Every Baby Matters

Guidelines for good nutrition in Bradford and Airedale

Food and nutrition in the first year of life
Weaning onto solid food
INTRODUCTION
Weaning onto solid foods is necessary as the needs of the rapidly growing
infant can no longer be met by breast or formula milk alone. From about 6
months infants have decreased body stores of iron and vitamin D combined
with increased needs for these and other nutrients.
Weaning enables infants to learn new skills that are required for them to
progress through key developmental stages for speech and self-feeding.
It is an important opportunity to introduce a variety of tastes and textures
that helps baby to learn to eat a varied and balanced diet and to avoid
problems with faddy eating at later stages.
Appropriate weaning is an important factor in preventing many health and
development problems in babies, children and throughout life including
obesity, faltering growth and stunting, iron deficiency, specific nutrient
deficiencies, dental caries and developmental delay. It is vital to help parents
and carers make the most of this important opportunity to influence their
child's future health and potential.

The guidelines below include information about:

What is weaning? Iron deficiency anaemia
When to start Vitamin D
Signs that an infant is ready to Dental health
start weaning Low income
How to start weaning at about 6 Black and ethnic minority infants
months
Allergy and intolerance
Drinks
Babies born prematurely
Progressing through the stages of
Babies with specific clinical or
weaning
nutritional need
Foods to avoid
Summary of weaning
Extra /additional advice if weaning recommendations at different
is started before 6 months stages from 6-12 months
Food Safety Examples of appropriate weaning
Vegetarian weaning foods for different ethnic groups
Vegan weaning
1 Commercial baby foods
Prepared by Bradford Nutrition and Dietetics Service 01274 783124 / 365384
 WHAT IS WEANING?
Weaning is the gradual process of introducing semi-solid food whilst
continuing with breast or infant formula milk. It takes place over a
period of months when infants progress through different food
consistencies, from pureed/ mashed (and soft finger foods) to minced, to
cut up food until they can eat normal family meals.

The purpose of introducing solid foods alongside an infant's milk feeds is to

Give extra energy and nutrients when milk no longer provides enough to
sustain the baby's rapid growth, optimal health and development.
Provide the chance to try new tastes and textures based on family foods
when the baby is at a receptive stage

WHEN TO START WEANING

The Department of Health recommends exclusive breastfeeding (or formula
feeding) for the first 6 months (26 weeks) as a population recommendation
The age at which infants need solid foods varies and all infants should be
managed individually
Weaning should not be delayed beyond 6 months as from this time breast or
formula milk is no longer sufficient to meet all the nutritional needs of the
growing baby (although breast milk or formula will still be the major source of
nutrients for many months after the start of weaning.)
Some parents may decide to start introducing solids before 6 months and
some individual babies may need weaning before 6 months. Solid foods should
not be introduced before 17 weeks (4 months) and the closer to 6 months the
better.
Parents and carers of babies who start to wean before 6 months should be
advised that there is additional advice they should follow eg regarding types of
food introduced and sterilization of feeding equipment-this is outlined later.

SIGNS THAT AN INFANT IS READY FOR WEANING

These signs are generally seen between four and six months and rarely appear
together until 6 months
When they can sit up (initially may require support) and hold their head
steadily.
Wants to chew and is putting things in the mouth.
When they show an interest in food – reaching for food, watching others eat.
They can co-ordinate their eyes, hand and mouth.
Doesn't appear satisfied after feeds or demanding more feeds even when
larger milk feeds have been offered over a period of a few days to a week.

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HOW TO START WEANING AT ABOUT 6 MONTHS
Equipment – small shallow plastic spoon and plastic feeding bowl,
bib and plastic mat or newspaper to protect the floor as weaning can
be messy.
Seating – infants need to be sitting up to avoid choking. A highchair is
best so that they will be sat at your level and will also be better able to
explore foods.
Quantity – one or two teaspoons should be offered at first.
Consistency – smooth puree mixed with usual breast/formula milk. For
infants starting weaning at 6 months, this stage may be very short or even
bypassed. At this age infants will need to quickly progress to a thicker
texture with soft lumps and finger foods.
Foods – Start with smooth vegetables or fruit, baby rice or other non-wheat
cereal such as sago, maize, cornmeal or millet. Once baby is used to these,
other foods should be included: pureed/mashed meat, fish, lentils or pulses;
full fat dairy products e.g. yoghurt or custard; other cereal foods and soft
finger foods. See Summary of Weaning Recommendations Table 1 for
examples of specific foods. New foods do not need to be introduced one at a
time unless there is an immediate family history of allergy.
Encourage the use of family foods but avoid adding salt and sugar/honey to
the food that will be offered to the baby.
Don't force feed - learn to recognise the signs that baby has had enough -
turns their head away, keeps mouth shut, pushes food or spoon away, holds
food in mouth and refuses to swallow or repeatedly spits out, cries, shouts,
tries to climb out of highchair, gags or retches.
Breastfeeding on demand or at least 500-600mls infant formula/day
should continue until one year of age.
Give children's vitamin drops containing vitamins A, C and D. Even on a
healthy balanced diet infants and children under 5 years may not get enough
of these vitamins, especially vitamin D. Advice should be provided on the
Healthy Start Scheme vitamin drops for children which are available free or at
low cost. www.healthystart.nhs.uk Parents can get more information from
their Health Visitor. Supplements can be safely started from birth and this
would be beneficial to babies across the Bradford district.

DRINKS
A lidded, free flowing cup can be introduced from 6 months. Water should be
offered so that infants learn to expect this rather than sweet drinks.
Well diluted pure fruit juice (half and half) can be given at meal times and will
increase iron absorption.
Cow's milk should not be offered as a drink until after 1 year of age as it is a
very poor source of iron compared to breast or formula milk. Full fat cow's
milk can be used in cooking eg custards and sauces.
Alcohol should never be given to babies or children and should be kept out of
their reach at all times.

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 PROGRESSING THROUGH WEANING STAGES
It is important to highlight to parents/carers the benefits of including
infants in family meals. This helps infants to develop self-feeding and
social skills and promotes good eating habits from an early age. Seeing
the family enjoying a variety of foods will encourage infants to try new
foods and mean they are less likely to be fussy eaters as they get older.
Infants need to be introduced to a wide range of new tastes and textures
Parents should be guided by infant's appetite and gradually increase the
amount offered, progressing to different foods being offered over 3 meal
times.
6-9 months – progress to mashed and minced food with soft lumps and soft
finger foods. It is important to encourage foods from the food groups below:
Starchy foods (potatoes, cereals, pasta, rice)
Fruit & vegetables
Milk products such as yoghurt, cheese, milk puddings
Protein foods such as meat, fish, well-cooked eggs, pulses and nut butters.
Foods containing iron should be included regularly and foods rich in vitamin C
served with meals to aid iron absorption.
Please see Summary of Weaning Recommendations Table 1 for examples.
9-12 months - infants can progress from minced to chopped family foods and
also have hard finger foods. Two courses can now be offered to make meals
more varied and interesting and 1-2 non-sugary snacks given between meals.
Amounts and types of foods for the first year are detailed in the Summary
of Weaning Recommendations Table 1.
Feeding from a bottle should be discontinued by one year.
Self-feeding skills – these can be encouraged from the beginning of weaning
by offering finger foods and giving infants their own spoon to try, whilst
parents/carers continue to help with feeding.
Never leave a baby alone at a mealtime – as there is always a risk of
choking.

‘Baby – led weaning'

This currently refers to a concept or method of weaning that is being promoted
via the internet and parenting books. Parents may ask for advice. It involves
weaning baby completely or mainly by giving them pieces of food (usually from
the families meal) that they can hold and self – feed. The advantages of this may
be that it may be easier for parents so more relaxed, may encourage a wide
range of foods/textures and involving the baby in family meals more easily. Most
babies will need additional nutrients from solid food to meet their requirements
for growth by six months and for some this may be before they are ready or able
to consume sufficient quantity or variety by finger feeding themselves only.
Parents should be encouraged however they choose to wean their baby
not to delay the introduction of solids beyond 6 months
to ensure that a variety of foods including those rich in iron are offered from
this age
to offer finger foods from 6 months (see Table 1)

4 In reality a mixture of approaches may be needed to ensure babies nutritional

needs are fully met.
FOODS TO AVOID
Salt – infants' kidneys are not fully developed at six months of age and
high amounts of salt/salty foods can be harmful. Salt should not be
added to foods. Processed foods such as stock cubes, gravy mixes, packet
soups, instant mashed potato, sauces, ready meals and salty snack foods
like crisps should be avoided.
Sugar – encourages a sweet tooth and can lead to dental decay
Honey – can contain botulinum bacteria and needs to be avoided until after
the age of one year.
Nuts – children under 5 should avoid whole nuts due to a risk of choking.
Peanut butter, pastes and ground peanuts can be included after 6 months of
age. If the child has been diagnosed with an allergy (eczema or other food
allergy) or there is a history of allergy in the immediate family parents should
talk to their GP, health visitor or medical allergy specialist before giving peanuts
for the first time.
Some Fish - avoid shark, swordfish and marlin due to mercury content. Avoid
raw shellfish due to the risk of food poisoning. Boys can have up to four portions
of oily fish a week, such as mackerel, salmon and sardines, but girls should have
no more than two portions of oily fish a week. Fish especially oily fish are a
valuable source of protein and essential fatty acids in the diet and apart from
these limitations can be introduced during weaning.
High fibre/low fat diets - are not recommended as these diets are very bulky
and can make it difficult for infants and young children to eat enough to meet
their energy requirements for growth. Fibre (eg added bran) can reduce the
amount of some nutrients (eg iron) absorbed from food. Full fat dairy products
(ie using full fat milk in food preparation, yogurts and cheese) are the best usual
choice for babies and children under 2 years.

EXTRA ADVICE IF WEANING IS STARTED BEFORE 6 MONTHS

If parents decide to start weaning earlier there are some extra points to
consider:
Weaning should not start before 17 weeks (4 months).
Plates, bowls and spoons should be sterilised.
Solids should be introduced at one feed initially and at a time of day when
parent and baby are relaxed.
A little breast or formula milk can be offered to settle a hungry baby, followed
by one teaspoon of pureed food mixed with breast milk or infant formula to a
thin consistency.
Finish with breast/formula feed.
Suitable first foods include baby rice, pureed cooked vegetables or fruit. (see
Table1)
Parents need to follow baby's appetite to gradually increase the amount,
frequency and variety of foods offered.
Infants weaned before 6 months may move through the different stages more
slowly but it is important to ensure they progress to mashed and lumpy foods.

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 Foods to avoid before 6 months
As weaning is a key time for establishing infants onto a balanced diet it is
important that foods are not avoided without good reason. There is
currently scientific debate amongst experts as to the foods that should be
avoided if starting weaning before 6 months and a major review is due to
start in 2011. Government advice is that there is insufficient evidence to
change their current general advice which is to avoid the following:
Unpasteurised cheeses and cheeses with a soft rind eg: brie and
camembert
Liver
Gluten containing foods (eg flour, bread, pasta, chapatti, wheat, rye, barley
and oats and cereals/rusks containing these)
Foods which are most likely to cause an allergy ie milk, eggs, wheat, nuts, soy,
seeds, fish and shellfish.

FOOD SAFETY
Parents/carers should be advised to follow strict hygiene rules when
purchasing, storing and preparing food for infants in order to reduce the risk
of food poisoning. This includes hand-washing, keeping surfaces and
chopping boards clean and keeping pets away from food/preparation areas.
Infants need to be supervised by an adult when feeding because of the risk of
choking.
Solid food should never be added to the bottle as there is a risk of choking.
Bottles and teats should be sterilised.
If weaning from 6 months, plates, bowls, cups and cutlery don't need to be
sterilised but should be washed with hot soapy water and rinsed with hot
water.
Freshly cooked food can be stored for up to 24 hours in the fridge.
Food for infants should be reheated until piping hot right through and then
cooled before feeding. Food should not be reheated more than once.
Manufacturers' instructions should be followed when preparing any
commercial baby foods.
If parents choose to use a microwave to heat foods, they should be advised
that the food will continue to heat up after it has been removed from the
microwave. Extra care must be taken to keep the food away from infants until
it has been stirred and cooled sufficiently to avoid the risk of burning from 'hot
spots'.
Foods that baby has half-eaten should be discarded.
Frozen food should be thawed in the fridge and should not be refrozen.
Eggs, meat, fish and shellfish should be well cooked right through to reduce
the risk of food poisoning.
Honey should not be given until the age of 1 year because it may contain
botulism spores.
Whole nuts should not be given until the age of 5 years because of the risk of
choking.
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VEGETARIAN WEANING
Vegetarian diets are more bulky and care needs to be taken to ensure
that vegetarian weaning foods provide all necessary nutrients.
There are various categories of vegetarians who exclude different foods
so it is important to check with parents/carers which foods their child
can eat.
All varieties of beans, lentils, cheese, eggs and ground seeds/nut butters
are suitable substitutes for meat, poultry and fish.
Good sources of iron need to be offered at each meal, together with
Vitamin c containing fruits and vegetables to help iron absorption. See
Summary of Weaning Recommendations Table 1 for examples.

VEGAN WEANING
Vegan diets are not recommended for infants because of the high risk of nutrient
deficiencies. It takes considerable planning to achieve a balanced diet and
infants may require vitamin supplementation. Parents considering weaning
infants onto a vegan diet are advised to consult a Registered Dietitian first.

COMMERCIAL BABY FOODS

Providing home prepared weaning foods encourages easier progression to
normal family foods than when using mainly commercial baby foods.
At this stage health professionals and other people who provide support to
parents should take opportunities to advise parents how to adapt family foods
for weaning to ensure that infants become accustomed to the wider range of
flavours and textures that these provide.
Parents using commercial baby foods still need to ensure that the baby is
offered a balanced diet, including savoury meals and fruit purees rather than
puddings. This can happen where parents use a lot of commercial foods (for
reasons of convenience or lack of confidence in preparing their own food for
weaning) but avoid those with animal products for cultural or religious
reasons. This can lead to a lack of protein and iron in the baby's diet. Help
given with reading labels and identifying suitable savoury foods (eg halal,
those based on good vegetarian protein sources like pulses) will be useful if
commercial baby foods need to be used.
Advise parents that even though commercial baby foods may state 'suitable
from 4 months', that this does not mean that weaning should begin as early as
this.

IRON DEFICIENCY ANAEMIA

Iron deficiency is a common nutritional problem in early childhood and occurs
more often in inner city areas and amongst Asian populations. Symptoms of
iron deficiency include poor appetite, lethargy, poor weight gain, developmental
delay and frequent infections. The effects of early iron deficiency on brain
development (eg intelligence, learning and behaviour) are increasingly being
shown to be irreversible even after the deficiency is corrected.

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 To prevent iron deficiency anaemia:
Good sources of iron need to be introduced into the weaning diet
between 6-8 months. (see Table 1)
Foods rich in vitamin C should be included at each meal to aid iron
absorption.
Tea or coffee should be avoided as they can reduce absorption of iron
from the diet.
Breast milk or infant formula should be used as the main drink during the
first 12 months.
The use of a bottle after 1 year should be discouraged as this can encourage
children to fill up on cow's milk instead of eating sufficient solid food.
If children are drinking excessive amounts of cow's milk (more than 500mls
every day) after 1 year and parents are struggling to reduce this, a follow-on
milk fortified with iron can be used.

VITAMIN D
A significant proportion of the population have low vitamin D levels which has
resulted in a rising number of cases of rickets and other disorders caused by
vitamin D deficiency.
The body relies on sunlight exposure to meet its vitamin D requirements and so
taking babies outdoors and encouraging safe outdoor play is a habit that should
be developed in families. Skin should always be protected (with
clothing/sunscreen) before it starts to redden and burn. Foods containing vitamin
D (e.g. fortified margarine, well-cooked egg yolk, fortified breakfast cereal, oily
fish) should be introduced as weaning progresses but parents should be made
aware that it is difficult to obtain enough vitamin D from diet alone.
A daily 7.5 ug vitamin D supplement is recommended for all babies and children
up to 5 years. Advice should be provided on the Healthy Start Scheme vitamin
drops for children which are available free or at low cost
(www.healthystart.nhs.uk) Parents can ask their health visitor for more
information. Supplements can be safely started from birth and this would be
beneficial to babies across the Bradford district.

DENTAL HEALTH
Tooth decay is one of the most easily preventable health conditions.
Parents/carers should be advised on ways to help reduce dental caries:
Sugary drinks should never be given in bottles. Feeding bottles should be used
only for expressed breast milk, infant formula or cooled boiled water.
From 6 months, infants should be given a free-flow cup to drink from and cup
feeding should replace bottle feeding by one year.
Fizzy drinks and squash should be avoided. Well diluted pure fruit juice (half
and half) can be provided at the same time as a meal.
Milk and water should be provided to drink between meals.
Foods and drinks containing sugar should be kept to a minimum and are best
kept to mealtimes
Avoid giving sweets and biscuits as treats.
8
Never dip dummies in honey, syrup or sugar.
 Tooth brushing should start as soon as infants' teeth appear using a
brush suitable for the child's age. Teeth should be brushed by
parent/carer before bed and on one other occasion. Children aged 0
to 3 years are recommended to use toothpaste with no less than 1000
parts per million fluoride and are advised to use only a smear of
toothpaste. If the child is thought to be at risk of dental disease a smear
of 1350-1500ppm toothpaste should be used) Children should not be
allowed to eat ot lick toothpaste from the tube. A list of toothpastes with
these levels of fluoride can be found in the Department of Health toolkit
'Delivering Better Oral Health'
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/Publicat
ionsPolicyAndGuidance/DH_102331
Infants can be taken to the dentist from around 6 months.
Sugar free medicines should be recommended.

LOW INCOME
Low income families are more likely to eat a diet that is low in fruit and
vegetables and high in fatty and sugary foods. Infants in these families may
have diets with lower levels of some nutrients, particularly iron and vitamin D.
Eligible families should be encouraged to take up the Healthy Start Scheme.
This entitles eligible pregnant women and children under 4 years to vouchers
for milk, fresh and frozen fruit and vegetables, vitamin supplements and
advice and support from health professionals. All pregnant women under age
of 18 qualify for this regardless of income.

BLACK AND MINORITY ETHNIC GROUPS

It is important that health professionals advising families are aware of dietary
customs, religious restrictions and traditional eating habits. Any advice needs to
be sensitive to include culturally appropriate weaning foods. Please see Table 2
for examples of appropriate weaning foods for different ethnic groups.
Asian weaning – Asian infants are traditionally weaned later than Western
infants. Weaning should be started by 6 months to avoid anaemia and long
term dietary problems. Parents/carers need to be made aware that giving mainly
sweet commercial baby foods leads to a diet with inadequate nutrients and that
savoury halal weaning foods are available from companies such as Mumtaz and
Petit Gems.

ALLERGY AND INTOLERANCE

Food allergy and intolerance are types of food sensitivity. If someone has a food
allergy their immune system mistakes a food as unsafe and this causes a serious
and possibly life-threatening reaction. A food intolerance also causes a reaction
but it doesn't involve the immune system and generally isn't life-threatening. It
may make them feel ill or affect their long-term health.
Some parents suspect that their infants are sensitive to foods but only 2-5%
actually have allergy or intolerance. Many infants grow out of this by 12
months.

9
 If parents do suspect food sensitivity then it is important that they don't
cut out whole food groups or a lot of different foods from their infants'
diet without medical /dietetic advice. This could result in them missing
out on essential nutrients for growth and development. NICE (2011) has
issued clinical guidelines on the diagnosis and assessment of food allergy
in children in primary and community care settings. It is important that
food allergy and intolerance is medically diagnosed and treated. This will
require appropriate dietetic advice /support to ensure that allergens are
removed from the diet whilst meeting nutritional requirements.
Weaning infants at high risk of allergy
Infants are more likely to develop allergies if there is a sibling or parent with
eczema, asthma, hay fever or diagnosed food allergy. These families should be
advised that exclusive breastfeeding for the first six months appears to give the
best protection against developing food allergies.
When introducing solids (weaning) to high risk infants, introduce the foods that
commonly cause allergies (milk, eggs, wheat, nuts, seeds, fish and shellfish,
celery, soya, mustard) one at a time allowing at least 3 days between so that any
reaction can be spotted. These foods should not be introduced before 6 months
but there is no evidence that further delay is beneficial. Continuing breastfeeding
whilst these foods are introduced may also protect against the development of
allergy. Other foods eg fruit, vegetables, rice, can be introduced alongside to
encourage a varied diet.

INFANTS BORN PREMATURELY

These infants may miss out on some of the nutrients acquired during the latter
stages of pregnancy. Some premature infants may need extra nutrition after
birth in order to 'catch-up'.
It is recommended that weaning starts when babies are 5-8 months old actual
age from birth. The process of weaning may take a little longer than term
babies.
Premature infants born close to term (ie: around 34 weeks) and who are well,
may be ready to wean at approximately 6 months of age (actual age from
birth) as advised for infants born at term.
Premature babies who are growing well should be introduced to a variety of
foods in the same way as any healthy full term infant.
By 9 months actual age from birth, a premature infant who is following
normal developmental stages is likely to benefit from being introduced to
lumps and finger foods.
Premature infants not achieving the above may benefit from a review by the
medical team caring for them.

BABIES WITH SPECIFIC CLINICAL OR NUTRITIONAL NEEDS

Some babies with specific clinical conditions, complex health needs or nutritional
needs may be advised by their specialist care team / dietitian to wean at a
different time, pace or way, according to their individual requirements. Parents
who have queries should be encouraged to discuss them with their care team
/dietitian.

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Table 1 - Summary of recommendations for weaning at different stages
from 6-12 months

Food At 6 months (26 weeks) 6-9 months 9-12 months

Starchy foods 1-2 servings per day 2-3 servings per day 3-4 servings per day
(e.g. potato and cereal Smooth cereals, e.g. Start to introduce more Starchy foods of
based foods) rice based, potatoes, cereals, lumpier normal adult texture
millet, oats, cornmeal, textures and finger
yam, sweet potato, foods e.g. toast, rice
green banana cakes, chapattis, pitta
bread, rusk, pasta
Vegetables and fruit 1-2 servings per day 2 servings per day 3-4 servings per day
Soft-cooked vegetables Raw soft fruit and Give with meals and as
and fruit as a smooth vegetables snacks
puree e.g. apple, pear, Cooked fruit and Cooked or raw
mango, banana, vegetables can be Include Vitamin C rich
pumpkin, carrot coarse or mashed in foods with meals (e.g.
texture oranges, pears,
strawberries, kiwi,
potato, cabbage,
tomato, peppers)
Include more variety
Meat and alternatives At least 1 serving per Minimum 1 serving per 1-2 servings per day
(e.g. fish, pulses, eggs, day day Minced/chopped/well
nut butter) Use soft cooked meat, Soft cooked, finely cooked meat, chicken
chicken, pulses as a minced, mashed meat, fish and pulses
puree chicken fish and pulses Limit liver to once a
Well cooked eggs week
Limit liver to once per
week
Dairy foods At least one serving per At least one serving per 1-2 servings per day
(e.g. milk or cheese day day Fruit/plain yoghurt,
based dishes) Plain yoghurt, fromage Fruit/plain yoghurt, cheese, milk puddings,
frais, milk puddings or cheese, milk puddings, custard
custard custard
Other advice Can have gluten based No sugar or honey No honey
foods No added salt or salty No added salt or salty
Encourage savoury foods foods
rather than sweet Introduce mild spices Discontinue bottles by
foods and herbs e.g. cumin, about 12 months – use
Introduce cup or turmeric, coriander cups or beakers
beaker Avoid low fat dairy By 12 months use
No sugar or honey foods more family foods
No added salt or salty Avoid low fat dairy
foods foods
Avoid low fat dairy Gradually introduce
foods hotter spices, e.g.
pepper, ginger, chilli

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 Table 1 - Con’t

Food At 6 months (26 weeks) 6-9 months 9-12 months

Finger foods Soft finger foods As 6-9 months and can

now also include:
Soft fruit pieces such
as banana, ripe melon, cubes of cheese
pear, peach, kiwi. Raw fruit and
Cooked vegetable vegetables such as
sticks/pieces such as raw peppers,
carrot, green beans, cucumber, carrot,
courgette, potato, apples, pears.
sweet potato,
cauliflower, broccoli.
Cooked pieces of
pasta
Bread or toast

Good sources of iron Meat, fish, beans and As at 6 months with As 6-9 months.
lentils, well cooked the addition of
eggs. fortified breakfast
cereals, green
vegetables
Drinks Water in a free-flow lidded cup can be introduced from 6 months. Well
diluted pure fruit juice ( half water, half juice) served in a cup can be
included with meals to help iron absorption. Breastfeeding on demand
or at least 500-600mls infant formula milk should continue to 1 year of
age. Cow's milk should not be introduced as a main drink until 1 year of
age. From one year milk consumption should be about 500mls/1 pint a
day and bottles should be discontinued by about this time.
Skills to learn Taking puree from a Moving soft lumps Chewing minced and
spoon around the mouth chopped foods
Moving food from the Chewing soft lumps More oro motor
front of the mouth to Self feeding using control
the back for hands and fingers Self-feeding attempts
swallowing with a spoon
Sips from a cup/beaker
Able to hold finger with support Improving hand to
foods mouth control
Hold cup or beaker
New textures to Smooth Purees Managing thicker Managing harder
introduce purees and then finger foods
mashed foods Soft diced or minced
Managing soft finger foods
foods

Adapted from the Manual of Dietetic Practice, page 286. 4th edition.
Ed Thomas and Bishop 2007

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Table 2 Examples of appropriate weaning foods for different ethnic groups
Adapted from Manual of Dietetic Practice, 4th edition

Group Weaning Food Finger Food

Asian vegetarian Rice boiled and mixed with yoghurt 3-4 servings per day
Chickpeas or lentils mashed and mixed with rice Starchy foods of
Rice flakes with breast/formula milk normal adult texture
Vegetables cooked and pureed or mashed eg
root or green vegetables, cauliflower, marrow,
aubergine
Potato cooked and mashed, may be mixed with
vegetables
Chapatti or roti made into crumbs and soaked in
breast/formula milk
Soft fruits mashed e.g. banana, papaya, mango
Puddings made from rice, rice flour, wheat flour,
semolina flour.
Asian non-vegetarian As above and also include: As above
Well cooked boiled egg (mashed or chopped)
Soft cooked meat, chicken, fish (pureed or
mashed)
African-Caribbean Cornmeal porridge, farine, baby cereals mixed Breads, rice cakes
with breast/formula milk Soft cooked pieces of
Rice root vegetables,
Potatoes, yams, sweet potato, pumpkin (pureed pumpkin, sweet
or mashed) potato, potato
Chicken and lamb (pureed or mashed) Soft fruits
Lentils, kidney beans, gungo (pureed or mashed)
Peas, root and green vegetables (pureed or
mashed)
Soft fruit (mashed)
Spices Mild spices such as coriander, cumin, turmeric, cinnamon can be used in
small amounts from 6 months.
Hotter spices can be gradually introduced from 9 months, e.g. ginger,
pepper, chilli. If the family meal is too spicy for the infant, try adding
some plain yoghurt to lessen the heat.

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 Some Key Sources and Resources

BLISS (2008). Weaning your premature baby. 5th Edition.

Booth, I. W. Aubett, M.A. (1997) Iron deficiency in infancy and early

childhood. Arch Dis Child, 76, p. 549-554.

British Dietetic Association (BDA) Paediatric Specialist Group (2004) Position

Statement on Breastfeeding and Weaning on to Solid Foods. Available as pdf
from British dietetic association web site http://www.bda.uk.com

British Dietetic Association (BDA) Food Allergy and Intolerance Specialist Group.
(2005)
Professional Consensus Statement on Practical Dietary Prevention Strategies for
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Department of Health / British Association for Community Dentistry (2009)

Delivering Better Oral Health; An evidence based toolkit for prevention 2nd ed
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olicyAndGuidance/DH_102331

ESPGHAN European Society for Paediatric Gastroenterology, Hepatology and

Nutrition Committee on Nutrition: Agostoni, C. Decsi,T. Fewtrell, M. Goulet, O.
Kolacek, S. Koletzko, B. Michaelsen, K.F. Moreno, L. Puntis, J. Rigo, J. Shamir, R.
Szajewska, H. Turck, D. van Goudoever, J. (2008). Complementary Feeding: A
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Healthy Start website (including sections and resources for parents and health
workers) http://www.healthystart.nhs.uk/

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assessment of food allergy in children and young people in primary care
and community settings
http://guidance.nice.org.uk/CG116
NHS Choices –Live well website –contains a wealth of practical
information for parents carers and those supporting them

http://www.nhs.uk/Planners/birthtofive/Pages/Healthydietweaninghub.aspx

Northstone, K. Emmett, P. Nethersole, F. ALSPAC study team. 2001. The effect

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SACN/Committee on toxicity (COT) Statement on the timing of the introduction

of gluten into the infant diet - March 2011

http://www.sacn.gov.uk/pdfs/sacn_cot_statement_timing_of_introduction_of
_gluten_into_.pdf

Thomas, B. Bishop, J. eds. (2007) Manual of Dietetic Practice. Fourth edition.

Blackwell Publishing and the British Dietetic Association.

Author: Bradford Dietitians

Date: Feb 2012
Review date: 2015

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