Special Report: Dietary Guidelines miss key pediatric guidance

In episode 5 of this Special Report, Colleen Sloan, PA-C, RDN, joined Catherine McManus, PhD, RDN, LD, and Viet Le, DMSc, MPAS, PA-C, FACC, to examine pediatric-specific gaps in the 2025–2030 US Dietary Guidelines and the potential implications for clinical care, education, and policy.

Sloan emphasized that while the condensed guidelines are designed to inform federal programs such as SNAP, school meal programs, and assisted living facilities, their shortened format may limit their usefulness at a policy and clinical level—particularly for pediatric populations. She noted that several safety- and development-focused recommendations present in prior guidelines were either minimized or omitted entirely.

McManus highlighted the absence of guidance on breast milk handling and storage in the infant section. Although the guidelines encourage breastfeeding and the use of iron-fortified formula when needed, she stressed that safe storage and handling are critical for infants, whose immune systems are still developing and who are particularly vulnerable to infection.

Sloan also pointed to the lack of explicit guidance on avoiding honey in infants younger than 1 year, a longstanding and important safety recommendation. In addition, both experts expressed concern over the reduced emphasis on iron-rich foods for infants and young children, despite the high prevalence of iron deficiency in early childhood.

McManus noted that while iron and vitamin D are mentioned, the guidance is brief compared with prior editions, which provided more detailed recommendations. She emphasized the importance of educating caregivers and clinicians about iron bioavailability, including differences between heme and non-heme iron sources, and the role of diet in preventing iron deficiency during infancy, toddlerhood, and the preschool years.

Overall, the panel agreed that while the updated Dietary Guidelines provide a broad population-level framework, clinicians must fill critical gaps—particularly in pediatric nutrition—through individualized counseling and evidence-based education.

Our Experts:
Colleen Sloan, PA-C, RDN, pediatric physician assistant and registered dietitian; host of The Exam Room Nutrition Podcast.
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.