Exclusive breastfeeding is recommended for the first 6 months (26 weeks) of life as it provides all the fluid and nutrients a baby needs. Introducing solid foods is the process of introducing an infant to foods alongside their usual breast milk or formula milk feeds. The age and types of food an infant is introduced to is very important. Parents should be encouraged to safely introduce solid foods to their infant, inline with Department of Health (DoH) guidance. The optimal recommend age to introduce solid foods is around six months.
There are a number of clear signs, which together, show that baby is ready for solid foods. It is very rare for these signs to appear together before six months.
- Baby can stay in a sitting position and hold their head steady
- Baby can co-ordinate their eyes, hand and mouth so they can look at the food, pick it up and put it to their mouth by themselves
- Baby can swallow food. Babies who are not ready will push the food back out of their mouth. However, if a baby is given a smooth, puree-type food, it is difficult to spit this out once in the mouth, so people may mistake involuntary swallowing of these foods with the ability to swallow food by choice.
Families choosing to introduce solid foods before six months should speak to their health visitor or other health professional (Dietician or Registered Nutritionist). They should also be advised there are a number of foods that should be avoided before six months and further advice can be found using resources such First Steps Nutrition ‘Eat well: The first year’.
It is important to introduce solid foods around six months to ensure infants receive sufficient energy and nutrients. During this time infants learn to chew and swallow a variety of textures alongside exposure to a range of tastes. Exposure to a variety of flavours and textures supports infants to more readily accept family foods. Families can support infants by preparing homemade foods and role modelling positive behaviours.
Homemade v’s Commercial Baby Foods
There is a huge market for baby food, but many families don’t realise what goes in to these jars and pouches. Families may purchase foods as they feel they lack the skills, knowledge and confidence in how to prepare foods for their infant. The last Infant Feeding Survey reported that 58% of babies at 4-6 months and 84% at 8-10 months had been given commercial baby food. There are regulations for baby foods in England, ‘Processed Cereal-based Foods and Baby Foods for Infant and Young Children (England) Regulations 2003. These regulations set a minimum or maximum amount for certain ingredients and nutrients but do not specify what the composition of baby foods should be.
We were lucky enough to attend the First Steps Nutrition Trust ‘Best Foot Forward’ conference recently where they launched their report ‘Baby Foods in the UK – A review of commercially produced jars and pouches of baby food marketed in the UK’. The report provides an overview of a number of key issues and we would urge all health professionals, who are likely to discuss commercial baby foods, to read the full report which will be available shortly online http://www.firststepsnutrition.org/news.html. We have summarised some of the key findings.
What is the report reviewing?
Review of 343 baby food products in jars, pouches, trays which are marketed for babies in the first year of life. The review took place between August and October 2016 of the top four baby manufacturers in the UK – Cow & Gate, Ella’s Kitchen, Heinz and Hipp Organic.
What are the key issues covered? We have pulled out the key points for some of the areas highlighted below. Please read the report for a full overview
Age foods are marketed from:
Challenges: EU regulations allow foods to be marketed for infants from 4 months of age. The review highlighted almost half (45%) of all foods from the four main manufacturers (Cow & Gate, Ella’s Kitchen, Heinz and Hipp Organic) marketed their products as suitable for infants less than six months. Some smaller manufacturers, as well as Asda, M&S own brand baby foods, and from 2017 Organix brand, market their baby food from 6 months of age, supporting global and national infant feeding guidelines.
Public Health Advice: It is currently recommended that infants should be introduced to complementary foods at about 6 months of age, regardless of the ages that baby food products are marketed for.
Ingredients used in commercial baby foods:
Challenges: Manufacturers are required by law to provide a list of ingredients, in order of magnitude in which they are present, but are not required to disclose the amount of each ingredient. It was found that manufactures vary in the amount of information they provide. Some of the products used organically certified ingredients, certified within the EU and carry the EU ‘leaf’ logo. Some of the products do not use organically sourced ingredients but use the term ‘baby grade’ which has no legal meaning. One manufacturer described ‘baby grade’ as, “We use the term ‘baby grade’ to communicate our very strict and specific requirements on, for example, extra raw material traceability. For example, an organic vegetable grown to meet the pesticide requirements under organic legislation may not meet the stricter pesticide requirements for foods manufactured for children”
Public Health Advice: All baby food manufacturers must comply with regulations to ensure a low content of pesticide residue and other harmful contaminants in foods marketed to infants, regardless of whether baby foods are made from organic or conventionally grown ingredients. Families should be encouraged to prepare homemade foods so they know exactly what ingredients are offered to infants.
Textures and Thickeners:
Challenges: Most of the baby foods marketed for infants in the first year are smooth, or smooth with soft lumps. These smooth textures do not support the importance of exposing infants to varied textures between the ages of 6-12 months. Pureeing results in a different taste and texture profile as they pass rapidly through the mouth and limit appreciation of flavours or may lead to over-eating, as the food is swallowed rapidly making it more difficult to know when the infant has had enough to eat. Thickeners were also used to make sure foods are a consistent texture and frequently starch based.
Public Health Advice: Encourage families to make homemade foods so they can control the consistency of the food and introduce mashed and chopped textures. This will help infants progress and develop the skills to manage different foods.
Cost of commercial baby foods:
Challenges: Commercial baby foods vary in price across brands, with food in pouches costing significantly more per 100g of product than those sold in jars. A family buying one pouch a day could spend £42/month (7-9 months) or £54/month (10 month +), the cost can vary between brands. A family with a 7-9 month old offering the most expensive infant formula (600mls), a baby breakfast and two savoury pouches could spend £6.80/day = £204/month!
Public Health Advice: Processed baby foods are expensive and when looking at the ingredients they represent poor nutritional value for money. Families can get ideas for preparing family foods using Start4Life, Fist Steps Nutrition or Children’s Food Trust recourses.
The report outlined that commercial infant foods can undermine the key messages from professional relating to infant feeding. They are expensive and restrict infants exposure to a range of tastes and textures and future challenges in offering family foods. Families should be supported to prepare homemade foods as they can control texture, introduce a range of tastes, avoid unnecessary ingredients and encourage a positive family mealtime experience.
For more advice on introducing solid foods book our Food and Nutrition for Infants module.
By Edwina Revel