Guide your youngest children safely on to solids with this advice from founder of Grub4Life, Nigel Denby…
In its guidance on infant feeding, the Department of Health recommends exclusively breastfeeding until six months – and, that all infants in childcare who are breastfed at home should have the opportunity to continue this in nursery. In reality, of course, only 35 per cent of the UK’s babies start off by being breastfed, and this falls to 21 per cent at six weeks and just seven per cent at four months. By the time most babies enter childcare, the vast majority are formula fed.
When it comes to formula feeds, there is little to distinguish the main brands nutritionally, and the choice about which brand of formula a baby is given should be the parents’. For early years practitioners, therefore, the main issue of concern regarding infant formula feeding is ensuring that safe hygienic practice is followed.
Infant formula powder is not sterile, which means it may contain micro-organisms such as Enterobacter sakazakii and salmonella. Whilst infection is rare, reducing the risk is good hygiene practice. A written policy for the preparation of infant formula should be displayed in your setting, and should form part of staff training. The Department of Health and Food Standards Agency offers the following guidance:
● Wash and dry hands, clean the work surface, sterilise all bottles and equipment.
● Use the scoop provided with the tin of formula feed, ensuring this is level and not compacted.
● Make up the feed with powder and freshly boiled water cooled to a temperature above 70 degrees. This means using water that has been left covered for just less than 30 minutes after boiling. Cool the bottle under cold running water before feeding.
● It is best to make up infant formula fresh for each feed (guidelines for each brand appear on all tins of infant formula).
● Where this is not possible, prepare feeds in separate bottles and store in a fridge at a temperature below five degrees for no more than 24 hours. Remove from the fridge just before needed, and then warm in a bottle warmer or with warm water.
● Do not use a microwave.
● Any feed started should be discarded within an hour.
● Any unused feed which is kept out of refrigeration should be discarded after three hours.
Weaning – the gradual introduction of semi-solid foods to a baby’s diet – is a staged process occurring over a period of months, where the quantity, range and textures of foods are gradually increased. Exactly when weaning should start is a contentious issue and always sparks lively debate and discussion during Grub4life early years nutrition training sessions!
The official line
“Up to the age of six months, breast milk or infant formula will provide all the nutrients and fluid that the majority of babies need.” It is from this evidence that the Department of Health, following WHO guidance, recommends that babies should not be given any solid foods until they are six months of age.
Weaning in practice
However, many parents may want to wean their child earlier than six months. As childcare professionals we are all aware of children who have been very successfully weaned before they reach the government’s recommended age. Four months or 17 weeks should be regarded as the earliest age at which solids should be introduced (DoH, 1994). Up until 17 weeks, a baby’s digestive system is not ready to deal with any foods other than breast or formula milk, and those who are weaned earlier are at a greater risk of developing food allergies.
● Grub4life recommends that no infants in childcare are offered any first solid foods by practitioners before they reach 26 weeks.
● However, where a baby has been weaned at home aged between 17 and 26 weeks, it is perfectly acceptable for practitioners to support and continue this.
● No solids should be offered to babies under the age of 17 weeks under any circumstances in childcare.
● Where a 26-week-old baby has not been weaned at home, practitioners should advise and support parents to start the process as soon as possible.
In short, when it comes to weaning the Grub4life mantra is “Always by six months, but never before four months!”
There are nutritional and developmental reasons why infants need solid foods from six months: by this time babies need more iron, vitamins and other nutrients than can be provided by milk alone.
Iron is particularly important. Newborns enter the world with a supply of iron from he mother, but by six months these body stores will have been used up and the baby needs to obtain iron from its diet. If weaning starts after the baby is six months there is a risk of iron deficiency and poor growth and development. At around six months a baby has also reached a developmental stage where new foods are more likely to be accepted. Babies who are weaned after six months can go on to develop a limited range of foods they will accept.
Breastfeeding and or/formula feeding should be continued after solids are introduced until at least one year of age, and for infants who are at risk of nutritional deficiencies it could be prolonged beyond this. Of course, this should not be at the expense of the baby eating solid foods.
For those infants who have been introduced to solids before 26 weeks, there are certain foods that can cause an allergic reaction. It is therefore recommended that babies should not be given the following before six months:
● Foods containing gluten (bread, pasta, chapattis, cereals, etc.)
● Nuts and seeds (you may well have a nut-free policy anyway)
● Raw or cooked shellfish
● Shark, swordfish and marlin
● Citrus fruit and juices
● Foods containing plant sterols (e.g. some margarines and yoghurts)
● Honey (this should not be given to children under the age of 12 months).
Remember, too, that foods – for example, custard powder, crushed rusks or baby rice – should not be added to bottles of milk! This practice does not allow the infant to learn how food feels in the mouth or how to chew, and may cause choking. Similarly, no manufactured weaning foods should be used. Although, pre-prepared puree foods may be offered outside the nursery by parents, these are not recommended as the main staples of a weaning diet.
It’s easy to prepare simple first-stage purees from a typical nursery menu. These first few days of weaning are less about nutrition and more about the baby learning to accept new tastes, and to manoeuvre food around the mouth to the back of the throat for swallowing.
Pureed combinations of two vegetables or fruits can be prepared alongside older children’s family food recipes, and experienced nursery cooks often make up purees and freeze them in ice cube trays to be used on days when vegetables form part of a composite dish, e.g. lasagne. This avoids having to prepare vegetables especially for weaning babies (the same can be done for fruit purees).
Once a baby is handling first-stage purees, it’s important to move on to lumpier, more challenging textures of vegetables, fruits and protein, as well as soft finger foods like blanched vegetable sticks and bread and butter soldiers, which will increase babies’ nutritional intake and their eating skills. In general, most babies who have started weaning between 17 and 26 weeks will be eating family food by the age of 12 months.
Although breast milk is nutritionally complete, recent surveys have identified low plasma vitamin D in 13–28% of women of childbearing age. If there is any doubt about a mother’s or baby’s vitamin D status, supplementation should start from as early as one month. Sure Start vitamin drops provide the ideal amount of vitamin D.
Two healthy recipes to try with your children…
What you need: (10 servings)
● 1 tbsp (15g) sunf lower oil
● 1 (150g) large onion, peeled and roughly chopped
● 2 (12g) cloves garlic, peeled and crushed
● 2 (60g) celery stalks, washed, trimmed and chopped
● 1 (100g) leek, trimmed and sliced
● 2 (320g) red peppers, deseeded and chopped 800g butternut squash, peeled, deseeded and cut into 2cm chunks
● 1 tsp ground cumin
● Pinch of pepper
● 800ml vegetable stock, made from Kallo low-salt stock cubes
What you do:
Heat the oil in a large saucepan. Add the onion, garlic, celery and leek and soften for 5–10 minutes. Add the red pepper and butternut squash and stir well. Add the ground cumin and season with pepper and cook for a further 10 minutes. Add the stock, bring to the boil, then reduce the heat and simmer for 15–20 minutes. Blitz the soup in a blender until smooth and serve with wholemeal rolls.
Cook’s tip: If butternut squash is difficult to obtain, you can replace it with the same quantity of sweet potato. Prepare extra butternut squash and leeks and make a puree for weaning diets.
Nutrition analysis per serving
Energy (159kcals) Protein (6g) Fat (3g) Carbohydrate
(29g) Sugar (0.02g) Salt (1.1mg) Iron (1.8mg)
What you need: (12 servings)
● 125ml milk
● 4 tbsp (60ml) sunflower oil
● 1 egg
● 100g soft brown sugar
● 2 (225g) dessert apples
● 125g self-raising flour
● 50g wholemeal flour
● 1 tsp (5g) baking powder
● 1 tsp (5g) mixed spice
What you do:
Preheat the oven to 180°C, 350°F, Gas 4. Line a muffin tin with 12 muffin cases. In a large bowl, beat the milk, oil, egg and sugar together. Peel core and grate the apples and stir into the mixture. In another bowl, mix the flours, baking powder and mixed spice. Make a well in the middle of the dry ingredients. Gradually add the liquid, combining it with the flour. Spoon the muffin mixture into the muffin cases and bake for 20 minutes, until they are golden. Transfer to a wire rack to cool.
Cook’s tip: Prepare extra apples and one other fruit to make a fruit puree for weaning diets. For wheat-free diets, use wheat-free flour For dair y-free diets use soya milk For egg-free diets, use egg replacer
Nutrition analysis per serving
Energy (172kcals) Protein (3g) Fat (7g)
Carbohydrate (26g) Sugar (10g) Salt (0.2mg)
Iron (0.7mg) Calcium (67mg)
Nigel Denby is a chef, a registered dietician and the founder of Grub4Life.