Nutrition Topics

Feeding Infants and Toddlers Study: Findings

Findings from our 2002 Feeding Infants and Toddlers Study were published in a special issue of the Journal of the American Dietetic Association in January 2006.

Survey Design

“Feeding Infants and Toddlers Study (FITS): Development of the FITS Survey in Comparison to Other Dietary Survey Methods.” Paula Ziegler, Ronette Briefel, Nancy Clusen, and Barbara Devaney. This article describes the planning steps and design of the study, including the rationale, sampling methodology, field data collection, survey instruments, and data processing and analysis. A brief review of existing national nutrition surveys and studies of infants and toddlers, as well as study designs and dietary methods, is also included.

Energy/Nutrient Sources and Intakes

“Sources of Energy and Nutrients in the Diets of Infants and Toddlers.” Mary Kay Fox, Kathleen Reidy, Timothy Novak, and Paula Ziegler. The authors identify major sources of energy and 24 nutrients in the diets of U.S. infants and toddlers, and describe shifts in major sources of nutrients as children age. These findings suggest that dietetic and health professionals should consider the contributions of fortified foods and dietary supplements to the nutrient intakes of infants and toddlers.

“Current Electrolyte Intakes of Infants and Toddlers.” William C. Heird, Paula Ziegler, Kathleen Reidy, and Ronette Briefel. This article focuses on how sodium, chloride, and potassium intakes of infants and toddlers compare with the Dietary Reference Intakes of these nutrients established by the Food and Nutrition Board of the Institute of Medicine. The findings indicate the need to limit sodium intake and increase potassium intake. Recommendations include bringing intakes closer to the adequate level by continuing breast- or formula-feeding, delaying the introduction of cow’s milk, increasing intakes of fruits and vegetables, and limiting the intake of salty foods.

Use of Supplements

“Feeding Infants and Toddlers Study: Do Vitamin and Mineral Supplements Contribute to Nutrient Adequacy or Excess Among US Infants and Toddlers?” Ronette Briefel, Charlotte Hanson, Mary Kay Fox, Timothy Novak, and Paula Ziegler. Data from FITS show that overall, 8 percent of infants ages 4 to 5 months received some type of dietary supplement, and the use of supplements increased with age—to 19 percent among infants 6 to 11 months and to 31 percent among toddlers 12 to 24 months. The most common was a multivitamin and/or mineral supplement. There were no significant differences in mean daily intakes of nutrients from foods alone or in the consumption of foods between those who used supplements and those who did not. Researchers found that healthy infants and toddlers can achieve recommended levels of vitamins and minerals from food alone.

Portion Sizes

"Average Portions of Foods Commonly Eaten by Infants and Toddlers in the United States.” Mary Kay Fox, Kathleen Reidy, Vatsala Karwe, and Paula Ziegler. This article examines average portion sizes consumed per eating occasion by infants and toddlers—valuable information from a national study that can inform meal planning for day care and child care programs. Findings show that for most foods (except infant formula), there was a gradual increase in the average portion as age increased from infancy to age two years. The data can be used to provide guidance to parents and caregivers about reasonable portion sizes. The researchers noted that advice about reasonable portion sizes should always be tempered with appropriate cautions about avoiding coercive “clean your plate” feeding practices.

“Relationship Between Portion Size and Energy Intake Among Infants and Toddlers: Evidence of Self-Regulation.” Mary Kay Fox, Barbara Devaney, Kathleen Reidy, Carol Razafindrakoto, and Paula Ziegler. Total energy intake is influenced not only by portion size, but by the number of eating occasions in a day and the number and energy density (that is, the number of calories per ounce) of foods consumed. An analysis of data confirms the presence of energy self-regulation among infants and young toddlers, and can help assure parents and caregivers that infants know how much to eat and how often. However, this self-regulation of intake was not noted for toddlers, indicating that parents and caregivers should be sensitive to infants’ and toddlers’ cues of hunger and satiety and avoid feeding behaviors that promote overfeeding and excessive food consumption.

Findings for Hispanics

“Feeding Infants and Toddlers Study: Characteristics and Usual Nutrient Intake of Hispanic and Non-Hispanic Infants and Toddlers.” Ronette Briefel, Paula Ziegler, Timothy Novak, and Michael Ponza. Researchers compared demographic and maternal characteristics and usual energy and nutrient intakes of Hispanic and non-Hispanic infants and toddlers. Results show that mothers of Hispanic infants and toddlers were younger, less likely to be married, had lower education levels, and had higher participation rates in WIC. Both Hispanics and non-Hispanics consumed more calories than their estimated energy requirements. Hispanic toddlers consumed a significantly higher proportion of energy from carbohydrates and a significantly lower percentage of energy from fat.

“Feeding Infants and Toddlers Study: The Types of Foods Fed to Hispanic Infants and Toddlers.” Julie A. Mennella, Paula Ziegler, Ronette Briefel, and Timothy Novak. Although there were some similarities, the early flavor and food experiences of Hispanic infants were different from similarly aged non-Hispanic infants in several ways. Hispanic infants younger than one year were more likely to have been breastfed, and those ages four to five months were more likely to be eating pureed baby foods on a daily basis. Six- to 11-month-old Hispanics were more likely to be eating fresh fruits, fruit-flavored sweetened drinks, baby cookies, and foods such as soups, rice, and beans that are common in Hispanic culture. Hispanic toddlers were more likely to be drinking sweetened beverages than non-Hispanic toddlers.

“Feeding Infants and Toddlers Study: Meal and Snack Intakes of Hispanic and Non-Hispanic Infants and Toddlers.” Paula Ziegler, Charlotte Hanson, Michael Ponza, Timothy Novak, and Kristy Hendricks. Hispanic and non-Hispanic infants and toddlers, on average, were fed seven times per day. Overall, the percentages of children who ate snacks increased with age, and more than 80 percent of toddlers aged 12 to 24 months consumed afternoon snacks, with more than 90 percent of Hispanic children consuming an afternoon snack. Popular snack choices ranged from healthier choices of whole milk or water and crackers, to less healthy choices, such as sweetened beverages and cookies, chips, or candy.

Location of Food Consumption

“Nutrient Intakes and Food Patterns of Toddlers’ Lunches and Snacks: Influence of Location.” Paula Ziegler, Ronette Briefel, Michael Ponza, Timothy Novak, and Kristy Hendricks. Overall, on any given day, 43 percent of toddlers consumed all meals and snacks at home, 8 percent consumed any meal or snack at child care (and others at home), and 49 percent consumed any meal or snack away from home (all other locations excluding child care). Lunches eaten at child care were significantly higher in calcium, phosphorus, magnesium, vitamin D, potassium, and riboflavin compared with those eaten at home or away. French fries were the most frequently consumed item for toddlers at away locations (35 percent).

Maternal Characteristics

“Maternal and Child Characteristics Associated with Infant and Toddler Feeding Practices.” Kristy Hendricks, Ronette Briefel, Timothy Novak, and Paula Ziegler. Having a college education was the maternal characteristic associated with the largest number of positive child feeding behaviors—or meeting feeding or dietary recommendations. Mothers with a college education were significantly more likely than other mothers to initiate breastfeeding and continue it for 6 to 12 months. They were also more likely to offer their children more fruit, and less likely to offer sweetened beverages and desserts or candy. Ever breastfeeding, living in the western region of the United States, and being married and older were also associated with multiple positive practices.