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Chapter: Paediatrics: Gastroenterology and nutrition

Paediatrics: Healthy eating for children

Breast milk is the ideal feed for almost all infants.

Healthy eating for children




·  Breast milk is the ideal feed for almost all infants.

·  Solids are not recommended until age 6mths (d food allergies).

·  Initial solids should be based on baby rice, fruit, and vegetables.

·  Gluten is acceptable from age 6mths.

·  Following introduction of solids, infants should experience and progress through a wide variety of tastes and appropriate textures.

·  Finger foods should be introduced from age 7mths.

·  Continue complementary breast or formula feeds until age 1yr. Normal full fat cow’s milk can then be introduced as the main drink.

·  Avoid addition of salt and sugar to food.

·  Low fat products are not suitable for infants.

·  Supplemental vitamins A, C, and D are recommended until age 5yrs.


Age 1–5yrs


A well balanced diet in early childhood is important to establish a lifetime pattern of healthy eating. The key recommendations for healthy eating to be achieved by age 5yrs are the following:


·  Decrease fat to 35% energy intake by avoiding excess high fat foods and changing milk to semi-skimmed at age 2yrs, and skimmed at age 5yrs.


·  Include whole grain cereals and 5 portions per day of fruits and vegetables to increase fibre intake.


·  Monitor for (accelerating weight velocity) and avoid obesity.


·  Moderate salt intake, e.g. not adding salt to cooking or at the table.


·  Avoid iron deficiency anaemia by restricting milk intake to 1 pint per day and including foods rich in iron (red meat, cereals, beans, pulses, egg yolk, dark green vegetables, and dried fruit). Add vitamin C as fruit juice at a meal to increase iron absorption. Drinking tea with meals decreases iron absorption.


·  Excessive consumption of fruit juices or squashes can contribute to chronic non-specific diarrhoea of childhood (toddler diarrhoea) and contribute to feeding problems.


Older children


Schoolchildren should eat a diet based on a wide variety of foods. Nutritional guidelines relating to school meals have been set out by many UK local authorities and healthy eating forms part of the UK national cur-riculum. A healthy diet should include:


·  At least one starchy food at each meal time, e.g. whole meal bread, potatoes, pasta, and rice.


·  Five portions per day of fruit and vegetables.


·  Two servings of meat or alternatives each day.


·  Two to three portions a day of skimmed milk, low-fat yoghurt, fromage frais, or cheese (a portion = 1 yoghurt, 1/3 pint milk, 30g cheese).


·  Only small and occasional amounts of sugar and fats


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