Nutrition for healthy term infants: recommendations from birth to six months.

This joint statement provides health professionals in Canada with evidence-informed principles and recommendations to promote communication of accurate, consistent advice to parents and caregivers on infant nutrition in the first six months. Participating organizations in the Infant Feeding Joint Work Group collaborated to revise guidance from 1998 and 2005. Development of this statement involved an extensive review of scientific evidence in peer-reviewed literature, with content guidance from the Infant Feeding Expert Advisory Group and broad stakeholder consultation. Updated guidance on nutrition from six months to two years will be available in early 2014. Each section of this joint statement includes recommendations, rationale and references, organized under seven principles. The first five principles and recommendations are: Breastfeeding is the normal and unequalled method of feeding infants. · Recommend exclusive breastfeeding for the first six months. Breastfeeding initiation and duration rates increase with active protection, support, and promotion. · Implement the policies and practices of the Baby-Friendly Initiative (BFI) for hospitals and community health services. Supplemental vitamin D is recommended for breastfed infants. · Recommend a daily vitamin D supplement of 10 µg (400 IU) for breastfed infants. First complementary foods should be iron-rich. · Recommend meat, meat alternatives, and iron-fortified cereal as an infant's first complementary foods. Routine growth monitoring is important to assess infant health and nutrition. · Use the World Health Organization (WHO) Growth Charts for Canada for optimal monitoring of infant growth. Additional recommendations are provided under the last two principles regarding unnecessary feeding changes (e.g., responding to infant gastrointestinal issues) and rare contraindications for breastfeeding (e.g., advising mothers with infections, using medications or illicit drugs). A separate section addresses recommendations on the use of breastmilk substitutes, including commercial infant formula choices, safe preparation and storage, and supervision of a feeding infant. The statement concludes with "in practice" guidance for talking to families about infant nutrition.