Dietary advice for parents/carers of infants
Breast milk provides the best source of nourishment for the early months of life. Mothers are encouraged and supported in breast-feeding and may choose to continue to breast-feed as the weaning diet becomes increasingly varied.
Children have high energy needs for growth and development. It is important that children are given energy rich foods that are nutritious such as cereals, breads, dairy foods, and meats, chicken and eggs. Foods from the first four shelves of the food pyramid should be used to replace foods from the very top shelf that are high in added sugars/fats such as chocolate, cakes and sweets.
- Do not add sugar to home prepared weaning foods
- Limit baby foods sweetened with added sugars
- Milk and water are the best drinks for children.
- Breast milk is the best form of nourishment for young infants. If is it not possible to breast feed, a suitable iron-fortified infant formula should be used. Cow’s milk is not advisable for infants less than 1 year old but is a suitable drink for older infants. Milk is a good source of calcium which is necessary for the development of teeth and bones.
- For children allergic to cow’s milk, soy milk (also called soya milk, soybean milk or soy juice) is an alternative. Soy milk contains sugar and can cause dental decay if children are allowed drink it on demand throughout the day from a feeding bottle. Soy milk should be used as a “feed” and not as a drink.
- Plain tap water is a suitable drink for all ages but should be boiled – just once, for about 1 or 2 minutes – and cooled for infants less than 1 year. Natural mineral/bottled waters may not be suitable for infants because of their mineral levels.
- Fruit juices should be unsweetened, well diluted to diminish their acidity and natural sugar content (1 measure to 4 or 5 measures of boiled water) and given only at mealtimes from a cup. Baby juices and herbal drinks are not needed, but if given should be used sparingly and only at mealtimes from a cup.
- Colas, squashes, fizzy drinks and diet drinks are unsuitable for infants as they are highly erosive to tooth enamel and have no nutritional value.
- Foods should never be added to the baby bottle as babies can choke from the added food.
- Infants should be weaned from using baby bottles by their first birthday.
Baby Bottle/Nursing Decay
Parents/carers of infants should be warned particularly about the dangers of putting fruit juices or sugar-sweetened drinks into feeding bottles or reservoir feeders and giving these to the baby/toddler to hold, especially in bed. Such practices result in almost continuous bathing of the enamel with sugars and leads to severe and rapid tooth destruction, a condition described as baby bottle/nursing decay.
This condition is preventable
"Children should be fed and put to bed - NOT, put to bed and fed"
- Do make sure that your child does not sleep with a bottle in his or her mouth
- Do avoid all sugar-containing liquids in nap or bedtime bottle
- Do encourage drinking from a cup
- Do discontinue bottle feeding by your child's first birthday
- Do avoid dipping a soother in sugar, honey or anything sweet before giving to your child.
Changes in eating habits due to relative independence from family influences and the influence of peers can result in changes in health behaviours and diet, specifically in relation to sugar.
Overall, there has been a slight improvement in the dietary habits of school-aged children in recent years: the 2006 Irish Health Behaviour of School-Aged Children (HBSC) Study reports a slightly higher percentage of children consuming fruits and vegetables more than once daily and a slightly lower percentage consuming sweets and soft drinks daily or more often, compared with 2002. The HBSC study also reported evidence of a social class gradient, with children from the highest social classes (SC 1-2) more likely to have frequent fruit and vegetables consumption and less likely to have frequent soft drink consumption.
The slight improvements in children's dietary habits are likely linked to similar changes in adult dietary habits revealed by the 2007 SLÁN. It can be conjectured that these slight changes in dietary habits stem from a greater population awareness of the health impacts of lifestyle behaviour, in light of the concern for rising obesity in Ireland. However, eating habits, specifically in relation to sugar, can be changed by peer influence as children gain relative independence from family influences. Overall, 39% of the children surveyed in the 2006 HBSC survey reported eating sweets and 26% drinking soft drinks daily or more frequently, with higher rates in the older age groups. The graphs below show the breakdown of daily sweets and soft drinks consumption by age group, gender and social class.
- Suggestions for between meal snacks are fruit, crisp raw vegetables, sandwiches, variety of breads, yoghurts, low fat cheese, plain popcorn and scones
- Cereals such as porridge and shredded wheat are excellent energy providers, but avoid the sugar-coated types. In general, the sugar and salt content of breakfast cereals should be checked as some breakfast cereals are high in one or the other or both.
- Milk and water are suitable to drink between meals.
- Pure juices, fruit squashes and smoothies should be consumed at meal times.
- Drinks containing added sugars, including probiotic and yoghurt type drinks, should be consumed at meal times.
- Regular intake of carbonated drinks, including sparkling water, can lead to enamel erosion of the teeth and should be avoided.
Health implications of soft drinks
Some 21% of school-aged children in Ireland report drinking soft drinks on a daily basis. Epidemiological studies in the United States, which has the highest per capita soft drink consumption in the world, have linked daily consumption of soft drinks containing cola (a phosphoric acid) with lower bone density in women. There is also concern that daily soft drink consumption is displacing milk intake, an important source of dietary calcium, thereby increasing the risk among young teenage girls of osteoporosis in later life. Research in the United States has also shown an association between soft drink consumption and the incidence of type 2 diabetes and obesity.
Dental Health Implications
The frequent consumption of sugar containing fizzy drinks not only put teeth at risk to decay but can also cause erosion of the enamel. This is due to their acidic content (see Tooth Wear for more details).
Fruit juices are an important source of vitamins in the diet. However, they should be taken with meals for two reasons. The frequent consumption of these can lead to enamel erosion and although pure juices may not contain sucrose they are rich in fructose and can also be cariogenic (cause tooth decay). As fructose in whole fruits pose little or no threat to dental health, whole fruits rather than fruit juices/smoothies should be consumed between meals.
Adults and Older people
Loss of natural teeth is associated with poor nutritional status in the elderly. Consumption of sugars seems to be higher in older adults than in younger adults.
A tendency towards reduced salivary flow together with a higher sugar intake and increased gum recession, places the older person with natural teeth at greater risk of dental caries (root caries) than younger adults.
This population group tend to be frequent users of over the counter medicines, e.g. cough drops, laxatives, antacids and various tonics, which are generally high in sugar. The most important cause of dental erosion in adults is regurgitation and acidic drinks. Dietary advice for dental health for adults with natural teeth should be consistent with general health dietary guidelines.
- Older people should be encouraged to eat a variety of healthy foods (e.g bananas, nuts, berries, yoghurts, vegetables and wholegrains) as snacks from the food pyramid and limit foods from the top level of the Food Pyramid that are high in sugar, fats and salts but low in nutrients such as cakes, sweets, biscuits and soft drinks.
- The consumption of 8-10 cups of fluid a day is important for this age group.