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0-4 years

Check out current guidance on eating well for children under 5 years old, including information on weaning and foods to avoid in the early years. Also read the current guidance on physical activity for children under 5 years old.

Programmes

Lifestyle, Eating & Activity for Families 0-6 years (LEAF)

The LEAF 0-6 years programme runs over 4 months and focuses on obesity in the 0-6 year old age group. The  programme brings together the expertise of dietitians, physical activity specialists and pediatricians. Throughout the programme we will explore topics such as; healthy foods, food labelling, internal and external triggers, behaviour change, routine and activity. After the programme finishes families will be supported closer to home by health visitors or school nurses

How do I join a LEAF 0-6 years programme?

If you are concerned about your child's weight and would like to find out more about the LEAF 0-6 years programme, please speak to your Health Visitor or School Nurse.

Nippers' Nutrition Programme

Nippers' Nutrition programme aims to improve the quality of food and drink in Cornwall's nurseries and pre-schools.

Does your child attend a Nippers' Nutrition Accredited Nursery or Preschool? Click here to view our current list of childcare providers that have the Nippers' Nutrition accreditation

Healthy Early Years (HEY)

HEY offers good practice guidance for early years settings in Cornwall to support the adoption of healthy practices and ethos. For more information and to see if your child care provider has the HEY scheme fully embedded download the list here. Or if you are a HEY setting, click here for more information

Healthy eating

It has been recognised that nutrition in infancy has a significant and lasting effect on health in later years. By providing a healthy balanced diet and encouraging sound eating habits, you are making the greatest contribution towards your child’s development and future health.  Many parents do not realise that children under the age of five have very different nutritional needs to older children.

While adults and children over five are encouraged to eat a diet that is high in starchy foods and low in fat, 1-4 year olds have very small stomachs and therefore need energy and nutrient dense foods. This means that the food they eat should provide energy and nutrients without being bulky.

What kind of food does my child need?

Children under five should be encouraged to eat the same healthy food as the rest of the family. They do not need special children’s foods. Food sold for children is often very expensive, and not necessarily a healthier option.For some healthy meal options for under fives CLICK HERE

Getting the right balance

The easiest way to ensure that your child’s nutritional needs are being met is to offer a wide variety of foods from the following four food groups:

Fruit and vegetables

It’s good to introduce lots of different types from an early age, whether fresh, frozen, canned or dried.
Avoid giving dried or tinned fruit between meals as the natural sugars will cause damage to teeth.
Make sure that fruit and vegetables are included in every meal.
Different fruits and vegetables contain different vitamins and minerals, so the more different types your toddler eats the better. But don’t worry if they’ll only eat one or two. You can keep giving them small amounts of other fruits and vegetables every so often, so that they can learn to like the taste.
Some children don’t like cooked vegetables but will nibble on raw vegetables while you’re preparing a meal. Try putting them on the top of a pizza or puréeing them in a sauce. Include a variety of cooked and raw fruit and vegetables. Try to offer five servings per day

Carbohydrates

Starchy foods provide energy, nutrients and some fibre. Whether it's bread or breakfast cereals, potatoes or yams, rice or couscous, pasta or chapattis, most children don't need much encouragement to eat foods from this group. You can also give your child wholegrain foods, such as wholemeal bread, pasta and brown rice. However, it’s not a good idea to only give wholegrain foods because they can fill your child up before they’ve taken in the calories they need. Cereals, bread, potato, rice, pasta, crackers, rice cakes, bread sticks, cous cous, noodles - try to offer a mixture of wholegrain and white and offer at every meal time and with some snacks

Meat, fish, eggs, beans, and other non-dairy sources of protein

Young children need protein and iron to grow and develop. Try to give your toddler one or two portions from this group each day. Meat, fish, eggs, pulses (for example, beans, lentils and peas) and foods made from pulses (such as tofu, hummus, and soya mince) are excellent sources of protein and iron. Nuts also contain protein, however, whole nuts including peanuts should not be given to children under five in case they choke. Meat, poultry, fish, eggs, tofu, pulses, ground nuts or nut butter - offer twice a day

Boys can have up to four portions of oily fish (such as mackerel, salmon, and sardines) a week, but it's best not to give girls more than two portions a week. This is because oily fish can contain low levels of pollutants that can build up in the body. Remember, don't stop feeding your child oily fish because the health benefits are greater than the risks, as long as they don't eat more than the recommended amounts.

Milk and dairy foods

Milk and diary products are a good source of calcium, which helps your child to develop strong bones and teeth. They also contain vitamin A, which helps the body resist infections and is needed for healthy skin and eyes. From the age of one, you can replace breast or infant formula with whole cows' milk or carry on breastfeeding. Semi-skimmed milk can be introduced from the age of two, provided your child is a good eater and growing well for their age. 1% fat or skimmed milk does not contain enough fat so is not recommended for children under five. Try to give your child 3 servings of calcium rich foods each day. This can be given as milk, or in the form of foods made from milk such as cheese, yoghurt or fromage frais.

At the age of one, children need less milk than they do as babies. It is important that children over 1 year do not fill up on milk before meal times.
*This is the Reference Nutrient Intake (RNI); a figure set by the DOH which describes the amount of nutrient that is enough to meet the dietary needs of most people in a group (97%). Milk, natural yoghurt, cream cheese, cottage cheese - offer three servings a day (this could be a part of breakfast, as a drink or snack, or as part of a pudding)

Recommended Calcium Intake

Age

Calcium needs*

Portion sizes

1-3 years

350 mg/day

100ml whole / semi-skimmed milk

80g yoghurt

15g cheese

These portion sizes provide a total of approximately 395mg of calcium

4-6 years

450 mg/day

130ml semi-skimmed milk

100g yoghurt

20g cheese

These portion sizes provide a total of approximately 510mg of calcium

 

Appetite

At this stage it is important to understand that your child’s appetite will fluctuate quite widely. Children become very hungry during a growth spurt, and may have a lack of interest in food at other times. Don’t worry – it’s normal. A child’s appetite is a good indicator of their nutritional needs. It is not a good idea to insist that he or she eats more than they want. It is better to offer a very small portion and if they refuse it, offer it another time. Young children all start to show strong preferences or dislikes for certain foods. They can be easily distracted and need to be encouraged to concentrate on eating. Family time at the table with no television in the background will help your child to enjoy meal time and try new foods.

How much is a portion?

Fruit and vegetables - Your child’s cupped handful
Carbohydrates (bread, pasta, potato, rice)  - Size of your child’s fist
Cheese portion - Size of your child’s first two fingers
Protein (meat, fish, eggs, pulses) - Size of your child’s palm
View here to see our latest Portion Sizes Tool 9mths - 6yrs.

Snack time

Snacks are an important part of your child’s daily intake of nutrients.
Try to plan snacks well before mealtimes and offer variety by serving foods from 2 or 3 of the food groups.
Click here to download our Healthy Snacks for Families poster.

Discourage a sweet tooth

Children naturally like sweetness, but sugary foods and snacks have little nutritional value and are major cause of tooth decay. Try to discourage a sweet tooth by getting your child used to savoury foods - if you do not serve sweet foods then they will not miss them.

  • Don’t add sugar to desserts (add only a tiny amount if necessary)
  • Mashed banana is naturally sweet and can be added to lots of foods to provide sweetness
  • Dried fruit should only be offered with a meal
  • Avoid giving your child squash. Milk and water is all they need.

Packed lunch

Parents often feel pressured to buy snack foods from supermarkets to place in packed lunch boxes, but this can work out very expensive, and is often not the healthiest option.
Young children need food that is easy to unpack and simple to eat. Try to also think about how much they can actually eat at lunch time. It may look small in the box, but remember they do have a tiny tummy (see portion sizes above).
Click here to download our Healthy Lunchbox poster.

Family mealtimes

Gradually your children will begin to take some responsibility for what they eat. It is therefore important that they understand that eating a balanced diet will keep them healthy and bouncing with energy.
Your children will be strongly influenced by the example set by you and the rest of the family. Relaxed family meals during which everyone can enjoy conversation and good food will be more effective in instilling sound eating habits than leaving your children to eat in front of the television whilst you rush around doing something else. Giving them simple tasks to help with the cooking will also stimulate an interest in good food.

Click to download the Eating Well recipe booklet (First Steps Nutrition Trust). This booklet contains simple, cost effective ideas for the whole family.

We also have some healthy eating resources such as meal plans, healthy snacks and packed lunch ideas for the under fives for you to download and use.

Helping your child to have enough iron

Iron is essential for your child’s health. Lack of iron can lead to anaemia, which can hold back your child’s physical and mental development. Children who carry on drinking too much milk are most at risk from anaemia.
Iron comes in two forms. One is found in meat and fish is easily absorbed by the body. The other is found in plant foods and is not as easy for the body to absorb.
Even a small amount of meat or fish is good because it helps the body to absorb iron from other food sources.
If your child doesn’t eat meat or fish, they will get enough iron if you give them plenty of:

  • fortified breakfast cereals 
  • dark green vegetables
  • bread beans
  • lentils and dhal
  • dried fruit such as apricots, figs and prunes (try not to serve these between meals as they are not good for your child's teeth)

Foods containing fat, sugar and salt

Fat

Young children, especially those under the age of two, need the concentrated energy provided by fat. There are also some vitamins that are only found in fats. This is why foods such as whole milk, yoghurt, cheese and oily fish are so important.
Once your child is two, you can gradually introduce lower fat dairy products and cut down on fat in other foods - (providing your child is a good eater and is growing well) - so that by the time your child is five they are eating a healthy low-fat diet like the one recommended for adults.

Sugar

To help keep your child’s teeth healthy (in addition to brushing their teeth regularly and visiting the dentist), limit the amount of added sugar they have. Added sugars are found in fizzy drinks, juice drinks, sweets, cakes and jam. If you give children these kinds of foods and drinks, give them at mealtimes and not as snacks.
Don't let your child sip sugary drinks and suck sugary sweets too often. The longer and more often the sugar touches your child’s teeth, the more damage it causes.
Dried fruit and 100% fruit juice can also damage teeth, so it is best to give these to your child at meal times and not as snacks. We recommend to dilute fruit juice (50% juice and 50% water).

Salt

There’s no need to add salt (sodium chloride) to your child’s food. Most foods already contain enough salt.
Too much salt can give your child a taste for salty foods and contribute towards high blood pressure in later life. Your whole family will benefit if you gradually reduce the amount of salt in your cooking. Try to limit the amount of salty foods your child has, and always check the label.
Babies up to one year old should have no more than 1g of salt a day. The maximum amount is 2g of salt a day for children aged one to three, and 3g a day for children aged four to six.

Caring for your child's teeth

Babies

As soon as your baby’s teeth start to come through, you can start brushing them. Use a baby toothbrush with a tiny smear of fluoride toothpaste.

Don’t worry if you don’t manage to brush much at first. The important thing is to get your baby used to teeth-brushing as part of their daily routine. You can help by setting a good example and letting them see you brushing your own teeth.

Brushing tips for babies and young children

Follow these tips and you can help keep your kids' teeth decay-free: 

  • Start to brush your baby's gums with a soft toothbrush at bath time, or even let your baby have a go themselves as long as you supervise them. This establishes brushing their teeth as part of the washing routine.
  • Start brushing your baby's teeth with fluoride toothpaste as soon as the first milk tooth breaks through (usually at around six months, but it can be earlier or later). It's important to use a fluoride paste as this helps prevent and control tooth decay. 
  • Not all children like having their teeth brushed, so you may have to keep trying. Don't let it turn into a battle. Instead, make it into a game, or brush your own teeth at the same time and then help your child finish their own.The easiest way to brush a baby’s teeth is to sit them on your knee with their head resting against your chest. With an older child, stand behind them and tilt their head upwards.
  • Children under the age of three can use a smear of family toothpaste containing at least 1,000ppm (parts per million) fluoride. Toothpaste with less fluoride is not as effective at preventing decay.
  • Children between the ages of three and six should use a pea-sized blob of toothpaste containing 1,350-1,500ppm fluoride. Check the toothpaste packet for this information or ask your dentist.
  • Make sure your child doesn’t eat or lick the toothpaste from the tube.
  • Brush your child's teeth for at least two minutes twice a day, once just before bedtime and at least one other time during the day. Encourage them to spit out excess toothpaste but not to rinse with lots of water.
  • Supervise tooth brushing until your child is seven or eight years old, either by brushing their teeth yourself or, if they brush their own teeth, by watching how they do it. From the age of seven or eight they should be able to brush their own teeth, but it’s still a good idea to watch them now and again to make sure they brush properly and for the whole two minutes.

Making sure they brush properly

  • Guide your child's hand so they can feel the correct movement.

  • Use a mirror to help your child see exactly where the brush is cleaning their teeth.
  • Make tooth brushing as fun as possible, using an egg timer to time it for at least two minutes.
  • Don't let children run around with a toothbrush in their mouth as they may damage their mouths or choke if they fall over.

Taking your child to the dentist

Once you've established a good tooth-brushing routine at home, the next step is the first trip to the dentist. These tips can make this a lot easier:

  • Take your child to the dentist when they're as young as possible and at least once by the time they're two. This is so they become familiar with the environment and get to know the dentist. The dentist can help to prevent decay and identify any health problems at an early stage. Just opening up the child's mouth for the dentist to take a look is useful practice for when they could benefit from future preventive care. 
  • When you visit the dentist, be positive about it and make the trip fun. This will stop your child worrying about future visits. NHS dental care for children is free.
  • Take your child with you when you go for your own dental check-up appointments so they get used to it.

Establishing good habits can help your child avoid oral health problems, such as tooth decay and gum disease. 

Kids teeth Q&A

Can I let my child have sweets?

Most children want sweets, but you can help prevent problems by making sure they don’t eat them often and encouraging them only to eat their sweets with a meal. This way, your child avoids the extra acid caused by eating sweets between meals. 

Try not to give sweets or sweet drinks as rewards.

What are the best snacks to give my child?

The best snacks are fruit and raw vegetables. Try tangerines, bananas, pieces of cucumber or carrot sticks. Other good snacks include breadsticks, crackers, rice cakes and plain popcorn.

Should I let my child have fizzy drinks?

No. Fizzy drinks contain acids that can affect the enamel on your child's teeth, making it thinner.

What are the best drinks for my child's teeth?

The best drinks for children over one year old are water or milk. Cows' milk is not suitable as a drink until your baby is 12 months old.

Use full-fat milk (whole milk) from the age of 12 months to two years. Semi-skimmed milk can be introduced from the age of two, as long as your child is a good eater and growing well for their age. Skimmed milk doesn't contain enough fat, so is not recommended for children under five.

Fruit juices contain sugars and acids, so it's best to have these only at mealtimes and use a straw. If your child is thirsty, it's better to give them water than to encourage a taste for sweet drinks. Try to avoid giving babies fruit-flavoured 'baby juices', and never give them in feeding bottles.

Fruit juice is not suitable for babies under six months.

Will milk at bedtime damage my child's teeth?

Water is the best drink to give at bedtime, but if you do give milk, don't add anything to it. Chocolate-flavoured drinks and milkshake powder usually contain sugars, which can increase the risk of decay if given at bedtime.

Are sugar-free medicines better for my child's teeth?

Yes. Always ask for sugar-free medicines and remind your doctor about this if you're being given a prescription for your child. This is especially important if your child is taking long-term medication.

When should my child give up bottles?

Your child should begin moving off the bottle and on to a feeder cup at six months. Bottles should be given up completely by the age of one because the teats and spouts encourage children to suck for long periods of time, which can mean the drinks that cause tooth decay stay in contact with your child's teeth for a long time.

Are sippy cups good for teeth?

There's no need for a child to use a sippy cup. These are similar to a bottle, in that they require the child to suck to make them work. A feeder cup is better as it doesn't have valves and the flow of liquid is unrestricted. This means children learn to drink normally rather than by sucking. 

Will a dummy or thumb sucking harm my child's teeth?

No, but they will encourage an open bite. This is when teeth move to make space for the dummy or thumb. They may also affect speech development. 

Thumb sucking and dummies won't cause permanent problems as long as the habit stops by the time your child gets their second teeth, but it can be a hard habit to break. Discourage your children from talking or making sounds with their thumb or a dummy in their mouth, and don't dip dummies in anything sweet such as sugar or jam.

What is fluoride varnish?

This is a special varnish that is painted onto a child's teeth to help protect them. It's done at the dental surgery or sometimes in schools. It's recommended that all children over the age of three have a fluoride varnish every six months. Talk to your dentist to find out if your child would benefit from this extra protection. 

Physical activity

  • Physical activity should be encouraged from birth, particularly through floor-based play and water-based activities in safe environments.

  • Children of pre-school age who are capable of walking unaided should be physically active daily for at least 180 minutes (3 hours), spread throughout the day.

  • All under fives should minimise the amount of time spent being sedentary (being restrained or sitting) for extended periods (except time spent sleeping).

  • Early years (under 5's) for infants not yet walking

  • Early years (under 5's) for children capable of walking

Factsheets and helpful links

Factsheets

Helpful links