Quality statement 5: Advice on introducing solid food

Quality statement

Parents and carers are given advice on introducing their baby to a variety of nutritious foods to complement breastmilk or formula milk.

Rationale

It is important that babies aged around 6 months are started on solid food, with the introduction of suitable foods in addition to breastmilk or formula milk to establish a healthy and varied diet. This ensures that a varied and nutritionally adequate diet is already in place when breastmilk or formula milk are no longer given. Involving parents and carers in discussions about starting solid food when they attend the 6–8 week health visitor appointment with their baby helps them to introduce solid food when their baby is around 6 months, minimising poor infant outcomes associated with starting solid food earlier or later.

Quality measures

Structure

a) Evidence of local arrangements to advise parents and carers how to introduce a variety of nutritious foods to their baby to complement breastmilk or formula milk.

b) Evidence of local arrangements to advise parents and carers when to introduce a variety of nutritious foods to their baby to complement breastmilk or formula milk.

Data source: Local data collection.

Process

a) Proportion of 6–8 week health visitor appointments where parents and carers receive advice on how to introduce their baby to a variety of nutritious foods to complement breastmilk or formula milk.

Numerator – the number in the denominator where the parents and carers receive advice on how to introduce their baby to a variety of nutritious foods to complement breastmilk or formula milk.

Denominator – the number of 6–8 week health visitor appointments.

Data source: Local data collection.

b) Proportion of 6–8 week health visitor appointments where parents and carers receive advice on when to introduce their baby to a variety of nutritious foods to complement breastmilk or formula milk.

Numerator – the number in the denominator where the parents and carers receive advice on when to introduce their baby to a variety of nutritious foods to complement breastmilk or formula milk.

Denominator – the number of 6–8 week health visitor appointments.

Data source: Local data collection.

Outcome

a) Introduction of solid food at around 6 months.

Data source: Local data collection.

b) Infant obesity rates.

Data source: Local data collection.

c) Faltering infant growth.

Data source: Local data collection.

What the quality statement means for service providers, health and public health practitioners, and commissioners

Service providers (community providers) ensure that systems are in place for parents and carers to be advised on how and when to introduce their baby to a variety of nutritious foods to complement breastmilk or formula milk.

Health visitors ensure that they work with parents and carers, advising them at the 6–8 week appointment on how and when to introduce their baby to a variety of nutritious foods to complement breastmilk or formula milk.

Commissioners (such as clinical commissioning groups, NHS England and local authorities) specify that providers advise parents and carers how and when to introduce their baby to a variety of nutritious foods to complement breastmilk or formula milk.

What the quality statement means for service users and carers

Parents and carers are given advice on how and when to introduce their baby to different types of nutritious foods to complement breastmilk or formula milk. The health visitor explains that they should start their baby on solid food at around 6 months and introduce a wide variety of different foods to give their baby a healthy and varied diet in the first year, in addition to breastmilk or formula milk. This will help the baby to be healthy, support the development of motor skills and speech and language, and help the baby to stay at a healthy weight. Advice should also be given about the texture of food, the use of finger foods and how parents and carers can reduce the risk of choking.

Source guidance

Definitions of terms used in this quality statement

Advice on introducing their baby to a variety of nutritious foods

This is advice that includes, but is not limited to:

  • the reasons for starting solid food at around 6 months

  • the possible effects on the baby of starting solid food earlier or later

  • the reasons for continuing breastfeeding

  • maximising breastmilk or increasing infant formula feeds for a baby under 6 months who is feeding more frequently.

This information can be given by the health visitor at the mandated 6–8 week appointment.

[Expert consensus]

Equality and diversity considerations

This information should be culturally appropriate. It should also be accessible to people with additional needs such as physical, sensory or learning disabilities, and to people who do not speak or read English. Parents and carers should have access to an interpreter or advocate if needed.

People from some religious groups introduce solid food to babies when they are considerably older than 6 months of age. Health visitors should be mindful of different behaviours and beliefs while highlighting the importance of introducing a range of foods at around 6 months. This requires sensitive communication to inform parents and carers of the possible impact on their baby's health.