By Stewart McKenzie, chair of the Hospital Caterers Association (HCA) 

Catering for children in hospitals can be challenging. Many factors come into play, such as dietary requirements, portion control and more commonly, fussy eaters. Children are particularly vulnerable to poor nutrition, because of their extra requirements for growth, and undernutrition and over nutrition can have early and serious consequences.

Excess energy intake coupled with reduced physical activity can increase the risk of developing obesity, while undernutrition can cause growth to slow, impair neurodevelopment and increase the risk of infections. This would then lead to an increased length of hospital stay.

· Eating disorders are a common condition in children

· In England, according to data from the National Child Measurement Programme, 9% of reception age children (age 4-5) are obese, with a further 13% overweight

· 20% of Year 6 children (age 10-11) are obese and 14% overweight

· On the flipside, some children and young adults are not eating enough, resulting in anorexia. Anorexia most commonly affects girls and women, although it has become more common in the male gender in recent years

Understanding their needs It is important that we know exactly what individuals need so we can deliver a comfortable mealtime experience. This includes 24/7 availability, snack choices and more importantly, paediatric menus for children’s wards.

Children require care around the clock. The ‘Nutrition and Hydration 24/7,365’ campaign, led by the HCA, initiates the importance of providing quality healthy food at any time of the day. The collaboration of the three key professionals: Dietetics, nursing and catering through the ‘Power of 3’ campaign, creates a plan for a patient to change eating behaviour and restore a healthy weight.

There are recommended guidelines on food and drink consumption for children. It is vital that they consume sufficient meals to meet their nutritional requirements, to provide energy, nutrients for growth, development and activity. It is recommended that children should eat at least five portions of varied fruit and vegetables every day.

It is also recognised that with some children, diet is core to their recovery plan, particularly if they are overweight and at risk of developing obesity. Their hospital stay can be an opportunity to develop an awareness of and experience healthy eating. Catering in hospitals can influence what patients continue to consume outside of a healthcare setting.

Meals on wheels

Stuart Donald, catering manager, Aberdeen Royal Infirmary, advises:

  • Look at what children are eating in your specific area. At home, at school, and on the high street. This is what we are judged against, like it or not. Familiar foods are more comforting.
  • Make the menu and service as flexible as possible so that you can cater for as many different ages, conditions and circumstances.
  • Concentrate just as much on the style of service as the menu itself. Make whatever you offer bright, appealing, friendly and attractive.
  • Our biggest success has been our deli cart. The children do not choose from a menu card or the day before. They go to the cart and choose what they want from a selection of fresh items in front of them. In effect, building their own meal (similar to a high street sandwich deli) and we have found that they eat more fresh and healthy foods – sometimes things they have never tried before. You could also come to the cart every day for weeks and have something different every time.