Nutrition for healthy term infants, birth to six months: An overview

Question 1

What are the principles of infant feeding?

Answer 1

1. Breastfeeding is the normal and unequalled method of feeding infants.
2. Breastfeeding initiation and duration rates increase with active protection, support and promotion.
3. Supplemental vitamin D is recommended for breastfed infants
4. First complementary foods should be iron rich
5. Routine growth monitoring is important to assess infant health and nutrition.
6. Feeding changes are unecessary for most common health conditions in infancy
7. Breastfeeding is rarely contraindicated

Question 2

What are the recommendations for infant feeding?

Answer 2

1. Recommend exclusive breastfeeding for the first six months.
2. Implement the policies and practices of the Baby-Friendly Initiative for hospitals and community health services.
3. Recommend a daily vitamin D supplement of 10 µg (400 IU) for breastfed infants.
4. Recommend meat, meat alternatives and iron-fortified cereal as an infant’s first complementary foods.
5. Use the WHO Growth Charts for Canada for optimal monitoring of infant growth.
6. Explain that feeding changes do little to manage infantile colic.
7. Educate about the wide variation in normal bowel function, noting that true constipation is rare.
8. Reassure that reflux or ‘regurgitation’ is common and rarely needs treatment.
9. Manage mild to moderate dehydration from acute gastroenteritis with continued breastfeeding and oral rehydration therapy.
10. Recommend cow milk-based, commercial infant formula for an infant who is not exclusively fed breastmilk. Soy-based infant formula is indicated only for those infants who have galactosemia or who cannot consume dairy-based products for cultural or religious reasons.
11. Recommend infant formulas for special medical purposes only when you detect or suspect that the formula-fed infant has the indicated condition.
12. Discourage the use of home-made, evaporated milk formula. Cow milk, goat milk, soy beverage, rice beverage or any other beverages should not be given to young infants.
13. Advise on proper preparation and storage to reduce the risk of bacteria-related illness.
14. Warn of the risk of choking if infants are left alone while feeding. Explain the dangers of ‘propping’ a bottle.