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Recovering from a heart attack - patient information

Description: This booklet has been produced by the cardiac rehabilitation team to help you and your family understand more about your condition
Url: /Media/UHS-website-2019/Patientinformation/Heartandlungs/Recovering-from-a-heart-attack-1363-PIL.pdf

Recipe book - For babies who need to make the most of every mouthful

Description: RECIPE BOOK For babies who need to get the most out of every mouthful Contents 04 06 11 14 15 16 18 20 22 Acknowledgements & introduction Getting started... and useful tips Weaning advice (chart) Simple feeding plan for the first month (chart) Simple week meal planner (chart) Some general advice Shopping list Recipes: Contents Recipes: Veggies � Sweet potato & cashew butter � Peas, potatoes & mint � Butternut squash, peanut butter & cinnamon � Peas & carrots Recipes: Fruit � Prunes, apricots & ground almonds � Peaches, sultanas & baby rice � Mango & almond butter � Raspberry, banana & almonds Recipes: Colours of the rainbow � PURPLE: Plum, aubergine & blueberry � RED: Beetroot, apple, red pepper & cashew butter � ORANGE: Sweet potato, butternut, carrot & cinnamon � YELLOW: Mango, yellow courgette, sweet corn & turmeric � GREEN: Pea, kale, pear & avocado � WHITE: Apple, cauliflower & celeriac Recipes: Growing up � Pollock, carrots, kale, butternut squash & potato � Avocado, apple, lentil, broccoli, courgette & mint � Beef & prunes with mashed potato � Aromatic chicken & rice � Mauritian lamb with lentils & rice Recipes: Family favourites � Fish fingers & sweet potato chips � Bobotie � Pasta bolognaise � 1st Birthday cake 24 26 32 36 enjoy... 02 Acknowledgements This book has been written by Dr Luise Marino (RD, PhD) Clinical Academic Paediatric Dietitian at Southampton Children's Hospital. This book is part of independent research arising from a (Dr Luise Marino, Health Education England/NIHR Clinical Lectureship (ICA-CL-2016-02-001) supported by the National Institute for Health Research. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research, Health Education England or the Department of Health. The following people have provided generous help and feedback: � Parents of babies who need to make the most of every mouthful � thank you for your time and feedback, without which this book not be possible � Paediatric Dietitians � Catherine Kidd, Natalie Davies, Sian Phillips, Carol Fudge, Jennifer Hoare � for your expertise and invaluable comments � Paediatric Speech and Language Therapists � Lowri Daniel, Julia Robinson, Lucy Cuthbertson � for your guidance and practical instruction � Dr Rosan Meyer � for being so giving of her expertise and generously allowing us to adapt her weaning advice table � Specialist Paediatric Cardiac Liaison Nurses � Gill Harte, Colette Cochran, Cate Anson and Dr Tara Bharucha Consultant Paediatric Cardiologist � for your unfailing support and advice � Southampton Children's Hospital Charity and the publishers � Michelle Wheeler, Judith Stephens, Amy McBrayne, Alanna Lee for making it all possible � Angela Award Brown � for giving her time and photography for this book (http://www.feastsshootsandleaves.co.uk) and WhitSpaces, Arlseford for allowing us to use their incredible space � Heather Pierpoint (headfudgedesign.co.uk) � Graphic designer for bringing the publication to life Dedication For all the families and their precious babies who we are privileged to meet � your stories and journeys inspire us to do better. RECIPE BOOK For babies who need to get the most out of every mouthful From around 6 months � 12 months of age Who is this book intended for? Some babies are born with conditions which mean they need to get the most out of everything they drink and eat. These babies include those with congenital heart disease (CHD), cystic fibrosis (CF) and some babies who are born too early. For lots of different reasons weight gain and feeding problems are common amongst these babies and as a result some do not gain weight well. We have heard from parents that much of the advice available on parenting and baby websites does not give enough information to help with weight gain and moving babies onto food, which is why we have decided to write this book. This recipe book is the first of a series where we hope to provide practical advice as to how to get the most of our every mouthful. The recipes and advice within this booklet will not be suitable for infants with inherited metabolic disorders, kidney problems and for those with food allergies. If your baby has a food allergy or there is a history of food allergies in the family discuss food introduction with your paediatric dietitian. If you are unsure, please check with your dietitian/speech and language therapist or health care team about any of the information contained in this book. This book is not meant to replace medical advice and you should seek advice from your local health care professional if your baby is not gaining weight well or is having feeding difficulties. The information in this recipe book does not replace individualised dietetic or speech and language advice that has been adjusted for a child's oral motor skills. The information is correct at the time of publishing, and undergoes periodic reviews to ensure up-to-date evidence is used. Dr Luise Marino (RD, PhD) Clinical Academic Paediatric Dietitian HEE/NIHR ICA Clinical Lectureship Endorsement "As a new mum who is just about to start her baby's first weaning process it's so important that parents and carers get access to good dietary information, particularly if your child needs to get the most of every mouthful. This book has been created not only to support families through this process but with every penny raised going directly to the children's hospital to fundraise for valuable services to improve the life of children across the region" � Shelina Permalloo � Southampton children's hospital charity ambassador and winner of MasterChef winner 2012, restaurateur Lakaz Maman, Bedford Place, Southampton thank you 05 Getting started... What to expect in the beginning... Weaning your baby can be both an exciting and daunting process. Starting solids is a huge event for your little one. Up until now, they have only had the tastes of milk and medicine. But all of sudden there's a whole new world of tastes and textures to explore. Babies are not born knowing how to eat so don't be surprised if your little one isn't quite sure what to do, or if food is spat back out to begin with. As with drinking milk some babies find weaning easier than others, so try not to compare your little one to other babies or indeed other siblings. They will still be getting most of the nutrients they need from milk, so how much your baby eats is less important than getting them used to the idea of trying new flavours and textures. Ages and stages All babies are different � some babies take longer to move from the different texture stages, this is quite normal. Below is a general guide based on baby foods available in the supermarket. It also gives an idea of what home made foods should look like. � Stage 1: Smooth purees are best made with a blender and can be either - Thin puree runs easily off a spoon - Standard puree drops easily off a spoon - Thick puree can be eaten with a spoon � Stage 2: Thicker puree with tiny very soft lumps � Stage 3: Mashed foods usually blended - Thick puree with less sauce and small moist soft lumps around � the size of a 5p piece � Stage 4: Fork mashed and chopped are soft foods mashed down with a fork - Thick with small moist soft lumps around the size of a 5p � 10p piece Complementary food can be introduced from 17 weeks of age and by 6 months of age, depending on your little one's feeding readiness and oral skills To help you and your little one get started, here are some useful hints and tips for those first feeds � Always sit with your little one when they are eating � never leave them alone with food � Choose a time when both you and your little one are relaxed and there is not too much going on � usually mid-morning or lunchtime � After the first week or so you can introduce a new taste every few days to help expand the variety of foods they eat. Think of a rainbow and introduce a range of different coloured foods � Sit your baby in a supportive chair, or if able to sit, in their high chair. Use a small soft-flat weaning spoon and offer a very small amount When introducing something new... � Change only one thing at a time e.g. making a familiar flavoured pur�e slightly thicker or lumpier, or keep a familiar texture when you introduce a new food � Encourage your baby with smiles and sounds. It's important for them to know they're doing well � If possible have something to eat at the same time so they can see you are enjoying food too � Make gradual changes to texture sometimes just by adding a � a 5p piece amount of slightly lumpier food aid course which provides advice on what to do if your baby chokes on food � Remember all of the senses are involved in eating and drinking; smell, touch, sounds, sight and smells; - We eat food with our eyes, so it is important to make food look good - Touching food is as important as eating, so let you little one get messy - Smells of delicious food can encourage babies to eat 2 Offer your little one a variety of foods � think of a rainbow and all the different colours of food you could offer them to eat Before you start the exciting journey of introducing food It is important to consider whether your little one is ready � talk to your little one's health care team. As a general guide some signs of readiness are: � Your baby can hold their head up and has good head and neck control � Sits with support � You'll find your baby's mouth closes around the spoon and food stays in their mouth � You'll find your baby watches you eat and reaches for food � You'll find your baby leans forward and forward and opens their mouth when food approaches How do I know when my baby has had enough to eat? � Take your baby's lead to see when they've had enough � They'll start batting the spoon or bottle away, shut their mouth or turn their head away when they are finished � stop at this point � Your baby will also eat different amounts each day e.g. sometimes they may eat five teaspoons at one meal and very little at the next � it's all normal. You may even find your little one only eats well once every couple of days � All foods can be a choking hazard, so always sit with your baby whilst they are eating � it is a good idea to go on a first Babies should get messy when they eat � Let them get some food around their mouths, try not to wipe their mouth, hands and face clean after every mouthful e.g. with the spoon or wet wipe � Don't worry if your little one makes a face or even spits food out. Remember it can take 15 � 20 times of trying something before your little one will like it � so don't give up if they pull a face when you given them broccoli! 06 07 What foods should I give at this stage? The best food to begin with is often something like baby rice � it is very smooth and usually contains lots of extra vitamins and minerals, helping to support your baby's growth. Begin feeding your little one with a very small amount � for example 1 teaspoon. Then slowly increase the amount up to 1�3 measured tablespoons over a number of days or weeks. You'll also find that pureed vegetables such as carrots, parsnips, swede and potatoes are great first foods, as are unsweetened pureed fruits like apples and pears. Other good foods to include are; � Well-cooked red meat, chicken and fish, finely pureed with rice or vegetables � Smoothly pureed lentils, dhal or beans served with vegetables or rice � Eggs, soya and milk are also good sources of nutrients � The latest advice on peanuts encourages you to give your baby nuts � ensure nuts are finely ground to avoid choking or try nutritious smooth nut butters instead. Ready-made infant meals can be enriched using the ideas below. For home-made purees, there are some recipes included in this weaning guide � feel free to `swap' ingredients to make new combinations. To make the puree the right consistency for your little one, use your baby's usual milk instead of water. � Following a meal offer a fruit or full cream yogurt based dessert or custard or rice pudding or mashed avocado � For older babies e.g. > 10 months a teaspoon of grated cheese/cream cheese can be added to mashed potato or meat dishes, instead of a nut butter We do not recommend the addition of extra oil or cream to food � if you have had a heavy rich meal it can make you feel sick, babies have the same feeling. Instead try to use a teaspoon of smooth nut butters, coconut cream or smooth plain cream cheese or a small pinch of grated cheese. 4 From 7�8 months of age � offer textures and finger foods as well as pureed food at mealtimes When should I start adding texture? Amazingly, your baby doesn't need teeth to chew! Once your little one has become used to smooth textures and mild tastes, now is the time to gradually move them on to finely mashed foods. It'll encourage chewing which is important for developing muscles, and, believe it or not, speech. To begin with, if you are using pouches or a jar, take � � 1 teaspoon of stage 2 food and add it to the stage 1 food, mixing well. You may find your little one doesn't notice or gags a little bit, this is normal. Once they have got used to this texture add 2 � 3 teaspoons in until you have completely moved over. If you are using home made food, before it is a very fine puree take � � 1 teaspoon of a slightly coarser texture out and follow the same process. teach your baby simple tastes, e.g. green and orange vegetables and offer finger foods of these vegetables at the same time so they can learn what family foods look and feel like � Move onto textures that suit their age and stage. If your little one has had reflux or a nasogastric tube they may find it difficult to move onto food which has lumps and they may stay on one stage a little longer � don't worry too much if at 10 months of age they are still on smooth purees, your therapist will be able to provide advice � Change over to more textured food slowly making small changes every 2 � 3 days � Offer a mix of puree and finger foods at the same meal, so your little one can pick up items and self-feed. It may take a while for them to get the hang of it � All babies develop differently and they may only want to feed themselves when they are much older. So don't worry if they are not interested yet � Let your little one play with their food and get messy! It all helps them learn to accept lots of different foods � Babies and toddlers learn from watching you eat. So if they see you enjoying fruit and vegetables with your meal, they'll learn to love them too � Ideally your baby will sit in a high chair at the table and eat at the same time as the rest of the family Finger food for little fingers from around 7 months of age At first most of the food that is offered will go on the floor, but don't worry! Remember, we eat with all of our senses, so let them enjoy this journey of discovery. The easiest type of finger foods are those that dissolve � these make good first finger foods: � Puffs, baby biscuits The following finger foods are quick to prepare, packed with goodness and let your little one practice their picking up skills � the aim for these is to get your little one used to seeing what family foods look like � so don't worry if they are not eaten: � Soft-cooked vegetable batons like carrots, swede, sweet potato broccoli, avocado � Strips of meat are not usually offered until 10 months � Peeled soft fruit batons/thin slices such as melon sticks, banana, pear, peach slices � Baby biscuits like rusks that dissolve without crumbling How can I make meals energy-nutrient dense? As babies have small tummies (about the size of their fist) it is tricky to fit a lot in without either making them feel or be sick. You can use the nutrient dense recipes provided in this book or add the following examples to your little one's meals; Breakfast: � Add � � 1 teaspoon of smooth nut butter (almond, cashew, peanut) to warm baby porridge or � Add 1 tablespoon smooth fruit puree � To make the puree to the right consistency for your little one use your baby's usual milk instead of water Lunch and supper: � Offer protein at both main meals such as meat, fish, chicken or beans/lentils with a starch (rice/potatoes/pasta) and vegetables � add � � 1 teaspoon of a smooth nut butter � As you baby gets older e.g. over 9 months of age and their portion size increases, increase the amount of nut butter to 1 � 2 teaspoon per meal 3 How long will my baby need energy-nutrient dense feeds for? Your little one's dietitian or health care team will be able to provide advice Should I use shop bought or home-made food? Most families like to mix and match between puree meals they have made at home and ready to use infant food. Shop bought baby food is made to very high standards, so for busy families it is often a good alternative to home-made meals. What about finger foods? � Below are some tips on how to use a `mix and match' approach to weaning � at mealtimes � Offer individual tastes of puree foods to 08 09 Weaning advice: For babies needing to make the most of each meal Once your little one reaches 7 or 8 months, they may have a firmer grip � sometimes this develops a little later in babies who have had a number of operations. At this stage they may be able to use a finger and thumb to pick up smaller foods which helps them keep hold of foods like broccoli and develop their hand-to-eye co-ordination. Getting to grips with food is a great way for your baby to learn about exciting new tastes and textures. As all little ones learn new things at a different pace some will take a bit longer to learn to hold smaller bits of food. It is good to carry on offering pieces of food that are long enough to grip with the palm of the hand so they can bring it up to their mouth. HELP! � my baby is gagging during a meal It is normal for babies to gag when food is being introduced. The most important thing to remember is this is all new to your baby � some babies take longer than others to get the hang of it. If you are finding any aspect of introducing food difficult or your little one is showing signs of not wanting to eat at all � don't suffer in silence � we are here to help. Talk to you little one's health care team and speech and language therapist about how you and your baby can be supported. Food and feeding advice Stage 1: Around 6 months Introduce dairy, eggs, ground nuts meat, chicken, fish, wheat and soy Stage 2: Around 8 �10 months Encourage finger foods Stage 3 & 4: Around 10 months Encourage family foods and self feeding � Continue on breast milk or nutrient energy dense feed (16�18oz) � Continue with vegetables and fruit � place 1 or 2 food pieces on the highchair table � Continue with yoghurt/cheese � Main meals should include protein e.g. chicken, fish, beans, lentils, meat along with veggies and start e.g. potato, rice, pasta � If you are using ready to use baby food, add 1 teaspoon of smooth nut butter to each meal including porridge at breakfast Type of food to offer If you are making food at home, try some of our recipes in this booklet. � Continue on breast milk, usual formula milk or a nutrient energy dense feed formula (20 �22oz per day) � Offer 1 new fruit, vegetable or starchy food per day � First, offer baby rice, baby cereal (these have extra vitamins and minerals), cooked fruits or vegetables � Move on to foods such as milk, egg, nuts, chicken, turkey, lamb, beef, fish, wheat and pulses � After a few weeks every meal can have a carbohydrate, veg/fruit and a protein portion � If you are using ready-made baby meals add ��1 teaspoons of smooth nut butter to each meal including porridge at breakfast � Start with 1�2 ice cube amounts of food per meal. � Offer 1 meal per day then over 1 � 2 weeks increase to 3 meals per day. � At this stage of weaning, new tastes are more important than the portion size � Know when your little one has had enough e.g. turning his/her head away, closing his/her mouth � From around 7 months give soft lumps and finger foods put out on highchair table at same time as other food � Mealtimes should last for up to 15 minutes � When your baby can sit, introduce a high chair and make sure they are well supported in the highchair � Provide a spoon to play with and encourage playing with food � getting as messy as possible! � Continue on breast milk or nutrient energy dense feed formula (18�20oz) � Main meals should include protein e.g. chicken, fish, beans, lentils, meat along with veggies and start e.g. potato, rice, pasta � If you are using readymade baby meals add 1 � 2 teaspoons of smooth nut butter to each meal including porridge at breakfast � Try some of our recipe ideas from page 20 Portions � Soft lumpy meals (bigger lumps) � Know when your little one has had enough e.g. turning his/ her head away, closing his/ her mouth � Mealtimes should last for up to 15 minutes � Small pieces and bigger lumps � Promote finger foods � Know when your little one has had enough e.g. turning his/ her head away, closing his/her mouth � Mealtimes should last for up to 20 minutes Mealtimes � Should sit in a high chair � Provide a spoon to play with � Let your little one touch or play with food � Should sit in a high chair � Let your little one touch or play with food � Encourage self feeding * Suggested feeding times: 8-9 am, 11-1 pm, 4-5pm with milk in between (this is just a guideline) 10 11 Weaning advice: For babies needing to make the most of each meal Stages 1 Weaning advice: For babies needing to make the most of each meal Texture � Your little one's therapist may suggest a particular thickness of pur�e � Smooth pur�e can be either: - Thin pur�e runs easily off a spoon - Standard pur�e drops easily off a spoon - Thick pur�e can be eaten with a spoon � The thickness of a pur�e is changed by heat e.g. as food cools it can become thicker � Other foods such as cereals may need extra liquid or extra time for the milk to soak in � At this stage the lumps should be small and soft � When you are moving onto this texture there should only be a small amount of lumps � Blend the food stopping just before it is a smooth pur�e � take out a teaspoon of very well mashed food and put to one side� carry on blending then add the coarser texture back in � If your little one still finds this texture difficult � try half a teaspoon next time � Gradually increase the texture every 2 � 3 days unless your therapist advises otherwise � Fork mash needs some preparation in the mouth before swallowing � Avoid offering foods that have a mix of textures e.g. lumps floating in liquid such as cereal in milk What does it look like � Foods in this stage are very smooth and have no lumps � This is usually the first stage of foods that are tried � These foods need to blended or sieved for a very smooth texture Feeding skills � Smooth pur�es can be swallowed easily � No chewing is needed � Pur�e can be managed by sucking and swallowing � A standard pur�e that drops easily off a spoon is the easiest for little ones starting out to eat Stages Finger foods What does it look like � From around 7 months start to offer finger foods put a variety of different foods out on highchair table at same time as other puree foods � To begin with most food will end up on the floor � To begin with, the best types of foods to start off with are ones that dissolve easily e.g. sweetcorn puffs � Dissolving foods melt evenly in the mouth without leaving lumps e.g. carrot puffs � These types of food help with chewing skills as your little one needs enough skill to be able to hold the food in the mouth until it melts � Other good finger foods to then move onto are steamed, such as well cooked carrots sticks, banana, avocado, soft pear, soft flaky fish, toast finger, pasta shells � Some types of food are a choking hazard and should be avoided in babies and young children � This list may not included everything � so it is important that you sit with your little one at each meal & snack time � Young children should be encouraged to sit down and eat rather than run around Feeding skills � Always try the food yourself to check it dissolves easily before giving it to your little one � Foods that dissolve should initially be placed at the side of the mouth where their back teeth will come to encourage tongue movement � With practice your little one may be able to bite pieces off (bite-anddissolve) Texture � Always sit with your little one when they are eating any food � If able offer bite and dissolve foods e.g. vegetable flavoured puffs between meals � Move on to soft cooked vegetables, small pasta shells and soft fruit. � It is sometimes useful to offer these foods as in between meals snacks, so you are your little one can enjoy them exploring new foods and textures together 2 � When your little one is ready to move onto stage 2 foods, start by offering a thicker smooth stage 1 pur�e � Foods in this stage are still blended but to a coarse pur�e with a thick sauce � There will also be small moist, soft lumps and � the size of a 5p piece � In this stage flavour combinations are more complex and have a slightly stronger taste, e.g. cottage pie � In this stage your little one will be developing their feeding skills further learning to use their lips and tongues more for eating � Some little ones take a while to adapt to a change in texture � this is normal as not every baby develops at the same pace � Try to make very small changes of one thing at a time � Some foods may still need to be smooth pur�e and others mashed e.g. vegetables can be a thick mash, but meat may still need to be a smooth pur�e � Lumps should be moist and soft � Lumps should not be bigger than a 5p piece and they should be soft Choking hazards 3 � Foods in this stage can be well fork mashed and have less sauce � Babies often enjoy quite stronger tastes e.g. mild lamb curry and new combinations e.g. sweet and savoury chicken � Foods are forked mashed with some bite size pieces that older babies can pick up as finger foods � Raw vegetables are often hard � so offer soft cooked sticks e.g. carrot, courgette and celery � Hard pieces of raw fruit such as apple and pear should not be given � Avoid slippery foods such as pieces of canned fruit � cut them up into small pieces or mashed e.g. sweet corn kernels; � All finger foods should be cut in short thin sticks e.g. lengthways rather than then being round in shape, as this reduces the risk of choking - Mini sausages/mini scotch egg balls - Cut whole grapes, berries, cherries, melon balls, cherry/plum tomatoes lengthways into quarters - Cut orange/satsuma segments into quarters � take the pips out and remove any pith - Chunks of fish flaked should be checked for bones 4 � Foods at this stage can have tender pieces: soft cooked pieces e.g. 10p piece size in thick sauce � Sometimes when little ones are not well, they go back a couple of stages in terms of textures and feeding � this is normal so try not worry * Suggested feeding times: 8-9 am, 11-1 pm, 4-5pm with milk in between (this is just a guideline) * Suggested feeding times: 8-9 am, 11-1 pm, 4-5pm with milk in between (this is just a guideline) 12 13 Simple feeding plan for the first month: From around 6 months of age Stages NOTE: Simple week meal planner: From around 6 months of age Day MONDAY How much and when? All babies are different � some babies eat more than others at meal times, this is quite normal Examples � Purees should be very smooth Waking Baby's usual milk Breakfast Baby cereal with milk & � teaspoon smooth nut butter Baby cereal with milk & � teaspoon smooth nut butter Baby cereal with milk & � teaspoon smooth nut butter Baby cereal with milk & � teaspoon smooth nut butter Baby cereal with milk & � teaspoon smooth nut butter Baby cereal with milk & � teaspoon smooth nut butter Baby cereal with milk & � teaspoon smooth nut butter Mid morning Baby's usual milk Lunch Purple meal* Or Baby's usual milk Purple meal* Or Baby's usual milk Purple meal* Or Baby's usual milk Purple meal* Or Baby's usual milk Purple meal* Or Baby's usual milk Purple meal* Or Baby's usual milk Purple meal* Or Baby's usual milk Evening meal Meat, chicken or fish based ready prepared baby food & � � 1 teaspoon smooth nut butter Fruit pot Meat, chicken or fish based ready prepared baby food & � � 1 teaspoon smooth nut butter Yogurt Meat, chicken or fish based ready prepared baby food & � � 1 teaspoon smooth nut butter Oat based pudding Meat, chicken or fish based ready prepared baby food & � � 1 teaspoon smooth nut butter Fruit pot Meat, chicken or fish based ready prepared baby food & � � 1 teaspoon smooth nut butter Yogurt Meat, chicken or fish based ready prepared baby food & � � 1 teaspoon smooth nut butter Oat based pudding Meat, chicken or fish based ready prepared baby food & � � 1 teaspoon smooth nut butter Custard Evening milk Baby's usual milk TUESDAY WEEK 1 � Usual milk feeds plus small but increasing amounts of solids � Days 1 & 2 � In the middle of or after one milk feed, offer 1 small teaspoonful of solids � Days 3 & 4 � In the middle of or after one milk feed, offer 1 � 2 teaspoons of solids � Days 5 & 6 � After one milk feed, offer 2 � 4 teaspoons of solids � Day 7 � After one feed offer 2 � 5 teaspoons of solids � Usual milk feeds plus solids at one or two feeds a day � Breakfast � baby's usual milk plus 2 � 5 teaspoons of solids � Lunch or evening meal � baby's usual milk plus 2 � 5 teaspoons of solids � Usual milk feeds plus solids at two feeds a day � Breakfast � baby's usual milk plus 2 � 3 tablespoons of solids � Lunch or evening meal � baby's usual milk 2 � 3 tablespoons of solids � � � � Usual milk feeds plus solids at two or three feeds a day Breakfast � baby's usual milk plus 2 � 3 tablespoons of solids Lunch � baby's usual milk 2 � 3 tablespoons of solids Evening meal � baby's usual milk plus 2 � 3 tablespoons of solids � Baby first rice cereal � Baby first rice cereal with puree apple � Baby first rice cereal with puree carrots WEDNESDAY Baby's usual milk Baby's usual milk Baby's usual milk Baby's usual milk Baby's usual milk Baby's usual milk WEEK 2 � Baby first rice cereal with � teaspoon of smooth nut butter � Sweet potato & almond butter or peas, potato and mint THURSDAY Baby's usual milk Baby's usual milk Baby's usual milk FRIDAY WEEK 3 � Baby first rice cereal with � teaspoon of smooth nut butter � Peas and Carrots or Prunes, apricots and ground almonds as a butter � Baby first rice cereal with � teaspoon of smooth nut butter � Peas and Carrots or Prunes, apricots and ground almonds � Butternut and smooth peanut butter or peaches, sultanas and baby rice Baby's usual milk Baby's usual milk Baby's usual milk SATURDAY WEEK 4 Baby's usual milk Baby's usual milk Baby's usual milk SUNDAY Baby's usual milk Baby's usual milk Baby's usual milk * Suggested feeding times: 8-9 am, 11-1 pm, 4-5pm with milk in between (this is just a guideline) NOTES: 1. As your little one gets bigger rainbow meals can be used as side dishes. * for rainbow meals see recipes on page 28 2. Rainbow, growing up or ready prepared baby meals can be offered at lunch and evening meal * Suggested feeding times: 8-9 am, 11-1 pm, 4-5pm with milk in between (this is just a guideline) 14 15 Some general advice Recipes, foods to avoid, textures, safety and hygiene, storing, reheating, do's and don'ts Recipes The recipes below make 100g portions � Colours of the rainbow, fruit & veggies recipes make 100g portions of food, to begin with your little one may only manage 2 � 5 teaspoons at a meal, but as they get bigger they may eat 100g portions � Growing up recipes are between 200 � 260g servings and can be used for lunch and supper or as a single meal as your little one gets bigger � All of the recipes can be: - made in bigger batches, just scale up the amounts accordingly Textures All of the recipes can be adapted to the texture that suits your baby such as: � Stage 1 � 2 : Smooth purees are best made with a blender and can be either - Thin puree runs easily off a spoon - Standard puree drops easily off a spoon - Thick puree can be eaten with a spoon � Stage 3: Mashed foods usually blended - Thick puree with less sauce and small moist soft lumps around � the size of a 5p piece � Stage 4: Fork mashed are soft foods mashed down with a fork - Thick with small moist soft lumps around the size of a 5p � 10p piece Cool food as quickly as possible (ideally within 1 � 2 hours) and put it in the fridge or freezer. Food in the fridge should be eaten within 1 � 2 days. Frozen food should be thoroughly defrosted before reheating. The safest way to do this is to put frozen food in the fridge overnight or using the defrost setting on the microwave. Reheat food so it is really hot, but remember to let it cool down before you offer it to your baby. To cool food quickly, put it in an airtight container and hold it under a running cold tap, stopping to stir the contents from time to time, so it is cool all of the way through. DO'S Always wash your hands before preparing foods. Wash your baby's hands before feeding Wash all bowls, spoons and other utensils in hot soapy water or put on a hot wash in the dishwasher. Keep chopping boards and other utensils clean DON'TS Don't save and reuse food that your child has half eaten Avoid raw eggs � this includes uncooked cake mixture, homemade ice creams, mayonnaise or desserts that contain uncooked raw eggs. Always cook eggs until the yolks and whites are firm Avoid any shark, swordfish or marlin � this is because the levels of mercury in these fish can affect your baby's growing nervous system. You should also avoid giving raw shellfish to babies to reduce their risk of getting food poisoning Foods to avoid: � Salt � unless advised by your health care professional salt should not be added to your little one's food � Sugar � your little one doesn't need sugar added to any food � Honey � very occasionally honey contains a bacteria that produces toxins in your little one's intestines causing a serious illness called infant botulism. It is best not to give honey until your little one is over 1 year of age Keep utensils, chopping boards and surfaces clean. Keep any pets away from food or surfaces where food is prepared When reheating food from frozen, make sure it is hot all of the way through. If you are using a microwave, ensure you always stir it and check the temperature before feeding it to your baby. Cook all food thoroughly and cool it to a lukewarm temperature before giving it to your baby Keep cooked and raw meats away from each other in the fridge. Always wash your hands after touching raw meant Wash and peel fruit and vegetables, such as apples and carrots Safety & hygiene As a baby's immune system is still developing, bacteria in food can cause food poisoning. If you follow a few simple guidelines this will help protect your baby from germs. Don't give children food or drink whilst sitting on the potty Don't reheat cooked food more than once, as this increases the risk of food poisoning 16 17 Shopping list For the recipes you can buy fresh, frozen or tinned fruit and vegetables. All of these ingredients are available in budget as well as other supermarkets. Fr ui t & Ve gg ies � Frozen pe as ixe d pe pp ers � Frozen /f re sh m rn � Frozen swee t co rrot s � Frozen /f re sh ca sh � Bu tter nu t sq ua to � Swee t po ta � Ka le � Co urge tte � Swede � Pa rs ni ps Nut bu tters (n o adde d suga r va rie tie s) � Smoo th pe an ut bu tter � Smoo th ca sh ew bu tter � Smoo th almon d bu tter Pu ls es & grai ns � Ch ic kp ea, be an or gram flo ur � Ti nned ch ic kp ea s � Le nt ils � gree n an d re d � Grou nd almon ds � Ba by rice /c er ea l (s tage 1) � (n ot orga nic) � Q ui no a Oi ls � Co co nu t crea m � Ol ive oi l Fi sh & meat � Whi te or oi ly fish � Lam b � Be ef � Ch ic ke n � Po tato � Ba na na � Av oc ado spbe rr ies � Frozen /f re sh ra ue be rr ies � Frozen /f re sh bl ango � Frozen /f re sh m in ju ice � Ti nned pe ache s ju ice � Ti nned pr unes in ric ot s � Re ad y to eat ap � Su lta na s He rb s & sp ice s in t � Frozen /f re sh m ri an de r � Frozen /f re sh co nger � Frozen /f re sh gi ic � Grou nd tu rmer on � Grou nd cin nam 18 19 RECIPES Veggies � Sweet potato & cashew butter � Peas, potatoes & mint � Butternut squash, peanut butter & cinnamon � Peas & carrots Fruits � Prunes, apricots & ground almonds � Peaches, sultanas & baby rice � Mango & almond butter � Raspberry, banana & almonds Colours of the rainbow � Purple � Plum, aubergine & blueberry � Red � Beetroot, apple, red pepper & cashew butter � Orange � Sweet potato, butternut, carrot & cinnamon � Yellow � Mango, yellow courgette, sweet corn & turmeric � Green � Pea, kale, pear & avocado � White � Apple, cauliflower & celeriac Growing up � Pollock, carrots, kale, butternut squash & potato � Avocado, apple, lentil, broccoli, courgette & mint � Beef & prunes with mashed potato � Aromatic chicken & rice � Mauritian lamb with lentils & rice Family favourites � Fish fingers & sweet potato chips � Bobotie � Pasta bolognaise � 1st Birthday cake 20 21 VEGGIES: Sweet potato & cashew butter Ingredients � 90g sweet potato � 10g smooth cashew butter (or other smooth nut butter) Peas, potatoes & mint Ingredients � � � � 20g frozen garden peas 70g potato 10ml (2 teaspoons coconut cream) 2 � 3 mint leaves or 1 teaspoon frozen chopped mint Butternut squash, peanut butter & cinnamon Ingredients � 85g frozen or fresh butternut squash � 10g (2 level tablespoon) smooth peanut butter � 5ml (1 teaspoon) coconut cream � pinch of ground cinnamon Peas & carrots Ingredients � 30g frozen or fresh peas � 60g frozen or fresh carrots � 5g (1 teaspoon) smooth peanut butter Method � Peel the sweet potato and place in pan of unsalted cold water � Bring to the boil and cook until tender � Using a stick blender puree until smooth � Add in 20g or 2 tablespoons of smooth cashew butter � Using the stick blender to mix well � If the puree is a little thick add a small amount of your little one's usual infant formula or breast milk � Portion into ice cube trays Method � Place the carrots in a pan of boiling hot water, bring to the boil and cook until tender � Drain the carrots and place in a bowl � Cook peas in hot water for 2 minutes, drain and mash the peas through a sieve to get rid of the skins � Add the peas, carrots and smooth peanut butter together � Using a stick blender puree until smooth � If the puree is a little thick add a small amount of your little one's usual infant formula or breast milk � Portion into ice cube trays Method � Peel the potatoes and place in pan of unsalted cold water � Bring to the boil and cook until tender � Drain the potatoes and leave to one side � Cook peas in hot water for 2 minutes, drain and mash the peas through a sieve to get rid of the skins � Add the pea pulp to the potatoes and using a stick blender puree until smooth � If the puree is a little thick add a small amount of your little one's usual infant formula or breast milk � Portion into ice cube trays Method � Place the chopped butternut and a pinch of cinnamon in a pan of boiling hot water, bring to the boil and take off the heat � Using a stick blender puree until smooth � Add in 10g of ground almonds or 1 level tablespoon of smooth peanut or other nut butter along with 1 teaspoon of coconut cream � Use the stick blender and mix well � If the puree is a little thick add a small amount of your little one's usual infant formula or breast milk � Portion into ice cube trays Nutrition content per 100g 164 kcal / 3.7g protein / 5.5g fat / 26.2g carbohydrate / 9% protein energy ratio Nutrition content per 100g 104 kcal / 3g protein / 3.8g fat / 15g carbohydrate / 11.5% protein energy ratio Nutrition content per 100g 105 kcal / 3.3g protein / 7g fat / 8g carbohydrate / 12.5% protein energy ratio Nutrition content per 100g 105 kcal / 3.3g protein / 7g fat / 8g carbohydrate / 12.5% protein energy ratio 22 23 FRUIT: Prunes, apricots & ground almonds Ingredients � 75g tinned prunes in juice � 15g ready to eat apricots � 10g ground almonds Peaches, sultanas & baby rice Ingredients � 75g tinned peaches in juice � 15g sultanas � 20g baby rice Mango & almond butter Ingredients � 85g fresh mango � 15g (3 levels teaspoons) almond butter Raspberry, banana & almonds Ingredients � 40g fresh or frozen raspberries � 45g banana � 15g ground almonds Method � Place the tinned prunes and ready to eat apricots (approximately 4) with the prune juice in a pan and simmer on a low heat for 5 minutes or until the fruit it soft � Add in 10g or 1 tablespoon of ground almonds � Using a stick blender puree until smooth � If the puree is a little thick add a small amount of your little one's usual infant formula or breast milk � Portion into ice cube trays Method � Place the tinned peaches and sultanas with the juice in a pan and simmer on a low heat for 5 minutes � Add in 20g or 4 tablespoons of baby rice � Using a stick blender puree until smooth � If the puree is a little thick add a small amount of your little one's usual infant formula or breast milk � Portion into ice cube trays Method � Peel and chop the fresh mango into chunks � Place in a bowl along with 15g smooth almond butter (3 level teaspoons) � Using a stick blender puree until smooth � If the puree is a little thick add a small amount of your little one's usual infant formula or breast milk � Portion into ice cube trays Method � Place the raspberries in a pan, adding 20 ml of water � bring to a boil and then simmer for 2 � 3 minutes until cooked � Pour the raspberries into a bowl along with the banana and ground almonds � Using a stick blender puree until smooth � If the puree is a little thick add a small amount of your little one's usual infant formula or breast milk � Portion into ice cube trays 1 � 2 cubes can be added to your little one's usual breakfast cereal Nutrition content per 100g 132 kcal / 3g protein / 6g fat / 13g carbohydrate / 9% protein energy ratio Nutrition content per 100g 190 kcal / 4.1g protein / 1.5g fat / 42.6g carbohydrate / 8.6% protein energy ratio Nutrition content per 100g 120 kcal / 3.4g protein / 7g fat / 10g carbohydrate / 11% protein energy ratio Nutrition content per 100g 146 kcal / 4.2g protein / 8g fat / 13g carbohydrate / 11.5% protein energy ratio 24 25 COLOURS OF THE RAINBOW COLOURS OF THE RAINBOW: PURPLE RED ORANGE Plum, aubergine & blueberry Ingredients � � � � 40g plums canned in syrup 30g aubergine pulp (without the skin) 10g blueberries 20g chickpea flour or baby cereal Beetroot, apple, red pepper & cashew butter Ingredients � � � � � 30g beetroot 30g apple 25g red bell pepper 15g (3 teaspoons) cashew butter 20ml water Sweet potato, butternut, carrot & cinnamon Ingredients � � � � � � 30g sweet potato 30g butternut squash 25g carrots 15g (3 teaspoons) peanut butter pinch of cinnamon water Method � Peel and chop the aubergine into chunks, sprinkle with salt and leave for 10 minutes, before washing thoroughly under cold running water � Place aubergine chunks, plums and syrup, blueberries and chickpea flour in a pan � Simmer on a low heat until the aubergine is soft � add your little one's usual infant formula or breast milk as required � Using a stick blender puree until smooth � If the puree is a little thick add a small amount of your little one's usual infant formula or breast milk � Portion into ice cube trays Method � Peel and chop the beetroot into chunks � Dice the red pepper and peeled apple � Place all the beetroot, apple and red bell pepper into a pan, add in 50ml of water � Simmer on a low heat until the mixture is soft, drain off any excess water � Add in the cashew butter � Using a stick blender puree until smooth � If the puree is a little thick add a small amount of your little one's usual infant formula or breast milk � Portion into ice cube trays Method � Place all the sweet potato, butternut, carrot and a pinch of cinnamon into a pan cover with cold water and bring to the boil � Simmer on a low heat until the mixture is soft, drain off the excess water � Add in the peanut butter � Using a stick blender puree until smooth � If the puree is a little thick add a small amount of your little one's usual infant formula or breast milk � Portion into ice cube trays Nutrition content per 100g 94 kcal / 4.4g protein / 1.2g fat / 17.5g carbohydrate / 18.7% protein energy ratio Nutrition content per 100g 128 kcal / 4.3g protein / 9g fat / 9g carbohydrate / 13% protein energy ratio Nutrition content per 100g 143 kcal / 4.3g protein / 9g fat / 13g carbohydrate / 12% protein energy ratio 28 COLOURS OF THE RAINBOW: YELLOW GREEN WHITE Mango, yellow courgette, sweet corn & turmeric Ingredients � � � � � � 30g mango 25g yellow courgette (or green with no skin) 35g sweet corn 10g chickpea flour or baby cereal pinch of turmeric water � 50ml Pea, kale, pear & avocado Ingredients � � � � � 30g frozen garden peas 20g pear 20g kale 30g avocado water � 50ml Apple, cauliflower & celeriac Ingredients � � � � � � 25g apple 20g cauliflower 20g celeriac 20g chickpeas 5ml olive oil water � 50ml Method � Peel and chop the pear � Chop the kale into ribbons � Add the kale and pear into a pan with 50ml water � Simmer on a low heat until the mixture is soft, add in the peas and cook for a further 2 � 3 minutes � Take off the heat and add in the mashed avocado � Using a stick blender puree until smooth � If the puree is a little thick add a small amount of your little one's usual infant formula or breast milk � Portion into ice cube trays Method � Peel and chop the apple and celeriac � Break the cauliflower into florets � Add all of the ingredients, including the olive oil into a pan with 50ml water � Simmer on a low heat until the mixture is soft � Using a stick blender puree until smooth � If the puree is a little thick add a small amount of your little one's usual infant formula or breast milk � Portion into ice cube trays Method � Peel and chop the mango � Chop the yellow courgette or peeled green courgette if yellow are not available � Add all of the vegetables, chickpea flour, pinch of turmeric and 50ml water into a pan � Simmer on a low heat until the mixture is soft, drain off the excess water � Using a stick blender puree until smooth � If the puree is a little thick add a small amount of your little one's usual infant formula or breast milk � Portion into ice cube trays Nutrition content per 100g 107 kcal / 3.8g protein / 1.8g fat / 18.9g carbohydrate / 19% protein energy ratio Nutrition content per 100g 93 kcal / 3g protein / 6.6g fat / 5.6g carbohydrate / 13% protein energy ratio Nutrition content per 100g 89 kcal / 2.4g protein / 6g fat / 7g carbohydrate / 10.7% protein energy ratio 30 GROWING UP: Pollock, carrots, kale, butternut squash & potato Ingredients � � � � � � 15g white fish* 30g carrots 60g kale 35g butternut squash 60g potato 1 teaspoon coriander Avocado, apple, lentil, broccoli, courgette & mint Ingredients � � � � � 50g avocado 30g apple 20g red lentils (cooked) 30g broccoli 25g courgette � 25g rice (makes 100g cooked rice) � 50ml water � lemon juice � few sprigs of mint Method � Chop the carrots, kale and fish � Add the carrots, butternut squash, potato, fish, olive oil and coriander into a pan � Simmer on a low heat until the mixture is soft, add in the kale and cook for a further 2 � 3 minutes � Before mashing the mixture take out a couple of pieces of carrot and fish to be used as finger foods during the meal � Using a stick blender or fork mash the rest until soft lumps remain � If the meal is a little thick add a small amount of your little one's usual infant formula or breast milk Method � Cook the rice and lentils in unsalted water until tender � Cut the courgette and broccoli into small pieces, steam over the cooking rice � In the meantime grate the apples and cube the avocado, sprinkle with a little lemon juice to stop the mixture going brown � Wash the mint leaves and finely chop � Keep some grains of rice, lentils, vegetable and fruit mixture to one side � Mash the rest of the rice and lentils with a fork, then add in the courgette, broccoli, grated apple and avocado until soft lumps remain � If the meal is a little thick add a small amount of your little one's usual infant formula or breast milk From around 7 months of age introduce finger foods, take a few pieces of carrot and fish from the mixture before you puree it. Offer as finger foods at the same time as serving the meal. This way your little one gets used to see what different food looks like. Nutrition content per 100g 135 kcal / 5.8g protein / 6.1g fat / 15g carbohydrate / 17% protein energy ratio Nutrition content per 100g 278 kcal / 6.8g protein / 11.4g fat / 40g carbohydrate / 9.7% protein energy ratio 32 *For fish always check for bones. 33 GROWING UP: Beef & prunes with mashed potato Ingredients � � � � � 20g mince beef 10g onions 80g butternut 35g carrots 20g prunes (2) � � � � � 100g potato 100ml water 5ml olive oil pinch of ginger pinch of turmeric Aromatic chicken & rice Ingredients � � � � � � 20g chicken breast 10g onion 30g mango 80g sweet potato 30g spinach 15g rice (60g when cooked) � � � � � � 100ml water 5ml olive oil 10ml coconut cream pinch of coriander pinch of ginger pinch of turmeric Mauritian lamb with lentils & rice Ingredients � � � � � 20g lamb mince 10g apricots (2) 10g green lentils 80g carrots 30g kale � 75g macaroni or small shaped pasta � 100ml water � 10ml coconut cream � pinch of cinnamon � pinch of turmeric Method � Braise the mince beef and onions in the oil, add in the pinch of turmeric and ginger and cook on a low heat until the onions are soft � Chop the butternut squash, carrots and prunes into small cubes, then add to the beef mixture with an additional 100ml of water cook on a low heat until all of the ingredients are soft and the liquid is reduced � In a separate
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