A Unique Child: Nutrition - Chop and change

Once babies have been introduced to their first tastes of pureed fruit and vegetables and baby rice, they will be ready to move on to more nutrient-dense foods like pulses, fish and meat and full-fat dairy products such as fromage frais.

The texture and consistency of their food will change as they become more proficient in eating finger food and are able to chew soft, lumpy food. Between seven and nine months, babies will gradually move to two and then three meals a day, and by the time they reach 12 months they will be eating a range of minced and chopped food.

Weaning, which is now described by professionals as 'complementary feeding', is a crucial stage in a child's development, and it is important that nurseries help children develop good eating habits that will take them into their important second year of life.

SEVEN TO NINE MONTHS

By seven to nine months of age, a baby should have started on a range of pureed and mashed foods and some finger foods, and be eating three meals a day. In addition to this, they should be having four milk feeds of breast milk or infant formula, a total of about 600ml a day. Food should be mashed so that there are some small lumps in it.

Here are some examples of what to include in the three meals per day, as outlined in the CHEW guidance from the Caroline Walker Trust, Eating Well: first year of life. Portion sizes and recipes are at http://www.cwt.org.uk/pdfs/CHEW-1stYearLifePracticalGuide.pdf.

BREAKFASTS

- Baby rice, banana and kiwi chunks

- Porridge, chopped raisins and pear

- Wheat bisks and banana

- Scrambled egg and cream cheese, strawberry puree and strawberries

LUNCHES

- Butter bean and vegetable stew with potato pieces

- Pasta with lamb and tomato sauce and carrot

- Mashed potato with salmon and broccoli

- Chicken, leeks and carrots, with soft cooked potato

DESSERTS

- Rice pudding with strawberry puree

- Mandarins and fromage frais

- Yoghurt with raspberries

- Stewed apple and custard

At seven to eight months, infants will be able to use their thumb and forefinger to make more precise movements, so ensure that they are given finger foods at each meal. Cut soft foods into manageable-sized pieces, making sure there are no stringy bits, skin or pips.

Here are some examples of soft finger foods suitable for this age group:

- Cooked vegetables such as parsnip, carrot, green beans, mange tout

- Red pepper

- Soft fruit such as a mango, melon, banana, peach, kiwi or canned fruits in juice (drained)

- Cooked starchy foods like sweet potato, potato or pasta pieces

TEN TO 12 MONTHS

By ten to 12 months of age, a baby should be eating a range of minced and chopped foods and getting three meals a day. They should also be having a total of about 400ml of breast milk or infant formula a day, split between three feeds.

Babies of this age should be introduced to some harder foods to get them used to biting and chewing. Practitioners should cut up hard foods into bite-size pieces so that the baby can't bite off too large a piece and choke.

Breakfast could include an omelette with canned tomatoes and a satsuma chopped up as finger food, followed by a breast feed or 100ml infant formula in a cup. Lunch would consist of a savoury course such as fish pie and carrot sticks followed by rhubarb crumble with custard and raspberries and a cup of tap water, and tea could be vegetable couscous with cucumber sticks and chopped banana followed by a breast feed or 100ml infant formula in a cup. The final breast feed or cup of infant formula of 200ml should be given before bedtime.

Babies can also start to have a bigger range of finger foods with their meals at this age. These can include raw fruit and vegetables, with any pips and stones removed, and crunchy and chewy foods. Examples of these foods include:

- Raw fruit and vegetable pieces such as pear, banana, apple, orange segments, grapes, cucumber, carrot, pepper or green beans

- Starchy foods such as breadsticks, bread crusts, rice cakes, pitta bread strips, toast, potato or pasta

- Other foods, such as slices of hard-boiled egg, or tender pieces of meat or fish with all bones removed.

NEW FLAVOURS AND TEXTURES

A wide range of different flavours and textures need to be introduced in the first year of eating solids, because this is the time in a child's life when they are most open to trying new foods.

Registered nutritionist Annie Seeley says, 'When children reach around 18 months they can become neophobic. This means they have a fear of new food. Academics believe that our ancestors' children developed neophobia around the time that they became mobile and therefore it protected them from trying unrecognised foods when their mother wasn't around and so did not get poisoned.

'These days, neophobia is thought to last from around 18 months through to six years. In addition, toddlers begin to exert their independence and this can often be by refusing food, often foods that were previously accepted. It is therefore crucial for parents and childcare providers to offer a wide variety of foods before a child reaches 18 months old.

'Nurseries have a great role to play in ensuring that children continue to be offered small amounts of refused foods and new foods alongside foods they like to eat. I have seen nurseries where older children serve themselves, which is great. But the down side of this can be that they don't put a little of everything on their plate, so staff need to ensure they have a little of all foods on their plate. Also, research shows that children who eat with their peers are more likely to try new foods.'

CASE STUDY: YOUNG FRIENDS NURSERY

At Young Friends Nursery, a 44-place setting in Hove, East Sussex, each of the nine babies - ranging from six months to 16 months - are fed at different times, according to their feeding and sleeping patterns. Once they have been introduced to their first tastes, they are gradually moved on from the bland, pureed foods to different tastes and consistencies.

Manager Louise Lloyd-Evans, who is a Food Champion since undertaking a Healthy Early Years training module with Brighton and Hove City Council, says, 'At around seven months, babies are offered the same foods that the older children in the nursery are eating, but at different consistencies. For example, a baby of eight months who has taken to weaning well might be having a mashed meal of kedgeree - fresh fish, peas and rice or risotto. Our view is that when they are ready, the sooner you get proper fresh tastes in their mouth the better.

'At the initial stage of moving over from pureed foods to mashed, we make sure that there are plenty of staff on hand to support the children at mealtimes. There could be five babies eating lumpy food and some of them could be feeding themselves, whereas others might need complete support.

'They all sit together at the same level, on high-sided booster seats. If they are still a bit wobbly, they will sit in a high chair.

'We have a board up each day that gives details of every child's feeding and sleeping patterns. We also support the parents and work with them on their child's weaning programme and progress.

'The only issue we've had to deal with is parents who ask for their child to have a jar of baby food if they do not eat our freshly-cooked food. We do not allow jars at the nursery - it is in our nutrition policy.

'Healthy eating is part of our whole ethos. Our on-site chef cooks freshly cooked food in the open-plan kitchen. Children are involved the preparation of food. They cut herbs and plant and harvest vegetables in the garden. Even the babies have fun making patties.

'We have structured menus that follow the national guidelines and they are offered appropriate finger foods with each meal. Our policy is to never hold back food. We always offer the children finger food and we will never refuse pudding.

'Puddings include semolina, bread and butter pudding with fruit, stewed fruit, yoghurts and fruit salad. We don't use sugar or salt in our food for children under one, and very little for older children, and cook savoury alternatives such as cheese straws instead of any biscuits or cakes.'

MORE INFORMATION

• Annie Seeley's blog, www.anniesdorsetkitchen.com
• Birth to five guide, www.nhs.uk/planners/birthtofive/Pages/Birthtofivehome.aspx Start4life www.nhs.uk/start4life
• Caroline Walker Trust Eating well: first year of life, www.cwt.org.uk/pdfs/CHEW-1stYearLife PracticalGuide.pdf (see page 16 for a list of food and drinks that should not be given to children in the first year of life)
• World Health Organisation guidance on weaning, www.who.int/nutrition/topics/ infantfeeding_recommendation/en/index.html.

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