Reviewed by Hansa D. Bhargava, MD on May 23, 2019
From the WebMD Archives

May 22, 2019 -- If you’re confused about what to feed your baby, the government is finally going to weigh in.

For the first time, the U.S. Dietary Guidelines will include feeding recommendations for birth to 24 months. The government released the first dietary guidelines almost 40 years ago and has had recommendations only for ages 2 and older.

Registered dietitian Katherine Tallmadge says the importance of adding children from birth to 2 years old cannot be underestimated.

“We know that psychologically, from birth to 3 years is when the personality, the psychology of people develop in the strongest way,” says Tallmadge, author of Diet Simple. “It’s also when we have the most influence on a child’s brain development, on a child’s tastes in food. Teaching variety in children’s diets and all of those kinds of things have really gone downhill as food processing and fast food, less healthy food, is available 24-7.”

Guidelines Offer Food Map

The birth to 24 months committee will look at wide-ranging questions that will be the cornerstone of their advice. Those topics include the duration of exclusive breast milk and infant feeding; dietary patterns; dietary supplements; and the relationship between diet during pregnancy and lactation and food allergies, according to the U.S. Department of Agriculture.

What not to expect this time around? Formula guidelines addressing issues like organic vs. non-organic and regular vs. soy.

Every 5 years, the Department of Agriculture and the Department of Health and Human Services release updated guidelines aimed at making sure Americans have the tools they need to make the best food choices at each stage of life and cut their risk of chronic disease.

Before the guidelines are released, an advisory committee of national experts in nutrition and health look at the most recent scientific and medical research and make recommendations to the government.

The panel established six topic area subcommittees to do that work. They are: pregnancy and lactation, birth to 24 months, dietary patterns, beverages and added sugars, dietary fats and seafood, and frequency of eating.

Healthy Diets Start Early

Kelly Scaggs of Olney, MD, is the mother of two small boys: Griffin, 6, and Travis, 3. She’s also 6 months pregnant and expecting a little girl in August.  Eating a healthy diet is a top priority for Scaggs, and she has a tried and true plan: breastfeeding exclusively for the first 6 months, then introducing simple foods like oatmeal, cereal, and bananas.  She says the guidelines will help fill in the gaps because there are so many things to consider.

“I think some people are really educated on nutrition, but I also feel like it can be overwhelming with all the information out there,” says Scaggs, 35. “It’s also a lot more time-consuming and expensive to eat healthy. I feel like I teeter on both sides, especially with understanding all of the ingredients found in some of our foods. I try to buy organic and stay away from processed foods as much as possible, which is really hard with kids. Having set guidelines are really helpful to have.”

Dietitian Tallmadge says if she had the committee’s ear, here’s what she’d want them to consider:

“Number 1, the importance of breastfeeding. Some information on the importance of the microbiome -- or the digestive tract. The importance of how to introduce foods, when to introduce what foods. How to positively reinforce the eating of healthy foods, when to eat and when to stop -- listening to body signals. I think those things need to be addressed because they all affect health and obesity later in life and also brain development.”

Managing Conflicts

The Center for Science in the Public Interest has long been a champion of these guidelines. Angela Amico, a senior policy associate at the center, says they’re working to make sure groups that focus specifically on infants, young children, and maternity are involved in this process.

“We want to make sure that groups that work in breastfeeding advocacy are familiar with the process so they can be involved. We can certainly expect that infant formula industry is going to play a role in the guidelines,” she says. “The food and beverage industry has historically been really well-organized around the dietary guidelines.”

Amico is keeping an eye on any potential conflicts of interest and says the center has already reviewed advisory committee members. “Some have visible links to the food and beverage industry. Making sure that those potential conflicts are managed during the process is a key priority for CSPI. The recommendations should be grounded in science and not industry interests,” she says.

There has been much debate about how industry influences nutrition policy, and with the addition of the birth to 24 months category, that’s sure to continue.

Mardi Mountford, president of the Infant Nutrition Council of America, feels it’s crucial that the birth to 24 months guidelines aren’t just a product of teamwork among experts in pediatric and infant nutrition, but are communicated clearly.

“Parents have the right to evidence-based information on all appropriate and safe feeding options in order to make informed nutrition decisions for their infants and young children,” she says. “The B-24 Dietary Guidelines should state that mothers should be encouraged and supported to breastfeed; however, they should also note that science-based, commercial iron-fortified infant formula is the only alternative to breast milk that provides the right mix of nutrients their baby needs to grow and develop.”

Nestle, parent company to baby food giant Gerber, conducts the Feeding Infants and Toddlers Study (FITS) that focuses on the diets of infants, toddlers, and preschoolers. It showed that many of these children are not getting enough fruits, vegetables, whole grains, dairy, and nutrients like iron, vitamin D, potassium, and fiber.

Putting Plan into Action

It’s a lot to digest. Scaggs says she and her friends who are moms learn from each other, but having these guidelines to fall back on will help.

“I definitely want to keep updated on any new information they have found, to make sure my kids are as healthy as possible. So, I’ll definitely check them out. I think that I’m going in the right direction with what we’re eating, but I’m always looking to learn more about it.”

Show Sources

Katherine Tallmadge, registered dietitian; author, Diet Simple.

Angela Amico, senior policy associate, Center for Science in the Public Interest.

Mardi Mountford, president, Infant Nutrition Council of America.

Kelly Scaggs, parent.

U.S. Department of Agriculture: “Dietary Guidelines for Americans,” “Topics and Questions to be Examined by the Committee.”

Gerber: “Nearly One in Five Infants’ Diets Fall Short on Iron, a Key Nutrient for Brain Development.”

News release, National Press Foundation: “Learn More About Dietary Guidelines and Menu Labeling.”


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