A guide to weaning All the nourishment infants need during

A guide to weaning All the nourishment infants need during the first four to six months comes from either breast milk or infant formula milk. Between four and six months infants should begin taking a wider variety of foods to allow them to grow and develop - this process is called weaning. Weaning before four to six months is not recommended as most infants’ digestive systems and kidneys are not fully developed. Weaning too soon may cause problems, such as food allergies, in the future. The tables on the following pages outline current recommendations for the three stages of weaning, ie from four to six months, from six to nine months and from nine to twelve months. Stage 1: From 4 to 6 months Texture Suitable foods Foods to avoid The following foods should be avoided at this stage: • rusks and other foods made from wheat, eg bread, spaghetti and other pasta, breakfast cereals, eg Weetabix, Shreddies, Ready Brek; • eggs; • fish and shellfish; • nuts and seeds, including peanut butter. Notes First foods should be smooth and runny. First weaning foods • baby rice; • puréed potato, carrot, parsnip, turnip, cauliflower; • puréed banana, stewed fruits, eg apple, pear, apricots; • unsweetened custard (made using custard powder); • plain/natural yogurt; • suitable commercial baby foods labelled from 4 months (these should be free from wheat, eggs, sugar and salt). As infants get used to spoon feeds • puréed beef, pork, lamb, chicken; • puréed peas, green beans, lentils; • puréed broccoli, Brussels sprouts, spinach. Cook vegetables or fruit (without added salt or sugar) until they are soft, then purée. Breast milk or infant formula milk can be used to mix with cereals, potatoes etc to give a smooth consistency. At this stage the infant will continue to receive at least 600 mls (20 fl oz) of expressed breast milk or infant formula milk each day. This should be provided in accordance with the parents’ guidance. Cooled boiled water can be offered between feeds if the infant seems thirsty. Cow’s milk and follow-on formula are not suitable as drinks at this stage, but some products made from cow’s milk may be used, eg plain/natural yogurt, unsweetened custard, cheese sauce. Stage 2: From 6 to 9 months Texture Suitable foods Foods that can be added from 6 months: • foods made from wheat, eg bread, pasta, semolina, breakfast cereals such as plain Ready Brek, Weetabix, porridge; • well-cooked egg (the white and yolk should be solid); • fish, eg cod (with bones removed), tuna, tinned sardines (well mashed). Foods to avoid It is recommended that peanuts and products containing them, eg peanut butter, are not provided in the childcare setting. This is to protect children who may be at risk of peanut allergy. All young children are at risk of choking on nuts. Notes Menu ideas Between 6 and 9 months infants will gradually move on from puréed foods to mashed foods. From about 7 months the food does not have to be so smooth just mash the food with a fork leaving some soft lumps. This will encourage the infant to learn how to chew. During this time offer the infant a wider range of tastes and textures. At this stage the infant will continue to receive 500-600mls (16-20 fl oz) of expressed breast milk or infant formula milk. Introduce a cup for drinks of infant formula milk or water. Whole cow’s milk can be used to mix into foods such as mashed potato and breakfast cereal, but should not be given as a main drink until after 1 year. Encourage infants to hold spoons. Begin to offer finger foods (refer to page 14). Main meal ideas: • mashed hard boiled egg or mashed baked beans with fingers of toast; • tuna and pasta bake with broccoli; • macaroni cheese with peas; • shepherd’s pie with carrots; • minced chicken with mashed potato and Brussels sprouts; • corned beef hash with sliced green beans; • meat or lentil stew with mashed potato. Dessert ideas: • pieces of fresh soft fruit, eg pear, banana, melon; • stewed fruit, eg apples, apricots, prunes (with stones removed); • tinned soft fruit in its own juice, eg strawberries, peaches, pears; • milk pudding, yogurt or fromage frais (do not use ‘diet’ varieties). Stage 3: From 9 to 12 months Texture Suitable foods All family foods can be offered at this stage. Foods to avoid It is recommended that peanuts and products containing them, eg peanut butter, are not provided in the childcare setting. This is to protect children who may be at risk of peanut allergy. All young children are at risk of choking on nuts. Notes Menu ideas During this stage infants will move on from mashed to chopped foods. At this stage infants will continue to receive about 500-600mls (16-20 fl oz) of expressed breast milk or infant formula milk each day. Water or very dilute pure fruit juice can be given as a drink at mealtimes. By now, most drinks should be given from a cup. From 12 months, the use of a bottle should be discouraged. Encourage infants to eat a wide variety of foods. For suitable snacks and drinks refer to pages 14 and 15. Some meal ideas to try Breakfast: • unsweetened breakfast cereal with whole cow’s milk; • toast with well-cooked egg scrambled, poached or boiled. Lunch: • baked beans on toast; • sandwiches filled with tuna or chopped chicken • soup with a sandwich; • pasta shapes in tomato sauce with grated cheese; • pizza with chopped fresh tomato. Dinner: • minced or chopped meat, mashed potatoes and carrots; • fish fingers, peas and mashed potatoes; • chicken casserole and rice; • lasagne with broccoli; • vegetable risotto with grated cheese; • beef or lentil burgers, courgettes, sliced tomato and boiled potatoes; • cauliflower cheese, boiled potatoes and green beans. Finger foods: • • • • • soft fresh fruit, eg banana, melon, peeled pear; pieces of cooked vegetables, eg green beans, cauliflower, carrot; fingers of toast, unsalted breadsticks, pitta bread; fingers of hard cheese; low-sugar rusks (these should only be used occasionally, as even low-sugar varieties still contain a lot of sugar). Snacks for older infants aged 9 to 12 months Snacks that contain a little or no sugar can be given freely. These include: • chopped fruit and vegetables, eg peeled apple, pear, peach, banana, orange, carrot, cucumber; • bread, toast, breadsticks, scones, pancakes; • plain yogurt, plain fromage frais; • cheese. If on occasions, sweet foods are to be given to infants, they should be given at mealtimes when they are less damaging to teeth. Drinks for infants up to 12 months old Breast milk or infant formula milk This should be the main drink during the first year. Follow-on formula This is unsuitable for infants under six months. It may be used after six months but has no advantage over breast milk or ordinary infant formula milk. Cow’s milk Whole cow’s milk should not be used as the main drink until after one year. Between one and five years it is recommended that whole cow’s milk should be used routinely in the childcare setting as it contains more calories and vitamins A and D. Other drinks A little cooled boiled tap water can be given if an infant seems very thirsty (after six months, water straight from the mains tap is suitable). Very dilute fruit juice (one part pure orange juice to eight parts water) from a cup may be given occasionally with meals. Drinks that are not recommended • Baby juices and herbal drinks contain sugar and can damage developing teeth if they are used frequently or given from a bottle. • Sugary diluting squashes contain sugar and can damage developing teeth. If used, they should be very well diluted (one part squash to eight parts water) and given from a cup at main meals. Drinks that should not be given • Colas, lemonades and fizzy drinks including ‘diet’ drinks are acidic and can cause damage to teeth. ‘Diet’ drinks are also high in artificial sweeteners which are unsuitable for babies under one year. • Tea and coffee may reduce the absorption of iron. • Bottled mineral waters, both still and sparkling, may contain high levels of minerals which make them unsuitable for babies under one year. • Goat’s and sheep’s milk lack essential vitamins and minerals needed for babies’ growth and development. Menu planning The following points will be helpful when planning menus. • Children need to eat regularly and it is recommended that they are offered something to eat at least every three hours. • All children need a breakfast. This could either be at home or in childcare if available. • Children in full day care will receive most of their food while in childcare. It is recommended that they receive one hot meal (lunch) and two snacks (mid-morning and mid-afternoon). It is assumed that the evening meal will be taken in the child’s own home. • Children in half-day care should receive one meal and at least one snack. • Sessional care does not normally include a main meal. Children who attend for a morning or afternoon session should receive at least one snack. • Some children may eat slowly. It is important to ensure that all children have enough time to eat. • The menu cycle should be for a minimum of three weeks, with a range of dishes used. • A variety of foods from the four main food groups should be served throughout the menu cycle in meals and snacks. • Copies of the menu should be displayed in a prominent position and/or made available to the parents/guardians. It is recommended that parents/guardians are given the opportunity to contribute ideas to the menu. • A main meal must include a food from the following food groups: - bread, other cereals and potatoes; - fruit and vegetables; - meat, fish and alternatives (see information on food groups, pages 7-9). • Choose combinations of colours to make the food attractive. Three or four defined areas of colour look good on a plate. • A combination of different textures increases appeal. Children will appreciate crisp, crunchy, chewy, smooth and soft foods. • Taste should be varied but meals containing too many different new flavours may not be acceptable to children. • Some finger foods, as well as foods which require cutlery, allow variation at mealtimes. Children following a vegetarian diet People who follow vegetarian diets may differ in the types of food they eat or exclude. It is important therefore to find out the type of food that the vegetarian child can eat. For example some children may eat chicken, fish, eggs, milk and dairy products such as cheese or yogurt, whereas strict vegans exclude all foods of animal origin. A vegetarian diet is a healthy diet providing that a wide variety of foods are eaten. When meat and animal products are excluded from meals it is important that the nutrients they provide are gained from other foods. Vegetarian sources of protein should be provided at each meal. Refer to the notes on Meat, fish and alternatives, page 9 for main meal ideas. To ensure an adequate intake of all the essential amino acids, a vegetable source of protein (pulses, nuts) should be eaten with a cereal food (bread, rice, pasta), for example chickpea casserole with pasta, lentil stew with rice, beans on toast. Children from ethnic communities following a traditional diet When planning food provision and menus, childcare providers must accommodate the traditions and customs of ethnic communities. Details the foods traditionally avoided by particular groups are shown below: Hindus and Sikhs are strict vegetarians and do not eat meat, fish, eggs or anything made with them. Muslims eat meat provided it has been killed by the halal method. They exclude all pork and pork products. Other foods may also be avoided if there is uncertainty about the content, eg pastries and puddings which may contain pig fat. Many savoury baby products contain meat which has not been killed by the halal method, and these products are unacceptable to Muslims. Jewish people eat meat provided it is kosher. They exclude all pork and pork products. They eat those fish which have fins and scales, but exclude all shellfish and eels. Products from animals that have not been prepared by the kosher method are also avoided, eg gelatine, animal fats. They do not eat meat and milk or milk products at the same meal. They should not be offered cheese that contains rennet or biscuits that contain animal fat. Chinese people generally exclude dairy produce. The Chinese community also believes that good health depends on a balance of two opposite elements in the body: yin (referred to as ‘cold’) and yan (referred to as ‘hot’). Infant formula milk is regarded as ‘very hot’. Where a mother has chosen to bottle feed her baby, she may want to give her baby ‘cooling’ drinks such as cooled boiled water. of • • • • Children with special dietary needs Providing special diets Special diets such as gluten-free (coeliac), diabetic, milk-free or nut-free, can be quite complex. Parents should be able to provide a diet sheet about their child’s specific dietary needs which has been prepared by a State Registered Dietitian. Food allergy Many parents believe that their child is sensitive to certain foods. However the true incidence of food allergy is likely to be much lower than reported. Parents requesting special diets for their children because of food allergy should be encouraged to seek medical advice. It is unwise to restrict food choice among young children without professional help and advice. Peanut allergy Peanut allergy is usually severe - sensitive individuals may even react to peanut dust. All nuts and nut products must be avoided, including peanut butter. Care should also be taken to prevent accidental consumption of food containing nuts or nut products or food that has come into contact with them. Children with peanut allergy are advised to carry identification and may require a pre-filled syringe of adrenaline (eg epipen, anopen) which can be administered if they have a reaction. The Department of Health Expert Panel recommends that children with a family history of asthma, eczema, hay fever or food allergy should avoid peanuts and peanut products until the age of three years. So as a precautionary measure, it is recommended that childcare facilities should not provide peanuts or foods containing them, eg peanut butter, to any children in their care. Sample menus SAMPLE MENU - WEEK 1 Meal Lunch Monday Homemade beefburgers (grilled or oven baked), cabbage and mashed potatoes (as champ) Milk jelly with tinned fruit Tuesday Pork pieces casseroled with pineapple and peppers, with boiled rice Wednesday Savoury mince with baked potatoes, frozen peas and sweetcorn Thursday Roast chicken with carrots/parsnips and roast potatoes Friday Grilled fish fingers with baked beans and boiled potatoes Madeira cake with banana slices Semolina with tinned peaches Apple crumble and custard Kiwi fruit with natural yogurt or fromage frais To drink: milk, water Midmorning and midafternoon snacks For snack suggestions, refer to snack list, page 10. A more substantial snack could be provided for children staying later, eg sandwiches with meat or alternative filling; beans, cheese or sardines on toast. SAMPLE MENU - WEEK 2 Meal Lunch Monday Beef casserole with carrots and turnip, with boiled potatoes Tuesday Liquidised lentil soup with bread rolls/baps Wednesday Tuna, sweetcorn and pasta bake with sliced tomatoes Thursday Chicken portions casseroled with carrots and leeks, with mashed potatoes Apple pie with custard Friday Bolognese mince and spaghetti with green beans Fresh fruit salad with yogurt Bread and butter pudding with custard Peach or banana custard Fruit jelly with ice cream To drink: milk, water Midmorning and midafternoon snacks For snack suggestions, refer to snack list, page 10. A more substantial snack could be provided for children staying later, eg sandwiches with meat or alternative filling; beans, cheese or sardines on toast. SAMPLE MENU - WEEK 3 Meal Lunch Monday Shepherd’s pie with cauliflower/ broccoli and wheaten/soft grain white bread Tuesday Boiled ham with cabbage/carrots and boiled potatoes Wednesday Irish stew Thursday Fish in white sauce or ovenbaked fish in breadcrumbs with mashed potato and mixed frozen vegetables Friday Roast pork or oven-baked pork steaks and gravy with roast potatoes and green beans Milk-based instant dessert with banana or kiwi fruit Rice pudding with peaches, tinned in fruit juice Sponge topped Fruit sponge with puréed fruit (Eve’s pudding) and fromage frais and custard Ice cream with fresh or tinned fruit To drink: milk, water Midmorning and midafternoon snacks For snack suggestions, refer to snack list, page 10. A more substantial snack could be provided for children staying later, eg sandwiches with meat or alternative filling; beans, cheese or sardines on toast.