Fruit and Vegetable Intake in Infancy and Early Childhood

Health communication extols the benefits of breastfeeding, some would say to a fault. Friends of mine who can’t breastfeed because of technical difficulties, work schedules, twin births (not producing enough milk), or disease (a friend who has MS goes off of her injections to get pregnant, and then has to go back on them immediately after giving birth) cite these messages as inducing fear about the health of their children and anger at the suggestion that they are inferior parents because of their inability to breastfeed. 

I thought that this week’s topic of child and maternal health would be an opportune time to explore recent research into correlations between infant feeding practices and health later in life. I looked at an article that is part of the September 1 issue of Pediatrics that was dedicated solely to examining these possible correlations. 

The study, Fruit and Vegetable Intake During Infancy and Early Childhood, uses data from the CDC’s Infant Feeding Practices Study II (IFPS II) and the Year 6 Follow-Up (Y6FU). In these studies, mothers (it did not mention fathers) tracked their children’s feeding habits weekly by indicating the number of various categories of fruits and vegetables their children had consumed each week. These same dyads were also tracked in the children’s sixth year.

After analyzing the data, researchers found that infants who eat fruits and vegetables less than once daily are ~2.5 times more likely to eat fruits and vegetables less than once daily as 6-year-olds. Considering that 32% of 2-3 year olds and 63% of 4-8-year-olds don’t get enough fruit ( a recommended 1-1.5 cups of fruit per day, NOT including juice), and that 80% of 2-3-year-olds and 92% of 4-8-year-olds don’t get enough vegetables, this research has acute implications for child health as it appears that fruit and vegetable consumption drops dramatically between ages 2 and 8. 

The study did not find any connections between age of introduction of these foods and longevity of fruit-and-vegetable-eating habits.

The authors of the study indicate several possible influences on children adapting long-term healthy eating habits. One is obvious: being exposed to healthy foods in infancy sets habits whereby children continue to eat these foods. Because the study didn’t assess whether the infants who didn’t eat enough fruits and vegetables were offered these foods in the first place, if they were, there could be a correlation between parents visibly eating fruits and vegetables and their children eating them as well. Multiple studies show that parents who engage in healthy eating in front of their children have children who eat these foods as well. An additional effect is that of breastfeeding. Breast milk changes in taste depending on what the mother eats; formula maintains the same taste regardless. Breastfeeding could introduce these foods to infants in a way in which formula can’t.

I think this is a fascinating study, especially when coupled with another study in the issue that shows correlation between sugar-sweetened beverages introduced in infancy and childhood obesity. In researching food security, one of the salient arguments (that I’ve witnessed in my own life) is that mothers who are food insecure often feed their children first, and feed them the most nutritious foods they have. It’s possible that these children don’t get enough healthy food in infancy, which sets them up for making less healthy choices when they go to school as 4-8-year-olds. Additionally, for food insecure households, studies show that parents are less likely to eat healthy foods, and therefore don’t model these behaviors to their children. So even if they did offer these foods to the infants, it might not do any good if the parents weren’t visibly eating these foods themselves. And last, mothers who are food insecure and also breastfeed might not consume the proper foods for developing the palate of an infant to later desire fruits and vegetables. 

While I think that talks of “developing your child’s palate” smacks of middle class Pinterest elitism (full disclosure: my partner and I talk incessantly of developing our hypothetical child’s hypothetical vegan palate), I do believe that palates have implications for eating behaviors and possibly for obesity. It’s a topic I would like to explore further through research and my own (hypothetical) personal experience. 

Grimm, K. A., Kim, S. A., Yaroch, A. L., & Scanlon, K. S. (2014). Fruit and vegetable intake during infancy and early childhood. Pediatrics, 134(Supplement), S63-S69.