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Infant nutrition and breastfeeding
Exclusive breastfeeding for about 6 months, a vitamin D supplement for every infant in the first year, an iron supplement from 4 months, complementary foods around 6 months with early exposure to allergens — and cow's milk as the main drink and honey only after one year.
Why it matters in the exam
Nutrition questions test simple rules with standard distractors: should breastfeeding stop because of maternal illness (usually not), when to start complementary foods (around 6 months, not before 4), when to introduce peanut and egg (early, at 4–6 months, which reduces allergy), and why not to give cow's milk before one year (iron deficiency and occult intestinal bleeding) or honey (botulism).
Supplements per the Ministry of Health: vitamin D 400 IU a day from the first days until one year for every infant — including breastfed infants; iron from 4 months until 18 months in the term infant (7.5 mg a day, then 15 mg from 6 months), and from 2 weeks in the preterm infant. The basic growth facts: weight loss of up to 7–10% in the first days, regaining birth weight by 10–14 days, doubling birth weight at 4–5 months and tripling it at one year.
Know the few contraindications to breastfeeding: classic galactosaemia in the infant, maternal HIV in countries with access to a safe substitute, untreated active tuberculosis (separation until treated, but expressed milk can be given), a herpes lesion on the breast, chemotherapy or radioactive agents, and drug use. Hepatitis B (after vaccine and HBIG for the infant), hepatitis C, mastitis and most medicines are not reasons to stop. A breastfed infant under 6 months needs no additional water.
Key points
- Exclusive breastfeeding for about 6 months.
- Vitamin D 400 IU a day for every infant in the first year.
- Iron from 4 months to 18 months.
- Complementary foods around 6 months; allergens early.
- Cow's milk and honey — only after one year.
Summary table
| Topic | Recommendation | Age or dose | Trap |
|---|---|---|---|
| Breastfeeding | Exclusive for about 6 months, then with complementary foods | To two years and beyond as desired | Most maternal illnesses and most medicines are not a reason to stop |
| Vitamin D | For every infant, including breastfed | 400 IU a day from birth to one year | Breast milk is low in vitamin D |
| Iron | Supplement for every term infant | From 4 months to 18 months; in the preterm from 2 weeks | Cow's milk before one year causes iron deficiency |
| Complementary foods and allergens | Solids around 6 months; peanut and egg early | Not before 4 months; allergens at 4–6 months | Delaying allergens raises the risk of allergy |
| What not to give | Cow's milk as the main drink and honey | Only after one year | Honey — infant botulism |
| Normal growth | Initial loss and return to birth weight | Up to 7–10% loss; regained by 10–14 days; doubled at 4–5 months; tripled at one year | Loss over 10% needs a breastfeeding assessment |
Free exam questions
אב מגיע למרפאה עם תינוק בן 5 חודשים הניזון מהנקה מלאה. אחיו בן 6 שנים אובחן לפני חודש עם מחלת הצליאק. מה תהיה המלצתך לגבי הבירור?והטיפול בתינוק זה (the question as examined, in Hebrew)
- א. הפעוט עדיין לא צורך גלוטן ולכן אין דרך לברר מחלה
- ב. ניתן לבצע בדיקה גנטית ל- HLA DQ8 DQ2
- ג. ביצוע גסטרוסקופיה וביופסיית תריסריון
- ד. מומלץ לא לכלול גלוטן בכלכלת התינוק
מה יש לעשות בעקבות קבלת תשובה חיובית ל- CMV בבדיקה ברוק ביילוד שניזון מהנקה ושנלקחה ממנו עקב לידה במשקל נמוך לגיל ההיריון? (the question as examined, in Hebrew)
- א. להתחיל טיפול ב– Valgancyclovir בשל CMV מחלת .מולדת
- ב. לבקש דגימת רוק נוספת של היילוד ולחזור על הבדיקה
- ג. לאמת את האבחנה על ידי בדיקת שתן CMV PCR
- ד. לאמת את האבחנה על ידי בדיקת CMV PCR .בדם
בת 6 חדשים אשר ניזונה מהנקה, הופנתה למרפאה בשל הגדלת שד חד צדדית, ללא תשעורת מינית, ללא הפרשה נרתיקית. צילום כף יד לגיל עצמות.תואם גיל כרונולוגי מה האבחנה הסבירה ביותר? (the question as examined, in Hebrew)
- א. Premature telarche
- ב. Central precocious puberty
- ג. Ovarian tumor
- ד. Estrogens from mother's breast milk
In the full version for subscribers
- A simple algorithm
- Memory aid
- Exam traps
- 5 review cards
- Enough for IMLE
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Sources
- Israeli Ministry of Health, infant nutrition and supplementation recommendations (current) — Breastfeeding, vitamin D and iron supplementation
- Israel Ministry of Health, 2024 — Circular 3/2024: prevention of anaemia and iron deficiency in infants and toddlers
- AAP Policy Statement: Breastfeeding and the Use of Human Milk, 2022 — Exclusive breastfeeding and contraindications
- NIAID Addendum Guidelines for the Prevention of Peanut Allergy, 2017 — Early introduction of allergenic foods
Sources are given for further reading; the text is written afresh and not copied from them.
Reviewed by the Examqo AI Professor · 2026-11-06. The text may contain errors; when in doubt, check the source.