Are Eating Habits Set in Infancy?

Are kids' diet habits set in infancy, as a recent New York Times article suggests? According to the article, the findings of several new studies published in Pediatrics suggest that, "Efforts to improve what children eat should begin before they even learn to walk."

In one study, researchers looked at the association between bottle-feeding practices during infancy with maternal feeding style and children's eating behavior at six years old. They found that bottle-feeding practices during infancy may have long-term effects on both maternal feeding style and children's eating behavior at age six. Frequent bottle emptying encouraged by mothers during early infancy increased the likelihood they'd pressure their six-year-old child to eat enough and eat all the food on their plate. Also, high bottle feeding intensity during early infancy increased the likelihood mothers would be especially careful to ensure their six-year-olds eat enough. Based on the findings, lead researcher Ruowei Li, MD, PhD suggests breastfeeding as the first feeding choice for infants. She adds, "When feeding at the breast is not feasible, supplementing breastfeeding with expressed breastmilk is a good alternative, but special attention is needed for infants' internal feeding cues while bottle-feeding."

Another study found that infrequent intake of fruits and vegetables during late infancy is associated with infrequent intake of these foods at six years of age. The researchers concluded that it's important for parents to find ways to encourage their infants to eat fruits and vegetables despite perceived barriers to produce intake.

Two other studies, also published in Pediatrics, unsurprisingly found some perils associated with sugar-sweetened beverage (SSB) intake. In the first study, infants who drank any amount of SSBs were two times more likely to drink them at least once daily at age six. Based on their findings, the researchers point out the importance of establishing healthy beverage practices in infancy.

In the second study, 10- to 12-month-olds who drank SSBs more than three times a week were twice as likely to be obese at age six than those who consumed none as infants. The researchers concluded that SSB consumption during infancy can be a risk factor for obesity in early childhood.

We all do our best as parents to raise and nurture our kids, which includes trying to feed them well, and help them meet their basic nutrient needs. I know I felt empowered when my sons who were breastfed would grow at each and every visit to the pediatrician. It made me feel great to know that my milk alone, at least for several months when they were exclusively breastfed, fed them. But as kids grow, like everything else feeding gets a little more complicated. Transitioning from breast milk or formula to "real food" can be a real challenge for many.

Also, since food is love in many cultures, learning how to feed your growing infants and toddlers enough, but not too much, to meet their needs can be easier said than done. This makes it even more important that parents learn and respect their children's mealtime cues e.g. that they're hungry or that they've had enough. I always say that if your kids' trips to the pediatrician show they're growing at a rate that's consistent for him or her, it's likely they're at least meeting their calorie needs. If they're moving too much in one direction or another on growth charts, that's when it's important to really consider dietary tweaks. In such cases, working even a few times with a registered dietitian nutritionist can help parents not only know what and how much their child needs but how to help them meet those needs without food fights.

As infants grow into toddlers and then full-fledged school-age children and become exposed to more and more nutrient-poor options whether at school or when on-the-go, things get even more complicated and challenging. But as the Pediatrics studies illustrate, it's vital for parents to simply try to feed their children well starting in infancy. We can do this by exposing them to a wide variety of nutrient-rich foods such as fruits and vegetables (pureed or mashed), by eating with/in front of them, and by making mealtimes calm and pleasant.

While it's ideal to start kids off on a nutritious path when they're very young by offering to them a variety of nutrient-rich foods and to limit their exposure to empty-calorie, nutrient-poor foods and fast food, even when kids are older it's never too late for parents to make some changes in the home and when on the go or at a restaurant to help the whole family move in a more healthful direction. Food preferences can still change and develop as children grow, and just because your child doesn't like or accept a particular food at a young age doesn't mean he or she won't at age 12 or beyond. The key is to repeatedly expose children to a wide variety of foods and to keep discussions about eating and food positive and encouraging so that they feel enticed rather than pressured to eat well.

It's also helpful to present foods in different and appealing ways, and to involve kids, even when they're older, in shopping for, preparing, and cooking food. That can help them develop a love and appreciation for quality foods and healthy eating practices and help them develop skills that they can bring with them as they grow.

Keeping more of the foods and beverages you want your children to consume more of around the house and limiting their exposure at home to items like SSBs and other empty-calorie foods and beverages can also encourage healthier habits. Enjoying family meals can also help infants and all family members feel more connected to one another and even can enhance nutrient intake, protect against obesity, and have other health benefits.

Even if eating habits are at least in part set in infancy, that's no reason for us parents to not at least try to improve what and how we offer foods and beverages to our children. Habits can be enhanced and tweaked at any age, and if we make more nutritious choices for ourselves in front of our children, and show them through our example the joys of eating moderately and mindfully, it's likely that over time our children will internalize that. And hopefully, that will also encourage them to follow suit.

You can check out new nutrition guidance for 2- to 11-year-olds in a previous Scoop on Food post here.

How do you help your infants eat well and develop more healthful food and nutrition habits?

Image of girl eating watermelon via shutterstock.

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