Community Health Services .::New Nutrition Recommendations for Healthy Term Infants::.

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Home>Health Information>Infant Health>New Nutrition Recommendations for Healthy Term Infants

New Nutrition Recommendations for Healthy Term Infants

This page was reviewed or revised on Friday, August 14, 2009.

In the Spring of 1998, the Canadian Paediatric Society, Dietitians of Canada, and Health Canada released guidelines to assist health care professionals in providing parents and caregivers with consistent information on nutrition for healthy term infants from birth to 24 months of age.

The guidelines present 50 recommendations on topics such as breastfeeding, alternate milk, transition to solid foods, feeding safety, dietary fat, supplements, and vegetarian diets. The following are the recommendation highlights:

Breastfeeding

Encourage and support exclusive breastfeeding for the first six months of life. Breastfeeding is rarely contraindicated, including in women who smoke and consume moderate, infrequent alcohol. It is contraindicated when a mother is HIV antibody positive.

Criteria for hospital discharge should include at least 2 successful nursings managed independently by mother and baby. As well, the mother and baby should be evaluated within 48 hours of discharge.

Vitamin D supplementation is recommended for all breastfed full-term infants and supplementation should continue until the infant's diet includes at least 10 micrograms (400 International Units) a day of vitamin D from other dietary sources or until the breastfed infant reaches one year of age.

Alternate Milks

If an infant is partially breastfed or not at all, a cow’s milk-based, iron-fortified formula is recommended until 9 to 12 months of age. Pasteurized whole cow’s milk may be started at nine months. Partly skimmed milk (1% or 2%) is not routinely recommended and skim milk is inappropriate for the first 2 years. Soy (except soy infant formula), rice or other vegetarian beverages are not recommended in the first two years.

Homemade formula made with canned evaporated milk is NOT recommended. It is low in iron and essential fatty acids and delivers a high renal solute load. However, if its use is necessary for financial reasons, use whole milk varieties, provide an iron source and mix according to directions given in the document.

Other Fluids

Bring all water for feeding infants under 4 months of age to a rolling boil for at least 2 minutes to ensure it is pathogen free. Limit fruit juice to avoid diarrhea and interfering with intake of milk. Do not use herbal teas or other beverages. If well water is used, it should be tested at least twice a year.

Solid Foods

Introduce at 6 months, beginning with iron-fortified cereals. To ensure food is safe, avoid feeding honey in the first year. Cook all eggs well, serving egg yolks only. Avoid egg whites for the first year. Do not use a "propped" bottle. Avoid hard, small, and round, smooth, and sticky solid foods which may cause choking. Always supervise infants and toddlers during feeding.

Nutrition in the Second Year

Older infants need four to six small nutritious meals a day in addition to their milk source. Pressuring infants to eat may lead to negative attitudes about eating, poor eating habits or over feeding that may foster excess weight gain.

Food allergies

Encourage exclusive breastfeeding for at least 4 months to decrease risk in infants with a positive family history. If food choices are restricted, ensure nutrient and energy needs are met.

Colic

Ensure that any dietary modification or pharmalogical interventions are safe. Dietary manipulations have limited success.

Constipation

In infancy, true constipation is infrequent; parents need to know about the wide variation in normal bowel function.

Dietary Fat

Restriction of fat during the first two years is not recommended.

Diabetes

There is no justification at this time to recommend changes to infant feeding practices for the purpose of preventing diabetes.

Dental Caries

Fluoride supplementation may be needed after 6 months of age depending on the amount found in the local water supply. Avoid giving bottles containing liquids other than water when putting infants to sleep.

Physicians and health care professionals may contact the health unit for more information or for a copy of the report, "Nutrition for Healthy Term Infants" at 383-8331 ext. 603.

Source: Sudbury & District Health Unit