Giving your baby a better start in life

Prepared by : ELAINE SMITH INFANT FEEDING CO-ORDINATOR , WEST LOCALTIY GEORGINA BERG INFANT FEEDING CO-ORDINATOR EAST & NORTH LOCALITY LYDIA JONES HIGHLY SPECIALIST SPEECH & LANGUAGE THERAPIST , COMPLEX NEEDS & DYSPHAGIA

QUIZ

When is my baby ready for solid food ? Your baby is ready if they can: Stay in a sitting position and hold their head steady Co-ordinate their eyes, hand mouth so that they can look at the food, pick it up and put it in their mouth all by themselves Swallow food. Babies who are not ready will push their food back out, so they get more round their face than they do in their mouths! It’s rare for these signs to appear together before 6 months.

Some signs mistaken for a baby being ready for solid foods • Chewing fists • Waking in the night when they have previously slept through • Wanting extra milk feeds • Watching parents eat True or false? Babies who are big for their age need solid foods earlier than other babies.

FALSE Babies are ready for solid food when their digestive systems are developed enough to cope usually around 6 months

First foods first! Here’s a handy guide to what foods you can offer : From 0 -6 months • Mum’s milk or infant formula From 6 months First foods: • Mashed or soft cooked sticks of fruit and vegetables or finger foods • Keep feeding mums milk or infant formula as as well Next foods: • Soft cooked meat such as chicken, • Mashed fish • Pasta, noodles • Toast, pieces of chapatti • Lentils, rice • Mashed hard boiled eggs • Full fat dairy products such as yoghurt, fromage frais or custard Introduce a cup from 6 months

From 8 -9 months • Move towards eating 3 meals a day • Mixture of finger foods, mashed and chopped foods From 12 months • 3 meals a day • They can now drink whole cow’s milk and have full fat dairy products

Create a happy mealtime environment • Make mealtimes a time for talking • Be face to face with your baby • Smile at your baby as they take their first tastes, even if they are pulling faces or seem unsure. • Observe and respond to your babies nonverbal behaviours and interpret them as communication

Link to NHS advice on the introduction to solids Video clip http: //www. bing. com/videos/search? q=NHS+introductio n+to+solids+video&view=detail&mid=E 6 BB 6629 B 884632 5 B 812 E 6 BB 6629 B 8846325 B 812&FORM=VIRE 1

INTRODUCING SOLIDS TO PRE TERM BABIES • The process of introducing solid food to your premature baby may take a little longer. • Most premature babies are ready to take solid food between five and eight months. • It is important that babies show signs of developmental readiness for the introduction of solid foods.

PRE-TERM BABIES, GETTING STARTED • Start with one meal a day and choose a time that’s best for you. • Keep feeding mums milk or infant formula as well. • Slowly introduce a wider range of foods with lumps usually one – two months after starting. • Encourage your baby to touch their food and participate in feeding. • If your baby coughs or gags gently encourage your baby and reassure them • Start to introduce finger foods and encourage your baby to finger feed.

MYTH BUSTING True or False? My child is at greater risk of not talking properly if they are not able to eat or chew properly

• Research shows that eating/chewing and speech development use different pathways in the brain. • Practising chewing skills is not going to improve speech development and vice versa.

. THINGS TO BE AWARE OF Watch out for the following when starting to feed your baby: • Sweet drinks • Cows’ milk • Sweet foods • Salt and salty food • Honey

True or false? You shouldn’t give your baby extra solid foods to stop them crying. TRUE Babies learn very quickly to use solid food or drinks from a bottle as a comforter. This could lead to weight problems later in life. A cuddle or mum’s milk is better.

Get into the habit • Always offer water with food, rather than sugary drinks. • Avoid using food as a reward. Instead, spend time with them • Offer a portion size appropriate to your babies age

Allergies Ø Introduce cow’s milk, eggs, wheat, gluten, nuts, peanut products, seeds, fish, and shellfish one at a time and not before 6 months. Ø introduce peanuts and peanut products if your baby does not have a known allergy or if there is a family history. Things to look out for: • skin reaction: blotchy, raised rashes, itchy patches and swelling around the mouth or sore, red and itchy eyes. • Breathing difficulties • Runny nose • Stomach upset If your child shows any of these symptoms, talk to your GP for advice or contact NHS 111 for non- urgent medical enquiries. If you think your is baby is suffering a severe allergic reaction, always call 999 and ask for a paramedic.

Gagging vs. Choking GAGGING • Gagging is a protective reflex and is normal. • It is commonly seen in babies and young children as they are introduced to new flavours and textures • You’ll often hear a child gag and you may see a piece of food propel forward in the mouth. CHOKING • Choking is silent • The airway is partially or fully blocked. • All children are at risk of choking, which is why advice is given to supervise babies and children at all times when they are eating and advice is given to cut grapes, cherry tomatoes etc. in half.

Video clip showing baby gagging

Safety Remember, you should always stay with your baby while they are eating in case they choke. Learn how to deal with choking by doing a first aid course

Ensure your baby is not at risk from germs as a result of food preparation and serving. • Thoroughly wash and dry all bowls and spoons for feeding in hot soapy water • Cooked food should not be reheated more than once • Cook all food thoroughly and cool it as quickly as possible to a lukewarm temperature before giving it to your baby • Wash and peel fruit and vegetables, such as apples and carrots • Avoid raw eggs and raw shellfish.

Storing and reheating food • Cool food as quickly as possible • Make sure that frozen food is thoroughly defrosted before reheating. • Reheat food thoroughly so it is very hot all the way through. • To cool food quickly, place the food in an airtight container and hold it under cold running water

Some final tips • This is an opportunity to develop good eating habits that will last your baby a life time. • Make meal times fun. • Let your baby get involved in the eating experience • Offer simple and unprocessed foods • For safety reasons, always watch your baby when they are eating. Never let them eat alone. • Never force feed your baby or put pressure on them to complete the meal. • Remember vitamin supplementation.

3 rd time lucky. . . or 15 th Eat together Homemade is How much? Tiny tums Sit up straight s sometime Jars or packets just. best

Vitamins Currently Hertfordshire County Council provides free vitamins for all pregnant women, all breastfeeding mums and babies aged from 6 months up to 4 years The vitamins can be collected from any of Hertfordshire’s children’s centres. Vouchers are not required.

We’re here to help you too Some children who experience difficulties with eating and drinking may need to see a Speech and Language Therapist. If you are concerned about your child’s eating and drinking skills, please speak to a member of the Health Visiting team in the first instance.

REFERENCES BLISS www. org. uk (2014 ) accessed 15. 07. 2015 First steps Nutrition www. firststepsnutrition. org Start 4 Life 2013 www. nhs. uk/start 4 life The Literacy Trust: www. literacytrust. org. uk/talk_to_your_baby UNICEF The Baby Friendly Initiative : unicef. org. uk/babyfriendly

Please request permission from Hertfordshire Community NHS Trust before using this presentation.