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08 Oct 2024

Exploring dietary requirements in early education and care

Eating and nutrition are a substantial part of the life of young children. In the early days, it can feel like newborn babies’ (and their parents’ or carers’) lives, solely revolve around feeding times. A short while later, the weaning journey carves out an individual path for all those involved to navigate – sometimes rocky and sometimes a smooth path to glide through. When it gets to the toddler era, we’re exploring new foods, testing portions and finding creative ways to interact with how we fuel our bodies. 

But, for some families there are additional considerations – some with more serious consequences than others – that influence how a child interacts with food and any precautions that might be needed. These can vary from considerations around food sizes and swallowing capabilities, to cultural requirements around diet, or the sensory experience of specific tastes and textures, that impact a child’s experience at mealtimes. 

In this article, we are going to focus on specific requirements in relation to allergies and intolerances, exploring what they mean and what we can do to support an inclusive and safe environment for everyone. 

Some key terms

It can be easy to get mixed up with the terminology that is used around dietary requirements, because they are often used to mean similar things. However, there is a big difference between what we refer to as an intolerance and what we should consider an allergy to be, which has a significant impact on how we respond to individual needs. 

What is an allergy? 

Whilst food allergies are prominent, they are only one of the allergies that children can experience. Allergies are very common amongst children and, whilst some are lifelong experiences, children may grow out of certain reactions as they get older. 

Allergy UK provide a helpful description of what an allergy is: 

“An allergy is the response of the body’s immune system to normally harmless substances, but the body identifies them as a threat and produces an inappropriate response.”

When the body interprets this threat, it produces a reaction that can vary from mild symptoms to a life-threatening reaction. Allergies can have many causes, but the most common ones for children include foods such as: 

  • cows’ milk
  • eggs
  • foods containing gluten
  • nuts
  • soya
  • shellfish 
  • fish.  

Symptoms are also varied, causing anything from hives and or a rash on the skin, to sinus symptoms such as coughs and sneezes. Whilst the majority of reactions are mild, some cases may result in a severe reaction of anaphylaxis. This is a rapid and extreme reaction that requires emergency medical attention. 

What is an intolerance? 

A food intolerance is different to an allergy in that it is caused by not being able to digest a food’s ingredient properly. It does not produce a reaction by your immune system in the way that an allergy can, but it can still cause a child to feel very unwell. 

Common foods associated with intolerances include: 

  • lactose (sugar found in dairy) - this is very common and there are many kinds to consider with babies of all ages. 
  • gluten 
  • histamine 
  • caffeine.

Unlike an allergy, where the reaction presents itself very soon after contact with the allergen, signs of intolerance can be delayed by hours or even days. 

The symptoms are also more specific than those of an allergy, largely focused on the tummy area because the intolerance relates to digestion. These might include bloating or tummy ache, sickness and bowel movement issues, including constipation and diarrhoea. 

Whilst intolerances do not produce a serious reaction, they can make the sufferer quite poorly and should be considered with the same care and attention as allergies. 

A recent study found that food allergies in England are on the rise, with the number of people with a food allergy having doubled between 2008 and 2018. The greatest increase was observed in children between birth and four years of age.

With growing numbers of those experiencing food hypersensitivity, it’s important now, more than ever, that we have a solid knowledge of food hygiene and the impact of intolerances and allergies. In addition, it’s vital that we know how to confidently deal with any issues that arise because of food sensitivity. 

How can we support food hypersensitivities in our practice?

As with all children's needs, it is important that we ensure we provide a safe, secure and consistent environment whilst children are in our care. This is a priority when it comes to food sensitivities through intolerances and allergies, where carelessness or misinformation can cause real harm. 

Communication with everyone

The risks of intolerances and allergies are not obvious, so the potential risks to an individual child need to be made very clear to staff, along with clear instructions around any responsibility they have to mitigate those risks. Whilst staff who are permanently in the room should have a thorough knowledge of every child’s individual needs, it is everyone’s responsibility to ensure a safe environment is maintained. 

mmunicating individual intolerance and allergy needs to staff who might support for short periods of time, such as lunch cover, is key to establishing thorough communication and informative practice to ensure everyone feels confident of their role.

  • Any known intolerances or allergies across the setting should be recorded   for reference and to allow unfamiliar staff to check their understanding of any concerns. 
  • Ensure that everyone knows where medication, such as adrenaline pens or antihistamines and creams for individual children are kept in case of emergency. 
  • It is important to follow the setting’s policy when administering any medication so ensure this is also followed-up during these critical conversations.
  • It’s also important to communicate these hazards to the other children, ensuring that food is not taken off others’ plates, drinks are not swapped and shared and that effective hygiene is maintained by everyone. 
  • Explaining the value of this can also enhance children’s awareness of their friend’s differences and needs, embracing these situations with empathy and care, to know what to do if something seems wrong.  

Keep things visual, keep things clear

Children’s plates can be colour coded to signal another action to be taken in association to an intolerance, prompting professionals to ‘think again’ before serving. A different colour of plate might indicate an intolerance or allergy which requires a change of menu accordingly, or it could indicate that a child is required to sit away from any allergens that other children might be eating.  This practice can also be used for cups to ensure precautions around drinks are taken and risks avoided. 

When food might need to be altered to accommodate to an individual’s diet needs, it should be labelled appropriately and stored safely to reduce any risk of cross contamination. This can also help staff members to provide an inclusive mealtime where children with food allergies and intolerances, are able to participate in self-serve activities in the same way as their friends. 

The value of record keeping

Record keeping is a significant responsibility for early  education and care professionals each day. Providing parents and carers with details of their child’s sleep, toileting or nappy changes, as well as their food and drink intake, is an essential aspect of communication.  Not only can this practice support with establishing and sustaining routines, it can also often help to explain patterns of behaviours, or indeed, help to identify potential food intolerances or allergies. 

Wrapping up

Allergies and intolerances impact the lives of many young children in our care and, as evidence shows, they are becoming a more common issue. It’s important to not only have an awareness of what intolerances and allergies are, but also to pay particular attention to your setting’s own policies, direct action and risk assessments, when it comes to food. 

  1. Check your policies are up to date and staff are confident with the procedures involved
  2. Ensure a clear process for keeping new and temporary staff informed of all dietary requirements across the setting
  3. Review your current means for identifying an allergy or intolerance – how easily identifiable are they? 
  4. Are all staff clear about the administration requirements of medicines relating to food requirements and how this is navigated within setting?

Make sure you have a good understanding of what these processes involve and always ask questions about any aspects you are unsure of.