The first year of life is a critical period for establishing healthy eating habits and ensuring proper growth and development. During this time, an infant’s nutritional needs evolve rapidly—from exclusive milk feeding in the early months to gradual introduction of solid foods. This transitional period lays the groundwork for lifelong dietary behaviours, impacting health outcomes far into adulthood (Mennella et al., 2016).
This article provides parents and carers with evidence-based guidance on infant nutrition, focusing on breastfeeding, formula feeding, the introduction of solid foods, and the importance of responsive feeding practices.
1.0 Breastfeeding: The Gold Standard
Breastfeeding is widely acknowledged as the optimal source of nutrition for infants in the first months of life. According to the World Health Organization (WHO) and NHS, exclusive breastfeeding is recommended for the first six months (26 weeks) of life, followed by continued breastfeeding alongside the introduction of solid foods (NHS, 2023; WHO, 2021).
Breast milk contains the perfect balance of macronutrients, micronutrients, and immunological components that support physical and cognitive development. It also helps protect against respiratory infections, gastrointestinal illnesses, and reduces the risk of sudden infant death syndrome (SIDS) (Victora et al., 2016).
In addition to health benefits for the infant, breastfeeding also contributes to maternal health, lowering the risk of breast and ovarian cancer and supporting postpartum weight regulation (Binns et al., 2020).
2.0 Infant Formula: When Breastfeeding Is Not Possible
When breastfeeding is not possible or preferred, infant formula is the recommended substitute. In the UK, formula is regulated to provide adequate levels of iron, vitamin D, and other essential nutrients (First Steps Nutrition Trust, 2022).
Parents should use only first infant formula for the first year, as follow-on milks and toddler milks are not necessary and often contain added sugars (NHS, 2023). Formula should be prepared safely and hygienically, following instructions exactly, and bottles should be sterilised until at least 12 months of age.
It is crucial to avoid adding cereal or other solids to bottles, as this can increase the risk of overfeeding and choking, while also hindering the development of oral motor skills (Brown, 2020).
3.0 Responsive Feeding: Understanding Hunger and Satiety Cues
Whether feeding breast milk or formula, practising responsive feeding is essential. This approach involves feeding in response to early hunger cues—such as rooting, sucking fingers, or lip smacking—rather than waiting until the baby cries (Black & Aboud, 2011).
Similarly, recognising satiety signals—such as turning away, closing the mouth, or slowing down sucking—helps prevent overfeeding and teaches babies to self-regulate their intake. Responsive feeding supports the development of healthy eating behaviours and builds trust between the infant and caregiver.
4.0 Introducing Solid Foods: Complementary Feeding
At around six months, infants begin the process of complementary feeding—the introduction of solid foods while continuing breastfeeding or formula feeding. This marks a critical nutritional milestone, as breast milk alone is no longer sufficient to meet the baby’s growing energy and micronutrient needs, particularly iron and zinc (Fewtrell et al., 2017).
The NHS (2023) recommends starting with soft, mashed or pureed foods and gradually introducing a variety of textures and flavours. Good first foods include:
- Mashed vegetables (e.g. carrots, sweet potato)
- Mashed fruits (e.g. banana, pear)
- Iron-rich foods (e.g. pureed meat, lentils, fortified baby cereals)
Introducing allergens (e.g. peanuts, eggs) early—between 6–12 months—may also reduce the risk of developing food allergies, especially in high-risk infants (Du Toit et al., 2015).
5.0 Food Variety and Nutritional Balance
As babies approach 9–12 months, they can begin eating a wider variety of family foods. Offering a diverse range of tastes, colours, and textures during this period encourages acceptance of healthy foods and may prevent fussy eating later on (Coulthard et al., 2010).
A well-balanced diet at this stage should include:
- Vegetables and fruits (aim for 5 portions per day)
- Protein sources: poultry, fish, eggs, pulses, tofu
- Starchy foods: bread, pasta, potatoes, cereals
- Dairy: full-fat milk, cheese, yoghurt (as part of meals)
Salt and sugar should be limited, as excessive intake is associated with later risk of hypertension, obesity, and tooth decay (Public Health England, 2020).
6.0 Drinks and Hydration
From birth to six months, infants should not require water if they are breastfed or formula-fed adequately. Once solid foods are introduced, boiled and cooled water can be offered in small amounts between meals (NHS, 2023).
Babies should be encouraged to drink from an open cup from around 6 months to support oral development. Fruit juice, squash, and fizzy drinks should be avoided due to their high sugar content and impact on dental health (Murkoff, 2014).
7.0 Vitamin Supplementation
The Department of Health advises that all infants should receive daily vitamin supplements containing vitamins A, C, and D from 6 months, unless they are drinking more than 500ml of infant formula per day (NHS, 2023).
Vitamin D is particularly crucial in the UK due to limited sunlight exposure, and supplementation helps prevent rickets and supports immune function (SACN, 2020).
8.0 Feeding Milestones and Safety
By their first birthday, most children can:
- Sit unsupported during meals
- Feed themselves with fingers and attempt to use a spoon
- Eat chopped versions of family foods
- Drink from a cup with some assistance
To ensure safety:
- Never leave a baby unattended while eating
- Avoid choking hazards like whole grapes, hard carrots, or nuts
- Introduce one new food at a time to watch for allergies
Building healthy eating habits from birth to one year of age is one of the most important gifts a caregiver can offer. With the right balance of milk feeding, nutritious solid foods, responsive care, and safe practices, babies can thrive physically and emotionally.
This foundational year not only supports optimal development but also nurtures a positive relationship with food that extends well beyond infancy. Parents and carers should feel empowered to seek support from health visitors, GPs, or dietitians to navigate the feeding journey confidently and knowledgeably.
References:
Binns, C., Lee, M. & Low, W.Y. (2020) The Long-Term Public Health Benefits of Breastfeeding. Asia Pacific Journal of Public Health, 32(2-3), pp. 89–92.
Black, M. & Aboud, F. (2011) Responsive Feeding Is Embedded in a Broader Framework of Child Development. The Journal of Nutrition, 141(3), pp. 490–494.
Brown, A. (2020) Why Starting Solids Matters: The Impact of the First Foods on Life-Long Health. Pinter & Martin Ltd.
Coulthard, H., Harris, G. & Emmett, P. (2010) Delayed Introduction of Lumpy Foods to Children During the Complementary Feeding Period Affects Feeding Difficulties at 7 Years. Pediatrics, 125(3), pp. e807-e814.
Du Toit, G. et al. (2015) Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy. New England Journal of Medicine, 372(9), pp. 803–813.
Fewtrell, M. et al. (2017) Complementary Feeding: A Position Paper by the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN). Journal of Pediatric Gastroenterology and Nutrition, 64(1), pp. 119–132.
First Steps Nutrition Trust (2022) Infant Milks in the UK: A Practical Guide for Health Professionals. [Online]. Available at: https://www.firststepsnutrition.org [Accessed 10 June 2024].
Mennella, J.A., Trabulsi, J.C. & Papas, M.A. (2016) Infant Feeding Practices and Early Taste Experiences: The Effect of Milk Feeding Type on Development. Appetite, 96, pp. 535–540.
Murkoff, H. (2014) What to Expect the First Year. Workman Publishing.
NHS (2023) Your Baby’s First Solid Foods. [Online]. Available at: https://www.nhs.uk/start-for-life/baby/weaning/ [Accessed 10 June 2024].
Public Health England (2020) The Eatwell Guide: Helping You Eat a Healthy Balanced Diet. [Online]. Available at: https://www.gov.uk/government/publications/the-eatwell-guide [Accessed 10 June 2024].
SACN – Scientific Advisory Committee on Nutrition (2020) Vitamin D and Health Report. [Online]. Available at: https://www.gov.uk/government/groups/scientific-advisory-committee-on-nutrition [Accessed 10 June 2024].
Victora, C.G. et al. (2016) Breastfeeding in the 21st Century: Epidemiology, Mechanisms, and Lifelong Effect. The Lancet, 387(10017), pp. 475–490.
World Health Organization (WHO) (2021) Breastfeeding. [Online]. Available at: https://www.who.int/news-room/fact-sheets/detail/breastfeeding [Accessed 10 June 2024].
