Healthy Eating (Child Care Manual)

Children grow and develop quickly. They need good nutrition to support healthy growth and development. In addition to providing nourishment, mealtimes provide a social time for children and caregivers to talk and learn from each other. These early experiences with eating can have a lasting impact on children’s future eating habits and attitudes about food.

In the Act

All infants and children attending child care centres in Ontario must be provided with enough safe and nutritious food to meet their individual energy and nutrient requirements (Child Care and Early Years Act O. Reg. 137/15).

Refer to the nutrition sections (42-44) of O. Reg. 137/15 for a detailed explanation of the requirements related to feeding. For example:

  • Receive written feeding instructions from parents for all children less than one year of age
  • Receive written instructions from parents for all children with special dietary needs. Food or drink provided by parents must be clearly labelled with the child's name and the date the food was sent to the centre.
  • Store food or drink in a manner that maximizes its nutritive value and minimizes the risk of contamination or spoilage
  • List all children with food allergies and the specifics of the allergy. Post this list in clear view in both the cooking and serving areas of the child care centre.
  • Post complete menus in an obvious and visible location for the current and following week
  • Keep menus for 30 days following the last day that it was applicable

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Feeding infants in your care

Dietitians of Canada partners with other health professional organizations and Health Canada to develop evidence-based guidance on feeding infants and toddlers.

Of particular relevance to child care providers is Nutrition for Healthy Term Infants from 6 to 24 months (2014), published by Health Canada, developed jointly by Dietitians of Canada, the Canadian Paediatric Society and the Breastfeeding Committee for Canada. A few key principles and recommendations include:

Foods for older infants and young children must be prepared, served, and stored safely

  • Infants and young children must be supervised during feeding
  • Avoid offering hard, small and round, or smooth and sticky, solid foods. These may cause aspiration and choking.
  • Prepare and store food safely to prevent foodborne illness. Avoid products that contain raw or undercooked meat, eggs, poultry, or fish; unpasteurized milk or milk products; unpasteurized juice; and cross-contamination between cooked and uncooked foods.
  • Do not give honey to a child under one year of age. This helps to prevent infant botulism.

Responsive feeding promotes the development of healthy eating skills

  • Encourage responsive feeding based on the child's hunger and satiety cues (e.g. closing mouth, turning head away, etc.)
  • Promote offering finger foods to encourage self-feeding
  • Encourage use of an open cup, initially with help

From one year of age, young children begin to have a regular schedule of meals and snacks

  • Set a regular schedule of meals and snacks, offering a variety of nutritious foods from Canada’s Food Guide
  • Prepare foods with little or no added salt or sugar
  • Nutritious, higher-fat foods are an important source of energy for young children
  • Encourage continued breastfeeding, or offering 500 mL per day of homogenized (3.25% M.F.) cow's milk
  • Offer water to satisfy thirst
  • Role model healthy eating habits

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Supporting breastfeeding

Child care centres play an important role in supporting a family' s decision to provide breastmilk for their child. Demonstrate support to breastfeeding families by:

  • Arranging a comfortable place where mothers can breastfeed their children or express / pump breastmilk
  • Practicing the safe handling, storage, and preparation of expressed breastmilk when it is provided by a family with instruction to give to their child while in the child care centre

Feeding expressed breastmilk

Warm breastmilk by placing under warm running water or in a bowl of warm water for no longer than 15 minutes. Swirl the bottle to evenly heat. The milk should feel slightly warm, not hot. Throw away any breastmilk a child does not finish within two hours or that has been thawed for longer than 24 hours. Thawed breastmilk may look blue, yellow, or brown with fatty layers.

Fresh milk can be kept in the fridge for up to 4 days, while thawed milk can be kept in the fridge for up to 24 hours. It can take up to 12 hours to thaw in the fridge, or it can be placed directly from the freezer under cool then warm running water. Breastmilk can be kept in the freezer for six to 12 months.

The Canadian Paediatric Society provides the following guidelines when handling expressed breastmilk in child care centres:

  • Breastmilk container labels should include the child's name and the date the milk was expressed. The label should be carefully checked (preferably by two people) before every feeding. It is important to avoid giving breastmilk to the wrong baby as there is a small risk of a blood-borne virus being present.
  • Have a protocol for managing breastmilk errors. Both the mother who produced the breastmilk and the parents of the baby who was given the wrong milk must be advised and if an error occurs, and public health authorities contacted without delay. Blood tests may be required and the baby who received the milk may require immunization against hepatitis B.

If a breastmilk error occurs, contact the Infectious Disease Program at Public Health at 905-688-8248 ext. 7330 or 1-888-505-6074 ext. 7330. For infants receiving breastmilk substitutes, follow the steps to safely prepare infant formula.

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Menu planning and supportive nutrition environments

The Ontario Dietitians in Public Health have created child care nutrition resources to support child care providers in planning and preparing healthy food for children (one year of age and older) in their care.

They reflect current best practices for creating supportive nutrition environments in child care settings and will help child care providers meet the food and drink requirements set out in section 42 of the CCEYA O. Reg. 137/15. They include:

Menu Planning and Supportive Nutrition Environments Practical Guide
Includes information for child care providers on menu planning, food and beverages that should be served, appropriate portion sizes for different age groups, sample menus and templates as well as strategies to create a supportive nutrition environment.

Menu and Nutrition Environment Self-assessment Tool
Helps child care cooks, chefs and providers assess their menus to meet the food and drink requirements in section 42 the CCEYA O. Reg. 137/15.

Paint Your Plate Vegetables and Fruit Toolkit
Fun and engaging ideas to make it easier for young children in your care to enjoy vegetables and fruit, as well as seasonal menus, factsheets, posters, sample policies and tips for sharing the Paint Your Plate message with families.

Online learning modules
For operators, supervisors, cooks and staff in child care settings to understand and apply the nutrition recommendations outlined in the Menu Planning and Supportive Nutrition Environments in Child Care Settings Practical Guide.

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Canada’s new Food Guide

January marked the launch of Canada’s new Food Guide. It is no longer a one-size-fits-all print document, but is now a web application that provides information and up-to-date advice on eating well. New resources include:

It recognizes the importance of:

  • Traditional foods for Indigenous Peoples
  • Cultural diversity
  • Environmental sustainability

It recommends making it a habit to eat a variety of healthy foods each day:

  • Eat plenty of vegetables and fruits, whole grain foods and protein foods. Choose protein foods that come from plants more often.
  • Choose foods with healthy fats instead of saturated fat
  • Limit highly processed foods. If you choose these foods, eat them less often and in small amounts.
  • Prepare meals and snacks using ingredients that have little to no added sodium, sugars or saturated fat
  • Choose healthier menu options when eating out
  • Make water your drink of choice
  • Replace sugary drinks with water
  • Use food labels
  • Be aware that food marketing can influence your choices

It recognizes that healthy eating is more than the foods we eat:

  • Be mindful of your eating habits
  • Cook more often
  • Enjoy your food
  • Eat meals with others

Many changes in the new food guide align with the Ontario Dietitians in Public Health’s Menu Planning and Supportive Nutrition Environments in Child Care Settings Practical Guide:

The new Canada’s Food Guide The Practical Guide
Advises limiting foods high in saturated fat, sodium and sugar Categorizes foods high in saturated fat, sodium and sugar as “Do Not Serve”
No longer includes fruit juice and flavoured milks No longer includes fruit juice and flavoured milks Categorizes fruit juice and flavoured milks as ‘Do Not Serve’
Emphasizes drinking water Advises that water should be available at all times
Highlights the importance of how to eat, not just what to eat (e.g. enjoying food, eating with others, cooking more often) Aligns with Section 7: Strategies to Create a Supportive Nutrition Environment

Later in 2019, Health Canada will be releasing guidance for institutions and settings that are involved with purchasing, preparing and serving food (e.g. child care, long-term care, etc.).

The Ministry of Education supports child care settings in using the Practical Guide from the Ontario Dietitians in Public Health for menu planning.

For more information

The Dietitians of Canada website, UnlockFood.ca includes hundreds of articles on healthy eating topics, recipes, menu plans, videos, interactive tools, as well as help in finding a dietitian.

You can also speak to a:

Registered Dietitian at Telehealth Ontario
1-866-797-0000 (Monday to Friday, 9 a.m. to 5 p.m.)

Public Health Nurse at Niagara Parents
905-688-8248 or 1-888-505-6074 ext. 7555 (Monday to Friday, 8:30 a.m. to 4:30 p.m.)
Email Niagara Parents

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Last updated: Sept. 30, 2019

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