Release of Draft Infant Feeding Guidelines for Health Workers

The National Health and Medical Research Council (NHMRC) has released the long awaited  draft Infant Feeding Guidelines for Health Workers for public consultation. Comments must be received, preferably online, by 5th December 2011.

These guidelines are an important  tool for health workers to help them support mothers and/or carers  of young children aged up to  2 years with breast feeding, infant formula feeding and introducing solids and family foods. They are based on the latest scientific research.

Some of the recommendations made in the draft guidelines include:-

• Exclusive breastfeeding for around six months and then continued for 12 months and beyond. Around six months is defined as within 4 weeks of 6 months or between 22-26 weeks. Any breast feeding is beneficial to the infant.
• Where an infant is not breast fed or only partially breast fed, a commercial infant formula must be used. Health professionals must be knowledgeable about infant formula so they can inform mothers correctly about the types available, be able to demonstrate how to prepare them, store and feed them to the infant  to ensure optimal nutrition and minimize infection. Cows milk based formulas are recommended. Soy, goats, and special formulas should only be used for medical, cultural or religious reasons.
• In contrast to WHO Guidelines on the preparation of infant formula ,the draft guidelines do not recommend the addition of infant formula powder to hot water at a temperature of 70 degrees C. This is because there is a risk of burns at this temperature and valuable nutrients in the formula can be destroyed. In Australia the risk of E. sakazakii infection is also low. Preparation instructions  are based on guidelines from the Infant Nutrition Council (INC).
• Marketing in Australia of Infant Formula ( MAIF) Agreement is the primary way the WHO Code is implemented in  Australia and Australia does not implement all aspects of the WHO Code
• Dummies should be discouraged before 4 weeks of age as they interfer with breastfeeding
• All water for infants should be boiled
• Solids or spoon foods should be introduced around six months - between 22 - 26 weeks to meet nutritional and developmental needs. Iron containing foods should be among the first solids introduced but there is no set order as to which foods groups should be introduced first. Salt and sugar should not be added to infant foods.
• The age of introduction of solids around 6 months fits in with "window of tolerance" to minimize allergies and to protect against obesity.
• Foods not recommended for infants or to be used with care include:- honey ( not before age 2 years); tea and herbal teas; soft drinks; nuts; fruit juices ( not for infants under 6 months); cows milk as main milk is not suitable for infants less than 12 months; goats milk is not suitable for infants  less than 12 months; and reduced fat milk should only be used after age 2 years.

Reference.

NHMRC. Infant Feeding Guidelines for Health Workers. Draft for Public Consultation October 2011.