Infant and child nutrition

Good nutrition is especially important in early life for

Healthy growth and to support learning and development
Developing muscles and building skills needed for eating and talking
Learning to like and develop habits for healthy foods and water
Reducing risk of chronic diseases later in life (eg diabetes, heart and kidney disease)

Children grow well with

A healthy environment that includes love, care, play and sleep
Only breastmilk until around 6 months of age
A variety of age-appropriate foods introduced at around 6 months

Nutrition under 6 months of age

Breastmilk will meet all of baby’s nutritional needs until around 6 months of age — no other food or fluids including water are needed
Babies who are not breastfed should be provided with Stage 1 (newborn) infant formula
See Postnatal nutrition for mother and baby (up to 6 months old)

Introducing solid foods

Do not offer solid foods before 4 months of age
Babies need food as well as breastmilk at around 6 months of age when they

Can hold their head up and sit with minimal support
Are interested in and grab for food — Figure 3.1
Open their mouth when you offer food — Figure 3.2
Are still hungry after breastfeeds

If baby is not eating any solid foods by 7 months of age — medical or child health nurse consult
Iron rich foods (iron fortified cereal, meat, chicken, fish, eggs, legumes) are needed to support growth, development and prevent anaemia — see Anaemia (weak blood) in children and youth

Figure 3.1

nutrition - baby reaching.jpg

Figure 3.2

nutrition - baby mouth open.jpg

Feeding young children

Offer a variety of foods regularly across the day (3 meals plus snacks)
Let children guide how much food to eat. Children are hungry when they

Are excited about and try to reach for food when they see others eating
Lean forward and open their mouth ready to be fed

Do not force children to eat if they are not hungry. Offer food later if a child

Turns their head away, pushes spoon away or firmly closes their mouth
Is distracted or not interested in food

Encourage families to eat meals together. Children learn new eating skills by watching other people

Table 3.5

Age/Stage	Food/Drink	When to offer	How to offer
Birth to around 6 months	Breastmilk only (or stage 1 infant formula until 12 months old if not breastfed) No other food or fluids Oral iron supplement if high risk of anaemia — see Anaemia in children	On demand	Responsive feeding when baby shows signs of hunger — see Breastfeeding
First foods Around 6 months (not before 4 months) when developmentally ready	Iron rich foods with breastmilk Iron fortified cereal (eg Farex) with expressed breastmilk or cool boiled water Mashed, minced or stewed meats, fish or eggs Mashed legumes or baked beans Offer with mashed vegetables and fruit Can also offer soft, easy to hold finger foods (eg soft fruit or vegetable pieces)	Offer food after or between breastfeeds Offer food 2–3 times a day and continue to breastfeed on demand	Do not give small, hard foods these can be choking risk. Offer soft lumps that dissolve in the mouth Offer food when baby is happy and relaxed — not when tired Sit baby on carer’s lap or in highchair to eat. Always supervise baby when they eat Give baby time to practice eating skills. Might spit out food or make faces at first. Keep offering foods that have been refused and try new flavours Let baby make a mess — try to feed themselves
As baby learns to eat After a few weeks of eating	Offer foods with lumpier textures and finger foods that encourage chewing Pieces of soft stewed meat or chicken, fish, eggs Legumes, baked beans, peanut butter Toast, damper, pasta, rice, cereals Soft vegetables and fruits Yoghurt, cheese (small amounts of full fat cow’s milk can be used in cooking and on cereal) Continue to offer regular breastfeeds until at least 12 months old — stage 1 formula is needed if not breastfed Offer cool, boiled water in a cup after and between meals	Offer food before or between breastfeeds Offer food every 2–3 hours, at least 4–6 times a day	Do not give small hard foods that are a choking risk Do not add salt or sugar to foods Offer a mixture of spoon feeding and finger foods so baby can try to feed themselves Let baby eat with the family Choose lumpy, healthy meals from family foods Sit down to eat. Walking with food is a choking risk Commercial baby foods are not needed. If used choose savoury option and feed from a spoon — not pouch
Toddlers and young children Over 12 months	Do not give tea or sweet drinks Offer water as a drink Can give up to 2 cups a day full fat cow’s milk as drink (reduced fat after 2 years) Continue to breastfeed, with healthy food, for as long as mother and child want. Solid foods should give most of the nutrition Infant formula is not needed after one year (unless prescribed by doctor or dietitian) Offer a variety of healthy foods from family meal	3 meals plus 1–2 snacks every day	Eat together as a family and serve child same healthy foods as adults It is common for toddlers to eat small amounts and be fussy Do not push children to eat or use bribes or rewards Offer food and drink regularly, every 3–4 hours Give more finger foods so children can feed themselves and involve children in choosing and making foods Offer drinks in a cup. Bottles are not needed after 1 year