Make Every Bite Count, Even Little Bites!

By Janet M. de Jesus, MS, RD, Nutition Advisor, Office of Disease Prevention and Health Promotion 

The period from birth until a child’s second birthday is a critically important time for growth and development. Nutrition during this early stage of life not only affects the health of the growing child, but may continue to affect their health through adulthood.

Until recently, the Dietary Guidelines for Americans — which serves as the basis for federal food policy — has focused on Americans ages 2 and older. HHS and USDA expanded the Guidelines, given the growing availability of scientific literature and the importance of establishing dietary recommendations for children under age 2. For the first time, the 2020 Dietary Guidelines Advisory Committee completed scientific reviews related to infants and toddlers.

The newest edition, Dietary Guidelines for Americans, 2020–2025, now includes recommendations for healthy dietary patterns by life stage, including infants and toddlers. This exciting evolution provides new guidance and tips that health professionals can use to help shape the dietary patterns of the youngest Americans.

Health professionals can advise parents and caregivers to follow the Dietary Guidelines’ Key Recommendations for infants and toddlers from Birth Through 23 Months:

  • For about the first 6 months of life, exclusively feed infants human milk. Continue to feed infants human milk through at least the first year of life, and longer if desired. Feed infants iron-fortified infant formula during the first year of life when human milk is unavailable.
  • Provide infants with supplemental vitamin D beginning soon after birth.
  • At about 6 months, introduce infants to nutrient-dense complementary foods.
  • Introduce infants to potentially allergenic foods along with other complementary foods.
  • Encourage infants and toddlers to consume a variety of foods from all food groups. Include foods rich in iron and zinc, particularly for infants fed human milk.
  • Avoid foods and beverages with added sugars.
  • Limit foods and beverages higher in sodium.
  • As infants wean from human milk or infant formula, transition to a healthy dietary pattern.

Establishing a Healthy Dietary Pattern

In addition to meeting nutrient and calorie requirements, the dietary patterns of infants and toddlers can influence the trajectory of eating behaviors throughout their lives. Taste preferences begin to form during this period, and research shows that early food preferences influence later food choices.

As very young children are exposed to new textures and flavors for the first time, it may take them up to 10 exposures to accept a new type of food. Encouraging parents and caregivers to offer new foods such as fruits and vegetables repeatedly increases the likelihood of children accepting them. Offering the healthiest food and beverage choices at an early age can set young children on a path toward making nutrient-dense choices in the years to come.

Healthy Dietary Patterns During the Second Year of Life

In the second year of life, toddlers consume less human milk, and infant formula is not recommended. Toddlers should get their calorie and nutrient needs through a healthy dietary pattern of age-appropriate foods and beverages.

Because nutrient requirements for toddlers are quite high relative to their size, and the amount of food they consume is small, a healthy dietary pattern for toddlers has virtually no room for added sugars. However, many toddlers currently consume more than 100 calories from added sugars each day.

Added sugars can come from a wide variety of sources in a toddler’s diet, including sugar-sweetened beverages, sweetened bakery products, flavored yogurts, ready-to-eat cereals, flavored milk, and some baby food products. Health care providers can play an important part in educating parents and caregivers about how to identify added sugars and make thoughtful choices across all food groups.

Supporting Healthy Eating

Since parents and caregivers have a central role in nutrition during this life stage, it’s critically important for health care providers to help caregivers focus on both what and how to feed young children. For example, caregivers may not be aware that many common foods are high in added sugars and calories but low in vitamins and minerals.

One strategy to support healthy eating among infants and toddlers is to encourage parents and caregivers to shift from common choices to healthier, more nutrient-dense choices.

Image displays six different scenarios where a healthier food choice can be made. Choose cereal with minimal added sugars over cereal with added sugars. Choose Fruit, for example, canned in 100% juice instead of fruit products with added sugars. Choose roasted vegetables instead of fried vegetables. Select vegetables instead of high-sodium snacks. Eat ground lean meats instead of high-sodium meats. Choose unsweetened beverages over beverages with added sugars.

Another important strategy is to encourage responsive feeding. Responsive feeding emphasizes recognizing and responding to the hunger or fullness cues of an infant or young child. This feeding style helps young children learn how to self-regulate their food intake.

Find More Information About Feeding Infants and Toddlers

Many resources are available to support healthy growth and development during infancy and toddlerhood.

There are also a variety of online materials to support the use and implementation of the Dietary Guidelines.

This figure includes images of two burrito bowl meals with iced tea as a beverage. The first image is a typical meal and the second image demonstrates improvements to the meal that improves its nutrient-density. The total calories of the typical meal equal 1,120 and after the shifts the nutrient-dense meal is 715 calories. Shifts include changing white rice to a smaller portion of brown rice, using reduced sodium black beans, increasing the amount of vegetables, and reducing saturated fat through reduced fat shredded cheese and removing the sour cream. Choosing unsweetened iced tea instead of sweetened tea reduces added sugars in this meal.

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