Nutrition recommendations for infants from six to 24 months

By Rosie Schwartz, RD on June 27, 2017

 

Question:

I understand the recommendations of what to feed babies and toddlers has changed. This includes first foods and foods that can cause allergies. Can you please clarify the current guidelines?

Answer:

There has been a real shake-up in the recommendations of what to feed babies and toddlers. For decades, there was a standard order of introducing cereal, in particular rice cereal, as the first solid food, followed by vegetables, then fruit and so on.

The new advice, called Nutrition for Healthy Term Infants: Recommendations from Six to 24 Months, is a joint statement of Health Canada, Canadian Paediatric Society, Dietitians of Canada and Breastfeeding Committee for Canada. Notice the age group in the title. Not only have the suggested foods changed, but also when to begin feeding solids. Rather than starting at four months of age, parents can enjoy watching their young ones eat solids for the first time at six months.

Iron-rich choices, such as meat and alternatives like pulses (lentils or kidney beans for example) and iron-fortified cereals should be the initial solids introduced at this time. But these selections should be complementary to the breast or formula feeding. Other foods can then be introduced in any order and can depend on what the family is eating.

Offering a variety of shapes and textures, from lumpy and pureed to finger foods, before nine months of age may help to prevent your child from developing into a picky eater. Avoid choking hazards such as whole grapes, whole nuts or seeds, nut butter on a spoon or thickly spread and pieces of raw hard fruits or vegetables like apples and carrots.

There’s a big change, however, in the area of potentially allergenic foods. Rather than holding off on their introduction, research is showing that feeding options such as eggs, cow’s milk, wheat, fish, soy and nuts and seeds earlier may decrease the risk of allergies. It can take a day for reactions to occur, so it’s best to introduce new foods at a slower pace of not more than one new food over a two-day period. If there’s no reaction, these selections should be included regularly to keep up the tolerance. But for those with food allergies, parents should consult their healthcare professional.

Believe it or not, it’s also time to forget the sippy cup. An open cup helps infants to develop mature drinking skills and doesn’t encourage prolonged bottle feeding.

There are a few other recommendations that still stand. Breast is best is still the mantra. However, when cow’s milk is introduced, it should still be homogenized milk, not fat-reduced, until the toddler is two years old. For breastfed babies, 400 IU of vitamin D is also recommended. Another long standing rule is to avoid feeding honey to an infant under one year of age as there is a risk of botulism poisoning at this age.

Rosie Schwartz is a consulting dietitian in private practice in Toronto and author of The Enlightened Eater’s Whole Foods Guide (Viking Canada). Read more at rosieschwartz.com.

Originally published in ParentsCanada magazine, Summer 2017.


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