The 2025-2030 dietary guidelines for Americans: a pediatric review of recommendations for children under 5 years

The 2025-2030 Dietary Guidelines for Americans, released in January 2026, marks a significant departure from prior editions, both in its development process and nutritional recommendations. This paper examines the guidelines for children in the first 5 y of life. We highlight both advances and areas that may require additional guidance by future advisory panels. Notable changes for this age group include a recognition of the potential risks of highly processed foods and strengthened guidance on added sugars through 10 y of age. We question whether the recommendation to avoid nearly all added sugars may be unrealistic and undermine adherence to other valuable guidance. The guidelines also omitted key themes from prior iterations. This included the removal of guidance on usage of infant cereals for complementary food introduction, despite its importance for iron and other micronutrient fortification during a critical developmental period. Specific warnings against unpasteurized dairy products are not present, and the guidance had inconsistencies around the handling of allergenic foods. Moving forward, guideline development for small children should be undertaken with a high level of transparency and involvement of pediatricians and should fully incorporate key aspects of the Dietary Guidelines Advisory Committee's scientific work reviewing early childhood nutrition.