11.6: Nutrition
- Page ID
- 225473
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- Identify USDA-recommended meal patterns for infants and toddlers.
- Describe foods that should be avoided in early childhood to reduce choking, allergic reactions, and nutritional risks.
- Discuss the long-term health risks associated with early exposure to added sugars and processed foods.
On-Demand Feeding for Young Infants
Feeding infants on demand—responding promptly to their hunger cues rather than adhering to a strict schedule—is widely recommended for promoting optimal growth and development. This responsive feeding approach aligns with infants' natural hunger and satiety signals.
Research indicates that demand-fed infants tend to have better cognitive outcomes compared to those fed on a schedule. A study analyzing data from the Avon Longitudinal Study of Parents and Children found that schedule-fed babies scored lower in standardized tests and IQ assessments up to 14 years of age, even after adjusting for various confounding factors (Iacovou & Sevilla, 2013). This suggests that feeding on demand may have long-term benefits for a child's cognitive development.
Moreover, on-demand feeding is associated with longer breastfeeding durations. A study published in PLOS ONE found that mothers who adopted infant-led feeding practices, which involve feeding in response to the baby's hunger cues, were more likely to continue breastfeeding for extended periods (Brown & Lee, 2013). This extended breastfeeding duration provides ongoing nutritional and immunological benefits to the infant.
Responsive feeding also plays a crucial role in establishing healthy eating behaviors. By recognizing and responding to their hunger and fullness cues, infants learn to self-regulate their food intake, which can help prevent overfeeding and its associated risks, such as obesity (Black & Aboud, 2011).
USDA Infant Meal Patterns
| Meal | 0-5 months | 6-11 months |
|---|---|---|
| Breakfast | 4-6 fluid ounces breastmilk or formula | 6-8 fluid ounces breastmilk or formula 0-4 tablespoons infant cereal, meat, fish, poultry, whole eggs, cooked dry beans or peas; or 0-2 ounces cheese; or 0-4 ounces (volume) cottage cheese; or 0-4 ounces yogurt; or a combination* 0-2 tablespoons vegetable, fruit, or both* |
| Lunch or Supper | 4-6 fluid ounces breastmilk or formula | 6-8 fluid ounces breastmilk or formula 0-4 tablespoons infant cereal, meat, fish, poultry, whole eggs, cooked dry beans or peas; or 0-2 ounces cheese; or 0-4 ounces (volume) cottage cheese; or 0-4 ounces yogurt; or a combination* 0-2 tablespoons vegetable, fruit, or both* |
| Snack | 4-6 fluid ounces breastmilk or formula | 2-4 fluid ounces breastmilk or formula 0-1⁄2 bread slice; or 0-2 crackers; or 0-4 tablespoons infant cereal or ready-to-eat cereal* 0-2 tablespoons vegetable, fruit, or both* |
USDA Toddler Meal Patterns
| Meal | Ages 1-2 |
|---|---|
| Breakfast | 1⁄2 cup milk 1⁄4 cup vegetables, fruit, or both 1⁄2 ounce equivalent grains |
| Lunch or Supper | 1⁄2 cup milk 1-ounce meat or meat alternative 1/8 cup vegetables 1/8 cup fruits 1⁄2 ounce equivalent of grains |
| Snack | Select two of the following: 1⁄2 cup of milk 1⁄2 ounce of meat or meat alternative 1⁄2 cup of vegetables 1⁄2 cup of fruit 1⁄2 ounce equivalent of grains |
Food Safety
Certain foods should be avoided to promote the health and safety of infants and toddlers. The introduction of inappropriate foods can increase the risk of choking, allergic reactions, and digestive issues. The next section will explore this topic in more detail, specifically introducing solid foods.
Foods That Pose a Choking Hazard
Infants and toddlers are still developing their ability to chew and swallow, making some foods particularly dangerous. According to the American Academy of Pediatrics (AAP), foods that should be avoided due to choking risk include whole grapes, hot dogs (unless cut into very small pieces), popcorn, nuts, raw vegetables, and hard candies (American Academy of Pediatrics, 2010). Foods with a sticky or thick consistency, such as peanut butter or marshmallows, should also be given with caution, as they can be difficult for young children to manage.
Honey and the Risk of Infant Botulism
Honey should never be given to infants under 12 months due to the risk of infant botulism, a rare but serious illness caused by Clostridium botulinum spores, which can colonize an infant’s immature digestive system and produce harmful toxins (Centers for Disease Control and Prevention [CDC], 2024). Even small amounts of honey in processed foods or homemade preparations can be dangerous for young infants.
Cow’s Milk and Alternatives Before One Year
Whole cow’s milk should not be introduced before the age of one year. While dairy products like yogurt and cheese can be introduced around six months, cow’s milk lacks the necessary iron content. It can lead to iron-deficiency anemia (Committee on Nutrition, AAP, 2014). Additionally, plant-based milk alternatives (e.g., almond, oat, or rice milk) should not be used as a primary beverage in infancy unless medically indicated, as they may not provide adequate nutrients for growth and development.
Highly Processed and Sugary Foods
The introduction of added sugars should be avoided in infancy and kept to a minimum in toddlerhood. Research indicates that early exposure to sugary foods and beverages, including fruit juices and sweetened cereals, increases the likelihood of developing unhealthy eating habits and obesity later in life (Vos et al., 2017). The AAP recommends avoiding fruit juice before the age of one and limiting juice intake thereafter. Highly processed foods with excessive sodium and artificial additives should also be minimized, as they may contribute to long-term health issues.
References, Contributors and Attributions
American Academy of Pediatrics. (2010). Prevention of choking among children. Committee on Injury, Violence, and Poison Prevention. Retrieved from: https://publications.aap.org/pediatr...ce=chatgpt.com
Black, M. M., & Aboud, F. E. (2011). Responsive feeding is embedded in a theoretical framework of responsive parenting. The Journal of Nutrition, 141(3), 490–494. https://doi.org/10.3945/jn.110.129973
Brown, A., & Lee, M. (2013). Breastfeeding duration and early parenting behaviour: The importance of an infant-led, responsive style. PLOS ONE, 8(2), e83893. https://doi.org/10.1371/journal.pone.0083893
Centers for Disease Control and Prevention. (2024). About botulism. Retrieved from: https://www.cdc.gov/botulism/about/index.html
Committee on Nutrition, American Academy of Pediatrics. (2014). The use of whole cow’s milk in infancy. Pediatrics, 133(3), 547-549.
Du Toit, G., Roberts, G., Sayre, P. H., Bahnson, H. T., Radulovic, S., Santos, A. F., ... & Lack, G. (2015). Randomized trial of peanut consumption in infants at risk for peanut allergy. New England Journal of Medicine, 372(9), 803-813.
Iacovou, M., & Sevilla, A. (2013). Infant feeding: The effects of scheduled vs. on-demand feeding on mothers' wellbeing and children's cognitive development. The European Journal of Public Health, 23(1), 13–19. https://doi.org/10.1093/eurpub/cks012
U.S. Department of Agriculture, Food and Nutrition Service. (n.d.). Infant meals. https://www.fns.usda.gov/cacfp/meals-and-snacks
U.S. Department of Agriculture, Food and Nutrition Service. (n.d.). Child and adult care food program: Meal patterns for children. https://www.fns.usda.gov/cacfp/meals-and-snacks
Vos, M. B., Kaar, J. L., Welsh, J. A., Van Horn, L. V., Feig, D. I., Anderson, C. A., ... & Johnson, R. K. (2017). Added sugars and cardiovascular disease risk in children: A scientific statement from the American Heart Association. Circulation, 135(19), e1017-e1034.