, Voluntary food and drink guidelines for early years settings in England – A practical guide, October 2012. 

6. British Dietetic Association, Policy Statement; Introducing a cup to an infant’s diet, March 2015, (last accessed 21.09.17)

7. British Dietetic Association, Food Fact sheet; Fluid, March 2017, (Last accessed 21.09.17)