At 6 months of age, infants are in the second stage of the 1000-d window of opportunity, and nutrition is the primary environmental factor that continues to have a critical impact on their growth, development, and subsequent health. In view of the feeding needs and possible problems of infants within 6 months of age in China, based on the available evidence and the relevant recommendations of the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF) and other international organizations, the Expert Committee on Revision of the Dietary Guidelines of the Chinese Nutrition Society has proposed the following guidelines for feeding infants within 6 months of age: ① Start breastfeeding as early as possible after delivery and insist that the first bite of the newborn is breast milk ① Start breastfeeding as early as possible after delivery and insist that the first food for newborns is breast milk; ② Insist on exclusive breastfeeding within 6 months of age; ③ Comply with feeding and establish a good routine; ④ Start vitamin D supplementation a few days after birth and do not need calcium supplementation; ⑤ Infant formula is a helpless choice when exclusive breastfeeding is not possible; ⑥ Monitor physical indicators to maintain healthy growth. Key recommendations 1. Start breastfeeding as early as possible after delivery and insist that the first food for newborns is breast milk 1.1 Key recommendations ① Start to let babies suck on the nipple repeatedly as early as possible after delivery; ② The first food for babies after birth should be breast milk; ③ Postnatal body mass loss should be insisted on exclusive breastfeeding as long as it does not exceed 7% of the birth body mass; ④ Babies do not need to wipe or disinfect the nipple excessively before sucking; ⑤ Warm environment, pleasant mood, spiritual encouragement, breast massage and other aids, ⑤ A warm environment, pleasant mood, spiritual encouragement, mammary massage and other auxiliary factors can help to open the breast smoothly and successfully. If the delivery is successful and the mother and child are in good health, the baby should suckle on the mother’s nipple as soon as possible after delivery to stimulate milk secretion and obtain colostrum. The sooner the milk starts, the better. The first breastfeeding of a normal newborn should start in the delivery room. After the newborn is delivered and the umbilical cord is broken and the amniotic fluid is dried, the newborn can be placed next to the mother, in contact with the mother’s skin, and begin to let the baby suck on both nipples for 3~5 min each, which can suck out several milliliters of colostrum. The newborn baby has a strong feeding and sucking reflex, and the mother is eager to see and touch her baby, so this parent-child contact is beneficial to milk secretion. Therefore, the first food for a newborn baby should be mother’s milk. In the case of normal delivery, sugar water and milk powder should not be added to avoid reducing the newborn’s motivation to suckle and also to reduce the risk of allergy. 1.3 Breastfeeding methods When breastfeeding the infant, sitting is recommended. Feed both breasts in turn, sucking up one side before sucking the other. If the amount of milk from one breast is sufficient for the baby’s needs, the milk from the other breast should be sucked out with a breast pump. After breastfeeding, do not put the baby flat immediately, but hold the baby upright with the head on the mother’s shoulder and pat the back to expel the air swallowed into the stomach to prevent milk overflow. 1.4 How to promote milk secretion The infant should be allowed to suckle breast milk as early as possible after birth and suckle diligently (each nipple should get suckled every 2~3h); if necessary (e.g. when the infant has limited suckling), the number of suckling can be increased with the assistance of a breast pump. The mother’s physical condition and nutritional intake are the prerequisites for breast milk secretion, therefore, after delivery, it is necessary to arrange maternal rest, diet and baby feeding reasonably, and to deal with the relationship between rest, meals, parent-child contact and breast milk sucking. Mental relaxation and psychological happiness are important conditions for successful breastfeeding. Mothers should experience the happiness of childbirth from the hard work of giving birth, be happy and enjoy breastfeeding and parent-child interaction. In addition, during pregnancy you need to fully understand the importance of breastfeeding and get the encouragement and support from your surrounding friends and family, which is also a necessary environment for successful breastfeeding. 1.5 How to judge the adequacy of breast milk production Adequacy of breast milk production can be judged by the following conditions: ① the infant is able to get 8-12 times more satisfying breastfeeding per day; ② the infant sucks rhythmically during feeding and can hear obvious swallowing sounds; ③ the infant urinates at least 1 or 2 times per day in the first 2 days after birth; ④ if there is pink urate crystals in the urine, it should disappear in the 3rd day after birth ⑤ Starting from the third day after birth, the infant should urinate 6~8 times every 24 hours; ⑥ At least 3 or 4 times every 24 hours after birth, and each stool should be more than 1 tablespoon; ⑦ After the third day after birth, the infant can pass soft and yellow stools 4~10 times a day. 2, insist on exclusive breastfeeding within 6 months of age 2.1 Key recommendations ① Exclusive breastfeeding can meet all the liquid, energy and nutrients required by infants within 6 months of age, and should be insisted on for 6 months; ② Feeding on demand, alternating between the two breasts; feeding 6 ~ 8 times a day or more; ③ Insist that infants suckle directly from breast milk, and do not use bottles to indirectly feed artificially expressed breast milk as much as possible; ④ Special circumstances Those who need to add complementary foods before 6 months of age should consult a physician or other professional before making a careful decision. 2.2 How to determine the amount of breast milk intake When breastfeeding, it is not necessary to express milk and weigh it to estimate the amount of milk intake of the infant, but to determine the adequacy of breast milk intake by observing the infant’s mood or urine output. Generally speaking, if the infant can wet 5 or 6 diapers per day, it means that the infant is able to eat. In addition, you can judge by weighing the infant’s body mass before and after breastfeeding. Regular measurements of length, body mass and head circumference, marked on the WHO Child Growth Curve, can determine whether the infant is growing normally. As long as the infant’s growth is normal, the diet is adequate. 2.3 When and how to breastfeed indirectly Although breast milk is sufficient, there are situations when the mother cannot ensure that the baby is fed directly when the baby is hungry, such as when the baby is critically preterm or when the mother is at work. When indirect breastfeeding is needed, it is recommended that breast milk be pumped out regularly and stored in a refrigerator or ice box for a certain period of time before being bottle-fed to the baby. The storage conditions and allowable storage time of breast milk are shown in Table 1. 2.4 Myths about breastfeeding The following are some misconceptions about breastfeeding: ① Sucking out milk and bottle feeding can easily determine the infant’s milk intake; ② To reduce the risk of infection in infants, the mother’s nipples need to be sterilized before breastfeeding; ③ Some mothers’ milk is too thin and not nutritious, so they need to add milk powder to supplement nutrition; ④ Breastfeeding too often will make ⑤After birth, newborns can be temporarily fed with milk powder and wait for milk secretion. 3.1 Key recommendations ① Breastfeeding should be progressive from on-demand feeding mode to regular feeding mode. ②Feeding should be done promptly when hunger causes crying, do not force the number of feedings and time, but generally the number of feedings per day may be more than 8 times, and initially after birth will be more than 10 times. ③As the baby gets older, gradually reduce the number of feedings and establish good eating habits with regular feedings. ④If the infant cries abnormally, non-starvation causes should be considered and active medical attention should be sought. 3.2 How to determine when an infant is crying because of hunger During the first few weeks of life, mothers are encouraged to have 8 to 12 feedings every 24 hours. Early signs of infant hunger include alertness, increased physical activity, and increased facial expressions; it is the subsequent signs of infant hunger that are crying. With feeding, if breastfeeding is appropriate, the number of feedings can be reduced to 8 times per 24 hours, and the maximum nighttime sleep without feeding can be up to 5 h. 4. Vitamin D supplementation starting a few days after birth, no calcium supplementation 4.1 Key recommendations ① Infants should start daily vitamin D3 supplementation of 10 μg (400 IU) a few days after birth; ② Infants who are exclusively breastfed do not need calcium supplementation; ③ Newborns should be given intramuscular injections of vitamin K1 after birth 1 mg. 4.2 How to give infants vitamin D supplementation About 2 weeks after birth, use vitamin D oil or emulsified water for daily vitamin D supplementation 10 μg (400 IU). The drops can be dosed into the infant’s mouth before breastfeeding. For those who have difficulty with daily oral supplementation, an equivalent dose of vitamin D can be given orally once a week or once a month. powdered formula-fed infants receive adequate amounts of vitamin D through formulas that meet national standards and do not require additional supplementation. A daily dose of 10 μg (400 IU) of vitamin D will meet the vitamin D needs of infants with no exposure to sunlight at all, so this supplementation level is largely adequate for infants in northern areas, during winter, or during the rainy season. 4.3 Whether infants up to 6 months of age can obtain the required vitamin D through sunlight exposure To obtain adequate amounts of vitamin D through sunlight exposure, infants need the following: adequate sunlight, adequate skin exposure, and adequate duration of sunlight exposure. Obviously these requirements are influenced by the local season, latitude of residence, environmental pollution, and other conditions. In comparison, supplementation by vitamin D supplements is less difficult and more reliable, so infants should receive 400 IU/d of vitamin D orally. 4.4 How to give vitamin K supplements to newborns and infants The amount of vitamin K in breast milk is low. Breastfed infants can be given 25 μg of vitamin K1 orally daily from birth to 3 months of age, or they can be given 2 mg of vitamin K1 orally after birth and then 5 mg orally for 3 times by 1 week and 1 month, respectively; or newborns can be given intra-muscular injections of vitamin K1 1~5 mg daily for 3 d by a professional, which can effectively prevent the occurrence of vitamin K deficiency bleeding disorder in newborns. Qualified formula with sufficient amount of vitamin K1 added, mixed-feeding infants and artificial-feeding infants fed with infant formula generally do not need additional vitamin K supplementation.