Healthy Feeding Guidelines for Infants and Toddlers

Three different methods were used to compile the data necessary to develop the Start Healthy Feeding Guidelines, including: evaluating existing recommendations and guidelines from recognized organizations; using the ADA’s evidence-based approach to analyze the literature; and conducting detailed analysis of the nutrient content of infants’ and toddlers’ diets compared to Dietary Reference Intakes (DRIs).

This article explores the detailed process that led to the Start Healthy Expert Panel’s.

Do we know why solid food introduction at early age was linked to obesity?
The exact cause for link between obesity risk and solid food is not known yet. The leading cause is believed to be more calories consumed by babies feeding on formula, which could be result of consumption of more milk.

The data look preliminary, but it reiterates the fact that breast milk is beneficial for the baby and if possible introduces solid food at later stage than sooner for healthier life. Parents today know that one of the best ways to give a baby a great start in life is with wholesome, homemade foods. While ready-made baby food is a convenience that any new parent can appreciate, feeding everyday fresh foods is the best way to teach a child healthy eating habits and an appreciation for good food from the cradle onward.

The Start Healthy Expert Panel utilized the same seven-step ADA evidence-based approach used to prepare clinical guidelines, which include:

Identifying a specific problem or area of uncertainty (in this project, areas for practical feeding advice);
Formulating the problem as a research question;
Developing a systematic search strategy and finding evidence;
Selecting the relevant evidence;
Evaluating and grading the evidence;
Forming recommendations or making decisions based on the best available evidence;
Summarizing and disseminating the findings.

Most health care providers are familiar with the formal evidence analysis grading process used to create medical guidelines. The major difference in the ADA evidence-based approach and the well-known and most commonly used Centre for Evidence-Based Medicine (CEBM) method is the way in which research is classified, graded, and the evidence summarized (Steps 5 and 6). In the ADA method, evidence is classified as A (randomized controlled trials), B (cohort study), C (nonrandomized trial with concurrent or historical controls, case-control study, study of sensitivity and specificity of diagnostic test, or population-based descriptive study), D (cross-sectional study, case series, or case report), M (meta-analysis, systematic review, decision analysis, cost-benefit analysis, cost-effectiveness study), N (narrative review, consensus statement, consensus report), and X (expert opinion).

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