Every five years, the Federal civil rights law, U.S. Department of Agriculture (USDA), and U.S. Department of Health and Human Services (HHS) releases new/updated dietary guidelines for people of all ages. As a pediatrician, I get the most questions regarding the 12 months to two-year time frame when they are discontinuing breast milk or formula and transitioning to regular table foods.
As most know, you should exclusively feed infants human milk for the first six months of life. Continue to feed infants human milk through at least the first year of life and longer if desired. Feed infants iron-fortified infant formula during the first year of life when human milk is unavailable. When exclusively breastfeeding, it is important to provide infants with supplemental vitamin D beginning soon after birth (By at least one month of age).
Around 4-6 months of age, we start to introduce infants to nutrient-dense complementary foods. Studies have shown that at six months, the introduction of infants to potentially allergenic foods along with other complementary foods helps to prevent food allergies.
Encourage infants and toddlers to consume a variety of foods from all food groups. Include foods rich in iron and zinc, particularly for infants fed human milk.
Zinc-rich complementary foods (e.g., meats, beans, zinc- fortified infant cereals) are important from age six months onwards to support adequate zinc status, which supports growth and immune function. Although the zinc content of human milk is initially high and efficiently absorbed, the concentration declines over the first six months of lactation and is not affected by maternal zinc intake. During the second half of infancy, approximately half (54%) of U.S. infants fed human milk have inadequate zinc intake. Prioritizing zinc-rich foods starting at six months of age to complement human milk feedings will help infants meet their requirement for zinc.
Avoid foods and beverages with added sugars.
Limit foods and beverages higher in sodium.
Developmental Readiness for Beginning to Eat Solid Foods
The age at which infants reach different developmental stages will vary. Typically, between ages of four and six months, infants develop the gross motor, oral, and fine motor skills necessary to begin to eat complementary foods. As an infant’s oral skills develop, the thickness and texture of foods can gradually be varied.
Signs that an infant is ready for complementary foods include:
- Being able to control head and neck.
- Sitting up alone or with support.
- Bringing objects to the mouth.
- Trying to grasp small objects, such as toys or food.
- Swallowing food rather than pushing it back out onto the chin.
Calorie level ranges: Energy levels are calculated based on median length and body weight reference individuals. Calorie needs vary based on many factors. The DRI Calculator for Healthcare Professionals, available at usda.gov/fnic/dri-calculator, can be used to estimate calorie needs based on age, sex, and weight.
This is an excerpt of some helpful guidelines, and you can read the entire document at DietaryGuidelines.gov. Talk with your pediatrician about your child’s appropriate nutritional needs.
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