Nutrition of healthy infants: recommendations of the Croatian society of paediatric gastroenterology, hepatology and nutrition

Abstract

Guidelines for nutrition of healthy infants and young children have been substantially changed over the past several decades. However, only very recently the results of a few important prospective cohort or randomized studies have been published, shedding a different light on many aspects of our present practice, particularly in respect of prevention of chronic diseases such as allergies. Therefore, both the ESPGHAN Committee on Nutrition, and the same body of the American Academy of Pediatrics have published their position papers regarding a few important aspects of infant nutrition. The aim of this paper is to summarize new developments on the topic of nutrition of healthy infants with particular emphasis on the timing and composition of complementary feeding. It also focuses on the nutritional options that may affect later development of chronic diseases such as allergy and coeliac disease. The first premise in the nutrition of healthy infants, also called the golden standard, is that exclusive breastfeeding for about 6 months is a desirable goal. Concerning solid foods or complementary feeding, it should not be introduced before 17 weeks and not later than 26 weeks. Prevention of allergies through infant dietetic measures have recently been thoroughly reviewed. So far, there is no convincing evidence that the avoidance or delayed introduction of potentially allergenic foods reduces allergy, either in infants with a positive atopic predisposition or without it. Also, there are no documented benefits for maternal elimination diets during pregnancy or during lactation in respect of allergy prevention. Finally, cow’s milk should not be used as a main drink before 12 months, although small amounts may be added to complementary foods.