Infant 6 months+ (developmental - puree)

Aim

To provide developmentally appropriate range of solids of manageable texture for children from approximately 6 months of age who have been introduced to solids and are ready for a puree texture.

Characteristics

A diet that conforms to the Nutrition standards for infants 6 months or older. Infant solids supplement breast milk and/or infant formula. Developmentally appropriate foods include infant cereals, vegetables, fruits, dairy, eggs, meat and meat products, chicken and fish.

Food is prepared without salt or sugar and with minimal fats. Texture of food is pureed to a uniform consistency. No hard or crunchy food is offered.

Note: ½ serve sizes to ensure sufficient food variety and manageable serve size.

Indications

Suitable for infants from 6 months of age, when developmentally appropriate and at parent/carer discretion.

May be combined with other therapeutic diet orders for children who have special or high nutritional needs. This diet may be combined with thickened fluids/texture modifications.

Nutritional adequacy

Nutritionally adequate.

Solids at this stage make partial contribution to nutrient requirements. Breast milk and/or infant formula provides most of nutrient requirements if age appropriate.

Age appropriate serves, e.g. ½ adult serve size, are appropriate.

Refer to Nutrition Standards – textures, serve sizes, and food sources by age for paediatric patients and Patient Choice Standard for paediatric patients for serve size requirements

Precautions

This diet is not intended to be a dysphagia diet however it can be used in combination with a texture modified diet e.g. smooth puree. Care should be taken to choose food that is suitable for the child’s age and stage of development.

Appropriate seating giving support to the head and neck should be available. Infants need to be supervised at all times when feeding to prevent choking.

For children with altered nutrition needs, additional therapeutic diet orders will affect textures and foods allowed.

Specific menu planning guidelines

Food type	Examples of allowed items	Examples of not allowed items
Hot main dishes	½ serve size Preferably one ingredient only Meats, chicken, fish pureed to a thick moist texture Pureed legumes with no husk in final puree	Large lumps Foods thicker than pureed texture
Sauces, gravies	Gravy Cheese-based/white sauce without lumps	Spicy or highly flavoured sauces Sauces with lumps
Starchy vegetables/pasta/rice	½ serve size Smooth mashed potato, sweet potato	Pasta, rice
Vegetables	½ serve size Smooth pureed sweet potato, pumpkin, broccoli, carrot All other vegetables – cooked, pureed	Salad, uncooked vegetables
Soups	None	All
Sandwiches	None	All
Salads, dressings	None	All
Breads, cereals	Iron-fortified infant cereals Strained porridge	All others
Spreads	None	All
Hot breakfast choices	Scrambled or boiled egg, pureed baked beans	All others
Fruit	Pureed soft fresh fruits, e.g. bananas, kiwifruit, watermelon Pureed canned or stewed fruit	Hard uncooked fruits, e.g. apple Dried fruit
Yoghurt	Smooth lump-free yoghurt (full-fat preferrable)	Fruit yoghurts with visible pieces or seeds
Desserts	Plain vanilla or egg custard (full-fat preferrable)	All other desserts, e.g. ice cream, jelly, cakes Reduced-fat yoghurt, custards Creamy rice
Milk and cheese	All cow's and goat's milk, milk alternatives, e.g. soy milk (all full-fat and served with cereal) Cheese – grated	Milk and milk alternatives as main beverage for infants under 12 months of age
Drinks	Breast milk Infant formula Water	Juice, cordial, soft drinks, tea or coffee Milk and milk alternatives as main beverage for infants under 12 months of age Reduced-fat milks
Biscuits	Infant rusks	All others
Miscellaneous	Starch based, locust bean (carob bean) gum and guar gum thickeners for thickening expressed breast milk (EBM) or formula or other fluids Age-appropriate cutlery	Xanthan gum-based thickeners for thickening EBM or formula or other fluids Salt and/or sugar in meal preparation Salt, pepper and/or sugar sachets Nuts, popcorn, alcohol

References

1. Agency for Clinical Innovation. Nutrition Standards.Sydney: ACI; 2024.
2. American Dietetic Association. Paediatric Nutrition Care Manual. Chicago: ADA [cited 1 Jan 2025].
3. National Health and Medical Research Council. Australian Dietary Guidelines. Canberra: NHMRC; 2013.
4. Sydney Children’s Hospital Network. Infant and baby nutrition. Sydney: SCHN; 2025.
5. Australian Breastfeeding Association.
6. National Health and Medical Research Council. Infant Feeding Guidelines for Health Workers. Canberra: NHMRC; 2012.
7. World Health Organization, UNICEF. Protecting, Promoting and Supporting Breastfeeding: The special role of maternity services. A joint World Health Organisation/UNICEF statement. Geneva, Switzerland: WHO; 1989.
8. World Health Organizaton. International Code of Marketing of Breastmilk Substitutes. Geneva, Switzerland: WHO; 1981.
9. Shaw V, Lawson M. Clinical Paediatric Dietetics. 5th ed. Wiley-Blackwell Publishing; 2020.
10. Australasian Society for Clinical Immunology and Allergy. Infant feeding and allergy advice. Sydney; ASCIA; 2023.
11. Agostoni C, Decsi T, Fewtrell M, et al. Complementary feeding: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2008;46(1):99-110. DOI:10.1097/01.mpg.0000304464.60788.bd
12. Food Standards Australia New Zealand. Food Standards Code. FSANZ; n.d. [cited 1 June 2025].
13. raisingchildren.net.au. Babies: breastfeeding, bottle-feeding & solids. raisingchildren.net.au; n.d. [cited 1 June 2025]
14. The Royal Children's Hospital Melbourne. Guide to foods: babies first year. Melbourne: RCH; n.d.
15. Dept of Health, Tasmania. Start Them Right booklet. Hobart: Dept of Health; 2024.
16. Centre for Children’s Health and Wellbeing. Baby’s first foods. Brisbane: Queensland Health; n.d.

Change log

Change date	Section updated	Change
August 2025	All	Updated general language
	Characteristics	Updated  for clarity
	Precautions	Removed general feeding advice
	References	Updated