When discussing the introduction of complementary foods, I am often asked by both parents and grandparents how much salt can be added to their baby’s meals. My answer is always the same – no salt for at least one year. Babies’ kidneys are not fully developed and, as a result, they are unable to filter out the excess salt like an adult’s kidney can. However, all of us need a little salt to survive, including babies, who require less than 1 gram of salt per day till they turn one. For the first six months, this requirement is met by either breast milk or formula. One- to three-year-olds should not have more than 2 gram of salt per day. Too much salt too early in life may promote a lifelong preference for salt, that is far from healthy. The excessive consumption of salt can cause babies to develop hypertension later in life, which is one of the precursors of heart disease in adults.

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How much is too much?

Once weaning begins and the quantity of milk reduces, your baby will meet her salt requirement from the food she consumes. It is around this time that things start to go wrong, and children consume more salt than is necessary, especially when parents practise baby-led weaning – where babies are offered adult food with a much larger salt content.

Babies are born with a preference for sweet and salty food. Repeatedly offering them salty food will reinforce this preference and they will reject less salty food. It is important to avoid adding salt to anything you cook from scratch. Parents and grandparents usually add salt to baby food hoping that this will improve the taste and thus encourage the baby to eat better. However, it is better to use herbs and spices as taste enhancers instead. You can make meat stock or vegetable stock and use this to make food for your baby.

Having a few titbits from your plate is okay as a lot of babies like picking off from adult plates. Pasta, rice, vegetables etc. are very low in salt and make excellent starchy options for the baby. Children love cheese but since the salt content is high, it is best to rotate it with other foods like vegetables, lentils, fish, eggs and chicken. Paneer is another good alternative to cheese.

High salt foods to avoid

Pre-packed meals not meant for babies

* Pies and cold cuts * Smoked salmon * Biscuits * Crackers * Readymade soups * Chips * Packaged noodles * Diet snacks

What to look for in labels

When looking for nutritional information in labels, check the amount of salt it contains. Salt is referred to as sodium chloride or sodium, and either of these names can be found in labels. Low salt foods will contain less than 0.3 gm per 100 gm. The European and American authorities differ slightly in their recommendation for the addition of salt to a baby’s diet, after one year. The European Food Safety Authority recommends 1100 mg of sodium per day – that is half a teaspoon of table salt – while the American authorities recommend a much smaller amount of 800 mg of sodium per day. Always check food labels before buying the ready-made purees and foods for babies. Store-bought foods are usually low in nutrient value so fresh food made at home is the way to go.

Signs of excessive salt intake

If babies are consuming too much salt in their diet, they will get very thirsty. In very rare cases, excessive ingestion of salt may lead to hypernatremia. In this condition, blood sodium levels are very high. Symptoms of hypernatremia are irritability, drowsiness, lethargy and, eventually, coma. It is difficult to pick up the milder cases as they may just appear fussy and their skin feels very doughy. If you think your baby has ingested large amounts of salt accidentally, you must contact your paediatrician.

Ways to limit the amount of salt in baby’s diet

* Don’t add salt when you are preparing the baby’s food from scratch * Choose fresh vegetables and not canned ones. If you are using canned vegetables, please rinse before using as they have a lot of salt * When you are preparing food for the family, keep some away for the baby and then add the salt for the rest of the family. You can improve the flavour by adding fresh herbs and other spices * Get into the habit of checking labels of food that you buy for your baby specially to look for the salt content * If you are going out for a meal, it might be a good idea to feed the baby before stepping out as restaurant food is always high in salt * Try not to add salt for babies under one year and you can ease up a little during the second year

To summarise, babies do need small amounts of salt in their diet, however, their kidneys cannot handle large amounts of it. Babies fed a high-salt diet can go on to develop hypertension and even heart disease in adulthood. Moreover, a salt rich diet may cause babies to develop a lifelong preference for salty food.

Dr Saroja Balan is consultant neonatologist and paediatrician at Indraprastha Apollo Hospital. Her column appears every fortnight

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Dr Saroja BalanDr Saroja Balan is consultant neonatologist and paediatrician at Indra... read more