The Latest Canadian Nutrition Guidelines For Infants and Children 6 Months to 2 Years of Age
Health Canada and the Infant Feeding Joint Working Group have recently released recommendation guidelines for the nutrition of older infants (six months – 12 months) and young children (12 – 24 months). We have summarized the recommendations below:
1. Human breast milk remains an important source of nutrition as a baby’s first foods are introduced.
According to the Institute of Medicine, breastfeeding, along with the introduction of appropriate complementary foods, is the nutrition standard for feeding older infants. According to the World Health Organization and UNICEF, Breastfeeding and offering appropriate complementary foods are among the most effective interventions to promote child health, growth and development. Keep in mind that there is no deadline to stop breastfeeding; weaning should be determined by the individual needs and circumstances of mother and child.
2. At least 400 IU/Day of vitamin D is recommended for infants and young children.
It is likely that breastfed infants beyond 6 months of age continue to require vitamin D supplementation. It is recommended to supplement breastfed babies with 10 µg (400 IU) of vitamin D daily. Some formula-fed babies meet their daily requirements for vitamin D whereas others may not (especially the ones who take quickly to eating complimentary foods). If in doubt, it is safe (in the vast majority of cases) to provide a baby, whether breastfed or not, with 400 IU of supplemental vitamin D daily.
3. Complimentary feeding, along with continued breastfeeding, provides the nutrients and energy to meet the needs of the older infant.
When introducing complimentary foods, it is recommended to gradually increase the number of times a day that they are offered while continuing to breastfeed. These first foods should be iron-rich meats, meat alternatives, and/or iron-fortified cereal. After these initial foods, move on to introduce healthful foods from family meals. The texture of complimentary foods should progress along with the child’s feeding abilities. It is important to provide a variety of textures (foods that are tender-cooked, finely minced, pureed, mashed and ground) and soft finger foods (bite-sized pieces of soft-cooked vegetables, soft fruits like ripe banana, soft deboned fish, scrampled egg, etc.)
4. Responsive feeding promotes the development of healthy eating skills.
‘Responsive feeding’ means that a parent or caregiver responds in a prompt, emotionally supportive, and developmentally appropriate way to the child’s hunger and fullness cues. The essential principles of responsive feeding include
- Allowing the child to guide the eating experience
- Promoting self-feeding as much as possible in a developmentally appropriate manner
- Using eye contact and positive verbal encouragement, but not verbal or physical coercion
- Offering age- and culture-appropriate eating utensils
- Responding to early hunger and fullness cues/behaviors
- Minimizing distractions during meals and snacks
- Offering broad varieties of food combinations, tastes, and textures
6. Foods for older infants and young children must be prepared, served, and stored safely.
Supervision during feeding is recommended. It is important to avoid offering foods that could cause a child to choke (hard, small and round, or smooth and sticky foods). The food most commonly associated with fatal choking in infants and young children is hot dogs. Hot dogs and sausages should be diced or at least cut lengthwise into long quarters before being offered.
Safely preparing and storing foods will help to prevent food-borne infections. Always prepare foods with working surfaces, utensils, and food items appropriately prepared and/or washed. Meat, eggs, poultry, and fish must always be thoroughly cooked. Unpasteurized milk, milk products, and juices should not be given to young children and infants. Honey should not be given to any children under one year of age due to a risk of infant botulism.
7. From one year of age, young children should begin to have a regular schedule of meals and snacks and generally follow the advice in Canada’s Food Guide.
A regular meal and snack schedule with foods from a variety of the four food groups is recommended. As often as possible, foods with little or no added salt or sugar should be offered. Foods should be nutrient-dense and relatively high in fat content (fat is an important source of energy for young children). Regularly breastfeeding infants and young children do not require dairy products. If not breastfeeding, then after one year of age, offer around 500ml per day of homogenized (3.25% M.F) milk. Fruit juices and sweetened beverages should be avoided in favor of water to quench thirst.
To best nourish your older infant or young child, continue breastfeeding for up to two years of age or beyond, ensure adequate intake of vitamin D, introduce complimentary foods that are initially iron-rich and then subsequently reflect what is generally served to the family at the table, practice responsive feeding based on your child’s cues, prepare and store foods safely, and offer a wide variety of nutrient-rich foods – higher in fat when possible and with little/no added salt or sugar.
Lastly and most importantly, young children are very impressionable. Starting as early as possible, be a healthy eating role model; that will set your child on the path to healthful eating for life!
Special thanks to Emily Murray for her help writing this summary.