Recommendations for feeding infants and young children have changed substantially over time owing to scientific advances, cultural influences, societal trends, and other factors. At the same time, stronger approaches to reviewing and synthesizing scientific evidence have evolved, such that there are now established protocols for developing evidence-based health recommendations. However, not all authoritative bodies have used such approaches for developing infant feeding guidance, and for many feeding questions there is little or no sound evidence available to guide best practices, despite the fact that research on infant and young child feeding has expanded in recent decades. Summarizing the current landscape of feeding recommendations for infants and young children can reveal the level of consistency of existing guidance, shed light on the types of evidence that underpin each recommendation, and provide insight into the feasibility of harmonizing guidelines. Feeding Infants and Children from Birth to 24 Months collects, compares, and summarizes existing recommendations on what and how to feed infants and young children from birth to 24 months of age. This report makes recommendations to stakeholders on strategies for communicating and disseminating feeding recommendations.

Contents

• The National Academies of SCIENCES • ENGINEERING • MEDICINE
• COMMITTEE ON SCOPING EXISTING GUIDELINES FOR FEEDING RECOMMENDATIONS FOR INFANTS AND YOUNG CHILDREN UNDER AGE 2
• Reviewers
• Summary
  • THE COMMITTEE'S TASK AND APPROACH
  • CONSISTENCY OF EXISTING FEEDING RECOMMENDATIONS
  • COMMUNICATION AND DISSEMINATION OF FEEDING RECOMMENDATIONS
  • CONCLUSIONS AND FUTURE DIRECTIONS
  • CONCLUDING REMARKS
• 1. Introduction
  • IMPORTANCE OF FEEDING PRACTICES FOR CHILDREN UNDER 2 YEARS OF AGE
  • CHALLENGES OF UNDERSTANDING WHAT AND HOW TO FEED INFANTS AND YOUNG CHILDREN
  • RECENT EFFORTS AND WORK ON FEEDING GUIDANCE FROM BIRTH TO 24 MONTHS
  • THE COMMITTEE'S TASK AND APPROACH
  • ORGANIZATION OF THE REPORT
• 2. Methodology
  • SEARCHES FOR GUIDELINE DOCUMENTS
  • ELIGIBILITY CRITERIA
  • ABSTRACTED INFORMATION
  • IDENTIFYING THE SPAN OF TOPICS COVERED AND CONSISTENCY OF RECOMMENDATIONS
  • CAPTURING GUIDANCE ON COMMUNICATION AND DISSEMINATION
  • SUMMARY
• 3. Characteristics of Included Guideline Documents
  • TYPES OF GUIDELINE DOCUMENTS
  • LEVEL OF COLLABORATION
  • SCOPE OF TOPICS COVERED
  • TARGET COUNTRY OR REGION
  • TARGET AUDIENCES
  • GUIDELINE DOCUMENT METHODOLOGIES
  • DECLARATION OF CONFLICTS OF INTEREST
  • STATEMENTS OF RECOMMENDATION
  • EVIDENCE MAPPING TO EACH RECOMMENDATION
  • INCLUSION OF GUIDANCE ON COMMUNICATION AND DISSEMINATION
  • INCLUSION OF RESEARCH RECOMMENDATIONS
  • SUMMARY
• 4. Existing Recommendations on What to Feed
  • EXCLUSIVE BREASTFEEDING
  • CONTINUATION OF BREASTFEEDING
  • SUPPLEMENTARY FORMULA FEEDING OF BREASTFED INFANTS
  • DURATION OF INFANT FORMULA USE
  • TYPE OF INFANT FORMULA
  • TODDLER MILKS AND FOLLOW-ON FORMULAS
  • MILK AND MILK-BASED PRODUCTS
  • FLUIDS: WATER, JUICE, SUGAR-SWEETENED BEVERAGES, AND OTHER NONMILK BEVERAGES
  • SUBSTANCES TO AVOID OR LIMIT
  • VARIETY AND HEALTHY, NUTRITIOUS FOODS
  • FRUITS AND VEGETABLES
  • VEGETARIAN AND VEGAN DIETS
  • FOODS ASSOCIATED WITH FOOD ALLERGY AND CELIAC DISEASE
  • IRON
  • VITAMIN D
  • IODINE
  • OTHER NUTRIENT SUPPLEMENTS
  • DIETARY FAT
  • SUMMARY
• 5. Existing Recommendations on How to Feed
  • BOTTLE USE AND PROPPING
  • CUP USE
  • SAFETY OF FOODS AND FEEDING PRACTICES
  • INTRODUCTION OF COMPLEMENTARY FOODS
  • FOOD CONSISTENCY AND TEXTURE
  • MEAL FREQUENCY
  • HUNGER AND SATIETY CUES
  • RESPONSIVE FEEDING
  • SUMMARY
• 6. Communication and Dissemination
  • DEFINING TERMINOLOGY
  • IDENTIFIED COMMUNICATION AND DISSEMINATION STRATEGIES FOR VARIOUS TARGET AUDIENCES
  • CONSIDERATIONS FOR COMMUNICATION AND DISSEMINATION STRATEGIES
  • SUMMARY
• 7. Conclusions and Future Directions
  • CONSISTENCY AMONG EXISTING FEEDING RECOMMENDATIONS AND TYPES OF EVIDENCE USED
  • HARMONIZING THE DEVELOPMENT OF FUTURE FEEDING GUIDELINES
  • EVIDENCE GAPS
  • CLOSING REMARKS
• References
• Appendix A. Excluded Guideline Documents
• Appendix B. Abstracted Recommendations
• Appendix C. Committee Member Biographical Sketches

Suggested citation:

National Academies of Sciences, Engineering, and Medicine. 2020. Feeding infants and children from birth to 24 months: Summarizing existing guidance. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25747.

Digital Object Identifier: https://doi.org/10.17226/25747

Library of Congress Control Number: 2020941774

Additional copies of this publication are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

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