The introduction of solids is an exciting new chapter for both baby and caregiver, but knowing which foods to offer first can often cause confusion. This is particularly true of cereals, with seemingly endless options lining the supermarket shelves, including many marketed specifically as infant, toddler or kid’s cereals.
By around 6 months of age, breastmilk (or infant formula) alone, can no longer provide infants with sufficient energy and nutrients for growth and development. This is particularly true of iron, which is required for healthy blood, energy and neurological development in infancy and childhood.1 As such, it is recommended that appropriately textured iron-rich foods, that are low in added salt and sugar, are offered at around 6-months of age. This includes iron-fortified cereals.2
What is a good cereal option?
Recommended cereal options for infants include those that are iron-fortified, whilst also being low in sodium and added sugar.
Excess sodium consumption has been linked to various adverse health outcomes and should be limited where possible, especially in infants and young children. When discussing the introduction of cereal, a value of <300 mg/100g is a reasonable target that is aligned with the current reformulation sodium target set by the Healthy Food Partnership.3
Frequent consumption of added sugars has also been associated with increased prevalence of negative health consequences, in particular an increased risk of dental caries in emerging and existing teeth.4 With respect to the introduction of cereal, a value of <10g/100g of added sugar is recommended.5
Let’s look at some specific examples.
Weet-Bix
Weet-Bix are iron fortified and therefore high in iron with 9.1mg/100g. The serving size of half a Weet-Bix provides 25% of the recommended daily intake of iron for infants aged 7-12 months. Weet-Bix can also be a great snack to help with iron deficiency in pregnancy.
Weet-Bix contain 270mg of sodium per 100g and would therefore not be considered a high sodium cereal. The amount of sodium from half a Weet-Bix is very small (20 mg) and well below the adequate intake recommendations for infants. Weet-Bix Kids are even lower in sodium; however, it is important to consider that they are a more expensive option. Food recommendations suitable for the entire family are always preferred to avoid reinforcing the notion that infants and toddlers need special “baby and toddler foods”.
Additionally, Weet-Bix only contain 3g of sugar per 100g meaning that the sugar in half a Weet-Bix would be negligible (0.2g) and well below the recommended target of 10g/100g.
Furthermore, Weet-Bix are a good source of fibre. Fibre promotes a healthy gut microbiome and may aid in the prevention of constipation which can be common upon the introduction of solids. 6
It should be noted that other wheat biscuits on the market (i.e., Coles, Woolworths, and Aldi) are not iron-fortified and are therefore not a good source of iron.
Iron-fortified rice cereal as a first food
Iron fortified rice cereal is a processed cereal made from refined rice flour that is commonly marketed as an ‘infant cereal’. Rice cereal is a popular first food choice when introducing solids as it provides a source of iron, is low in sodium and sugar (see table below), is cheap, easy to prepare and is generally well accepted by babies due to its bland taste when mixed with breastmilk (or formula if not breastfeeding).
Bellamy’s Organic Baby rice cereal with prebiotic | Cerelac Baby rice cereal | Bubs Organic Baby banana rice | Sunrice Australian baby rice cereal | Weet-Bix Original | Weet-Bix Little Kids
|
Nutrition Targets | |
Iron (per/100g) | 2.2mg | 2mg | 5.1mg | 1.1mg | 9.7mg | 9.1mg | 11mg/day7
(7-12 months) |
Sodium (per/100g) | 1mg | 8mg | 0.05mg | <5mg | 270mg | 10mg | <300mg/100g3 |
Sugar (per/100g) | 0.1g | 1.2g | 0.6g | 0.1g | 3g | 2.9mg | <10g /100g5 |
Fibre (per/100g) | Not listed | Not listed | 0.2g | Not listed | 12.9g | 12.4g | No specific recommendation
under 1yr |
Whilst rice cereal is a cheap and convenient option, it should be introduced with a range of first foods from across the five core food groups to ensure that infants are exposed to a variety of nutrients as well as varying tastes and textures. Whilst rice cereal will not generally be eaten by other members of the household, serving it alongside family friendly foods, will allow infants to participate in family mealtime.
It should also be noted that there are some concerns relating to arsenic levels in infant rice cereal. Rice is a leading dietary source of arsenic and as such, varying levels of arsenic can be found in rice-based food products such as infant rice cereal. Whilst more investigation into arsenic levels in Australian rice cereals is required, consideration should be given when consumption is regular or in larger quantities and use of rice cereal alongside other fortified cereals and grains should always be encouraged.8
How to prepare cereal?
Mixing up cereal is as easy as combining a tablespoon or two of the cereal with enough breastmilk or formula to make the cereal very soft. As the infant develops, the texture should become thicker and lumpier. Whilst the cereal should be kept plain at first, the addition of fruits high in vitamin C is recommended once the infant becomes more established with feeding, as vitamin C will improve the absorption of non-haem iron from the cereal.9 Mashed fruits such as berries, kiwi and mango, or finely grated apple or pear are great options.
If using home ground cereal (such as grinding short brown rice) remember that this is not iron fortified so parents/carers will need to make sure the baby is getting other iron rich foods.
How often should cereals be offered?
Cereals are one of many first foods that should be offered daily alongside a wide variety of high iron, low sodium/sugar foods such as pureed meats, fish (no bones), egg, cooked plain tofu, legumes (no added salt), vegetables and fruit. 10,11
Ultimately, the foods chosen by families when solids are first introduced will differ. Families from varying cultural backgrounds have diverse traditions regarding first foods and the kinds of foods consumed. A varied diet comprised of iron-rich foods, including iron-fortified cereals, will help caregivers ensure the nutritional requirements of the infant are being met.
Additional resources
The INFANT training course is available and provides evidence-based information on healthy eating and active play in early childhood, including the latest information on feeding and the introduction of solids. The INFANT course is available online, is self-paced and takes approximately 6-8 hours to complete, over a 4-week period. For more information, or to register for the training, please see this link: https://www.infantprogram.org/facilitator-training/
The INFANT team have also developed the My Baby Now app which allows for convenient access to information and resources covered in the training course. Health professionals can access the My Baby Now app by clicking this link: https://is.gd/clinicianMBN
For those who have completed the training, and have access to the facilitator resources, more information on starting solids can be found in the Facilitator Manual in the 3- and 6-month session outlines.
References
- Vitamin and minerals [Internet]. Raising Children Network. 2017. Available from: https://raisingchildren.net.au/teens/healthy-lifestyle/nutrients/vitamins-minerals
- Infant Feeding Guidelines Information for health workers [Internet]. Available from: https://www.eatforhealth.gov.au/sites/default/files/files/the_guidelines/n56_infant_feeding_guidelines_160822(1).pdf
- Partnership Reformulation Program: Food categories and reformulation targets Partnership Food Category Sub-category Nutrient target (maximum) Timeframe Bread [Internet]. Available from: https://www.health.gov.au/sites/default/files/documents/2021/07/partnership-reformulation-program-summary-of-food-categories-and-reformulation-targets-food-reformulation-program-summary-of-food-categories-and-reformulation-targets.pdf
- Australian Dental Association. Sugar & Nutrition [Internet]. www.ada.org.au. 2021. Available from: https://www.ada.org.au/Dental-Health-Week/Oral-Health-for-Busy-Lives/You-are-what-you-eat-and-drink
- Guideline for reading food labels [Internet]. Gov.au. [cited 2023 Jun 17]. Available from: https://www.health.qld.gov.au/__data/assets/pdf_file/0028/370756/paeds_foodlabels.pdf
- Fibres for your gut: sorting through the roughage [Internet]. Dietitiansaustralia.org.au. 2022. Available from: https://dietitiansaustralia.org.au/health-advice/fibres-your-gut-sorting-through-roughage
- Nutrient Reference Values for Australia and New Zealand Including Recommended Dietary Intakes | NHMRC [Internet]. www.nhmrc.gov.au. 2006. Available from: https://www.nhmrc.gov.au/about-us/publications/nutrient-reference-values-australia-and-new-zealand-including-recommended-dietary-intakes
- Iron-Fortified Rice Cereal – A First Food for Starting Solids? [Internet]. Nourish Little Lives. 2021 [cited 2023 May 25]. Available from: https://www.nourishlittlelives.com.au/post/iron-fortified-rice-cereal-a-first-food-for-starting-solids#:~:text=Australia%20and%20New%20Zealand%20(FSANZ)%20permitted%20maximum%20level%20in%20cereals
- Ems T, Huecker MR, St Lucia K. Biochemistry, Iron Absorption [Internet]. Nih.gov. StatPearls Publishing; 2018. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448204/
- Raising Children Network. Introducing solids: why, when, what and how [Internet]. Raising Children Network. 2020. Available from: https://raisingchildren.net.au/babies/breastfeeding-bottle-feeding-solids/solids-drinks/introducing-solids
- Services D of H & H. Eating tips for children – babies [Internet]. betterhealth.vic.gov.au. Available from: https://www.betterhealth.vic.gov.au/health/healthyliving/eating-tips-for-babies#babys-first-foods