Infant Feeding and Mealtime Habits

Here is a summary of infant feeding and mealtime recommendations for obesity prevention, based on a review of expert guidance from the American Academy of Pediatrics, the National Resource Center for Health and Safety in Child Care and Early Education, the Institute of Medicine, and others. Though these recommendations are designed for early child care providers, parents can follow these feeding and mealtime guidelines at home, too. For more detailed guidance on these recommendations and ideas for putting them into practice, explore the source list and the links to other resources.

Promote ideal and age-appropriate fluid intake among infants

• Educate parents on breastfeeding resources and services within the community (1,2,3,5)

• Provide a welcoming, private place for mothers to breastfeed on site (1,2,3,5)

• Serve human milk or infant formula, not cow’s milk, to children until at least 1 year of age unless documentation from a parent/provider indicates otherwise (1,2,3,5)

• Do not serve fruit juice to children under 1 year of age (1,2,3)

• Do not bottle feed an infant formula mixed with any cereal, juice, or other foods without documentation from a medical provider (1,2,3)

Practice responsive feeding

• Initiate feedings based on an infant’s cue (opening mouth, making suckling sounds) (1,2,3)

• Pay attention to an infant’s fullness cues to avoid overfeeding (turning away from the nipple, keeping mouth closed) (1,2,3)

• Position an infant appropriately in a caretaker’s arms or propped up in a caretaker’s lap, and don’t let infants bottle-feed themselves alone (1,2,3)

• Bottle feed only one infant at a time (1,2)

Introduce complementary foods at the appropriate age

• Create a plan for introducing solids in consultation with child’s parent (1,2)

• Introduce solids around 6 months of age, unless the child’s healthcare provider recommends earlier, and make sure to use iron-fortified foods for breastfed infants (1,2,3)

Encourage children to enjoy meals and regulate their own food intake

• Offer meals and snacks every 2 to 3 hours (1,2,3,4)

• Serve meals family style so older children can serve themselves (1,2,3,4)

• Provide small, age-appropriate portions using child-sized utensils and dishes (1,2,3,4)

• Ensure that children are seated and undistracted during mealtime (e.g., no television during meals) (1,2,4)

• Allow children to eat to their own fullness without pressure to overeat (1,2,3,4)

• Avoid the use of food as a reward or punishment (1,2,4)

Model healthy mealtime behaviors to children

• Sit and eat with children at meal time (1,2,3,4)

• Say positive things about foods during meals (1,2,3,4)

Infant Feeding and Mealtime Habits-Source List

1. American Academy of Pediatrics, American Public Health Association, and National Resource Center for Health and Safety in Child Care and Early Education. Preventing Childhood Obesity in Early Care and Education: Selected Standards from Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs,3rd Edition; 2010.

2. National Resource Center for Health and Safety in Child Care and Early Education, University of Colorado Denver. National Resource Center for Health and Safety in Child Care and Early Education: Achieving a State of Healthy Weight: A National Assessment of Obesity Prevention Terminology in Child Care Regulations 2010. Aurora, CO; 2011.

3. Institute of Medicine (IOM). Early Childhood Obesity Prevention Policies. Washington, DC: The National Academies Press; 2011.

4. Position of the American Dietetic Association: Benchmarks for Nutrition in Child Care. J Am Diet Assoc. 2011;111:607-615.

5. World Health Organization. Global Strategy for Infant and Young Child Feeding. 2003.