Are childcare settings' food menus fit for purpose? A qualitative analysis in England.

Childcare settings have a central role in feeding pre-school-aged infants and children. One of the ways in which childcare settings plan nutritious, balanced, and varied meals and snacks for preschool-aged infants and children (0-5 years) is through the use of a menu. Nevertheless, international studies indicate an overwhelming heterogeneity in uptake of menus, as well as use and format, with variable details of food and drinks provided. Thus, in the context of a nationally representative survey on food provision in early years settings in England, we invited respondents to upload sample menus. Of the 322 settings that completed the survey, 56 submitted menus (17.4%). Five were excluded because the attachment was either not a menu or was illegible. Data contained in the 51 readable menus was extracted into an Excel spreadsheet designed deductively from available guidance on menus and inductively based on patterns emerging from the menus themselves. The menus demonstrated great variations in depth of information, completeness and clarity. Breakfasts, snacks, and beverages were often excluded from menus or the information about them was unclear. Menus also sometimes contained dishes with names that were unclear. Early years settings are expected to promote healthy eating, but their ability to do so is shaped by wider structural factors. Thus while childcare settings can play a crucial role in the health promotion of young children during a time of vital development, the wider policy context and challenges faced by childcare settings and families must be addressed.