Breaking Down the New Dietary Guidelines 2025–2030: Evidence, Gaps, and Real-World Practice - Episode 5
Pediatric Gaps in the Dietary Guidelines
In part 5 of the discussion, the panel examines gaps within the pediatric sections of the updated dietary guidelines.
In part 5 of the discussion, the conversation shifted to pediatric-specific gaps in the updated dietary guidelines, with Colleen Sloan emphasizing that many of the concerns stem from how condensed the document has become.
While the guidelines are often interpreted through a clinical lens, she underscored that they ultimately function at a federal policy level, informing programs such as SNAP, school meal standards, and nutrition requirements in elder and assisted living facilities. From that perspective, the degree of shortening raises concerns, particularly in pediatrics, where more detailed guidance can directly support education, safety, and appropriate nutrition for vulnerable populations.
Catherine McManus pointed to one notable omission in the infant nutrition section: the lack of guidance on breast milk handling and storage. Although the guidelines appropriately encourage breastfeeding and recommend iron-fortified formula when breast milk is not available, previous versions also included practical information on safe handling.
McManus stressed that this omission is concerning given how vulnerable infants are during the first year of life, when their immune systems are still developing and they are especially susceptible to infection. As with other gaps discussed, she attributed this change largely to the significant condensation of the document, noting that safety-related guidance for infants is particularly important to retain.
Sloan also highlighted the absence of a clear recommendation to avoid honey in infants under one year of age, a long-standing and critical safety message due to the risk of botulism. In addition, she noted that guidance on iron intake for infants and young children was far less prominent than in prior versions.
While iron was mentioned, it lacked the emphasis and specificity that previously helped clinicians and caregivers understand its importance, particularly concerning given how common iron deficiency is in early childhood.
Expanding on this point, McManus agreed that although iron and vitamin D were included, the discussion was extremely brief compared with earlier guidelines. She emphasized that prior versions did a better job outlining iron-rich food sources and explaining why adequate iron intake is essential during infancy and early childhood.
McManus also noted the missed opportunity to educate caregivers on the differences between heme and non-heme iron sources, including their relative bioavailability, which can have meaningful implications for absorption and utilization. Given the frequency of iron deficiency not only in the first year of life but extending into toddlerhood and the preschool years, she emphasized that more robust, practical pediatric nutrition guidance would be a valuable area for improvement in future guideline updates.
Our Experts:
Colleen Sloan, PA-C, RDN, pediatric physician assistant and registered dietitian.
Catherine McManus, PhD, RDN, LD, assistant professor of nutrition, Case Western Reserve University; Cleveland Clinic Foundation.
Viet Le, DMSc, MPAS, PA-C, FACC, preventive cardiology physician assistant and associate professor of research, Intermountain Health.
