Category: Position Statements

The Infant & Toddler Forum (ITF) welcomes today’s launch of the School Food Trust’s voluntary guidelines for food and drink provision in early years settings.

Dr Atul Singhal, Professor of Paediatric Nutrition at the Institute of Child Health and Chair of the ITF, says: “The recommendations from the School Food Trust will support practitioners working in early years settings across England and help increase knowledge about managing feeding during this crucial stage of childhood development. However, toddlers’ eating habits are also hugely influenced at home so it is vital that families have easy access to simple, evidence-based advice. The ITF provides parents and carers with practical tips and tools to help them make the best choices when feeding toddlers and encourage positive attitudes to food.”

For more information and expert advice on how to feed toddlers well, see the ITF’s family website Little People’s Plates.

The Montpellier Panel recently presented a briefing urging governments to help tackle early years undernutrition, especially in developing countries, with committed funds and decisive action. The Panel is also calling for increased investment in the Scaling Up Nutrition (SUN) Framework, which recommends the action needed to improve the health of pregnant women, mothers and children under the age of two.

As experts in early years nutrition and child development, the Infant & Toddler Forum supports the evidence-based guidance provided by the SUN Framework and reiterates the Panel’s call to governments for significant action, although not just for developing countries. Many toddlers in the UK currently have a sub-optimal diet and show micronutrient deficiencies of iron, zinc and vitamin D. Iron, zinc and vitamins A and D are all crucial for optimizing growth, health and development in the early years of life.

“The Infant & Toddler Forum aims to provide health and childcare professionals, parents and carers with practical help and information on nutrition and development in the early years, including Factsheets on ‘Nutrients: Functions, Sources & Requirements’, ‘Common Nutritional Problems in Toddlers’, and ‘Iron Deficiency Anaemia in Toddlers”.

Panorama discussed the issues surrounding foods marketed at toddlers as well as the challenges of feeding toddlers today. The Infant & Toddler Forum and drivers of the Little Peoples Plates initiative for healthier eating for the under threes, have been working to put toddler nutrition on the agenda of politicians, healthcare professionals and parents for over five years. The Infant & Toddler Forum are committed to helping parents make informed choices about how to feed their toddler whether food is home cooked or pre prepared and have developed two new Factsheets to provide healthcare professionals and parents with guidance on how to select foods, including convenience foods that can be a nutritious option suitable for toddlers.

Convenience foods are now part of everyday life for most households in the UK. The combination of a lack of time, inadequate cooking skills and for some families, limited access to shops where affordable fresh produce is sold, means that convenience foods often become the default family food. Convenience foods vary in their suitability for toddlers. Some are less nutritious containing few of the key nutrients toddlers need and they may have high amounts of added salt, fat and sugar. Knowing which convenience foods to use and which to avoid is never easy. Helping parents to make this decision is a key aim of these Factsheets entitled Understanding food labels and How to choose nutritious fresh or convenience foods.

The Factsheets also provide advice on how to better understand food labelling. They explain the difference between foods marketed at toddlers, which do not have to comply with any regulations; and those labelled specifically as suitable for an infant or toddler under three years of age (e.g. 12+ months) which must comply with regulations requiring a minimum nutrient content and a maximum limit on salt, sodium, fat, sugar and pesticides. Advice is also given on how to interpret the information on labels when trying to make healthy food choices for toddlers.

Health and childcare professionals can visit www.infantandtoddlerforum.org to download factsheets

The World Cancer Research Fund (WCRF) has warned parents against giving children processed meats. The Infant & Toddler Forum, drivers of the Little People`s Plates initiative for healthier eating for the under threes, have the facts behind the headlines:

“Processed meats are nutritious foods containing a good source of iron which is often very low in toddlers diets, in fact one in eight UK toddlers are deficient in iron. As part of balanced nutritious family meals, quality processed meats are fine for the under threes a couple of times a week. On other days include fresh lean red meats, fish, chicken, hummus or eggs instead. A bigger problem for toddlers is too many salty and high fat snacks such as crisps, we’d urge parents to steer clear of these altogether.

“There is, in fact, little to no evidence that toddlers or children eating small amounts of processed meats will get cancer. The WCRF report showed only that adults who eat large amounts of processed meats every week are slightly more likely to get bowel cancer than those adults who only eat small amounts.”

New data from Southampton University published in the Journal of Clinical Endocrinology and Metabolism indicate that infants weaned on healthy homemade foods grow up leaner than those fed on commercial baby products1.This adds to an increasing body of evidence that there is no substitute for using fresh, nutritious foods to guarantee a healthy start in life. Current guidance on how to feed toddlers is built upon this evidence. However, we do need to consider the barriers to following this advice and acknowledge that not everyone follows the ideal of healthy home cooked foods. Information should be available to help parents using convenience foods as part of their child’s diet to make the best choices.

The Issues

Guidance

While there are clear national nutrition guidelines available on feeding infants under the age of one year and school-age children, there are currently no consistent nutrition guidelines for children between one and three years. Most information available to parents on toddler nutrition is often vague and lacks clear practical advice such as exactly which foods, how much of them and how often they should be eaten.

Knowledge and understanding

Toddlers need nutritious food for rapid growth and development in the pre-school years but a recent survey highlighted parents are confused, simply do not understand their child’s unique nutritional needs and want more information on how to feed their toddlers: The I&TF survey2 showed that 95% of parents said they were following the government guidance to feed their toddler like the rest of the family – but for 44% of mums that means using pre-prepared adult convenience foods which may contain too much salt, sugar and fat for the under threes.

Terminology

There needs to be greater clarification of terms, such as ‘home cooked’ or ‘family foods’ as very often ‘home cooked’ or ‘family foods’ are assembled from prepared ingredients or are based on adult ready meals. This fact was supported in the findings of the I&TF survey which reported that: · Only 35% claim to cook most meals for their toddler from scratch, with fresh ingredients especially for their toddler. 30% of under 3s are mostly offered a meal cooked with pre-prepared ingredients (e.g. ready-made pasta sauce or stock cube, Oxo) · 19% are mostly offered takeaways or adult convenience foods / ready meals both of which often contain high levels of salt, fat and sugar.

Conclusion

There is a great need for more practical information on healthy eating for the parents of toddlers – to provide them with clear interpretations of the guidance and to equip them with the knowledge that will allow them to make the best food choices for the health of their children – whether the food is home cooked or pre-prepared. The Infant & Toddler Forum are committed to the delivery of this information. They have launched ‘Little People’s Plates’ to translate the evidence based, practical information on toddler nutrition produced for healthcare professionals into an accessible and intelligible form for parents. All information is available at www.littlepeoplesplates.co.uk

1. Siân M Robinson, Lynne D Marriott, Sarah R Crozier, Nick C Harvey, Catharine R Gale, Hazel M Inskip, Janis Baird, Catherine M Law Keith M Godfrey, Cyrus Cooper, Southampton Women’s Survey Study Group. Variations in infant feeding practice are associated with body composition in childhood: a prospective cohort study. J Clin Endocrinol Metab. 2009 May.

2. Infant & Toddler Forum poll of 1,000 mothers with children aged between nine months and three years.

Food and nutrition for the under threes highlights results of a survey of what parents are feeding their toddlers. It reveals a heavy reliance on convenience foods and takeaways which can often be inappropriately high in salt, fat and sugar, but low in some key nutrients. Nevertheless many parents still feel that they are providing a healthy diet for their child. With increasing levels of obesity and its associated health problems, it is more important than ever that parents have a clear understanding of what constitutes a healthy diet for their young children. This can be a challenge, especially because much nutritional information on food labels can be confusing. The recently published Which? Cereals Report-Going Against the Grain confirms this problem, pointing out that despite making health claims many cereals are still very high in sugar. In addition, it questions the use of cartoon characters to advertise cereals which are high in sugar and salt. It is preferable to add fruit rather than sugar to cereal, to give it some sweetness for toddlers.

More support and information are needed to help parents choose foods that are nutritious for their children. Parents also need help to understand food labels so that they can easily identify `hidden` salt, sugar or fats.

A diet with excessive amounts of salt, saturated fat and sugar can increase the risk of obesity and of developing high blood pressure, heart disease and diabetes in later life. We also know that overweight and obesity start in the preschool years and obese children are more likely to become obese adults.

The Infant & Toddler Forum believe that clear nutritional guidance for parents and carers of all children should be a key public health strategy to ensure children are able to meet their full potential to grow into healthy adults. To help parents and carers make informed food choices, the Forum are committed to providing reliable, practical information on how to make the right food choices using either home-cooked or pre-prepared food.