Thursday, June 2, 2016

Whole Grain Intake for Infants and Toddlers

With a consensus reached at the Centre for Food & Allergy Research (CFAR) Australian Infant Feeding Guidelines Summit on recommended updates to current Australian infant feeding guidelines, parents have been provided with greater clarity on infant feeding. However, one area of infant feeding which is less clearly defined is the role of whole grain in early nutrition.

GLNC’s Nutrition Program Manager, Chris Cashman, outlines the recent recommended updates in infant feeding guidelines and discusses the challenges of providing specific whole grain recommendations for infants.

Starting a healthy habit with whole grains in early life
At the recent Centre for Food & Allergy Research (CFAR) Australian Infant Feeding Guidelines Summit, held in May, a resounding agreement was reached by all participants who included key research and industry bodies, on updates to Australian infant feeding advice. While the updates translate the available evidence to optimise food allergy management and treatments, they apply to all infants and include the following recommendations to change the current Australian infant feeding guidelines:

1)      When your infant is ready, at around 6 months, but not before 4 months, start to introduce a variety of solid foods, starting with iron rich foods, while continuing breastfeeding.
2)      All infants should be given allergenic solid foods including peanut butter, cooked egg and dairy and wheat products in the first year of life. This includes infants at high risk of allergy.

This consensus provides parents, educators and health professionals with more clarify around the introduction of foods in the first year of life, however one aspect of infant feeding recently brought to GLNC’s attention as part of the annual review of the Code of Practice for Whole Grain Ingredient Content Claims, is that there is a lack of guidance for parents and educators when it comes to whole grain food recommendations for infants (7-12 months).

The absence of a specific guidance on whole grain food intake recommendations in infant feeding guidelines is a reflection of the lack of research on whole grain intakes of children and health.  In consultation with paediatric Accredited Practising Dietitians, GLNC determined that a specific whole grain ingredient content claim or recommendation for infants (7 – 12 months) was not appropriate to be included in the GLNC Code of Practice for Whole Grain Ingredient Content Claims.  This is based on the fact that infants are highly variable in their development so requirements will vary. A set recommendation will not be applicable to all infants and may lead a parent to feed their child amounts of whole grain beyond their needs and thus increase risk of excessive fibre intakes (and risk of constipation or satiation leading to suboptimal breastmilk intake).  

However, while advice around whole grain food intake is not specified in infant feeding guidelines, this is not to say that whole grain foods such as wholemeal bread, rusks or other cereals cannot be offered in alignment with infant feeding guidelines to infants in their first year of life. Australian infant feeding guidelines encourage parents to start to introduce a variety of solid foods, when an infant is ready, at around 6 months but not before 4 months, while continuing breastfeeding. Guidelines suggest starting with iron rich foods which can include grain foods and legumes. When it comes to whole grain choices, GLNC encourages the inclusion of some whole grain foods in to the diet of infants to promote healthy habits from a young age. Parents should however be aware of choking risks of intact grains.

Beyond the first year of life, for generally healthy toddlers dietary recommendations are based around choosing a variety of foods within each food group, at an appropriate overall intake for an individual child to support their growth and development, avoiding choking hazards. Offering whole grain foods from an early age, contributes towards the whole grain Daily Target Intake (DTI) for children 1-3 years which is 24 grams and the DTI for children 4- 8 years which is 32-40 grams.

The current Infant Feeding Guidelines can be found here and more information on this recent summit and recommendation can be found here.