Quality standard
Quality statement 5: Advice on introducing solid food
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‑ to 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
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured and can be adapted and used flexibly.
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‑ to 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‑ to 8‑week health visitor appointments.
Data source: Local data collection. The number of 6‑ to 8‑week health visitor appointments at national, regional and local level in England is collected in the Office for Health Improvement and Disparities' Health visitor service delivery metrics (2017 onwards). This data is submitted on a voluntary basis.
b) Proportion of 6‑ to 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‑ to 8‑week health visitor appointments.
Data source: Local data collection. The number of 6‑ to 8‑week health visitor appointments at national, regional and local level in England is collected in the Office for Health Improvement and Disparities' Health visitor service delivery metrics (2017 onwards). This data is submitted on a voluntary basis.
What the quality statement means for different audiences
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‑ to 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 or integrated care systems, 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.
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
Maternal and child nutrition. NICE guideline PH11 (2008), recommendations 4 (key priority for implementation) and 22
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:
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the reasons for starting solid food at around 6 months
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the possible effects on the baby of starting solid food earlier or later
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the reasons for continuing breastfeeding
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maximising breastmilk or increasing infant formula feeds for babies under 6 months who are feeding more frequently.
This information can be given by the health visitor at the mandated 6‑ to 8‑week appointment. [Expert opinion]
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.
For people with additional needs related to a disability, impairment or sensory loss, information should be provided as set out in NHS England's Accessible Information Standard or the equivalent standards for the devolved nations.