Breast milk is still an important source of nutrition for infants and toddlers between 7 and 24 months of age, but breastfeeding alone can no longer fully meet their energy and nutrient needs, and other nutrient-rich foods must be introduced. At the same time, the development of the gastrointestinal tract and other digestive organs, sensory perception and cognitive-behavioral skills of infants and toddlers between 7 and 24 months of age require opportunities to experience and adapt to a variety of foods through exposure, sensation and experimentation, and to change from passive feeding to independent eating.
This process begins at 7 months of age and is completed by 24 months of age. This age group is also unique in that the feeding behaviors of parents and feeders have a significant impact on their nutritional and eating behaviors. Feeding in response to the needs of infants and toddlers helps form healthy eating habits and has long-term and far-reaching effects.
Infants and toddlers from 7 to 24 months of age are in the third stage of the 1000-day window of opportunity, and appropriate nutrition and feeding are not only related to the recent growth and development, but also to long-term health. In view of the needs of nutrition and feeding of infants and toddlers from 7 to 24 months of age in China, as well as possible problems, we propose feeding guidelines for infants and toddlers from 7 to 24 months of age based on the available evidence and with reference to the relevant recommendations of WHO and others.
[Recommended entries
1. Continue breastfeeding and add complementary foods from 6 months of age.
2.Start with iron-rich pureed foods and gradually add a variety of foods.
3.Advocate conformity feeding, encourage but not forced to eat.
4, complementary food without condiments, minimize the intake of sugar and salt.
5.Pay attention to dietary hygiene and eating safety.
6.Regularly monitor physical indicators to pursue healthy growth.
7. Continue breastfeeding and add complementary foods from 6 months of age.
Summary】
Breast milk can still provide some energy, high quality protein, calcium and other important nutrients, as well as various immune protective factors for infants and children after 6 months of age (180 days after birth). Continued breastfeeding also still helps to promote the intimate connection between mother and child and to promote infant and toddler development. Therefore, infants and toddlers from 7 to 24 months of age should continue to be breastfed. If breastfeeding is not possible or not enough, formula is needed as a supplement to breast milk.
When infants reach 6 months of age, the gastrointestinal tract and other digestive organs are relatively well developed and can digest diverse foods other than breast milk. At the same time, the infant’s oral motor function, taste, smell, touch and other sensory perceptions, as well as mental, cognitive and behavioral abilities are ready to accept new foods. Adding complementary foods at this time can not only meet the nutritional needs of infants, but also meet their psychological needs and promote the development of their sensory, psychological, cognitive and behavioral abilities.
Key recommendations
1.After infants reach 6 months of age, they should continue breastfeeding and gradually introduce various foods.
2. Complementary foods are foods of various natures other than breast milk and/or formula.
3.When there is a special need to adjust the addition time of complementary foods under the guidance of a doctor.
4.Infants who cannot breastfeed or whose breast milk is insufficient should choose formula as a supplement to breast milk.
5.Start with iron-rich pureed food and gradually add to achieve food diversity.
Summary】
7 to 12 months old infants need about 1/3 to 1/2 of the energy from complementary foods, 13 to 24 months old children about 1/2 to 2/3 of the energy from complementary foods, and breastfed infants and young children from complementary foods more up to 99% of the iron. Therefore, the first supplemental foods added to infants should be iron-rich, high-energy foods, such as iron-fortified infant rice flour and pureed meat. On top of this, other different types of foods should be introduced gradually to provide different nutrients.
The principle of adding complementary foods: add only one new food at a time, from small to large, from thin to thick, from fine to coarse, gradually. Start with an iron-rich paste, such as iron-fortified rice flour and pureed meat, and gradually increase the variety of foods, gradually transitioning to semi-solid or solid foods, such as rotten noodles, minced meat, chopped vegetables, diced fruits, etc. Each new food introduced should be adapted for 2 to 3 days, closely observe whether there are adverse reactions such as vomiting, diarrhea, rash, etc., and add other new foods after adapting to one food.
Key recommendation
1, with the reduction of breast milk, gradually increase the amount of complementary foods.
2.First add iron-fortified baby rice powder, pureed meat and other iron-rich pureed foods.
3.Introduce only one new food at a time and gradually achieve food diversification.
4.Begin with pureed foods and gradually transition to solid foods.
5.Add vegetable oil in appropriate amounts to complementary foods.
6.Advocate conformity feeding, encourage but not forced to eat
Summary】
With the growth and development of infants and toddlers, parents and feeders should follow the needs of infants and toddlers according to their changing nutritional needs, perception, and the development of cognitive, behavioral and motor skills, feeding, helping infants and toddlers to gradually achieve a consistent pattern of regular meals with their families, and learn to eat on their own and comply with the necessary meal etiquette.
Parents and feeders are responsible for providing a variety of foods that are appropriate to the developmental level of the infant and toddler, and for sensing signals of hunger or fullness during feeding and responding appropriately. Respect the infant’s choice of food, and patiently encourage and assist the infant to eat, but never force him/her to eat.
Parents and feeders are also responsible for creating a good environment for infants and toddlers to eat, keeping the environment quiet and pleasant, and avoiding distractions such as television and toys. The duration of each meal should not exceed 20 minutes. Parents and feeders should also be good role models for infants and toddlers in eating.
Key Recommendations
1. Feed patiently and encourage eating, but never force-feed.
2. Encourage and assist infants and toddlers to eat by themselves and develop an interest in eating.
3.Do not watch TV or play with toys during meals, and do not spend more than 20 minutes at each meal.
4. Feeders and infants should have sufficient communication during meals, and not use food as a reward or punishment.
Parents should maintain their own good eating habits and be a role model for their infants and toddlers.
6.No condiments should be added to complementary foods, and the intake of sugar and salt should be minimized.
Summary】
Complementary foods should be kept in their original taste, without adding salt, sugar and stimulating condiments, to maintain a light taste. Light tasting foods can improve infants’ acceptance of different natural food tastes and reduce the risk of picky eating. Light foods also reduce salt and sugar intake in infants and children, reducing the risk of obesity, diabetes, hypertension, and cardiovascular disease in childhood and adulthood.
The emphasis on not adding extra salt, sugar and harsh condiments to complementary foods for infants and young children is also to remind parents to keep light flavors when preparing family foods, i.e., to accommodate the needs of infants and young children and to protect the health of the whole family.
Key recommendations
1, infant and toddler complementary food should be made separately.
2.Keep the original taste of food, no need to add extra sugar, salt and various seasonings.
3, after 1 year old gradually try light taste of family meals.
4, pay attention to dietary hygiene and eating safety
Summary】
Choose fresh, high-quality, non-polluted food and clean water to make complementary foods. Wash your hands before making complementary foods. The tableware and places for making complementary food should be kept clean. Complementary foods should be cooked thoroughly. Prepared food should be consumed in time or properly stored. Wash your hands before eating and keep the utensils and eating environment clean and safe.
Infants and toddlers should always be watched by an adult when eating to prevent eating accidents. Whole peanuts, nuts, jelly and other foods are not suitable for infants and toddlers.
Key recommendations
1.Choose safe, high-quality, fresh ingredients.
2, always keep the production process clean and hygienic, separate raw and cooked.
3.No leftover food, proper storage and disposal of leftover food.
4.Wash hands before meals, have adult supervision when eating, and pay attention to the safety of the eating environment.
5.Regularly monitor physical indicators to pursue healthy growth.
Summary】
Moderate and steady growth is the best growth pattern. Regular monitoring and evaluation of physical growth indicators of infants and toddlers from 7 to 24 months of age every 3 months can help determine their nutritional status, and timely adjustment of nutrition and feeding can be made according to changes in physical growth indicators. The frequency of monitoring should be increased for infants and children with poor growth, overweight and obesity, and during acute and chronic diseases.
Key recommendation
1.Weight and length are the visual indicators reflecting the nutritional status of infants and toddlers.
2.Every 3 months, measure length, weight, head circumference and other physical growth indicators regularly.
3.Steady growth is the best growth pattern.