Infant nutrition – diet between 6 and 24 months, implications for paediatric growth, overweight and obesity

Infants are growing rapidly from 6–24 months and have high nutrient needs in proportion to their body size. This sub‐group of the population are prone to dietary imbalances and inadequacies. It is of vital importance to get nutrition right during this time period to support appropriate growth and development. Overweight and obesity rates are increasing in pre‐school children, and maternal nutritional status and early life feeding have been identified as ‘critical windows’ for obesity risk. After the recommended period of exclusive breastfeeding, an increasingly diversified selection of foods are offered to infants and young children, and milk becomes less dominant in the diet. Rapid weight gain during infancy is the strongest risk factor for childhood overweight and obesity, and this may be modifiable with early intervention. During the complementary feeding period, there is an increase in protein intake, which is in excess of requirements, and may be associated with adverse outcomes regarding later body mass index and body fatness. Guidelines for healthcare professionals have been developed to raise the issue of overfeeding during infancy, and to manage overweight if it arises. Dietary intake measures show a deteriorating quality of diet as infants move from the first 12 months of life into the second year, with potential excesses of protein, energy, saturated fatty acids, salt and non‐milk extrinsic sugars. Formula manufacturers can reduce the protein content of formulas for infants and young children in order to support appropriate growth, whilst supplements, fortified foods and milks can supply ‘at risk’ micronutrients.