Our position is that no infant and young child should be given food that they are known to be allergic to or is a choking risk for their age group.
In ECE services not only should standard health guidelines be followed for food safety and to reduce the risk of children choking on food, but extra caution must be taken compared with what is necessary in the child's own home. This is because of the group/social nature of the ECE setting and being fed by adults who are not their parents or family.
An infant died from choking on apple provided at an early childhood centre. We put out guidelines on what foods not to give an infant or young child, and how to prepare other foods to reduce the risk of choking, i.e. mash, boil or grate. The Ministry of Education promised the family of the infant that it would implement new rules so something similar would not happen to another child in ECE. But the Ministry did not do this.
When an under-2 was given raw apple to eat at another centre and nearly died, the mother asked Dr Sarah Alexander for assistance to get more information about her son's case, Dr Alexander saw that allowing services to provide children with high-risk choking food was a major and a serious issue that needed to be addressed. She prepared an investigative report and with the permission of the toddler's family, she shared the report's findings with TVNZ.
The report gained national (and international) media interest. We continued to talk about and write about this case and the wider issue that no family could be assured that their child would not be given food that was not safe to eat. This led in Dec 2020 to the Ministry of Education introducing a new requirement that services must follow health guidelines for reducing the risk of choking when providing food to children.
In regard to managing food allergies in ECE services, we have discussed safety issues with Allergy NZ and also provided input into Allergy NZ's advice and guidance to early childhood services. (Note that as per the Ministry of Primary Industry's National Programme 2, ECE centres must have a food allergen management plan, and must ensure that every person who touches food has had training on how to keep food safe and suitable, ensuring there is no cross-contamination in food preparation and serving).
We will monitor and continue to take an interest in how services are meeting the new licensing criteria to reduce the risk of infants and young children choking in ECE services. We will advise as and when needed on any improvements needed to the Ministry of Education's licensing criteria and to Food Safety requirements.