Page 197 - Nutrition Counseling and Education Skills: A Guide for Professionals

formulas are recommended to be the single source of nutrition during the first 4 to 6 months of life. Breast-
feeding has been shown to have positive nutrition outcomes for both mother and infant, particularly during
the first 3 months of life. Breast-feeding for the first full year of life may also reduce the incidence of toddler
obesity.8 Mothers can continue to express milk even when returning to work but need to be instructed on
collection procedures and safe milk storage. Most mothers, especially first-time mothers, need lots of support
in order to be successful. Resources for lactation support include lactation consultants, professional
organizations such as the La Leche League International, and peer mother networks.

A mother influences the earliest feeding decisions for her newborn.

Counseling Strategies

Individual counseling may be most effective when addressing unique issues or providing specific
individualized strategies. Observing actual breast-feeding practices may help in solving problems. Group
support may be more appropriate when both mothers and infants gather to interact. The nutrition
professional can act as a facilitator for discussion and guide the conversation to pertinent topics. Family
members and child-care partners can also be involved to replicate feeding environments and larger cultural
conversations.9

The nutrition professional should be objective when providing feeding information and respecting parental
attitudes toward breast-feeding. It is important to be up-to-date on all commercial formulas and their nutrient
composition. This information is necessary to deliver accurate and sound data upon which to make feeding
assessments for growth and tolerance.

Nutrition education is most critical when counseling about the choice and amount of complementary foods
introduced at 4 to 6 months of age. The American Academy of Pediatrics and other professional
organizations have published recommendations for the introduction of solid foods.10,11 Using
recommendations from recognized authorities derived from evidence-based analysis provides validity to
education sessions. Many of the first foods served to infants are higher in sodium than recommended, a direct
result of parent choices in feeding the foods they preferred or had available rather than more nutritious first
choices.12 The risk of childhood obesity is less when infants are breast-fed during the first year of life along
with low intake of sugar-sweetened beverages during the toddler years.8 Educational efforts can help parents

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