1. Supportive resource for:

2. When do you know a baby is ready to wean?  From a developmental perspective:  Physically  Gross physical development  Fine motor development  What social aspects should you consider when weaning an infant?  Infants with ie severe cerebral palsy

3. What should you give babies from birth to six months?  Breast feeding is best  Parents decisions re formula milk  Issue of vit D deficiency for breast feeding mothers  Premature infants  Donor breast milk

4. Why shouldn’t you wean before 6mths: the info you need as student nurses  Digestive enzymes are not in sufficient quantity till 4-6mths of age  Gastric secretions less acidic than older children and adults  Smaller stomach capacity  Maturity of cardiac sphincter  Breast milk designed to match gut maturity  In babies peristalsis is faster so food wouldn’t stay long enough in the stomach to be digested  Liver function is immature right up to 1yrs including vitamin storage  Reduce risk of developing atopic conditions

5. 6mths onwards  What foods do you start with  texture  How much  Nutritional aspects ie Vit D guidance  http://www.dh.gov.uk/health/2012/02/vitami n-d/ http://www.dh.gov.uk/health/2012/02/vitami n-d/  Baby led or spoon fed debate

6. Infant drinks  what is follow on milk?  What is the current advice about follow on milk  Why?  Why not tea or coffee?  What about other drinks?  What age should you start using a beaker rather than a bottle during the day? Why?  Why should you use a free flow beaker rather than a non spill one?

7.  http://www.nhs.uk/news/2012/02February/Pa ges/spoonfeeding-baby-led-weaning- obesity.aspx http://www.nhs.uk/news/2012/02February/Pa ges/spoonfeeding-baby-led-weaning- obesity.aspx  Weaning video for parents NHS choices

8. What are the safety issues in relation to weaning infants?

9. How would you know if the child had a food allergy?  Which infants are more likely to develop a food allergy  What are the most common food allergies  What about food additives?  How will you know if the child is having an allergy to a food?

10. Further reading  Berry NJ, Jones SC, Iverson D (2011) relax, you are soaking in it: sources of information about infant formula. Breastfeeding review. 19(1):9-18  http://www.nhs.uk/start4life/pages/babies-introducing-solid-food.aspx http://www.nhs.uk/start4life/pages/babies-introducing-solid-food.aspx  Dept of Health (2008) Weaning. Starting solid food. London. DoH. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_084164.pdf (aimed at parents) http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_084164.pdf  Frewtrell M, Wilson D, Booth I, Lucas A (2011) Six months of exclusive breastfeeding: how good is the evidence? BMJ 2011; 342:c5955http://www.bmj.com/cgi/doi/10.1136/bmj.c5955http://www.bmj.com/cgi/doi/10.1136/bmj.c5955  McNiel ME ; Labbok MH ; Abrahams SW (2010) What are the risks associated with formula feeding? A re-analysis and review. Breastfeeding Review.18(2): 25-32  Meyer R (2009) Infant feeding in the first year. 2: feeding practices from 6-12 months of life. Jnal of Family Health Care ; 19(2): 47-50  Ntouva, A. ; Rogers, I. ; MacAdam, A. ; Emmett, P. (2011) Weaning practices and iron status of exclusively breast fed infants. Journal of Human Nutrition & Dietetics. 24(3): 297-8  Olson BH, Horodynski MA, Brophy-Herb H, Iwanski KC (2010) Health professionals' perspectives on the infant feeding practices of low income mothers. Maternal & Child Health Jnl. 14(1): 75-85  Public Health Agency (2010) Weaning made easy, moving from milk to family meals. www.publichealth.hscni.net/sites/default/files/weaning_0.pdf – for parentswww.publichealth.hscni.net/sites/default/files/weaning_0.pdf  Public Health Agency (2011) PHA Statement on exclusive breastfeeding and recommendations for the introduction of solid foods at six months. http://www.publichealth.hscni.net/news/pha-statement-exclusive-breastfeeding-and- recommendations-introduction-solid-foods-six-months. accessed June 2012http://www.publichealth.hscni.net/news/pha-statement-exclusive-breastfeeding-and- recommendations-introduction-solid-foods-six-months  Smith HA (2012) Formula supplementation and the risk of cow's milk allergy. British Jnl of Midwifery 20(5): 345-50