HEALTHY EATING GUIDELINE 10
Ensure that food is safely prepared for children to eat – from the preparation stages to consumption.
Food safety is a critically important consideration in early childhood settings. It includes managing any possible risk of children choking on food, avoiding both allergic reactions and intolerant or sensitive reactions to foods, and ensuring that food is not contaminated. Each state and territory has specific requirements with regards to food safety and allergies. Be sure to check the requirements for the local area.
Allergies and intolerances
There are various situations where children may have an adverse reaction to a food because of an allergy, intolerance or sensitivity. Many people in the community refer to food intolerance as a food allergy. This can be confusing as food intolerance is far less severe than an allergy. How each should be managed in the individual childcare settings is different. It is important that centre staff know the difference between food allergy and food intolerance.
Food allergies are caused by a reaction of the immune system to a protein in a food. The most common sources of food allergy in children under five are cow’s milk, soy, eggs, peanuts, tree nuts, wheat, sesame, fish and shellfish. Even very small amounts of food can cause an allergic reaction. Food allergies occur in around one in 20 children, and some of these allergies are severe. Symptoms of an allergic reaction are usually immediate and can include hives or a rash on the skin; swelling of the lips, tongue or mouth; vomiting; diarrhoea; or difficulty breathing. Severe cases of allergic reaction can lead to an anaphylactic reaction, where breathing becomes extremely difficult. This can cause loss of consciousness and severe injury or death.
When children have a severe food allergy, it is likely that parents will already have an allergy management plan that has been developed with their doctor. Individual allergy management plans must be developed by families, in conjunction with the setting’s director or coordinator. Refer to the Australasian Society for Clinical Immunology and Allergy (ASCIA) website for more information on allergy management plans.
Ensuring that children avoid exposure to foods they are allergic to is the only way to manage a food allergy. This means avoiding exposure at all times – mealtimes, during cooking, and craft activities. Everyone working with children needs to be aware of the early symptoms of a food allergy, and must be trained in how to manage allergic reactions. Each setting should have its own allergy management policy, in addition to individual allergy management plans.
Food provided by the setting
It is important to ensure that safe, allergen-free foods are provided to children with allergies. In some instances the easiest way to do this may be to exclude foods from the menu to which children attending the setting have been diagnosed as allergic. An alternative is to prepare meals and snacks specifically for children with particular allergies, or sometimes, after discussion with the family, it may be decided that the safest option is for the child to bring food from home. Children with food allergies must be closely supervised
at meal and snack times.
Food brought from home
Children should be discouraged from swapping or sharing food. If a child attending the setting has a severe allergy, it may be necessary to have a policy that prohibits children from bringing snacks and lunches containing that particular food. For example, if a child has a peanut allergy, the policy may be that no peanuts or peanut pastes are allowed in the setting at any time. The policy and its implementation will depend on the types and number of foods that may need to be avoided, the severity of each child’s allergies, and the possible nutritional impact on other children of omitting those foods. Again, close supervision at meal and snack times is essential.
Food intolerance or sensitivity typically results in less severe reactions than allergies. Usually, a larger dose of food is required to cause a reaction from food intolerance. Symptoms of food intolerance can include headaches, skin rashes and stomach upsets. It is important to work with parents to develop a plan to manage a child’s food intolerance which minimises the child’s exposure to particular foods.
Choking risks for toddlers and young children
Children can easily inhale or ingest food, and their small airways are easily blocked. Children should sit down whenever they are eating, and their eating should be supervised. Particular food items pose greater choking risks to young children, and extra care should be taken with these foods. Hard, small, round and/or sticky solid foods are not recommended because they can cause choking and aspiration.
Foods to be careful with include:
hard food that can break into smaller lumps or pieces
raw carrot, celery and apple pieces, which should be grated, finely sliced, cooked or mashed to prevent choking
nuts, seeds and popcorn
tough or chewy pieces of meat
sausages and hot dogs, which should have the skin removed and be cut into small pieces to prevent choking.
Hard lollies and corn chips also present a choking risk, but these should not
be offered in the setting as they are discretionary choices.
Young children’s immune systems are not fully developed, and food safety guidelines should be followed whenever preparing food for them.
Contamination in food can include:
foreign bodies – hair, pieces of metal or other objects accidentally picked up during the preparation and cooking process
chemicals from the food production process, or cleaning materials
natural contaminants, such as toxins
contamination from pests
Children are particularly vulnerable to illnesses caused by food-borne organisms because of their less mature immune systems. In early childhood settings the larger the number of children being fed the larger the risk, because it is more difficult to handle larger quantities of food safely.
Most states and territories have separate legal requirements, in addition to other regulations, that specifically relate to food safety. In some states and territories these may be handled by the local government authority, and some authorities will require staff and carers to undertake formal training. Check what is required in the local area.
Bacteria in foods
There are bacteria present in most foods. The only foods which have no bacteria are those produced synthetically in a sterile factory, or foods which have been heat-treated after preparation. Examples include canned foods and liquid baby formula. All other foods have some bacteria. Keeping food safe is about controlling the increase in the number of bacteria.
Food spoilage is often caused by bacteria, which can make food inedible and unpleasant but not necessarily harmful. Some bacteria however, called pathogens, are harmful. Pathogenic bacteria can be common. If this form of bacteria is present in a sufficiently large amount it can cause food poisoning or gastro-enteritis. These illnesses typically involve nausea, vomiting, diarrhoea and stomach cramps.
For bacteria to grow to a number large enough to cause illness, food must have nutrients for growth, moisture and be at a temperature that allows bacteria to reproduce quickly.
The time interval between consuming harmful bacteria and showing symptoms of illness varies.
Different bacteria cause different illnesses. Some can cause very brief and mild illness, while others may lead to more serious illness and dehydration that can require hospitalisation. Food poisoning is especially serious in children and elderly people because their immune systems are more vulnerable and they become dehydrated more easily.
The most common cause of gastro-enteritis is viral illness passed on through contact between people, rather than through food. These illnesses are very common, generally very acute and short term. Good hygiene, particularly hand-washing, is very important in limiting the spread of viral gastro-enteritis.
Foods that allow the easy growth of bacteria are those that are moist and contain a lot of nutrients. These foods, called ‘high-risk’ foods, include milk, meat and fish, as well as any dishes containing them. Cooked rice also allows some bacteria to grow. If these foods are left out of the refrigerator for long periods of time they will spoil, but will only cause illness if they contain harmful pathogenic bacteria. Keeping food safe for consumption relies on controlling all aspects of food handling and any food-related conditions, to ensure that bacteria cannot reproduce and grow to large numbers.
Foods unlikely to encourage bacterial growth, or ‘low-risk’ foods, include uncooked pasta and rice, breads and biscuits, packaged snack foods, lollies and chocolates. These foods can be kept safely for long periods of time without refrigeration. Canned food is safe while the can is still sealed, but once opened the food may become high-risk. Lollies, chocolates and many packaged snack foods are ‘discretionary choices’, and should not be offered in the setting. Low-risk foods are useful for the store cupboard at early childhood settings, but need to be combined with high-risk foods in an adequate eating pattern to provide proper nutrition.
Always wash hands before handling food, and again during the preparation of food if hair is touched, after wiping the nose with a tissue, after sneezing or going to the toilet, or if other items which may carry bacteria are touched.
Buy food only from trusted suppliers. When buying fresh food, choose food that looks fresh, from places where turnover is high.
Make sure packages are unbroken and products are within the use-by date.
Transport high-risk foods quickly or in cool containers.
Keep all kitchen areas clean; protect low-risk foods by placing them in sealed containers once their packages are open.
Use separate boards for cutting raw meat and fish, cooked items such as meat and vegetables, and fruit. Colour code boards to identify their use.
Clean knives and cooking utensils between using them for uncooked meat or fish and other foods ready to be eaten.
Cooking, heating, cooling and storing
Keep high-risk foods refrigerated before cooking, or until they are ready to be eaten. Place any cooked high-risk foods back in the refrigerator if they are not being eaten straight away.
Do not reheat cooked food more than once. Discard food that is served and not eaten. Discard any food that was not served but has been out of the refrigerator for more than two hours.
Reheat refrigerated food to steaming hot, allow it to cool to serving temperature and then serve immediately.
Check daily that the refrigerator is working and that food is cold.
Wash dishes in hot soapy water and leave them to dry, rather than using a tea towel. Generally, a dishwasher is required for safe washing of children’s dishes.
Food preparation with children
Ensure that children always wash hands before handling any food.
Supervise children at all times while in the kitchen.
Take care to avoid any injuries from sharp knives and hot surfaces.
Serving food safely
Children and adults should wash hands before eating.
Tongs and spoons should be used for serving food.
All food served to the table or individual plates should be discarded, and not served again later.
Any food not served from the kitchen can be covered and refrigerated, then reheated and served later. Food already reheated cannot be heated again – for example, a curry cooked the night before and refrigerated, then reheated and served the next day in the setting cannot be reheated again and served later.
Children should not share bowls or utensils, or eat from each other’s plates or cups.
Food dropped on the floor should not be eaten.
Handling kitchen emergencies safely
The cook’s day off
If the setting is large enough to employ a cook, it helps to have an extra day’s meal prepared and frozen, for a day when the cook is unable to come to work. (Some recipes that freeze well are provided in the Cooking for Children book, and are marked at the top of the recipe.) Unless the freezer at the setting is very large, it may be easier to prepare and freeze pasta sauce, for example, and cook pasta on the day. Any frozen food must be used within three months; if it is not needed for an emergency, it can be served and then simply replaced in the freezer by a freshly cooked meal.
Sandwiches are time-consuming to prepare for large numbers, and therefore not recommended if time is limited.
Baked beans with bread or toast are easy to prepare when time is limited.
What if the refrigerator breaks down?
The menu will need to be changed so that the most expensive foods can be used straight away. However, if the refrigerator is kept closed, the temperature will stay low for some time. Buying some ice to keep food cold will allow enough time for cooking, arranging for alternative storage or refrigerator repair.
Food that cannot be used straight away can perhaps be stored in another refrigerator – for example, parents’ refrigerators.
Until the refrigerator is repaired, any food served should be low-risk – for example, sandwiches with fillings such as baked beans, tomato, peanut butter (if it is allowed in the setting), egg or tuna (cooked or prepared just before it is needed).
Dishes containing low-risk food items can be prepared and served. Pasta, rice, onions, fresh and canned fruit, canned tomato and tuna are all low-risk foods. Canned, evaporated or dried milk is safe to include, as are canned or freeze-dried vegetables. Any food not used at a mealtime should be discarded.
Individual allergy management plans are developed for children with diagnosed allergies.
Staff and carers are trained to prevent allergic reactions, and know how to manage a child showing symptoms of an allergic response.
Choking risks are minimised through supervision, appropriate seating and the provision of appropriate foods.
Food is prepared safely to minimise any risk of contamination.
Food is served safely and the appropriate serving utensils are provided.
Safe and hygienic hand-washing practices are observed at all times.
Food-handling staff and carers attend relevant training courses as required.