In 1989 and 1994, the Gerber Products Company published Dietary Guidelines for Infants, modeled after HHS/USDA's 1990 Dietary Guidelines for Americans. The Gerber guidelines were based on statements by the American Academy of Pediatrics' Committee on Nutrition and were prepared with the help of several nutrition experts. Their aim was to provide sufficient nourishment while fostering the development of healthful eating habits. Gerber officials have said they were prompted by a telephone survey showing that many parents were responding inappropriately to adult nutritional guidelines by giving their babies skim milk instead of whole milk. In addition, cases had been reported of older children who failed to grow properly because of overzealous, medically unsupervised dietary treatment for high cholesterol levels.
In 1997, the American Academy of Pediatrics (AAP) issued a position statement recommending breast-feeding for nearly all infants. The statement recommends that breastfeeding continue for at least 12 months and thereafter for as long as mutually desired. This article is adapted from literature supplied by the Gerber Products Corporation but #1 has been modified to reflect the recent AAP recommendations. The guidelines are applicable whether the child is breast-fed or bottle-fed.
1. Build to a variety of foods.
Children below the age of two are not "little adults. Unlike adults, they do not require variety to secure nutrition during the first six months or so of life. Except for fluoride and vitamin D (in the absence of sunlight), human milk alone provides the vitamins, minerals, carbohydrates, fats, and proteins needed for normal growth and development during early infancy. In the first 6 months, water, juice, and other foods are generally unnecessary for breastfed infants. Vitamin D and iron may need to be given before 6 months of age in selected groups of infants (vitamin D for infants whose mothers are vitamin D-deficient or those infants not exposed to adequate sunlight; iron for those who have low iron stores or anemia). Infants weaned before 12 months of age should not receive cow's milk feedings but should receive iron-fortified infant formula.
Most babies are ready to start supplemental foods at approximately six months of age. Single-grain cereal is often the first one added. Other single-ingredient foods can be added gradually until the baby is eating a variety of foods. New foods should be added one at a time, at intervals of a few days. This allows the baby to get used to the flavor of the food and can reveal whether a food might not agree with the baby.
Fluoride should not be administered to infants during the first 6 months after birth, whether they are breast- or formula-fed. During the period from 6 months to 3 years of age, infants require fluoride supplementation only if the water supply is severely deficient in fluoride (less than 0.3 ppm). This should be discussed with the child's doctor.
2. Pay attention to your baby's appetite to avoid overfeeding or underfeeding.
Although healthy infants can vary considerably from one another in their caloric intake, appetite is likely to be the most efficient way to determine what an infant needs. Most infants instinctively know how much food they need and will not undereat or overeat unless pressured. Babies should be fed when hungry but should not be forced to finish the last few ounces of formula or food. The baby's physician can check whether growth and development are progressing normally.
3. Babies need fat.
Although low-fat and low-cholesterol diets are widely recommended for adults, they are not appropriate for children under the age of two. Nutritional requirements are higher during infancy than during any other period. At the same time, stomach capacity is limited, so food sources must provide sufficient calories and nutrients in a small volume. Infants require fat in their diet for normal growth and development.
4. Introduce fruits, vegetables, and grains, but don't overdo high-fiber foods.
Infants and young children who eat a highly varied diet will consume enough fiber for their needs. A diet high in fiber may be too low in calories and may interfere with absorption of iron, calcium, magnesium, and zinc.
5. Babies need sugars in moderation.
Sugar, which exists in several forms, is a source of calories and makes some foods taste better. Breast milk, the ideal food for infants, contains 5% to 9% lactose, which is similar to table sugar but much less sweet. Other foods in a balanced diet may contain moderate amounts of sugar, but excessive amounts can crowd out more nutritious foods. Sugar has not been shown to cause hyperactivity, diabetes, obesity, or chronic diseases later in life. Sugar is linked to tooth decay, but good dental hygiene, proper bottle-feeding practices, and adequate fluoride intake will reduce the likelihood. Bottles of milk or juice, or a pacifier dipped in honey, should not be used to put a baby to sleep, because prolonged contact with their natural sugars can cause tooth decay. Artificially sweetened foods should be avoided because they lack the calories that growing babies need.
6. Babies need sodium in moderation.
Salt also increases the palatability of some foods. Although the amount of sodium in the diet of a small percentage of adults is related to high blood pressure, the sodium content of an infant's diet has not been shown to cause high blood pressure in later life. Even though healthy infants can tolerate a range of sodium intakes without apparent ill effects, moderation in sodium intake is urged.
7. Choose foods with iron, zinc, and calcium.
Infants are born with enough stored iron for four to six months. During this period, human milk or cow milkbased formulas usually supply sufficient amounts of zinc and calcium. After that, iron is more likely than any other nutrient to be lacking in the infant's diet. For this reason, special efforts should be made to provide infants with iron during the first two years. In addition to breast milk, the best sources are meats and poultry, iron-fortified formula, and iron-fortified infant cereal. Dietary sources of zinc include oat cereals, meats and poultry, wheat germ, egg yolk, and cheddar cheese. Calcium is abundant in milk and other dairy products.
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