NB chat to Georgia, all about nutrition, nuts and baby weaning

This month we have been very lucky to snatch a few minutes with Georgia, a Registered Nutritionist who specialises in maternal, infant and child nutrition.

Georgia works for the NHS in East London, as a Senior Nutritionist for an Early Start Group. She is responsible for delivering nutrition training and support within early years settings (for example, nurseries, children’s centres and childminders).

Children are spending more time within childcare and it is vital early years practitioners have a firm understanding of good nutrition for children under 5.

We asked Georgia a few questions on the mind boggling complexities of weaning and nutrition to see if she could help clear up our thinking and generally make the whole thing much less confusing.

Which guidelines do you recommend following when starting to wean your child?

In the UK (which is supported by World Health Organisation advice) we recommend introducing babies to solid foods at around 6 months.

Some of Georgia’s top tops are:

  • Lots of variety and texture (banana v potato)
  • Simple foods which are easy to distinguish
  • No sugar, salt, spice
  • Eat with your baby (when you can!)
  • Try not to worry if your baby eats nothing one day then plenty the next. Look at the bigger picture and reflect on how much they’ve eaten over the course of a week/month

The big question around nuts

Georgia gave us lots of helpful advice here.

She said “Nuts, including peanuts, can be introduced to your baby from around the age of 6 months, as long as they are crushed, ground or a smooth nut butter. Whole and broken nuts however aren’t suitable for children under the age of 5 as their size makes them a choking hazard”.

The most recent guidance from the Scientific Advisory Committee on Nutrition (SACN) states that ‘allergenic foods such as peanuts, hen’s egg, gluten and fish can be introduced from around 6 months of age and need not be differentiated from other solid food’. In fact, the deliberate exclusion or delayed introduction of allergen foods, including nuts, beyond the age of 6 to 12 months may increase a child’s risk of allergy.

“When you start to introduce your baby to solids at around 6 months, introduce allergen foods, one at a time and in very small amounts. That way, if you do spot any reaction, you are more easily able to pinpoint which food could have caused it”. For more information on Food Allergies in babies and young children I recommend visiting- https://www.nhs.uk/conditions/pregnancy-and-baby/food-allergies-in-babies-and-young-children/

Note: if there is a history of food allergies and/or other types of allergies in your family, you should speak to your GP or Health Visitor before introducing nuts and peanuts to your baby. It’s more likely your baby will have a food or other allergy if they come from an ‘atopic’ family (a family where one or both parents have eczema, hay fever or asthma, or have food allergies themselves).

In what format should you give your baby nuts initially?

Georgia recommends offering nuts that are finely crushed, ground or in the form of smooth nut butters.

“Nut butters are really versatile and a great way of adding protein, iron and other important nutrients into dishes for babies and toddlers. Good examples include porridge, thinly spread on a sandwich, dip for fruit and veggies or a dollop in a stew or curry”.  

How much should you be giving, and should you be giving a variety of different nuts?

“You can introduce your baby to a variety of nut butters from the age of 6 months as we know that different nuts contain different beneficial nutrients. There aren’t any current guidelines on how much nut butter to offer babies and toddlers; just add a little to the meals and snacks of your choosing. Remember, that it’s all about getting your baby familiar with a wide range of tastes, textures and flavours!”.

What are the allergen signs that you should be looking out for?

The NHS states that an allergic reaction can consist of 1 or more of the following:

  • Diarrhoea or vomiting
  • A cough
  • Wheezing and shortness of breath
  • Itchy throat and tongue
  • Itchy skin or rash
  • Swollen lips and throat
  • Runny or blocked nose
  • Sore, red and itchy eyes.

Additional NHS advice

If you think your child is having an allergic reaction that’s related to food, talk to your GP for advice, or call NHS Direct on 111 for non-urgent medical enquiries.

In rare cases, foods can cause a severe allergic reaction known as anaphylaxis, which can be life- threatening. If you think your baby is suffering a severe allergic reaction, always call 999.

If you suspect that your child has a food allergy don’t attempt to experiment by cutting out a major food as this could result in your child not getting the nutrients they need. It’s best to speak to your GP or Health Visitor for advice and a possible referral to a registered Dietitian.

Finally we asked Georgia the difference between traditional weaning and baby led weaning

“Baby- led weaning (BLW) has become an increasingly popular method of feeding. It refers to offering only fingers foods when you begin to introduce baby to solids (avoiding pureed or mashed foods on a spoon) and encourages them to feed themselves from the start. Some families prefer to follow the BLW approach, rather than the more traditional spoon feeding approach, while other families do a bit of both”.  

Research around BLW vs. traditional spoon feeding is inconclusive. “One of the benefits often cited around the BLW approach is the increased acceptance of foods, however the evidence is mixed. Some research has also suggested that babies who feed themselves are more likely to control their appetite, and perhaps reduce their risk of obesity later in life; however other research suggests that’s not the case”.   

We know that no matter what approach you take it’s important to introduce your baby to a variety of tastes and textures. The latest guidance from the UK Government in the Feeding in the First Year of Life report states: “Skills such as munching and chewing can only be acquired with experience and exposure to progressively firmer food textures. There is insufficient evidence to give detailed guidance on the speed of progression of solid food textures, but observational evidence suggests that exposure to lumpy foods before 9 months may be beneficial.” While the BLW approach encourages finger foods from the beginning, it’s important to remember that the more traditional spoon feeding approach also encourages the introduction of lumpy and fingers foods by the age of 7 months.

“So in conclusion, there really is no right or wrong way to introduce your baby to solid foods! The most important thing is that you offer baby a wide variety of foods so they are exposed to different tastes and textures and get all the nutrients they need. Remember that every baby is different and you know your baby best, so follow their lead at mealtimes!”.

A few tips around offering finger foods:

·         Start with soft finger foods that will easily dissolve or disintegrate in baby’s mouth. As baby becomes more confident you can introduce firmer finger foods.

Check out First Steps Nutrition for lots of finger food ideas: https://static1.squarespace.com/static/59f75004f09ca48694070f3b/t/5a5a41479140b7e31a75ccbc/1515864404727/Eating_well_the_first_year_Sep_17_small.pdf

·         Don’t worry if baby doesn’t have any teeth yet as their gums are strong (the teeth are just below the surface)

·         It can be useful to make the finger foods slightly bigger than baby’s hand, so that they can grip things in their fist. The size of an adult finger is a good guide

·         Don’t give baby pieces of sausage, chunks of meat or cheese, whole grapes and nuts or chunks of raw vegetables or fruit that could be swallowed and lodged in the airway

·         Wash any fruits and vegetables you offer baby

·         Remove tough skin, pips, seeds and stones

·         Make sure you always sit with baby when they eat

·         While it can seem scary, gagging is a perfectly normal reflex. Gagging is the safety mechanism that helps reduce the risk of babies choking as it helps bring food back to the front of the mouth. As baby gets used to lumpy and fingers foods the gag reflex moves further to the back of the mouth

·         If you’re still worried about choking. Visit the NHS website for more information: https://www.nhs.uk/conditions/pregnancy-and-baby/helping-choking-baby/

Future reading

There are so many websites related to weaning and it is overwhelming, Georgia recommends sticking to ones that are evidence based. The list below is a good starting point.

Start4Lifehttps://www.nhs.uk/start4life/weaning/

NHShttps://www.nhs.uk/conditions/pregnancy-and-baby/solid-foods-weaning/

First Steps Nutrition (fantastic recipe ideas including some using nut butters- e.g. sweet potato stew, peanut butter and banana sandwiches)-  https://static1.squarespace.com/static/59f75004f09ca48694070f3b/t/5a5a41479140b7e31a75ccbc/1515864404727/Eating_well_the_first_year_Sep_17_small.pdf

Early Start Nutrition– for a range of blogs containing tips and information- https://www.earlystartgroup.com/category/nutrition-services/infant-nutrition-blogs/