Food safety is an important aspect of feeding infants, children and adolescents. It includes choking hazards, food allergies and safety related to infectious agents and environmental contaminants.
Infants and young children are at a high risk of choking. The presence of teeth does not mean that they can handle all types of food. It is important to provide age appropriate textures and appropriately sized foods. When starting solids, give foods that can easily mix with saliva and do not require chewing. Mix cereals and mashed cooked grains with breast milk, formula or water to make it smooth and easy for baby to swallow. Mash or puree vegetables and fruits. Hard foods like apples and carrots should be cooked so that they can be easily mashed or pureed. As babies oral skills develop, thicker and chunkier foods can be introduced.
In general, some foods that pose choking risks should be avoided in children under four years of age:
Small firm foods that do not become soft in the mouth like nuts, popcorn, dry cereal flakes, chips, chunks of raw vegetables, whole olives, whole cherry tomatoes etc. should be avoided in this age group. Vegetables like carrots should be cookedand cut up. Slippery foods like whole grapes, hot dogs and lollipops should not be offered to small children. Grapes should be peeled and cut into quarters. Cylindrical foods like string cheese and sausage should be cut into short thin strips instead of round pieces that could get stuck in the airway. Sticky foods like peanut butter can stick to the roof of the mouth and cause choking. Spread the nut butter as a thin film on bread or other food. Do not give it straight from a spoon or finger.
Never leave the child unattended while they are eating. Encourage them to eat slowly and chew well before swallowing. Do not allow the children to lie down or run around or play while eating or drinking.
Preventing food borne illnesses:
Observe good hygiene practices while preparing food and feeding your child. Hand washing is the most effective measure you can adopt to prevent food borne illnesses in your baby and toddler. Teach your children to wash their hands after touching pets, using the toilet and before eating. Be sure to wash bottles, sippy cups, feeding utensils and other feeding supplies in hot soapy water and rinse thoroughly. Certain foods should not be given to babies and toddlers as they are more prone to cause infection.
They include the following:
All unpasteurized dairy and dairy productsRaw or partially cooked eggs or foods containing raw eggsRaw or undercooked meat and poultry Raw or undercooked fish and shellfishUnpasteurized juices unless freshly squeezed at homeRaw sproutsHoney till one year of age
Avoid feeding directly from a container that will be stored again such as a baby food jar. The double-dipping from spoon to mouth and back to container introduces bacteria from your child’s mouth into the rest of the food. The desired quantity of food should be spooned into a separate dish and used to feed your child. Throw away all uneaten food from the dish. The leftover food that did not come into contact with the baby’s saliva can be saved in the refrigerator for later use.
While reheating food, make sure it is steaming hot all the way through, then let it cool down before giving it to your child. If using a microwave, always stir the food and check the temperature before feeding it to your child. There may hot spots in the food that can cause burns. Do not reheat cooked food more than once.
During weaning, start with one single ingredient food at a time this helps to know if your child has any reaction to that food such as food allergies. Wait three to five days between each new food. Your child will soon be on his way to eating and enjoying lots of different varieties of new foods. Introduce potentially allergenic foods when other foods are introduced. The common potentially allergenic foods include cow’s milk and milk products, eggs, fish, shellfish, nuts wheat and soy. Cow’s milk should be given only after one year of age, but milk products like yogurt and cheese can be introduced earlier. Talk with your child’s doctor if your child has severe eczema or a family history of food allergies or other concerns.
Environmental toxins and heavy metals
Baby foods may contain variable levels of arsenic, lead, cadmium and mercury. These are found in the environment and can get into crops and food during cultivation or during processing. Heavy metals cannot be completely avoided even with organic farming methods. It is usually present in miniscule amounts to cause any adverse effects. But it raises a lot of concerns for parents. Some of the measures that can be taken to avoid high levels of such elements are the following:
Feed your child healthy meals and snacks and not too much of one thing.Limit higher risk foods e.g. rice can contain arsenic. So limit rice and try rice-free foods like oatmeal, quinoa, and multigrain cereal. Similarly, veggies that grow underground (carrots and sweet potatoes) are a good source of nutrients, but can contain lead and cadmium. So mix and serve a variety of fruits and vegetables from every colour of the rainbow during the week. This helps prevent accumulation of the toxin or heavy metal from the same food item given over and over again. Certain types of seafood have high mercury content e.g. albacore tuna, mackerel and sword fish. Fish is a good source of lean protein and therefore an important part of your baby and toddler’s diet. Opt for low mercury choices such as salmon, cod, light tuna, tilapia and cat fish.
Some parents prefer organic foods for their children secondary to concerns regarding chemical and hormonal content of animals and produce. Organic food is defined as produce and ingredients that are grown without the use of pesticides, synthetic fertilisers, sewage sludge, genetically modified organisms or ionising radiation. The animals that produce meat, poultry, eggs and dairy products are not given antibiotics or growth hormones. The nutritional differences between organic and conventional foods is clinically not relevant. It is also hard to establish the clinical significance of pesticides in non organic foods. The amount of bovine growth hormone in milk is neither clinically significant nor biologically active in humans. Thus the desire to feed organic foods to your child would be a parental preference.
Dr. Ayisha Bahauddin Specialist Paediatrician, Mediclinic Dubai Mall