A Family Guide to Weaning for Children with Kidney Disease
This guide offers practical tips and advice to help you through the weaning process whilst supporting your child’s kidney health. You’ll find useful information, along with kidney-friendly recipes, to ensure your child is well nourished as they begin trying new foods. Always consult your healthcare team to make sure any weaning plan meets your child's unique needs.
When to start your baby on first tastes?
Weaning is an exciting time for you and your little one as they start to explore a variety of new tastes and textures. Breast milk or infant formula can meet a baby’s needs for growth until about six months of age.
Babies usually start weaning around 6 months of age, however all babies are different. Some may be ready to start food a little earlier than others. Solids should only be given when your baby is ready and not before 17 weeks of age as their digestive systems are not mature enough.
The following signs are a good indication of when to begin weaning:
- Your baby can sit up on their own and hold their head in a steady position
- Your baby is showing an interest in food
- Your baby can grab things and put them in their mouth
Feeding your baby with kidney disease
Healthy kidneys filter blood and remove excess water, salt and waste from the body in the urine. Babies with kidney disease have impaired kidney function, and their kidneys do not remove water, salt and waste from the body as well as they should.
Potassium and phosphate are minerals that can build up in the blood as kidney function decreases. We get potassium and phosphate from the foods we eat, and your baby’s intake of potassium and phosphate may need to be adjusted if their potassium and phosphate blood levels start to rise.
Your dietitian will help you with any changes you may need to make to your baby’s diet.
Potassium: To help control potassium levels your dietitian may ask you to reduce your baby’s intake of some high potassium foods that are often used for first weaning foods e.g. potato, sweet potato, tomatoes, banana, and avocado.
Phosphate: To help control phosphate levels we advise cooking meals from scratch (home-made meals) and trying to avoid processed foods that contain phosphate additives.
Your Dietitian may advise that you use a specialised feed which is low in potassium and phosphate in combination with breast milk or infant formula.
Salt: Cooking from scratch and not adding salt during cooking or at the table will help limit your baby’s salt intake. A small number of babies require extra salt and will be prescribed salt supplements.
Baby jars and pouches can be used in addition to homemade food when needed
One of the most important parts of weaning is that your baby enjoys whatever they can manage and they progress at their own rate. Often babies and children with kidney disease can only manage small amounts of food. Children who have had positive experiences with food such as touching, playing, licking, throwing and eating small amounts of food, progress with eating after their kidney transplant.
Due to the symptoms associated with kidney disease, you may find that your baby is not keen on trying solid food or is uninterested in food. Don’t worry, this is common for children with kidney disease. Just licking or playing with the food is a positive thing!
Once children with kidney disease have a kidney transplant, their appetite improves, food tastes better and the majority of children eat a normal healthy diet.
To encourage eating always try to:
- Include your baby at family mealtimes
- Eat with others and include other children where possible e.g. siblings, friends
- Keep mealtimes relaxed and fun
- Try not to worry if your baby doesn’t eat anything and makes lots of mess!
- Keep mealtimes to a maximum of 30 minutes
- Set regular times for meals.
General weaning advice
- Always stay with your child when they are eating.
- Avoid adding salt or sugar.
- Some foods can contain a lot of sugar or salt e.g. stock cubes, baked beans and tinned soups. Try to avoid these and try using baby friendly stock cubes.
- Avoid honey for children under 1 year of age.
If you are concerned about any food allergies please speak to your dietitian or healthcare professional
What you need in your weaning kitchen
We encourage home cooking where possible without adding salt and sugar.
Cooking food yourself will allow you to know exactly what you are giving your baby. Cooking from scratch allows us to keep any additives to a minimum, helping to reduce the potassium and phosphate content of the meal.
Home cooked food can be tastier, cheaper and there is often less waste. Homemade food can be made in large batches and then frozen in small ice cube trays so that you can defrost and use these when needed.
Equipment needed:
- Vegetable peeler
- Sharp knife - to chop fruit and veg into small chunks
- Potato masher - to create a smooth texture or larger lumps as your baby progresses with their textures
- Grater
- Hand blender/food processor - for whizzing up foods into the correct texture
- Small pans - to reheat small portions (or you can use a microwave)
- Ice cube tray for freezing
- Spoons and bowls
- Bibs
Getting started
Choose a time when your baby is not tired.
Give solids before your baby’s usual milk feed.
Solid foods are introduced in stages, gradually moving towards the family’s diet.
Stage 1 - First tastes - small amounts of purée, usually starting with single vegetable ingredients and moving on to fruits.
Stage 2 - Mashed foods, progressing to lumpy textures.
Stage 3 - Chopped up food with lumps and increasing in size.
Stage 4 - Family foods.
Stage 1: Purée foods
Babies need a smooth purée texture to begin with. Start by offering 1-2 spoonfuls of the purée food once a day. Gradually increase the amount according to your baby’s appetite.
Make batches of foods. You can then put these into ice cube trays and defrost them when you want to use them.
Boiling, steaming and roasting vegetables are all suitable ways to cook vegetables.
If your baby is on a fluid restriction, try removing the excess liquid from the recipes or use a minimal amount.
How to add extra calories
Your baby may need extra calories to help them grow. Adding the following to food will help boost calories:
- Add margarine/unsalted butter/oil to cooking.
- Add olive oil to pasta.
- Add cream to cooking and desserts.
- Add crème fraiche, cream cheese and cream to cooking.
- Use full fat products e.g yogurts, rice pudding, custard, mayonnaise, milk, margarines.
- Add peanut butter† or cream cheese to toast/bread.
- Hummus as a dip with bread sticks.
- Add mayonnaise to foods e.g tuna/egg for sandwiches.
How to Start
Start with offering single purée vegetables. Once you have introduced a range of vegetables, try mixing vegetables together and then introduce fruits. The following fruits and vegetables are the most suitable for babies with kidney disease.
Vegetables: Purée aubergine, broccoli, butternut squash, green cabbage, carrot, courgette, cauliflower, leek, peas, pumpkin, spinach, swede and sweetcorn.
Fruit: Apple, blackberries, blueberries, cherries, pear, pineapple and raspberries.
Baby rice/baby cereals can also be used.
Try some of our purée recipes!
Stage 2: Mashed, moving to lumpy textures
Gradually moving onto mashed and lumpier food will encourage your child to chew. Mash food with a fork or potato masher instead of using a blender. You can start to offer soft finger foods.
Breafast ideas:
Weetabix, porridge, and baby cereals
Soft fruit e.g soft pear, blueberries and raspberries (cut these fruits into halves)
You can add formula to your baby’s cereals or a small amount of full fat cow’s milk.
Meal ideas:
Small portion of soft cooked meat e.g chicken, beef, lamb, pork, fish, eggs, lentils or beans (kidney beans/ Cannellini beans/chickpeas)
Soft vegetables
Pasta, rice, cous cous, egg/rice noodles/potatoes
Pudding ideas:
Rice pudding/custard
Dairy foods:
Aim for 2-3 portions a day:
1 small pot of yogurt
Small portion of custard or rice pudding
1 thin slice of cheese
Finger foods
Offering your baby finger foods is a good way to help your baby to learn how to feed themselves and it can help them become familiar with different textures of food.
Finger food ideas from 6/7 months onwards:
Cut the foods into small strips which your baby can easily hold.
- Soft cooked vegetables: broccoli, carrot, cauliflower and cucumber
- Soft pear, raspberries, blackberries
- Soft wholemeal toast or bread/pitta/chapati with margarine/unsalted butter/soft cheese/smooth peanut butter†
- Bread sticks with hummus/cream cheese
- Soft pasta
- Fingers of omelette
- Baby corn/wheat snacks
- Rice cakes
- Homemade oat bars/plain biscuits
Some baby biscuits and snack bars often contain high amounts of sugar and are not recommended for daily consumption.
Your dietitian will help you with any changes you may need to make to your baby’s diet.
