Feeding Infants and Toddlers
Dietitians of Canada partners with other health professional organizations and Health Canada to develop evidence-based guidance on feeding infants and toddlers and monitoring their growth and development.
The positions of Dietitians of Canada (DC) on feeding infants and young children are contained in the following Joint and endorsed Statements:
- Breastfeeding - exclusively for up to six months, and sustained for up to two years or longer - and a daily vitamin D supplement of 10 µg (400 IU) for breastfed infants
- Iron-rich foods such as meat, meat alternatives, and iron-fortified cereal, as an infant's first complementary foods - may be introduced a few weeks before or just after the sixth month
- Common food allergens, such as peanut, fish, wheat (including iron-fortified infant cereals with wheat), milk products, soy and whole eggs - can be introduced from about six months of age and then continue to offer these foods regularly
- Routine growth monitoring using the WHO Growth Charts for Canada
- Responsive feeding of infants to promote the development of healthy eating skills, including feeding that is responsive to infant’s cues, promotion of self-feeding and use of an open cup
- Nutritious family foods, offered in a variety of textures
- Regularly scheduled meals and snacks for young children, from one year of age.
Dietitians of Canada supports implementation of the policies and practices of the Baby-Friendly Initiative (BFI) for hospitals and community health services.
Actions and Public Policy Statements
Dietitians of Canada has been a partner with Health Canada and the Canadian Paediatric Society (CPS) since national guidance for health professionals on infant feeding (Nutrition for Healthy Term Infants) was first released in 1998. These organizations, joined by the Breastfeeding Committee for Canada, collaborated through the Infant Feeding Joint Working Group to revise guidance from 1998 and 2005. Revised guidance for feeding infants ages 0-6 months was released in 2012, followed by revised guidance for older infants/toddlers, ages 6-24 months in 2014.
Dietitians of Canada collaborated with CPS, the College of Family Physicians and the Community Health Nurses of Canada to develop the public policy statement on Promoting Optimal Monitoring of Child Growth in Canada in 2010. Together with the Canadian Pediatric Endocrine Group (CPEG), the WHO Growth Charts Adapted for Canada were redesigned and released in 2014.
Dietitians of Canada also endorsed the 2014 Rourke Baby Record, an evidence-based health supervision guide for health care providers to use in their care of children from birth to five years. years. In response to evolving evidence, a resource was developed on Food Allergy Prevention in Infants, for subscribers to Practice-based Evidence in Nutrition (PEN®) and members of Dietitians of Canada.
Dietitians of Canada, the Canadian Paediatric Society and Health Canada do not endorse the use of any homemade infant formulas. Breastfeeding is the normal and most beneficial method of feeding infants. Commercial infant formulas are the only recommended alternative for parents/caregivers of infants who have made an informed decision to transition from breastfeeding or breastmilk. For infants between 9-12 months of age who are no longer breastfed, pasteurized, whole cow milk or commercial infant formula is recommended.
Recent evidence suggests potential risk reduction strategies for infants at high risk of allergic response to some allergen-containing solid foods. Dietitians of Canada published an Evidence Clip in April 2016; and in January 2017 we published advice for Canadian dietitians, following the release of new guidance in the United States.
- Introduction of Allergenic Foods to Infants, especially Peanuts: Interim Guidance for Canadian Dietitians
(January 2017) This interim DC communication provides DC members with information on the scientific evidence regarding the introduction of peanuts to infants and how the current dietetic practice recommendations agree and differ from NIAID recommendations in January 2017.
- Food Allergy Prevention in Infants
(April 2016) This Evidence Clip by PEN® describes current evidence for introducing allergen-containing solid foods to infants at high risk for food allergy, before or at 6 months of age.
- Concerns About the Use of Homemade Infant Formulas
(November 2014) - Dietitians of Canada, with the Canadian Paediatric Society and Health Canada, advises Canadian parents and caregivers of the potential health risks associated with homemade infant formulas.
- Feeding Infants and Toddlers
(2014) Guidance for parents on breastfeeding and the introduction of first foods for 0-24 months: a series of eleven factsheets, about feeding infants and toddlers, 0-6 months, 6-12 months, 12-24 months.
- Nutrition for Healthy Term Infants: Recommendations from Birth to Six Months – A joint statement of Health Canada, Canadian Paediatric Society, Dietitians of Canada, and Breastfeeding Committee for Canada
(September 2012) This on-line document is intended as guidance for health professionals, to promote communication of accurate, consistent advice to parents and caregivers on infant nutrition in the first six months. It includes recommendations for breastfeeding and first complementary foods, as well as information about the use of infant formula or breastmilk substitutes.
- Nutrition for Healthy Term Infants: Recommendations from Six to 24 Months – A joint statement of Health Canada, Canadian Paediatric Society, Dietitians of Canada, and Breastfeeding Committee for Canada
(April 2014) This on-line document is intended as guidance for health professionals, to promote communication of accurate, consistent advice to parents and caregivers on infant and toddler nutrition between six to 24 months. It includes recommendations for offering a variety of nutritious family foods with different textures and promoting healthy eating skills, as well as specific information about iron-rich foods, potentially allergenic foods, and food safety.