Sending Milk and Food to Nursery

Start with the setting's own rules

Nurseries and childminders work to their own food safety and allergy policies, and those come first, because they are the ones enforceable in that room. Ask what they will and will not accept before you pack anything: many settings will not warm a bottle you have already made up, some will not accept homemade food for babies under one, and most will want everything labelled with your child's name and the date.

What follows is the health guidance that sits underneath those policies, so that you know which of their rules are food safety and which are house style.

Milk: what travels well and what does not

Made-up formula is the awkward one. The HSE's advice for feeding away from home is built around avoiding a made-up bottle that has been sitting at the wrong temperature: the safest options are to carry the powder and the cooled boiled water separately and make the feed when it is needed, or to carry a ready-to-feed carton. If a made-up feed must travel, it needs to be properly chilled first and kept cold, and used within the storage window rather than left in a bag all morning.

The clocks are worth writing on the label. The HSE allows correctly prepared formula 24 hours at the back of a fridge set to 5C or below, and asks for any feed not finished within two hours of the feed starting to be thrown away. The NHS's room-temperature limit for unused made-up formula is the same two hours.

Expressed breast milk travels chilled, in a cool bag with ice blocks, and goes into the setting's fridge on arrival. Label every bottle with your baby's name and the date it was expressed, because a nursery fridge with several babies' milk in it is exactly the situation labelling exists for.

Whatever the milk, the warming rule is the same everywhere: a bowl of warm water or a bottle warmer, with the water level below the neck of the bottle, for no more than 15 minutes, and never a microwave. The HSE and the NHS both give the same reason, which is that microwaves heat unevenly and create hot spots that can scald a baby's mouth.

Food: the four-hour rule

The NHS's guidance on food on the go is short and specific. If you take food out with you, use a cool bag with frozen bottles of water or ice blocks to keep it cold until it is eaten. If food is not kept cold, it should be eaten as soon as possible and within four hours at most, and any leftovers should be thrown away.

The NHS's general storing guidance fills in the rest. Food you have batch-cooked should be cooled within one to two hours and then refrigerated or frozen; anything kept in the fridge should be used within two days. Rice is stricter: cooled within an hour, eaten within 24 hours if refrigerated, and never reheated more than once. Frozen food is defrosted thoroughly first, safest in the fridge or on a microwave's defrost setting, and eaten within 24 hours of defrosting.

Two rules matter especially in a setting where several children are eating from several containers. Already-cooked food is only ever reheated once. And half-eaten portions are thrown away rather than saved: the NHS says never to save, store or reheat food a child has already eaten from.

Why babies get the stricter rulebook

Food Standards Australia New Zealand lists newborn babies among the vulnerable people who have a greater risk of getting sick, because their immune system is weakened or still developing. That is the reasoning behind the tighter cooling and reheating limits, and it is why a nursery that seems fussy about a lukewarm pot of pasta is not being difficult.

The NHS's own hygiene page gives the domestic version: wash hands before preparing food and after handling raw meat, poultry, fish, shellfish, raw vegetables and eggs; check the child's hands are clean before feeding; wash bowls and spoons thoroughly in hot soapy water; cook food thoroughly and cool it until lukewarm before it is given; and do not save and reuse food left on a plate.

Choking guidance written for settings

HealthLink BC publishes a version of its choking guidance addressed specifically to child care providers, which makes it a useful reference to share with a setting. Its core instructions are: do not offer round, hard, sticky or difficult-to-swallow foods to children under four, including whole nuts and seeds, popcorn, marshmallows, dried fruit such as raisins, hard or gel sweets, chewing gum and chewable vitamins, and no food served on cocktail sticks or skewers.

For the foods that are allowed, it asks for grapes, cherry tomatoes, large berries and hot dogs to be cut lengthwise and into small pieces, raw carrots and apples to be grated or finely chopped, pits and seeds to be removed, stringy foods such as celery and pineapple to be finely chopped, bones to be removed from chicken and fish, and nut and seed butters to be spread thinly rather than served in lumps, because a chunk can form a plug that blocks the airway.

It also lists the situational rules that matter in a busy room: offer food in small amounts so a child does not put too much in their mouth, make sure the child is awake and alert, have them sit up while eating and drinking, never give food or drink while a child is walking, playing or in a moving buggy, and wait for a laughing or crying child to settle before offering food. It is explicit that a baby should never be propped or left alone with a bottle, because the liquid can come out too fast and cause choking.

Its final point is one to check when you are choosing a setting rather than packing a bag: anyone caring for young children should be trained in infant CPR, including what to do if a child chokes.

Allergies and labels

Tell the setting in writing about any diagnosed allergy, what the reaction looks like, and what they should do. Label food containers as well as bottles. If your baby is at the stage of having allergens introduced at home, it is usually simpler to keep doing that at home first, so that any reaction happens where you can see it.

When to ask

Speak to a health visitor or public health nurse if your baby is eating well at home and refusing everything at nursery for more than a couple of weeks, if they are dropping milk feeds during the day and not making them up, or if weight gain slows after starting childcare. Ask the setting for a written record of what your baby actually ate and drank; it turns a worry into information.