Infant 7 - 12 months

Aim

To provide a developmentally appropriate range of solids of manageable texture for children 7-12 months of age who are tolerating purees and are ready for texture progression to mashed, cut-up and finger food.

Characteristics

A diet that provides a minced or mashed meal for infants as a progressive step following the introduction of pureed solid foods. Meets the Nutrition standards for paediatric inpatients in NSW hospitals for infants 7-12 months of age. Main beverage continues to be breast milk and/or infant formula until 1 year of age.

Developmentally appropriate foods include cereals, vegetables, fruits, dairy, eggs, bread, pasta, rice, meat and meat products, chicken and fish.

Foods are given in combinations as well as individually i.e. casseroles. Food may be prepared with small amounts of salt, sugar and fats. Strong flavours are avoided.

Texture of food is minced and mashed to a thick and variable consistency, containing lumps (max 0.5cm pieces). Finger foods are offered such as soft fresh fruit, cheese sticks, and plain biscuits. Dissolvable solids are preferable. Soft foods that are easily mashed with a fork and soft bread can be included.

Indications

Suitable for infants from 7 months, when developmentally appropriate and at parent/carer discretion. Suitable for infants who are nutritionally well and nutritionally at-risk.

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 make a considerable contribution to nutrient requirements. However, breast milk and/or infant formula still forms an essential part of nutrient intake. This will vary depending on each individual child and their progress with solids.

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

Refer to the Paediatric Nutrition Standards for Minimum Menu Choice for serve size requirements for varying ages.

Precautions

Care should be taken to choose food that is suitable for the child’s age and stage of development.

Texture progression will develop at different rates in individual children. Inappropriate textures can present a safety risk to the child. Non-progression of solids can lead to later difficulties as children become used to a certain texture.

Solids should be offered before breast or formula to meet developmental and nutrition needs.

Breast milk or formula are still important in nutrient intake but can be given less frequently. Individual differences will depend on progression with solids. Cereals should be iron fortified.

Appropriate seating giving support to the head and neck should be available. Age appropriate cutlery should be used. 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

	Allowed	Not allowed
Hot main dishes	½ serve size Coarsely minced, tender meats or fish with a sauce Casserole dishes may be blended or mashed to reduce particle size Very soft egg dishes (e.g. scrambled eggs, soft frittata) Well cooked legumes, partially mashed and blended (e.g. baked beans) Soft tofu, in small pieces or blended	Sliced roast meats or grills Meats with gristle Crumbed or fried fish Dishes with pastry (e.g. spinach pie, quiche, pizza) Casseroles with large pieces (e.g. chicken cacciatore) Dishes with crisp topping Strong spices and flavours
Sauces, gravies	All others	Strongly spiced and flavoured
Starchy vegetables/pasta/rice	½ serve size Mashed potato Small moist pieces of pasta Well cooked rice with plenty of sauce	Dry roast/baked potato Crunchy potato Boiled new potato Rice that does not hold together Crisp or dry pasta
Vegetables	½ serve size Tender cooked vegetables that are easily mashed with a fork (e.g. carrots, pumpkin, sweet potato) or dissolvable Cooked pureed vegetables (e.g. roast pumpkin pieces, cooked zucchini) Soft uncooked vegetables (e.g. tomato, avocado)	Hard, raw vegetables
Soups	None	All
Sandwiches	All with soft fillings, cut up, using allowed breads	Crunchy/hard/stringy fillings Roast meats
Salads, dressings	None	All
Breads, cereals	Soft sliced bread – white and wholemeal with crusts Cooked breakfast cereals and ready to eat cereals that soften (e.g. Weet-Bix™) Iron-fortified infant cereals	Toast Bread with seeds or fruit, bread rolls Breakfast cereals not softened by soaking (e.g. toasted muesli) Unprocessed bran
Spreads	Butter and margarine	All others
Hot breakfast choices	Scrambled or poached eggs (chopped), baked beans, canned spaghetti, creamed corn	All others (e.g. fried eggs, crispy bacon, sausages)
Fruit	Mashed soft fresh fruits (e.g. banana, kiwifruit, watermelon) Finely diced or pureed canned or stewed fruit	Hard pieces of fresh fruit (e.g. apple pieces >0.5cm, grapes) Dried fruit
Yoghurt	All yoghurt and Frûche® (including soft fruit)	-
Desserts	Custard, creamy rice	Any desserts with fruit pieces, seeds, nuts, crumble, pastry or non-pureed garnishes Cakes Ice-cream Jelly High fat/sugar desserts
Milk and cheese	Full fat cows’ milk with cereal Cheese	Cows’ milk as main beverage for infants under 12 months of age Reduced fat milks
Beverages	Breast milk Infant formula Water	Juice, cordial, soft drinks, tea or coffee Cows’ milk as main beverage for infants under 12 months of age Reduced fat milks
Biscuits	Plain biscuits or crackers	Cream biscuits, choc coated biscuits Highly salted, highly flavoured biscuits Biscuits with nuts or hard pieces that don’t dissolve
Miscellaneous	Starch based, locust bean (carob bean) gum and guar gum thickeners for thickening EBM or formula or other fluids	Xanthan gum based thickeners for thickening EBM or formula or other fluids Salt, sugar in meal preparation Salt, pepper, sugar sachet Nuts Popcorn Sultanas Alcohol

References

1. Agency for Clinical Innovation. Nutrition standards for paediatric inpatients in NSW hospitals. Sydney 2011.
2. Agency for Clinical Innovation. Nutrition standards for adult inpatients in NSW hospitals. Sydney 2011.
3. Dietitians Association of Australia. 2009. Nutrition Manual 8th ed. Canberra: DAA.
4. American Dietetic Association. Paediatric Nutrition Care Manual. Chicago: ADA.
5. NHMRC 2003 Dietary Guidelines for Children and Adolescents in Australia.
6. Sydney Children’s Hospital Network factsheets on Breastfeeding, Breastfeeding – Is it for me?, Baby's first foods, and Preparation of Infant Formula.
7. Australian Breastfeeding Association.
8. Infant Feeding Guidelines for Health Workers. NHMRC 1996.
9. Baby-Friendly Hospital Initiative
10. Shaw V and Lawson M. Clinical Paediatric Dietetics. 3rd Edition. 2007. Blackwell Publishing.
11. Australasian Society for Clinical Immunology and Allergy. 2008. Infant feeding advice.
12. Agostoni C, Decsi T, Fewtrell M, Goulet O, Kolacek S, Koletzko B, Fleischer Michaelsen K, Moreno L, Puntis J, Rigo J, Shamir R, Szajewska S, Turck D, van Goudoever J. 2008. Medical Position Paper – Complementary Feeding: A Commentary by the ESPGHAN Committee on Nutrition. Journal of Pediatric Gastroenterology and Nutrition 46:99-110.
13. NSW Ministry of Health. Breastfeeding in NSW: Promotion, protection and support. 2011.
14. Food Standards Code FSANZ.

Change log

August 2021

Section updated	Change
Specific menu planning guidelines - Spreads	In Allowed, deleted All
	In Allowed, added Butter and margarine
	In Not Allowed, added All others