Healthy childhood

Babies grow and develop at a very rapid rate during the first year and so it is important that they receive good nutrition. Babies go through various stages - from being solely breast and/or formula fed, to the introduction of complimentary foods and then the transition to family foods. Each stage can present its own challenges and can be a learning experience for both infants and parents/carers. Resources provide information and support but remember, you can always contact your health visitor if you need more advice.

Breastfeeding: Breastfeeding is recommended as it contains the nutrients your baby needs, and there are many health benefits for both the mother and baby. For the first 6 months, exclusive breastfeeding is recommended, then from 6 months your baby can be introduced to food alongside breastfeeding up to 2 years, or beyond. Whilst breastfeeding it's important that the mother eats a healthy, balanced diet.

Formula feeding: Some parents may be unable to breastfeed or choose not to breastfeed, and will use formula milk instead. Formula is normally used up to 1 year, then babies can transition to whole cow's milk, or a milk-free alternative.

Weaning: Babies are usually introduced to foods from around 6 months, which is often called weaning or complimentary feeding. Solid foods help provide additional nutrients alongside their usual milk. At first babies start with only a very small amount of food, once a day, and gradually this can be increased to 3 meals a day. Some days your baby may eat more than others which is normal.

Some parents choose to wean babies onto smooth purees first, followed by lumpier textures, whilst others choose finger-sized pieces of food which the baby can feed themselves. Either option is fine but it's important to introduce your baby to a range of different foods, tastes and texture. Babies should be introduced to all of the food groups, to ensure a wide range of nutrients. Babies do not need any salt or sugar added to their food, honey should be avoided up to 1 year, and be aware of food such as whole nuts or grapes which your baby could choke on. Start4Life have lots of recipe suggestions.

Allergens: For children with no known allergies, it's important to expose babies to allergens early on in their weaning journey. Start with small amounts, gradually increasing in size, with only one allergen at a time, to help identify any reactions. Common allergens include: milk, egg, soya, wheat, legumes, nuts, seeds, fish and shellfish. Allergy UK have useful advice on introducing foods that commonly cause allergies.

If your baby has a higher risk of allergies, it's important to speak to your health visitor or GP. Find out more about allergies, including symptoms to look out for.

Premature Babies: Around five months corrected age is the youngest age a premature baby may show cues that they are ready to begin weaning. Before this time, they probably won’t have developed all the skills they need to eat solid foods. 

By around six months corrected age many babies are ready to begin solid foods. Go by your baby’s cues and if they are not ready by this time it’s okay to leave it another week or two. If your baby is still not showing readiness cues to wean by seven months corrected age, contact your Health Visitor for advice.  

Bliss is a useful website for premature babies.

Vitamins: From birth, most babies should be given an age appropriate multivitamin liquid or drops, containing Vitamin D, including those who are breastfed. Breastfeeding mothers should also consider taking a Calcium and Vitamin D supplement. Babies who have more than 500ml of infant formula, do not require a supplement. You can check if you're eligible to free Healthy Start Vitamins. If eligible for Healthy Start you can also receive money towards buying milk, fruits and vegetables for your child.

Important things to consider for toddlers between 1 and 4 years include providing the right amount of nutrients for normal growth and development, the right amount of energy for a healthy weight and a balanced diet with lots of variety to help young children develop a liking for healthy foods. Young children have small stomachs and eat smaller amounts, often in the form of regular meals and snacks. Young children are naturally good at managing their own hunger and fullness cues, and their appetites can vary day-to-day. Thus it's important to allow your child to decide how much they eat. The Eatwell guide is not the best tool to use for under young children as some of the advice does not apply.  A more appropriate tool for this age group is British Nutrition Foundation's 5532-a-day.

• Starchy Carbohydrates: 5 portions of starchy carbohydrates should be offered a day, within meals and snacks. It's important to choose a mix of white & wholegrains in under 2s, as wholegrains contain more fibre which can fill small tummies quickly. From 2-5 years, increase to mainly wholegrains.
• Fruits & Vegetables: 5 or more portions of fruits and vegetables should be offered a day. It's important to include a wide variety to help expose children early on, helping them develop a liking for different flavours. A fruit or vegetable portion is likely to be around the size of your child's fist or handful. Fruits and vegetables can be offered as a snack, with a main meal, or mixed into a meal. Dried fruit should only be offered at mealtimes due to the sugar content.
• Dairy: 3 portions of dairy foods should be offered daily, the equivalent of a total of 350ml of milk, to help meet children's calcium requirements. Whole milk should be given up to 2 years, and semi-skimmed can be offered from 2 years. Milk-free alternatives like soya or oat milks, must be fortified with calcium and other nutrients, and rice milk must be avoided due to the high levels of arsenic. Other dairy foods include yoghurts, cheeses and more.
• Protein: 2 portions of protein should be offered daily, 3 if vegetarian. These foods are often high in iron including red meat, pulses and nut butters. Fish should be included at least twice a week, processed meats limited due to salt content and whole nuts should be avoided due to the choking risk.

HFSS: It is recommended that toddlers should avoid consuming sugar and salt, avoiding all foods with added sugar and limiting salt intake to no more than 2g/day. Rather than lots of crisps, sweets and biscuits, it's important to choose healthier foods.

Hydration: Toddlers should be drinking around 1L/day, split across 6-8 drinks of 120-150ml, and should mainly be water and plain milk. Young children may need to be reminded to have regular drinks. Fruit juice should be limited, and no tea, coffee, fizzy or sugary drinks should be given.

Vitamins: All toddlers are recommended to have a multivitamin, to ensure they are meeting their requirements. Drops or liquid are recommended for babies & toddlers, and a chewable vitamin can be given from 3 years. You can check if you're eligible to free Healthy Start Vitamins. If eligible for Healthy Start you can also receive money towards buying milk, fruits and vegetables for your child.

Children between 5 and 11 are developing habits for life. It's important to encourage your child to eat a diet full of variety, meeting all of their nutrient requirements. Children are beginning to make more choices about what they eat and it's important to give your child some choice, such as offering peas or carrots with their dinner. Getting children involved with shopping for food, preparing meals and talking about foods can make trying new foods a more enjoyable experience.

Children 5-11 years can follow the Eatwell guide for advice on healthy diets and food groups. The nutrients found in these food groups are important for children and should be offered every day, including;

• Fruits & Vegetables: Children should be having 5 or more portions a day, with one portion being about the size of your child's fist or handful.
• Starchy Carbohydrates: Children over 5 should be having mainly wholegrains as these contain more fibre so are healthier and more filling. It's a good idea to base every meal around starchy carbohydrates to make sure your child is getting enough energy, as children are growing rapidly and can be very active.
• Protein: A variety of protein sources should be eaten 2-3 times a day, including oily fish once a week as they contain omega-3s which are essential for normal brain development.
• Dairy: Calcium-rich foods are important for children of this age so try to aim for three servings a day. Lower fat options like semi-skimmed milk can be introduced as theses tend to have the same amount of calcium and other nutrient compared to full fat varieties. If using milk-free alternatives, choose ones fortified with calcium and other nutrients. Various alternatives (including rice milk) are appropriate for children in this age range.
• Oils & Spreads: Choose mainly unsaturated and in small amounts.

The Eatwell guide shows how much of each food should be eaten, e.g. a third fruits & vegetables, a third carbohydrates, and the final third spilt between protein, dairy and oils & spreads. The overall amount of food your child needs to eat will depend on many things including their age and how active they are. Children are usually good at managing how hungry or full they are and using your child's hand as a guide for portion sizes is a good place to start.

HFSS: Foods high in fat, salt and sugar should be eaten less often. Avoid adding salt to children's meals and limit salt intake to no more than 5g/day. Sugar should be limited to no more than 5-6 cubes of added sugar/day (19g-24g). We do not need to worry about natural sugar in whole fruits and vegetables, or plain milks and yoghurts.

Hydration: Children should be drinking around 1.1-1.4L/day, split across 6-8 drinks of 150-200ml, and should mainly be water and plain milk. Children may need to be reminded to have regular drinks. Fruit juice should be limited, and no tea, coffee, fizzy or sugary drinks should be given. Fizzy drinks can harm children's teeth, including sugar-free because of the acid in them.

Vitamins: You may wish to consider buying an age-appropriate multivitamin for your child, to ensure they are meeting their requirements.

School Meals: School-aged children usually eat at least one meal a day at school. School meals can be a good choice as they have to meet national standards around healthy food. Children in Reception, Year 1 and Year 2 receive Universal Infant Free School Meals. Families on lower incomes should check if they're eligible for benefit-based free school meals.

If choosing to give your child a packed lunch, it's important to make sure it's healthy by having at least one of their 5-a-day, and limiting treats. NHS Healthier Families have some brilliant information including lunchbox recipes and tips.

Teenagers have quite a good understanding of healthy eating, and they may have much more choice over what they eat, such as choosing their school lunch, or visiting a shop while out with friends. The Eatwell guide is the best tool for understanding what a healthy, balanced diet looks like for teenagers, as this contains information about food groups, hydration and traffic light labels. A healthy balanced diet is important during this stage of growth. As teenagers begin to become more independent they may choose less healthy options, and/or may become more aware of their bodyweight. If you are concerned about your teenager's bodyweight you can use the NHS BMI calculator to check if they're a healthy weight.

Top tips for teenagers:

• Ensure three balanced meals, plus healthy snacks - teenagers often skip breakfast, but it's important they meet their energy and nutrient requirements throughout the day.
• Teenagers may choose less healthy snacks when out with friends, so making sure there is a range of healthy snacks at home, that they can take out with them can help teenagers make healthier choices.
• Talk to teenagers about reading labels on foods so they can see which foods are high in fat, sugar and salt. Foods high in fat, salt and sugar should be eaten less often. Limit salt intake to no more than 6g/day and sugar to no more than 7 cubes of sugar/day (30g). We do not need to worry about natural sugar in whole fruits and vegetables, or plain milks and yoghurts.
• Calcium is a key nutrient for teenagers - bones are continuing to grow and strengthen during teenage years. More information on calcium can be found here.
• Iron is a key nutrients for teenagers, especially in girls due to periods and almost 50% of teenage girls don't get enough iron. Iron is important for red blood cells which carry oxygen. More information on iron can be found here.
• Teenagers sometimes choose energy drinks which contain high amounts caffeine, which can cause headaches, tiredness and sleeping issues. It's important for teenagers to limit their caffeine intake and focus on mainly drinking water (2-2.5L/day).

School Meals: Teenagers usually eat at least one meal a day at school. School meals can be a good choice as they have to meet national standards around healthy food, but there is a lot more flexibility and choice in Secondary schools, which can mean teens choose less nutritious options. Families on lower incomes should check if they're eligible for benefit-based free school meals.

If choosing to give your child a packed lunch, it's important to make sure it's healthy by having at least one of their 5-a-day, and limiting treats. NHS Healthier Families have some brilliant information including lunchbox recipes and tips.

Vitamins: You may wish to consider buying an age-appropriate multivitamin for your teenager, to ensure they are meeting their requirements.