The menu design allows a healthcare facility to design a menu that prioritises patient needs and preferences.
Menu planning, design and review
Include consumers in the menu design and planning process so that cultural preference and appropriate comfort foods of the cohort are reflected.
Your menu design should show consideration of:
- patient profile and length of stay
- religious, cultural, lifestyle and life stage food preferences and requirements
- cultural diversity, in the selection of main meal items, condiments and meal accompaniments
- variation in ingredients, preparation styles, flavours and textures
- limited repetition
- offering foods that have had minimal processing for each meal and snack, along with a fresh food choice at each mealtime.
Do not repeat items at consecutive meals or on consecutive days, except if the menu is a static-style menu or if the items are popular and preferred.
Paediatric menu design should include:
- foods preferred by young children, e.g. mild-tasting and easy to identify and consume
- varied portion sizes
- foods that are safe for children to consume and not a choking hazard e.g. not tough or stringy, no skin, gristle or bones, and appropriate texture and size (refer to Textures, serve sizes and food sources by age for paediatric patients for appropriate textures and sizes)
- mid-meals to allow grazing.
A menu review activity may be:
- a full menu review; or
- occasional component review or interchange of items, e.g. based on seasonal availability.
A menu review must show:
- consideration of patient needs and preferences including patient feedback data. This includes religious, cultural, lifestyle and life stage food preferences and requirements
- engagement and input from key stakeholders of the healthcare facility such as food service representatives, clinical dietitian representatives, clinicians, patients and carers.
Complete an assessment of the compliance of the menu to the Nutrition Standards every two years to inform the menu review.
Length of stay considerations
Very long length of stay (four weeks or more)
- A healthcare facility has mechanisms to identify patients with a very long length of stay.
- The menu design includes strategies to offer additional variety for these patients. Additional variety should be offered for all meal components, not just main meals.
Short length of stay (three nights or less)
- Facilities where the length of stay is three nights or less and patients are nutritionally well can consider implementing a short-stay menu. Use patient characteristics to guide the menu design. This may include reduced numbers of options and a shorter menu cycle.
Minimum standard serve for paediatric patients
Beverages
1-8 years: 1 option per day.
9-18 years: 1-2 options per day.
n/a
0-12 months
- One milk option at breakfast when cereal is served. Do not offer milk as a beverage.
- Breastmilk or infant formula provide majority of fluid.
1-18 years
- Two milk options at each main meal and mid-meal.
- Water offered at all main and mid-meals.
- Other drinks optional.
Soy milk to be available on request.
0-12 months: Only offer full cream milk with cereal.
1-2 years: Full cream milk is recommended.
1-18 years: Offer full cream and reduced fat milk at each meal.
3-18 years
- Flavoured milk optional.
- Cordial and soft drinks optional but must not be included as part of a default meal or mid-meal.
1-18 years: One sugar option at meals when cereal served.
Do not offer sugar substitutes.
Do not include sugar as part of a default meal.
Breakfast
0-18 years: One option per breakfast meal.
0-12 months: Pureed texture.
0-12 months: Two options per breakfast meal.
1-18 years: Four options per breakfast meal.
All breakfast cereals contain less than 30g sugar per 100g.
1-18 years: At least 50% of cold breakfast cereals provide at least 3g fibre per serve.
1 option per breakfast meal (providing at least 5g protein).
Other low-protein options, such as spaghetti, tomato and mushrooms, may be offered as optional additions.
Breads and spreads
0-18 years: Two options at each main meal.
Offer variety, including white and wholemeal.
1-18 years: Also offer wholegrain and multigrain bread.
0-18 years: One margarine option at each main meal. One portion to be used for two slices of bread.
May also offer butter.
0-12 months: May offer one option per breakfast meal.
1-18 years
- Three options per breakfast meal.
- Offer at least three varieties each day at other meals, e.g. jams, marmalade, honey and Vegemite.
Do not offer low joule spreads.
Offering peanut butter is optional.
If peanut butter is available, the facility must have procedures in place to manage risk of allergen exposure at the ward level.
Peanut butter is not included as part of a default meal.
0-12 months
- One variety available each day, e.g. jam.
- Do not offer honey.
- Vegemite should be available, but not offered.
Lunch and dinner
If offered, then one Band 1 option at one main meal per day.
Offer Band 1 or 2 for any additional soups.
Soups can be offered on the menu as a good source of vegetables or easy to consume main meal.
If offered, the facility must have procedures in place to minimise the risk of burns or scalds.
Soups are not included as part of a default meal.
0-12 months: At least one option at two main meals per day (two different options are offered per day).
1-18 years
- Two options at two main meals per day (four options per day).
- One option per main meal must be Band 1 or Band 2 meat, poultry or fish.
- One option per main meal can be any band meat, poultry or fish or Band 1 vegetarian.
- Optional unbanded food choice.
Meal options are suitable for children, including foods that are not too spicy and use tender meats.
Offer variety in meat and protein options at consecutive meals.
0-12 months
- Predominantly single ingredient meat, poultry or fish, cooked with no added salt.
- At least one hot choice per day must be red meat.
- All options are free of bones and gristle and are not tough to chew.
1-18 years
- Offer fish 2-3 times per week (this may be in hot main or main salads or sandwiches).
- One hot choice per day is a vegetarian option, unless a vegetarian main salad or sandwich is offered as an alternative.
- One unbanded option can be included per meal, but it must be in addition to the minimum number of banded options.
1-8 years: One hot option per meal must be a softer and moist texture, and one choice a finger food option.
14-18 years: One option of a large serve size is available.
0-12 months: One option at each meal offering main hot choices.
1-18 years: Two options at each meal offering main hot choices.
Offer alternative to potato at least once per day (for patients older than seven months).
Offer rice or pasta is when it would be a typical accompaniment with a meal.
Small serves that are fortified with protein and/or energy are available (where possible).
Recipe-based dishes must comply to the sodium and saturated fat limits stated in the Nutrient Goal Standard.
14-18 years: An option of a large serve size is available.
0-12 months: One option at each meal offering main hot choices.
1-18 years
- Two options at each meal offering main hot choices.
- One option per day may be a Band 3 side salad.
- Soups containing a significant amount of vegetables per serve can be included as one of the vegetable options.
0-12 months: Option may be red, orange or green vegetables.
1-3 years: Standard serve can be requested.
4-18 years: Small serve can be requested.
14-18 years: An option of a large serve is available.
1-18 years
- Offer at least one red or orange vegetable per day.
- Offer at least one green vegetable per day.
One Band 1 option at two main meal occasions per day.
One sandwich per day is a vegetarian option, unless a vegetarian hot choice or main salad is offered.
0-12 months
- Offer at least one option with wholemeal bread per day.
- Multigrain bread is not offered.
1-18 years: Offer at least one option made with wholemeal or multigrain bread per day.
14-18 years: An option of a large serve (3 slices of bread) is available.
1-18 years: One Band 1 or Band 2 option at one main meal per day.
Portion control salad dressings are offered.
1-8 years: An option of a small serve is available.
14-18 years: An option of a large serve is available.
1-18 years: May be offered or available on request.
A range of condiment options to be available (e.g. tomato sauce and mayonnaise).
Do not offer salt sachets.
Desserts and fruit
Two options per day at main meals.
One option must be Band 1.
One option available at each main meal.
One option available at each mid-meal.
A variety of fruit is offered including full pieces, canned options and cut up options.
Snacks
0-12 months: May be requested.
1-18 years: A high-energy (at least 500kJ) and a high-protein (at least 3g) snack are available per day. These can be combined.
0-12 months: A small finger food option of appropriate texture for age is preferable.
1-18 years
- Include both savoury and sweet options in range.
- Include options appropriate for young children in range.
1-18 years
- Two options at each mid-meal per day.
- At least two different lower energy, nutritious snack options available each day (less than 400kJ per serve).
0-12 months: A small finger food option of appropriate texture for age is preferable.
1-18 years
- Avoid offering dry, hard biscuits that may impose a choking risk.
- Include both savoury and sweet options in range.
- Include options appropriate for young children in range.