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Complementary Feeding for Infants 6 to 12 months

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Learning files
Infant feeding practices in the UK
Complementary feeding for
infants 6 to 12 months
Dietitian and public health nutritionist Kathy Cowbrough
reviews current thinking on this important topic
Kathy Cowbrough RD RPHNutr
ABSTRACT
Complementary feeding, also known as weaning, mixed
feeding or introduction of solid foods, should begin for
infants by six months of age (26 weeks) but not before 17
weeks. Breast milk or infant formula should continue
during the complementary feeding period with amounts
gradually reduced as the variety of foods increases. As all
infants’ needs are different, health care professionals have
to be aware of key nutrients and foods needed at the same
time as monitoring growth and understanding the needs
of parents and the resources available to them.
Journal of Family Health Care 2010; 20(1): XX-XX
Key words:
complementary feeding; complementary foods;
infant feeding; weaning; solid foods; vitamin D; iron
Introduction
The term “complementary feeding” is increasingly
used at the international level in preference to
“weaning”. This is to emphasise the recommend-
ation that mothers should continue breast-feeding
their babies after the introduction of appropriate
solid foods for at least the first year of life. While the
original World Health Organization (WHO) defin-
ition of complementary feeding included infant
formula as a complementary food1, the term now
refers to all solid foods and liquids other than breast
milk or infant formula and follow-on formula2,3. The
terms “complementary feeding” or “introducing
solid foods” will be used in this article.
Following a systematic review by WHO in 2004,
the UK Department of Health (DH) recommended
exclusive breast-feeding for the first six months of
an infant’s life and that solids should be introduced
from six months of age (26 weeks)5. More recently
in 2008, the European Society of Paediatric
Gastroenterology, Hepatology and Nutrition
(ESPGHAN)3 and the North American Society for
Pediatric Gastroenterology, Hepatology and
XX © Journal of Family Health Care 2010 Vol 20 No 1
Nutrition (NASPGHAN) reviewed the literature on
complementary feeding for healthy term infants
and recommended that:
! Exclusive breast-feeding for around six
months is a desirable goal
! Complementary feeding should not be
introduced before 17 weeks (four months)
and not later than 26 weeks (six months)
! Breast-feeding continues throughout
weaning, particularly the early stages
! Introducing gluten between four and seven
months while breast-feeding may reduce
the risk of coeliac disease, type 1 diabetes
and wheat allergy.
While the DH recommends avoiding high-
allergen foods such as egg and fish until after six
months of age, the ESPGHAN review claims there is
no evidence that this delay will reduce the
likelihood of allergies. However, both WHO4 and
DH5 recommended that each infant must be man-
aged individually since they grow at different rates.
Current complementary feeding
practices in the UK
Health care professionals should advise parents
to wait until six months of age to begin comple-
mentary feeding but many parents wish to start
earlier than six months6,7,8. Preterm infants are a
special case; the degree of prematurity must be
considered and advice should be sought from the
dietitian and medical team who are caring for
them9. A booklet on weaning premature infants is
available from the charity Bliss (see Further
Information).
A very recent study across five European
countries found that 37% of formula fed infants had
received solid foods before four months compared
to only 17% of breast-fed infants10. The early intro-
duction of complementary foods in British infants
was associated with formula feeding (on average
two weeks earlier than in breast-fed infants), lower
maternal age and maternal smoking10.
In the UK about 50% of infants are given
complementary foods between the ages of four and
six months; the other half are given solid foods
before four months6. Only 2% had delayed the
introduction of solid foods until six month10.
Reasons for earlier introduction were more often
based on informal advice from family and friends,
previous experience and subjective criteria such as
whether the infant was considered to be sufficiently
satisfied with milk feeds. Later introduction was
associated with receiving advice from health
professionals10.
A recent study across five European countries
found that 37% of formula-fed infants had received
solid foods before four months, compared to only
17% of breast-fed infants10. The early introduction
of complementary foods in British infants was
associated with formula feeding (on average two
weeks earlier than in breast-fed infants), lower
maternal age and maternal smoking11.
Changing nutritional and
developmental needs
Until approximately six months of age, breast milk
or infant formula, as well as the stores of certain
nutrients that infants are born with, will meet all
their energy and nutrient requirements12,13. Thus
continuing breast milk or formula milk and
introducing complementary food and drink needs
to be started at six months to:
! Provide extra energy (calories) and
nutrients to sustain normal growth and
optimal health and development
! Give infants the opportunity to learn to like
new tastes and textures, based on family
foods, at a time when they are receptive to
them, thus potentially preventing food
refusal later12.
Infants have very different nutritional needs
from adults. They double their birth weight in the
first six months and triple it by the end of the first
year and therefore have higher requirements for
www.jfhc.co.uk
 Learning files
Table 1: Complementary foods – a guide to the stages of introduction (adapted from10,13,18). N.B. Ages are approximate, as every infant is different and will develop at their own pace

Stage of Complementary feeding Skills to learn Textures to introduce Foods to introduce

First Stage: 6 months (26 weeks) but
not before 4 months (17 weeks) if
parents choose to begin earlier
Second Stage or 6-9 months
Third Stage or 9-12 months
* Different foods should be offered at three different meal times. An example is:
Breakfast: Cereal and fruit with breast/formula milk Midday meal: Meat/fish/pulses with potatoes or rice and vegetables Evening meal: Egg/grated cheese/dhal with bread/chapati or pasta
** For further information on the nutrients provided by these four food groups, see Table 3 in Learning File 2 (JFHC 2009; 19(2): 47-50)
http://www.jfhc.co.uk/index.php?option=com_content&view=article&id=398&Itemid=200024
- Taking food from a spoon
- Moving food from the front
of the mouth to the back for
swallowing
- Managing thicker purées and
mashed food
- Moving lumps around the
mouth
- Chewing lumps
- Self-feeding using hands and
fingers
- Sipping from a cup
(N.B. some infants will be able
to do this before 6 months)
- Chewing minced and
chopped food
- Attempting to self-feed with a Minced and chopped family
spoon
Smooth purées Suitable first foods:
• Carrot, parsnip, potato, yam and courgette, or
Mashed foods • Baby rice mixed with breast or formula milk, rice, maize, millet, or
• Banana, cooked apple and pear, or
• Lentils or split pulses
Incorporate iron-rich foods at all stages. Examples are:
• Red meat (beef, lamb, pork)
• Green vegetables
• Oily fish (sardines, tuna and pilchards)
• Beans and pulses
• Iron-fortified unsweetened breakfast cereals
Mashed foods with soft lumps Increase variety of fruit and vegetables
• Minced meat, fish and poultry (including liver up to once per week
Soft finger foods • Mashed lentils, split pulses or pasta
• Milk products (full-fat yoghurt, fromage frais and custard)
Liquids in a lidded beaker or • Whole pasteurised cow’s milk in cooking
cup
Examples of soft finger foods:
• Soft fruit pieces, e.g. melon, banana, soft ripe pear, peach and kiwi
• Cooked vegetable sticks, e.g. carrot sticks, green beans, courgette
sticks, potato and sweet potato
• Cooked vegetable pieces, e.g. cauliflower and broccoli florets
• Cooked pasta pieces
• Crusts of bread or toast
• Cheese cubes
• Roasted soft vegetable sticks, e.g. potato, sweet potato, parsnip,
pepper, carrot and courgette
Hard finger foods • Include a wide range of foods, offered at three meals each day*
• Offer fruit and vegetables at every meal and try to give five small
servings of fruit or vegetables each day
foods • Incorporate these four food groups so the infant gets the full range
of nutrients**. Ideally these foods would be part of nutritious family
meals:
1. Starchy foods – potatoes, plantain, yam, pasta, rice, oats, bread and
breakfast cereals
2. Fruits and vegetables
3. Full-fat yoghurt and cheese. Full fat milk can also be used during
cooking
4. Meat, fish, well cooked eggs, smooth nut butters and pulses such as
lentils, dhal or hummus

energy and certain key vitamins and minerals than
adults, relative to their size. To meet these high
nutrient requirements, infants need to consume
energy-dense and nutrient-dense foods. This
means ensuring that their diet is relatively high in
fat compared to an adult diet, to provide sufficient
energy; and low in fibre, to avoid filling them up
at the expense of other nutrients.
Since their stomachs are small, infants need to
be offered small meals at frequent intervals. The
complementary feeding period is an opportunity
for parents to help infants develop positive
attitudes towards food by allowing them to decide
how much they wish to eat, not persuading them
to eat more when they indicate they have had
enough, and being relaxed about feeding12.
Practicalities of complementary
feeding
The developmental signs below are generally
seen between four and six months. This seems to
be the best time to start solids because from this
age infants learn to accept new tastes and foods
relatively quickly14.
In practice the developmental signs that
suggest that an infant is ready to accept solid
foods are:
! Putting toys and other objects in the mouth
! Chewing fists
! Watching others with interest when they are
eating
! Seeming hungry between milk feeds, or
demanding feeds more often even though
larger milk feeds have been offered12,13.
Breast milk or formula milk continues to be an
important part of the infant’s nutritional intake for
the first 12 months of life. However, these milk
feeds should decrease as the quantity of solid food
increases. Breast-feeding can be on demand but
less frequently, and formula milk intake should be
about 500–600 ml per day.
Complementary feeding usually begins with 1–2
teaspoons of a smooth purée or mashed (first
stage) food being offered once a day13,15. Infants
who are six months old will progress more rapidly
from this stage or bypass it completely, moving on
to soft lumps and soft finger foods (second stage).
As the infant learns to manage complementary
food, tries different textures and begins to take a
larger quantity, a second and then a third meal can
be introduced.
Once three meals are established, a variety of
foods from the four food groups for complement-
ary feeding should be included (see Table 1 for food
group definitions). Some infants are kept on
puréed foods for too long: the Avon Longitudinal
Study of Parents and Children found that those who
were not offered lumps and finger foods by nine
months old were more likely to be fussy eaters at an
older age16,17.
Table 1 is designed as a guide only, as the ages are
approximate and will depend on when comple-
mentary feeding is first introduced. Every infant is
different and will develop at their own pace, so
parents should be encouraged to progress at a rate
suitable for their infant and to read the cues for
readiness. It is important, however, to keep offering
different tastes and textures through their first year.
Infants may be introduced to a vegetarian diet by
giving two servings a day of pulses (such as lentils,
beans or chickpeas, finely ground or nut butters), or
tofu, in place of meat and/or fish, including other
iron-rich foods and vitamin C from fruits and
vegetables to help the absorption of iron. Vegan diets
that contain no animal products are not recom-

www.jfhc.co.uk © Journal of Family Health Care 2010 Vol 20 No 1 XX

Learning files
mended as meeting energy and nutrient require-
ments without careful planning can be difficult, and
parents are advised to consult a dietitian18.
Homemade and manufactured foods
Both home-made and manufactured baby foods
are suitable as complementary foods. The 2008
DH infant feeding survey found that manufactured
baby foods were more often used between four
and six months10. Manufactured baby foods are
convenient, have to adhere to strict European
compositional regulations including nutritional
content19 and are easier to prepare. However, an
infant fed a diet of commercial foods may be
reluctant to change later to home-prepared foods.
The nutrient content of home-prepared foods
varies considerably and reflects that of the
ingredients used15. Limited analyses have found
the nutrient content very variable, with a
tendency for sampled foods to be low in fat,
protein and iron20.
Using home-made foods can introduce more
varied tastes and textures and seems to provide
an easier transition to family foods13,21. Home-
made foods can be cheaper and the parent knows
what ingredients are used in the food, but parents
and carers should be cautioned to avoid adding
salt and sugar and using adult convenience foods
such as gravy mixes, instant potato, soups, sauces
and ready meals because of their high salt
content. Appropriate advice and support is
essential to encourage parents to use suitable
family foods.
Drinks
From the age of six months, water and diluted fruit
juices (one part of juice to 10 parts of water) can be
given as part of a meal and offered in a cup. This
should be lidded if necessary but free flowing and
not valved, to help the infant learn to sip and to
reduce the risk of causing dental caries18. Drinks
between meals should be confined to water or breast
or formula milk. Cow’s milk should not be used as a
main drink before 12 months but small amounts can
be added to foods after six months of age13.
Foods and drink to limit or avoid during
complementary feeding are outlined in Table 2.
Some feeding problems
Complementary feeding should not be delayed
beyond six months of age as this increases the risk
of nutrient and energy deficiencies. Iron defic-
iency anaemia is more common in infants weaned
after six months21. To help prevent iron deficiency,
the diet should include the following: iron-rich
foods (meat, fish, well-cooked eggs, pulses [beans,
peas, lentils], nut butters or pastes of finely-
ground nuts, fortified [non-organic] breakfast
cereals, softened dried fruits and green veg-
etables). Foods containing vitamin C will aid the
absorption of iron. Using infant formula is
advisable for the infant not being breast-fed. To
XX © Journal of Family Health Care 2010 Vol 20 No 1
Table 2: Food and drink to limit or avoid during complementary feeding (adapted from13,18,21)
What to limit or avoid Why How
Salt >1g of salt Infants’ kidneys cannot cope with Salt should not be added to food for
(or 400 mg of sodium) per day for high salt intakes34 infants either during cooking or at the
infants > 12 months33 table. Processed foods for adult
consumption such as bacon, pasta sauces
and soups should be limited. Salty snack
foods should not be given to infants26
Sugar added to foods Infants have small stomachs and • Do not add sugar to foods
these foods/drinks can fill up infants, • Do not offer sugary food or drinks
Sugar-rich foods or drinks thus replacing more nutritious foods between meals. Diluted fruit juice can
containing sugar or sweeteners be used from 6 months but only
- Sugar (including honey) can lead to offered at meals13
tooth decay when the first teeth
start to come through35 Drinks to avoid include13:
Also, during complementary feeding • Juice drinks, fizzy drinks, sugary drinks
the infant also needs to learn to like and squashes
a variety of other tastes besides • Diet drinks, “low-calorie” and “no
sweet tastes36 added sugar” drinks (anything with
sweeteners)
• Flavoured milks and flavoured waters
• Baby drinks and herbal drinks
• Tea, coffee (the tannin interferes with
the absorption of iron21)
Honey - In addition to being a sugar, it • Avoid for the first year
contains a toxin which may cause
infant botulism
Whole nuts - May cause choking or could be • Do not give to children under five
inhaled
Peanuts - If infant is not diagnosed with • Families with allergy risk should
allergy or has no family history of consult their doctor, health visitor
allergy, parents can choose to give or medical allergy specialist before
finely ground peanuts after six giving peanuts
months as long as they are crushed • All infants avoid before six months13
Shark, swordfish or marlin - The levels of mercury in these fish • Do not give for first year
may affect an infant’s growing
nervous system
Shellfish -To reduce risk of food poisoning • Do not give for first year
help prevent iron deficiency, unmodified cow’s the area of allergies and infants. After reviewing
milk should not be introduced as a main drink the literature on complementary feeding for
before 12 months of age13,22,23. There is no healthy term infants, ESPGHAN recommended in
advantage in using follow-on formula (with a 20083 that:
higher iron content) compared to an infant ! Introducing gluten between 4–7 months of
formula. However, if an infant’s diet is low in iron age while breast-feeding may reduce the
a follow-on formula may be helpful24. Organic risk of coeliac disease, type 1 diabetes and
baby cereals are not a good source of iron since wheat allergy. (Foods containing gluten are
organic restrictions prevent iron fortification25. wheat, rye, barley and oats. These cereals
The risk of vitamin D deficiency between 0 and are present in bread, wheat, some breakfast
12 months may be due to the rapid rate of bone cereals and rusks)
growth. In addition, infants with dark skin who do
not make enough vitamin D in their skin, or ! High-allergen foods such as egg and fish do
whose mothers have low vitamin D status, may not need to be delayed until after six
also be at risk of deficiency26. Vitamin A require- months as there is no evidence that this will
ments are also high and about 50% of infants do reduce the likelihood of allergies.
not eat enough vitamin A in their food27. The UK However, this is not currently DH policy. For
Health Departments recommend a supplement more on this topic, see the Learning Files on
of vitamins A, C and D for: infant allergy30,31.
! Breast-fed infants from six months (or from
one month if there is any doubt about the Summary
mother’s nutritional status during pregnancy)
! Formula-fed infants over six months when
Full breast-feeding for around six months is a
they are taking less than 500 ml of formula desirable goal, introducing complementary
per day feeding no later than 26 weeks but not before 17
weeks while continuing to breast-feed3.
! Children under four years of age28.
Guidance from health care professionals is a key
For further information, see the Learning File factor in influencing parents to begin complement-
article on feeding practices from 6–12 months of ary feeding at six months in accordance with
life29. current recommendations10. However, infants’
There has been recent interest and research in individual needs should be considered, and some
www.jfhc.co.uk
 Learning files
which may help to set balanced food habits for later life37.
Self-assessed learning an opportunity for the infant to learn to like a variety of tastes, not just sweet tastes,
questions and answers or containing sugar increases the risk of dental caries36. Also, complementary feeding is
have little other nutritional value. Frequently giving food and drinks with added sugar
Questions
developing a taste preference for salt34,35. Sugar is often found in food or drinks that
foods like sauces, soups and gravy mixes. Avoiding these may also prevent infants
1. What are the current DH recommendations large amounts. Thus parents should avoid adding salt and using highly salted adult
on introducing complementary food and
than 1 g of salt or 0.4 g sodium per day) because infants’ kidneys cannot cope with
drink?
2. The recommended amount of salt (sodium) for infants is a very small amount (no more
2. Why should parents avoid giving salt and
sugar to their infant? as they develop at different rates.
and not later than 26 weeks (six months)3,4. Infants should be considered individually
1. Term infants should not begin complementary feeding before 17 weeks (four months)
Answers

research shows that 4–6 months should be viewed
as the window of opportunity to introduce
complementary foods14. Introducing a variety of
tastes and textures from the four food groups for
complementary feeding (Table 1), and moving to
three meals a day while continuing with breast
and/or formula milk to age 12 months, should
provide infants with the nutrients they need. Ideally
these should be nutritious family foods
that infants will be expected to continue
eating during their toddler years.
References
1. World Health Organization [WHO]. Complementary Feeding of Young
Children in Developing Countries: A Review of Current Scientific
Knowledge. Geneva: WHO, 1998. (WHO/NUT/98.1.)
2. Fewtrell MS, Morgan JB, Duggan C et al. Optimal duration of exclusive
breastfeeding: what is the evidence to support current recommendations?
American Journal of Clinical Nutrition 2007; 85(2) (Suppl): 635S-638S
3. Agostoni C, Decsi T, Fewtrell M et al. Complementary Feeding: A
Commentary by the ESPGHAN Committee on Nutrition. Journal of
Pediatric Gastroenterology and Nutrition 2008; 46(1): 99-110
4. World Health Organization [WHO]. Global Strategy for Infant and Young
Child Feeding. WHO: Geneva, 2003
5. Department of Health]. Infant Feeding Recommendation. May 2003.
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/Publication
sPolicyAndGuidance/DH_4097197 (accessed 2 Jan 2009)
6. Bolling K, Grant C, Hamlyn B, Thornton A. Infant Feeding Survey 2005.
London: The Information Centre, 2007 www.ic.nhs.uk
7. Fewtrell MS, Lucas A, Morgan JB. Factors associated with weaning in
full term and preterm infants. Archives of Disease in Childhood – Fetal and
Neonatal Edition 2003; 88(4): 296-301. Review
8. Foote KD, Marriott LD. Weaning of infants. Archives of Disease in
Childhood 2003; 88(6): 488-492. Review
9. Institute of Child Health. Clinical Guideline. Infant Feeding: Weaning.
28 October 2009.
http://www.ich.ucl.ac.uk/clinical_information/clinical_guidelines/cpg_guide
line_00048/ (accessed 10 Jan 2010)
10. Scientific Advisory Committee on Nutrition [SACN]. Infant Feeding
Survey 2005: A Commentary on Infant Feeding Practices in the UK.
London: The Stationery Office, 2008.
http://www.sacn.gov.uk/pdfs/sacn_ifs_paper_2008.pdf (accessed 9 Dec
2009)
11. Schiess S, Grote V, Scaglioni S et al; European Childhood Obesity
Project. Introduction of complementary feeding in 5 European countries.
Journal of Pediatric Gastroenterology and Nutrition 2010; 50(1): 92-98
12. Shaw, V and Lawson, M (eds). Clinical Paediatric Dietetics. (3rd edn.)
London: Blackwell (now part of Wiley), 2007
13. Department of Health [DH]. Birth to Five. London: DH, 2005. Available
at: www.dh.gov.uk (accessed 10 Jan 2010)
14. Harris RJ. Nutrition in the 21st century: what is going wrong. Archives
of Disease in Childhood 2004; 89(2) 154-158. Review
15. Stordy BJ, Redfern AM, Morgan J. Healthy eating for infants – mothers’
actions. Acta Paediatrica 1995; 84(7): 733-741
16. Coulthard H, Harris G, Emmett P. Delayed introduction of lumpy foods
to children during the complementary feeding period affects child’s food
acceptance and feeding at 7 years of age. Maternal & Child Nutrition 2009;
5(1): 75-85
17. Northstone K, Emmett P, Nethersole F and the ALSPAC study team. The
effect of age of introduction to lumpy solids on foods eaten and reported
feeding difficulties at 6 and 15 months. Journal of Human Nutrition and
Dietetics 2001; 14(1): 43-54
18. Food Standards Agency eatwell website – weaning information.
http://www.eatwell.gov.uk/agesandstages/baby/weaning/#cat227288
(accessed 10 Dec 2009)
19. The Processed Cereal-based Foods and Baby Foods for Infants and
Young Children (England) Regulations 2003.
http://www.opsi.gov.uk/si/si2003/ukso_20033207_en.pdf (accessed 12
Dec 2009)
20. Morgan JB, Redfern AM, Stordy B J. Nutritional composition (by
chemical analysis) of home prepared weaning foods for infants.
Proceedings of the Nutrition Society 1993; 52: 384A
21. Department of Health. Weaning and the Weaning Diet. Report of the
Working Group on the Weaning Diet of the Committee on Medical Aspects
of Food Policy. Report on Health and Social Subjects No 45. London:
HMSO, 1994
22. Morgan, J. The Formative Years. Network Health Dietitians. July 2007;
issue 25
23. Male C, Persson LA, Freeman V, Guerra A, van’t Hof MA, Haschke F.
Euro-Growth Iron Study Group. Prevalence of iron deficiency in 12-month
old infants from 11 European areas and influence of dietary factors on iron
status. Euro-Growth Study. Acta Paediatrica 2001; 90(5): 492-498
24. Moy, RJ. D. Iron fortification of infant formula. Nutrition Research
Reviews 2000; 13(2): 215-227
25. More J. Organic baby food. Journal of Family Health Care 2003; 13(1):
6-8. Review
26. Hamlyn B, Brooker S, Oleinkova, K, Wands S. Infant Feeding 2000.
London: The Stationery Office, 2002
27. Gregory JR, Collins DL, Davies PSW, Hughes JM, Clarke PC. National
Diet and Nutrition Survey: children aged 1.5 to 4.5 years. London: HMSO,
1995
28. NHS. Healthy Start. Vitamin Supplement Recommendations.
http://healthystart.nhs.uk/en/fe/vitamin_supplement_recommendations.htm
l (accessed 9 Jan 2010)
29. Meyer R. Infant feeding in the first year. 2: Feeding practices from 6-12
months of life. [Learning files series] Journal of Family Health Care 2009;
19(2): 47-50.
http://www.jfhc.co.uk/index.php?option=com_content&view=article&id=39
8&Itemid=200024
30. Venter C. Infant atopy and allergic diseases: an introduction to dietary
aspects. Journal of Family Health Care 2009; 19(3): 92-95
(http://www.jfhc.co.uk/index.php?option=com_content&view=article&id=39
8&Itemid=200024)
31. Venter C. Cow’s milk protein allergy and other food hypersensitivities in
infants. Journal of Family Health Care 2009; 19(4): 128-134
http://www.jfhc.co.uk/index.php?option=com_content&view=article&id=39
8&Itemid=200024)
32. Dangour A, Aikenhead A, Hayter A, Allen E, Lock K, Uauy R.
Comparison of putative health effects of organically and conventionally
produced foodstuffs: a systematic review. Report for the Food Standards
Agency. Nutrition and Public Health Intervention Research Unit, London
School of Hygiene & Tropical Medicine, July 2009
http://www.food.gov.uk/multimedia/pdfs/organicreviewreport.pdf (accessed
12 Dec 2009)
33. Food Standards Agency. Salt recommendations for babies. [Online.]
Available from:
http://www.eatwell.gov.uk/agesandstages/baby/weaning/#cat227298 or
http://www.eatwell.gov.uk/healthydiet/fss/salt/howmuchsalteat/ (accessed
15 Oct 2009)
34. Scientific Advisory Committee on Nutrition [SACN]. Salt and Health.
London: The Stationery Office, 2003
http://www.food.gov.uk/multimedia/pdfs/saltandhealth0503.pdf (accessed
12 Dec 2009)
35. Holt RD. Weaning and dental health. Proceedings of the Nutrition
Society 1997; 56(1A): 131-138. Review
36. Beauchamp GK, Mennella JA. Early flavor learning and its impact on
later feeding behavior. Journal of Pediatic Gastroenterology and Nutrition
2009; 48 (Suppl 1): S25-30. Review
Frequently Asked Questions
1. Will using organic baby foods give my baby
more nutrients?
Organic baby foods or using organic food to make
your own complementary foods will not provide
your baby with more nutrients32. You may prefer
them for your baby and use them for ethical
reasons, which is your choice. Regular
manufactured baby foods may have additional
nutrients such as iron added, whereas
manufactured organic baby foods may be lower in
iron than similar regular foods because regulations
prohibit additional nutrients being added to organic
foods25. This will also apply to other organic food
such as cereal and bread.
2. Do I need to worry about my baby getting
enough iron?
If your baby is breast-fed, iron is readily absorbed
from breast milk and if you are using formula milk
this has iron added to it, so it is rare for infants
under 12 months to be low in iron. But by the age
of six months, the iron stores your baby was born
with need to be added to by including iron-rich
foods daily, e.g. meat, oily fish, well-cooked eggs,
beans, lentils, pulses, or softened dried prunes.
Further information
National Institute for Health and Clinical Excellence (NICE)
Improving the nutrition of pregnant and breastfeeding mothers
and children in low-income households. Public Health
Guidance 11, 2008
http://www.nice.org.uk/guidance/index.jsp?action=byID&o=1
1943
Department of Health [DH] and Food Standards Agency [FSA]
The DH (www.dh.gov.uk/) and FSA (www.food.gov.uk)
websites give guidance on complementary feeding for health
professionals and parents and have useful leaflets to order
British Dietetic Association
Factsheets on weaning and vitamin supplements available at:
http://www.bda.uk.com/foodfacts/
Bliss
Weaning your premature baby. (Booklet).
http://www.bliss.org.uk/page.asp?section=584&sectionTitle=
Weaning+your+premature+baby (accessed 2 Jan 2009)
University of Sheffield Baby Centre
http://www.babycentre.co.uk/baby/startingsolids/introducing/
This Learning File is supported by an educational grant
from Aptamil. It represents the inedpendent views of
the author and has been independently peer reviewed
by JFHC.
The information was correct at the time of publication
(January/February 2010).
The next Learning File topic will be breast-feeding and
will be published in the March/April issue of JFHC.

www.jfhc.co.uk © Journal of Family Health Care 2010 Vol 20 No 1 XXX

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