Variety is the key to achieving a healthy diet. Offering a wide range of different foods during weaning, will not only ensure that an infant obtains the nutrients needed for growth and development, but will also help to shape their future dietary preferences. To ensure a balanced diet during weaning, a variety of foods should be offered from the four main food groups.


















[Adapted from Department of Health Weaning and the Weaning Diet¹]

References:

1. Department of Health. Report on Health and Social Subjects 41 Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. London: HMSO, 1991

For more information visit (click to access)

Past Nurture & Nutrition article – ‘Home cooked food isn’t what it used to be’

Although it is important to offer a varied diet, there are some foods that should be avoided in infancy.

Salt

An infant’s kidneys cannot cope with large amounts of salt and a diet high in salt has been associated with later health problems¹. It is recommended that infants should have no more than 1g of salt a day¹ (1/6th of the recommended maximum intake for adults) and that salt should not be added to food prepared for infants².

The salt content of manufactured baby foods is strictly controlled but foods not specifically made for babies (e.g. sauces, ready-made porridge, breakfast cereals) can often be high in salt and should therefore be avoided³. Click here for more information on C&G baby foods.

Sugar

Sugary foods can encourage a sweet tooth and frequent consumption can lead to tooth decay⁴. Whilst sugar is a good source of energy, it contains few nutrients. Consequently, sugary foods should be limited in the diet and sugar should only be added to home prepared foods if it is absolutely necessary e.g. to reduce the sour taste of some fruits. Parents should look for ‘no added sugar’ or ‘low sugar’ options when shopping for their baby.

Honey

Spoonable honey should not be given to infants before one year². This is because on rare occasions honey can contain bacterial spores that produce toxins in a baby’s intestine and can cause a serious illness known as infant botulism.

Nuts

Whole nuts, including whole peanuts, should not be given to children under five as they can be a choking risk². In addition, peanuts and foods containing peanuts, such as peanut butter, should be avoided until three years of age² by infants who have a family history of atopy (i.e. one or more of the immediate family have a food allergy, eczema, asthma or hayfever).

Foods to avoid if weaning before 6 months²

There are several additional foods that should be avoided, if parents have chosen to wean their child before 6 months, due to their potential to cause allergies or contain harmful bacteria. These include:

• Foods containing gluten or wheat
• Egg
• Fish and shellfish
• Unpasteurised cheese

References:

1. Scientific Advisory Committee on Nutrition. 2003. Salt and Health. Available at: http://www.sacn.gov.uk/pdfs/sacn_salt_final.pdf [accessed August 2008]
2. Department of Health. 2007. Birth to Five. Available at: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_074924[accessed August 2008]
3. Food Standards Agency. 2008. Feeding your baby in the first year. Available at: http://www.foodstandards.gov.uk/multimedia/pdfs/publication/yourbaby.pdf [accessed August 2008]
4. Department of Health. Report on Health and Social Subjects 45 Weaning and the Weaning Diet. London: HMSO, 1994

For more information visit (click links to access)

Past Nurture & Nutrition article – ‘The role of weaning in the development of allergies’

Iron

Iron deficiency anaemia (IDA) is the most commonly reported nutritional disorder in childhood¹. Infants are born with body stores of iron but at around 6 months these begin to run low. Infants are therefore at risk of becoming iron deficient if enough iron is not supplied by the weaning diet. Iron is important for blood formation but also in the development of the brain. IDA in infancy can therefore have both short and long term effects on mental and physical development².

Facts about iron and iron deficiency:

1. Iron deficiency anaemia is the most common nutritional deficiency in the UK¹

2. The reported prevalence of iron deficiency in UK toddlers is 12% but can be as high as 40% in deprived inner city areas^3,4

3. UK dietary surveys show that almost ¾ of UK infants have iron intakes below recommended levels⁵

4. One of the biggest cause of iron deficiency anaemia is thought to be the use of cows’ milk as a main drink before 1 year of age⁶

5. Symptoms of iron deficiency include lethargy, apathy, irritability and loss of appetite

6. The effects of iron deficiency anaemia on both mental and physical performance can be lifelong, since vital brain connections are made before the age of 2 years²

7. Follow-on milks contain extra iron and can be recommended for infants over six months as part of their weaning diet. They are a good ‘safety net’, helping to ensure that infants get enough iron in their diet

Due to the important role of iron in the growth and development of infants, parents should be encouraged to include good food sources of iron (see Figure 1 below) in the weaning diet every day.

There are two types of iron present within foods; haem iron and non-haem iron.

• Haem iron this is the most effectively absorbed form, found in meat and meat products
• Non-haem iron found in plants, it is less well absorbed but its uptake by the body can be improved by vitamin C.

It is therefore advisable to consume non-haem iron sources with foods that are also a good source of vitamin C e.g. iron-fortified cereal with a glass of orange juice.

Figure 1: Iron requirements in infancy and sources of iron within the diet^7,8
























Vitamin D

Vitamin D is essential for the absorption and utilisation of calcium and phosphorus in building strong teeth and bones. Although vitamin D can be made by the body through the action of sunlight on the skin, infants require an additional dietary source due to their rapid growth and formation of the skeleton¹.

Dietary sources of vitamin D include:

• Oily fish e.g. mackerel, sardines
• Fortified baby breakfast cereals
• Infant formula and follow-on formula
• Egg yolk

Prolonged vitamin D deficiency in infants and toddlers can lead to the development of rickets which is characterised by the softening and bowing of the legs due to the failure of bones to properly mineralise. Unfortunately, rickets is a re-emerging condition in the UK and other developed countries, particularly among ethnic groups⁹. Vitamin D supplementation (along with vitamin A and C) is recommended in infants after 6 months if they are being breastfed, or if formula intake is less than 500ml per day¹.

References:

1. Department of Health. Report on Health and Social Subjects 45 Weaning and the Weaning Diet. London: HMSO, 1994
2. Lozoff, B, et al. Long-lasting neural and behavioural effects of iron deficiency in infancy. Nutrition Reviews. 2006; 64: S34-43.
3. Gregory, J, et al. National Diet and Nutrition Survey: children aged 1 ½ to 4 ½ years. London: HMSO, 1995.
4. Booth IW, & Aukett MA. Iron deficiency anaemia in infancy and childhood. Archives of Disease in Childhood. 1997; 76 (6): 549-553
5. Mill A, & Tyler H. Food and nutrient intakes of British infants aged 6-12 months. London: HMSO, 1992.
6. Hopkins D, et al. Infant feeding in the second 6 months of life related to iron status: an observational study. Archives of Disease in Childhood. 1997; 92: 850-852.
7. Food Standards Agency. McCance and Widdowson’s The Composition of Foods. 6th ed. London: Royal Society of Chemistry, 2002.
8. Ministry of Agriculture, Fisheries and Food. Food Portion Sizes. 2nd ed. London: The Stationary Office, 1993.
9. Allgrove J. Is nutritional rickets returning? Archives of Disease in Childhood. 2004; 89 (8): 699-701

Despite its decreasing volumes, milk still plays a key role in an infant’s diet during weaning, providing an essential source of energy and nutrients to support growth and development at this important time.

Breastmilk, infant formula or follow-on formulas are the only suitable options in the second half of infancy. Cows’ milk should not be given before 12 months of age as it is too high in protein and sodium (which can put strain on an infants immature kidneys) and low in vitamin D and iron¹.




Follow-on formulas are suitable from 6 months and are designed to complement the weaning diet by providing essential nutrients in a smaller volume as well as extra iron and vitamin D.

Growing up milks are nutritionally tailored for toddlers (1+ years). They are nutritionally superior to cows’ milk, providing more of the ‘at risk’ nutrients that toddler diets may be deficient in at this stage. For example, just 500ml of Cow & Gate Growing up milk contains more iron, vitamin D and vitamin C than 6 pints of cows’ milk.

From 6 months, 500-600ml (approximately 1 pint) is the recommended amount that should be given once solid foods have been introduced¹. Although milk provides a useful source of nutrients during weaning it is important to discourage parents from offering large volumes of milk (>600ml) at the expense of other foods.

References:

1. Department of Health. Report on Health and Social Subjects 45 Weaning and the Weaning Diet. London: HMSO, 1994.

For more information visit (click links to access)

Past Nurture & Nutrition article – ‘Introducing cows’ milk to an infants diet – is there a perfect time?’

For practical advice and information on weaning including meal planners, weaning stages, recipes and hints & tips, visit the Cow & Gate website using this link:

Cow & Gate parents website - weaning information