2019 Pediatric Nutrition Guidelines (Birth to Six Years) – ODPH

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The Pediatric Nutrition Guidelines (Birth to Six Years) for Health Professionals were developed by members of the Family Health Nutrition Advisory Group of ODPH. The document outlines evidence-based nutrition and feeding guidelines along with red flags for healthy, full-term infants and children up to 6 years of age.

You can download the Pediatric Nutrition Guidelines (Birth to Six Years) from the original source (click here).

Ontario Dietitians in Public Health would like to thank the more than thirty dietitians, nurses, lactation consultants, pediatricians, and other health professionals from throughout the province who reviewed the guidelines and provided feedback. Your time, expertise and knowledge are truly appreciated.

Ontario Dietitians in Public Health (ODPH) is the independent and official voice of registered dietitians working in the Ontario public health system. These guidelines were written by members of the Family Health Nutrition Advisory Working Group, a subgroup of ODPH.

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Growth monitoring

● Measure weight, length/height and head circumferences at 1 to 2 weeks after birth and at 1, 2, 4, 6, 9, 12, 18 and 24 months and once per year for children over 2 years. Infants should be weighed nude on a calibrated beam or electronic scale ● Plot on WHO Growth Charts for Canada when assessing growth ● Serial measures are more useful than unique measures and are ideal for assessing and monitoring growth patterns ● Growth measurements indicating a sharp incline or decline in growth in serial growth measures, or a growth-line that remains flat on the WHO Growth Charts for Canada, may indicate growth issues ● Refer to A Health Professional’s Guide for Using the WHO Growth Charts for Canada for recommended cut-off criteria ● Refer to WHO Growth Chart Training e-modules for more information

Food allergies

● Infants at high risk for developing a food allergy have a personal history of atopy, including eczema, or having a first-degree relative with atopy (e.g. eczema, food allergy, allergic rhinitis or asthma). For these high-risk infants, based on developmental readiness, consider introducing common allergenic complementary foods at about 6 months of age, but not before an infant is 4 months of age. Common allergenic foods include milk products, egg, peanut, tree nuts, fish, shellfish, wheat and soy. Breastfeeding should be protected, promoted and supported up to the age of 2 years and beyond ● Infants at no or low risk for food allergy, introduce complementary foods at about six months of age ● Introduce allergenic foods one at a time to gauge reaction, without unnecessary delay4 (i.e. every 2 days) between each food. Continue to offer common allergenic foods that are tolerated a few times a week to maintain tolerance ● Goat’s milk is not a suitable alternative for infants with cow’s milk protein allergy

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