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Never underestimate the power of Dora the Explorer, Scooby Doo, and Shrek. The results of a recent study, published in the July 2010 issue of Pediatrics, found that cartoon characters affect kids’ food preferences.

Researchers at Yale University asked 40 children (all 4 to 6 years old) to taste three pairs of identical foods in either a clear package or one with a picture of a cartoon character. The children were then asked whether the two foods tasted the same or one tasted better than the other, and which of the two foods they would most like as a snack.

For each of the three food pairs presented—gummy fruit snacks, graham crackers, and carrots—72 to 87 percent of the children chose the food with a cartoon character on the package. For example, 72 percent of the children chose the carrots with the character, 85 percent chose the  gummy fruit snacks with the character, and 87 percent chose graham crackers with the character. After tasting each pair of foods—50 to 55 percent of the children thought the food with a character on the package tasted best, and 25 to 37 percent thought the two foods tasted the same. Among children who thought the food without a character on the package tasted best—only 7 percent thought the graham crackers tasted best, 15 percent thought the gummy fruits snacks tasted best, and 25 percent thought the carrots tasted best.

Before you add your voice to those calling for restrictions or a total ban on the use of cartoon characters on food packages, consider the following:

• Only 40 children took part in the study—a small sample by any standard.

• Fifty percent of those who were invited to participate (parents and their children) declined, increasing the risk for bias in this small, self-selected sample.

• There were nearly twice as many boys as girls.

• There were 2-4 times as many whites compared to other ethnic groups (black, Hispanic, Asian).

• One-half of the children watched television 1 or more hours a day and movies at home or in the theater at least once a week.

• The participants were not blinded—each knew the purpose of the study and which package had a character on it—making it possible for the investigators to influence the children’s choices, either intentionally or unintentionally.

Cartoon characters as spokescharacters
In 2006, Kroger partnered with The Walt Disney Company to promote healthy eating among children. Most of the nearly 100 products in the premium food program contained zero grams of trans fat and included healthy foods such as yogurt.  The products were eventually phased out and replaced with Kroger Brand products, suggesting a lack of sustained sales.

Nickelodeon launched a similar program in 2007 designed to get kids to eat healthy foods by putting SpongeBob SquarePants on packages of vegetables (carrots, spinach). The program generated lots of interest at first—but two years later, the majority of products sporting a Nickelodeon character are foods with little nutritional value.

The Walt Disney Company’s decision in 2008 to end its 10-year contract with McDonald’s was applauded by many, as was Sesame Street’s promotion of anytime and sometime foods. While some have embraced industry efforts to promote healthy eating, others have urged caution—arguing that profits will ultimately trump health.

It remains to be seen whether restricting the use of cartoon characters to healthy foods, or banning their use altogether, will improve kid’s diets. In order to pass meaningful legislation, more data is needed.

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Disguised as a means for insuring that finicky toddlers would get essential vitamins and nutrients, Enfagrow was pulled from the market on June 9, 2010 in a surprise announcement by its maker, Mead Johnson. Originally launched in July 2009 sporting a vanilla flavor, it was the release of a chocolate flavored version in February 2010 that proved to be not only unhealthy but unwise. With 19 grams of sugar in each 6-ounce serving, critics of Enfagrow chocolate weren’t hard to find. And with childhood obesity having reached epidemic proportions, many argued that the last thing most children needed was a super-sweet, high-calorie food.

The name alone, Enfagrow Premium chocolate toddler formula, was enough to incite detractors. What toddler needs a formula? Why should parents pay a premium for an expensive supplement that takes the place of much-needed fruits, vegetables, whole grains, and dairy products?

Unlike its chocolate counterpart, Enfagrow plain and vanilla will remain on the market because of, according to Mead Johnson, “numerous positive comments from grateful parents who have told us that they consider these products an important option for helping to meet their child’s overall nutritional needs, especially those who are picky or erratic eaters.”

But for parents rightly concerned about the added sugar, it’s important to know that according to the label on the container, Enfagrow vanilla has 18 grams of sugar per serving—only one less than the chocolate version. If that’s not enough sugar to reinforce your toddler’s preference for all things sweet, Mead Johnson provides recipes online for banana muffins, pancakes, and strawberry or banana smoothies with 28, 18, 16, and 21 grams of sugar per serving, respectively.

Putting sugar aside, this controversy begs the question, when (at what age?) and how (in the womb? through breast milk?) do children acquire taste preferences. And do those preferences affect their risk for becoming overweight later in life?

Preferences develop in utero
A 2001 study found that babies (when fed foods with certain flavors) responded differently to the flavors of foods eaten by their mothers during pregnancy, suggesting that a child’s taste preference can be influenced even before she is born.

Research conducted in a 2004 study found that in utero exposure to different flavors may affect food preferences after birth. This study involved four groups of formula-fed babies. One group was fed a traditional cow’s milk based formula; a second group was given an unpleasant tasting predigested formula; the remaining groups were fed a combination of the cow’s milk based formula for three months and the predigested formula for four months. After seven months the babies were videotaped on three separate days while feeding on the different formulas. Results showed that the longer the exposure to a specific flavor, the greater the acceptance of the flavor. This supports the theory that exposure to different flavors—whether via amniotic fluid, breast milk, or formula—may affect individual food and flavor preferences.

The extent to which flavor preferences are genetically predetermined was the topic of a 2005 study. A total of 143 pairs of mothers and their babies were screened for the presence of a taste receptor gene associated with bitter and sweet tastes. The results showed that the presence of the gene was associated with taste preferences in children, but the same was not true for adults, which suggests that cultural and environmental factors can override genetically determined preferences.

What role does breastfeeding play?
When two groups of 4- to 8-month-old infants (44 percent of whom were breastfed) were given either green beans alone, or green beans followed by peaches, the food was more likely to be accepted if the breastfeeding mother ate the food regularly. On the contrary, when the formula feeding mothers ate more green beans, there was no difference in their infants’ acceptance of the vegetable. However, repeated exposure to a food did result in greater acceptance in both the breastfed and bottle-fed children. These findings highlight the need for parents to continue to offer babies healthy foods, even though the foods may not be well received at first. Healthy foods include:

• fruits and vegetables;
• fat-free or low-fat milk and milk products;
• lean meats, poultry, and fish;
• beans and nuts;
• eggs; and
• whole grain cereals and rice.

Be sure to include nutrient-dense foods as well, such as:

• avocados;
• broccoli;
• brown rice and other grains;
• cheese;
• eggs;
• fish;
• kidney beans;
• pasta;
• peanut butter;
• potatoes;
• poultry;
• squash;
• sweet potatoes;
• tofu; and
• yogurt.

There is no need to restrict foods beyond six months, even in children with a family history of food allergies. Parents are advised to introduce new foods one at a time (ideally in the early part of the day, just in case a child has an allergic reaction), and to wait 3-5 days in between.

Food preferences and obesity
It’s clear from the data that foods eaten by mothers during pregnancy and while breastfeeding can impact babies’ food preferences. Study results also underscore the fact that the preferences may not persist once a baby is weaned unless the foods continue to be offered. What is less clear is how food preferences affect the risk for obesity and to what extent parents, siblings, and peers acting as role models can modify those effects.

There’s a limit to what First Lady Michelle Obama can accomplish with her Let’s Move campaign. Parents are the key to preventing obesity in kids. Eating a healthy diet during pregnancy and while breastfeeding may be beneficial in the short-term, but it’s the foods that parents and caregivers offer day in and day out that kids wind up preferring.

Tips for keeping kids healthy and fit:

• Set a good example by eating healthy foods yourself.
• Be patient but persistent. Commit to offering your child a new food at least 10 times.
• Make fresh fruits and vegetables readily available (cleaned, peeled, cut). Children are more likely to eat healthy foods when they can see them.
• Avoid sweetened drinks including sweetened fruit juices, which play a major role in shaping kids’ tastes for sweets.
• Buy fewer high-calorie, low-nutrient foods. But allow kids to have “junk food” occasionally. Denying access to a particular food may actually increase rather than decrease a food preference.
• Teach your children about “sometime” foods and “anytime” foods. Avoid labeling foods as “good” or ”bad.”
• Don’t use food as a reward. Find another way to reward good behavior.
• Insist on healthy foods in school cafeterias and vending machines.
• Discourage eating meals or snacks while watching TV. Children (and adults) are less likely to pay attention to feelings of fullness and more likely to overeat.
• Limit the amount of time your child spends watching TV, playing video games, and using a computer.
• Exercise together regularly. Walk, bike, swim, dance, or garden—anything that keeps you active!

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New parents have countless concerns: Is my baby too hot or too cold? Is she sick or just fussy? Do I need to wake her at night to breastfeed? While concerns may vary from parent to parent, one concern is universal—how will I know my baby is getting enough (or too much) to eat? Learning to recognize your baby’s feeding cues and to respond in an appropriate way is an important part of parenting. All babies (at some point) will transition to eating solid foods and drinking from a cup, and when that occurs, the same feeding cues will apply.

Early signs of hunger and fullness
Breast milk provides all the nutrients your baby needs for the first six months. With a stomach the size of their fist and a growth rate that is unparalleled, it’s easy to see why babies need to eat 8, 10, or 12 times a day. Watching your baby for early signs of hunger—such as sucking on fingers or fists, making sucking sounds, wiggling or squirming, and rooting (searching for the breast)—and responding to your baby’s cues, will ensure that your baby gets all the nutrients he needs to grow. Just like feeding cues that say, “I’m hungry,” your baby will also give you cues to tell you when he is full, such as releasing the breast or refusing the bottle, turning his head, or holding up his hands as if to say, “Stop.” As a parent, you simply need to watch carefully, and respond accordingly.

Starting solids
Most babies will show an interest in solid foods around 6 months of age. You will know that your baby is ready for solid foods if she can:

• Sit up with little or no support;
• Hold her head up; and
• Pick up foods and put them in her mouth.

In addition to being developmentally ready, your baby needs to show an interest in foods other than breast milk or formula. Does he watch you eat? Does he try to snatch food from your plate? Does he react positively (opening his mouth wide) or negatively (clenching his jaw and turning his head) to a spoonful of food touching his lips? Regardless of your baby’s age, if you see signs telling you he’s not interested in solid foods, simply wait a few days, or even a week, and try again. Mealtime is a learning experience for you and your baby—one that is meant to be fun.

According to Ari Brown, M.D., a pediatrician in Austin, Texas, and co-author of Expecting 411, Baby 411, and Toddler 411, these early feedings are less about quantity taken and more about getting acquainted with new foods. “For kids under a year of age, breast milk or formula is still the mainstay of nutrition even after you introduce solid foods, so don’t worry if you haven’t gotten to all four food groups at each meal,” says Brown. “Just try to offer a variety of foods.”

How much is enough?
Babies come in all shapes and sizes, and those differences carry over to how much and how often they eat. According to Brown, 6-month-olds typically eat about two ounces of solids a day; 7-month-olds eat four ounces twice a day; and 8- to 9-month-olds, four to six ounces three times a day. While some parents have the urge to measure out these amounts, Dr. Brown says this is seldom necessary. “If a baby is not gaining weight appropriately, then it might be worthwhile, but otherwise it is a waste of time.”

Another time-waster is any attempt to carve out a mealtime schedule. Some babies prefer three meals with two snacks in between, while others prefer smaller meals scattered throughout the day. If you have a picky eater, mealtimes can be stressful—a positive attitude and a calm manner will benefit everyone. “Kids will eat if they’re hungry and have no other choices,” says Charles I. Shubin, M.D., medical director of the Children’s Health Center at the University of Maryland Medical Center. “I promise they won’t starve, but they will test the limits much further than what most adults can tolerate.”

“Most children are able to self-regulate calories until they reach the age of 5—eating when they are hungry and refusing to eat when they are full,” says Heather Russell, R.D., a pediatric registered dietitian at St. Joseph’s Children’s Hospital in Paterson, New Jersey. “This is normal and not something parents should worry about unless their child fails to gain weight or grow appropriately.”

Knowing your baby is eating enough
Regular checkups are the best way to ensure that your baby is getting enough to eat. “When you take your baby for checkups, the pediatrician will record your child’s height and weight on a growth chart to determine if the child is growing appropriately,” says Russell. “If the child’s height and weight are within normal limits, then you can be sure your baby is getting enough to eat.”

Keep in mind that as your baby becomes more mobile and starts crawling and walking, he will gain weight more slowly. For the first six months, your baby will likely gain one to two pounds a month. After that, weight gain generally slows to around one pound a month.

Knowing your baby is eating too much
One sign that your baby may be getting too much to eat is excessive weight gain. Parents should never force a child to eat. If your baby turns her head away from the spoon, try another food instead. And if she flat-out refuses this second attempt, it is likely she is trying to tell you that she is not hungry. Babies who are not hungry will:

• Turn their head away from the food;
• Push the spoon away from their mouth; or
• Lean back in their chair.

If you see these signs, take a break, and try again later.

Remember this: Your baby will let you know when she has had enough to eat. Generally, you don’t need to be concerned if, in some instances, more food ends up on the floor than in your baby’s mouth. “Anytime you think your kid isn’t getting enough to eat, just notice his energy level!” says Shubin. “We wish we had that much energy!”

If you have any concerns about your child’s weight and/or eating habits (undereating, overeating, picky eating), don’t hesitate to contact your child’s health care provider.

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The economy may be lagging, but organic food sales are booming. In 2009, sales of organic food and beverages were up an estimated 5.1 percent over 2008—a grand total of $24.8 billion in sales; organic fruits and vegetables alone increased 11.4 percent compared to 2008. Sales of organic baby food have trended upward as well, with a whopping 21.6 percent increase between 2006 and 2007. It is estimated that by 2012, organic baby food will be a $2.26 billion business.

Parents who give their babies organic foods typically do so because they believe they have higher levels of vitamins and minerals, and lower levels of pesticides and other potentially harmful chemicals. However, many parents question whether organic baby food is really worth the price.

Organic vs. non-organic
“Results actually do show that organic produce tends to be higher in certain nutrients,” says Amy Marlow, RD, MPH, a nutrition advisor at HappyBaby, and co-author of HappyBaby: The Organic Guide to Baby’s First 24 Months. “I will concede, however, that when it comes to some vitamins and minerals, there has not been a consistent finding that organic is more nutritious than conventional.”

Marlow cites a 2008 review suggesting that, over the long haul, organic foods tend to win out. “The researchers looked at 97 studies and compared 236 matched pairs of organic versus conventional crops,” says Marlow. “They found that in 61 percent of the pairs (145), the organic sample was more nutrient-rich, mostly in antioxidants.” What Marlow doesn’t point out is that the review was conducted by the Organic Center, an organization supported by businesses and individuals with a vested interest in organic food production and distribution. That’s not to say that the review is without merit, only that, like all scientific data, the risk of bias must be considered.

A similar analysis was performed in 2009 by a group of British researchers with funding from the Food Standards Agency, Britain’s version of the U.S. Department of Agriculture (USDA). The researchers compared the nutrient content of conventionally produced crops (non-organic) with those produced organically. Out of 52,471 articles they identified 162 studies—of those, only 55 were of satisfactory (not good but adequate) quality. Eleven nutrients were examined. With the exception of nitrogen and phosphorus—non-organic crops had a higher nitrogen content and organic crops had a higher phosphorus content—the nutrient levels in organic and non-organic foods were the same. The researchers did not measure levels of pesticides, herbicides, or fungicides. Nor did they attempt to look at taste and freshness. Given the lack of good quality data, the authors concluded that more research is needed before the nutrients in organic and non-organic foods can truly be compared. The Lancet, in an editorial response to criticisms of the British study advised its readers to buy organic food—not because it’s more nutritious, but “… do so because it might be fresher and taste better, contains far less chemical residues, and is kinder to farmed animals.”

Organic food and chemicals
For many moms and dads, there is no doubt in their minds that organic foods have lower levels of potentially harmful chemicals compared to conventional foods. But once again, the research is inconsistent.

One survey conducted in New Zealand found that organic products are more likely to contain pesticide residues than products grown conventionally. But that the average pesticide residue level is more likely to be higher in the conventionally grown products.

In contrast, an analysis by the USDA of USDA and other data documenting pesticide residues on fresh vegetables and fruits found that organic produce carries significantly fewer pesticide residues than conventional produce.

A recent study examined urine samples from 23 children ages 3-11 for pesticide residues. Samples were collected each morning for 15 consecutive days. During days 1-3 and 9-15 the children ate a normal diet; during days 4-8, organic foods were substituted for conventional foods. The results, published in Environmental Health Perspectives, showed that immediately after eating the organic foods, the children had significantly lower levels of pesticide residues in their urine; and that the levels remained low until conventionally grown foods were reintroduced.

“For me, this is the main health-related reason to buy organic foods,” says Marlow. “We know for a fact that young children who eat organic foods are exposed to fewer pesticides than children eating conventionally grown foods. We also know that exposure to synthetic pesticides has been linked to negative health outcomes. Further, babies and young children are more susceptible to the health effects of pesticide exposure because of their high percentage of body fat, because they are so rapidly growing, and because they eat more food per pound of body weight than adults.”

The bottom line on organics
Most parents tend to take a cautionary approach, which may explain why organic foods have become so popular with new moms and dads. If you’re on a tight budget, you might want to confine your organic purchases to those fruits and vegetables known to be highly contaminated. The Environmental Working Group publishes a list of the most- and least-contaminated fruits and vegetables each year—Dirty Dozen & Clean 15. This guide will help parents easily determine which fruits and vegetables are the most contaminated and replace them with their organic counterparts or with more of the conventionally grown Clean 15. Parents should also remember that diet is not the only method of pesticide exposure for children. A chemical-free environment both inside and outside a home is equally important.

Many parents may continue to purchase organic foods, motivated by the belief that every little bit helps. But still one wonders if the growing demand for organic food is a good thing or a prelude to “a future of less efficient, more expensive food?”

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Pass the peanuts may soon be passé if opponents of peanuts on airplanes have their way. The Department of Transportation (DOT) is considering banning peanuts on airplanes, and has given the public until August 6, 2010 to comment on the ban. But the DOT cautions that without scientific proof of severe allergic reactions to the tiny peanut particles that might be present on a plane, it cannot implement a ban.

Although peanut allergy is thought to be among the most serious food allergies, the overall prevalence of food allergies is unclear—so too are strategies for their diagnosis and management. The National Institute of Allergy and Infectious Disease (NIAID) is in the process of developing clinical practice guidelines to ensure better diagnosis and treatment of food allergies. To assist in that effort, researchers conducted a systematic review of the existing scientific evidence.

More than 12,000 articles were identified but only 72 met the criteria for inclusion—sufficient data and rigorous testing—revealing that most of the studies on food allergies were poorly done making the results suspect. While nearly 30 percent of the population report having a food allergy, only about 8 percent of children and 5 percent of adults actually do, according to Dr. Marc Riedl, one of the study’s authors. “Even the belief that breastfed babies have fewer allergies or that babies should avoid eggs in their first year of life lack strong evidence,” said Riedl.

Studies rife with limitations
The authors cited numerous study limitations—food allergy has no universally accepted definition; self-report was used as a means of diagnosis; no well-accepted criteria for diagnosing food allergies; limited data for the effectiveness of various treatments such as elimination diets, immunotherapy (shots), probiotics, and education; and limited data for the use of prevention strategies such as exclusive breastfeeding, delayed introduction of solid foods, use of hydrolyzed formulas, and use of probiotics.

Although U.S. studies found a statistically significant increase in food allergy over time (3.3 percent of children in 1997 compared to 3.9 percent in 2007), the authors of those studies acknowledged that the increase could be due to increased awareness rather than an increase in actual food allergies.

The authors concluded:

• Food allergies affect 1-2 percent but less than 10 percent of the population;
• It is unclear whether the prevalence of food allergies in increasing;
• No one diagnostic test has sufficient sensitivity to be recommended over other tests;
• No single test (either the skin-prick test or IgE antibody test) should be used as the basis for a diagnosis of food allergy;
• A food challenge test is a better way to confirm a diagnosis of food allergy;
• Elimination diets are the mainstay of allergy therapy. However, their effectiveness is unproven;
• Immunotherapy may result in desensitization, but long-term tolerance is yet to be determined; and
• Definitions of ‘high-risk’ and ‘hydrolyzed formula’ do not exist. Therefore the effectiveness of probiotics in conjunction with breastfeeding or hypoallergenic formula in preventing food allergy in high-risk infants is unclear.

Data on food allergies is plentiful, but very little is high quality. Before decisions can be made about prevalence, treatment, and prevention, consensus needs to be reached as to the criteria for food allergy and evidence-based guidelines for making the diagnosis. If you have a family history of food allergy, talk with your doctor and your baby’s doctor before pursuing any strategies to prevent food allergies—the unproven benefits may not be worth the known risks.

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When you think about the essential vitamins and minerals you need during pregnancy and while breastfeeding, iodine is not one that usually comes to mind. Yet experts say that a small amount of iodine (about 0.2 milligrams a day) is essential for pregnant and breastfeeding mothers, as it plays an important role in the neurological development of the baby.

“Iodine helps make thyroid hormone, which regulates body growth and energy use,” says Ari Brown, M.D., a pediatrician in Austin, Texas, and co-author of Expecting 411, Baby 411 and Toddler 411. “And in pregnancy, iodine deficiency can lead to subtle neurological problems and to intellectual disability, such as mental retardations.”

Concerns about iodine deficiency
In Australia, health officials have voiced concerns about iodine deficiency. According to the Australian Thyroid Foundation, more than 50 percent of Australian women and children are iodine deficient.

Addressing the issue in America
Unlike Australia, Dr. Brown does not see that same concern here in the United States. One of the main reasons that iodine deficiency is not (yet) an issue in the States is because we consume a lot of salty foods—actually too much.

Make no mistake—the overabundance of salt in American diets is a real concern, and it can lead to an increased risk of stroke and other forms of heart disease, as well as kidney failure. But as long as a small portion of that salt is iodized table salt, it offers American women the adequate iodine that they need to prevent iodine deficiency. In fact, even if women restrict their sodium intake to the levels recommended by health experts, they would still get enough iodine from iodized table salt.

Tips for getting enough iodine
If you’re concerned about your iodine intake and how it relates to the health of your unborn or breastfeeding baby, here are some steps you can take:

• Limit your salt. Just because you need salt to get iodine doesn’t mean that you need a lot of it. “It doesn’t take very much table salt to meet the daily requirement of iodine,” says Dr. Brown. Even if you stick to a low-sodium diet as recommended by health experts, you’ll likely still get your needed iodine intake.

• Avoid kosher salt or sea salt. “Kosher salt and sea salt are not iodized,” says Dr. Brown. “So if you only use these salts and no table salt, that’s about the only way you might be deficient.”

• Eat seafood. Seafood also helps you get an adequate intake of iodine. The current recommendation for consumption of fish during pregnancy is a maximum of 12 ounces per week. Some experts are claiming these recommendations are out of date and no longer consistent with current science and that pregnant woman should be eating more fish than previously recommended (read more here). Still, if you’re worried about mercury, the Food & Drug Administration and Environmental Protection Agency recommend you choose shrimp, canned light tuna, salmon, pollock, and catfish; avoid large predatory fish like swordfish, shark, tilefish, and king mackerel; avoid raw fish, oysters, and clams; and always cook seafood thoroughly.

Of course, always talk to your doctor if you’re concerned about your iodine intake. Most women get plenty in their diets, but if you eat an extremely low-sodium diet, you might want to ask if a supplement could be right for you—and your baby.

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We know that breastfeeding reduces the risk of childhood obesity, but how? A new study published in the journal Pediatrics found that it may have to do with babies inability to self-regulate their milk intake—whether that’s expressed breast milk or formula—when they drink from bottles.

Around 17 percent of children and adolescents ages 2-19 are obese, according to the Centers for Disease Control and Prevention (CDC). For children 2-5 years old, obesity increased from 5 to 10.4 percent between 1976-1980 and 2007-2008; for children 6-11 years old, the obesity rate increased from 6.5-19.6 percent; and for 12-19-year-olds, it increased from 5 to 18.1 percent.

Obese children are more likely to become obese adults, putting them at risk for high cholesterol levels, high blood pressure, abnormal blood sugar levels, asthma, hepatic steatosis (liver damage due to high levels of liver enzymes), sleep apnea, and Type 2 diabetes.

That breastfeeding reduces the risk for childhood obesity is old news. Breastfeeding has long been linked with a reduced risk of obesity, based on research from 2004, 2006, and 2007. But this new study is the first to look at infant’s self-regulation of food intake as the possible mechanism.

Research
The question posed by the study authors—“Do Infants Fed From Bottles Lack Self-Regulation of Milk Intake Compared With Directly Breastfed Infants?” demands just one answer, and, according to the study results, that answer is yes.

Researchers Ruowei Li, Sara B. Fein, and Laurence M. Grummer-Strawn analyzed data from the 2005-2007 Infant Practices Study II, a large-scale study conducted by the Food and Drug Administration and the CDC. Participants received monthly questionnaires, and researchers were able to look at complete data for 1,250 infants.

Results
Data showed that babies who were bottle-fed in early infancy were more likely to empty their bottles or cups in late infancy, regardless of the type of milk in the bottle or cup. The numbers are substantial:

• 27 percent of babies who were exclusively breastfed in early infancy emptied their bottles in late infancy
• 54 percent of babies who were both breast- and bottle-fed emptied their bottles in late infancy
• 68 percent of exclusively bottle-fed babies emptied their bottles in late infancy

“Bottle-feeding, regardless of type of milk in the bottle, is distinct from feeding at the breast in its effect on infants’ self-regulation of milk intake,” the study’s authors wrote.

So, do babies who keep drinking until the bottle is dry—regardless of whether they are actually still hungry—repeat this behavior with food and drink as kids? Well, no one can say for sure; in fact, that is one of the study’s self-proclaimed limitations (along with underrepresenting black and Hispanic mothers, and the possibility that reporting errors may have occurred.)

It would make sense that eating patterns established in infancy would affect later childhood. But there is more at work here.

The study authors suggest three main reasons to explain the disparity in self-regulation:

1. Breastfeeding babies control intake since they decide when to start and stop suckling; bottle-fed babies are less likely to control milk intake. When babies are encouraged to finish a bottle completely despite being full, they don’t learn to regulate their intake.
2. Breastfeeding requires both non-nutritive and nutritive sucking. The baby’s sucking triggers the let-down reflex, so there are moments in which the baby is sucking but not actually getting any milk. This very transition in sucking styles may affect self-regulation: when babies control the milk flow by adjusting their sucking, “they may establish a greater level of responsiveness to internal cues of hunger and satiety,” according to the study. This way of sucking does not exist in bottle-feeding.
3. Breast milk varies in composition and taste. Near the end of a feeding, the fat content in the breast milk is higher, which may signal to the baby that the nursing session is coming to an end. This signaling doesn’t happen with bottle-feeding. The study’s authors also suggest that missing out on the “sensory experience” of varied breast milk flavors may effect the regulation of food intake later in life.

Recommendations
All children, regardless of how they were fed as infants, can maintain a healthy weight throughout their lives—with their parents’ guidance.

If you bottle-feed your baby, remember that newborns may take only an ounce or two of formula at each feeding; by two months, it may be just 3-4 ounces. Watch for hunger cues (your baby may smack his lips or put his hands to his mouth) and check for his rooting reflex (turning his head toward your hand when you touch his cheek). And remember that crying is actually a late indicator for hunger, so don’t wait for your baby to cry to feed him.

When your child is older, continue to encourage healthy eating habits and regular physical activity; you can find inspiration in the CDC’s tips on preventing childhood obesity. If you struggle with weight, become an example for your child and strive to stay healthy together. Take a look at the newest version of the food pyramid and be an active participant in your child’s life.

The best advice for new moms is to breastfeed your baby for at least a year (exclusively for the first six months). However, any amount of breastfeeding for any length of time benefits your child—and you.

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Many parents switch from breast milk (or formula) to pasteurized cow’s milk around one year of age. A few months ago, we made the switch with our son, thinking it would be easy. But he flat-out refused to drink it—at first. We continued to try (using the tips in this article to coax!) until we finally succeeded, but a lingering question remained for me and my wife: Knowing how important breast milk and breastfeeding is for a child, was our son missing out on essential nutrients by making this switch from breast milk to cow’s milk? Here, experts explain why many parents make the switch and how to handle the transition.

Why switch?
According to the American Academy of Pediatrics (AAP), once your baby celebrates his first birthday, you can begin to offer him cow’s milk, provided he is eating a variety of solid foods (cereals, vegetables, fruits, and meats). Many parents continue to breastfeed beyond their child’s first birthday. And the World Health Organization actually recommends breastfeeding (in addition to age-appropriate solid foods) until a child is at least 2 years old given the many benefits of breastfeeding and human milk. But if you (or your baby) are ready to wean and your baby is at least 1 year old, you can safely transition to cow’s milk.

Whole milk or low-fat?
Whole milk provides many of the important nutrients babies needs. If you’re concerned (like we were) that your child might be missing out on important nutrients, don’t be. According to Heather Russell, R.D., a pediatric registered dietitian at St. Joseph’s Children’s Hospital in Paterson, New Jersey, “It is appropriate to advance the child to whole milk after one year, so the child will continue to receive calcium, phosphorus, and vitamin D to help with development and growth of teeth and bones.”

If a mother and her baby are ready to transition from breast milk to cow’s milk, the consensus among our experts is that whole, vitamin D-fortified cow’s milk is the best choice unless the child has weight issues. At this age, fat should make up about half of a baby’s daily caloric intake, so the higher fat content in whole milk is essential. Babies also need the vitamin A available from whole milk.

However, according to the AAP, if your baby is overweight or at risk of being overweight, or you have a family history of obesity, high blood pressure, or heart disease, your baby’s pediatrician might recommend 2 percent milk as an alternative. One percent or skim milk are not recommended until your baby reaches his second birthday. For babies with no risk factors, whole milk is preferred.

“I usually recommend whole milk until the second year of age due to its higher fat content, which is necessary for proper brain development and growth,” says Russell. “However, in certain cases if the child is already overweight or has a history of cardiac issues such as high cholesterol, I would recommend 2 percent milk.”

Some parents choose organic milk because of concerns over the use of bovine growth hormone in dairy cows. “There is no data concerning bovine growth hormone sufficient enough to recommend organic,” says Ari Brown, M.D., a pediatrician in Austin, Texas, and co-author of Expecting 411, Baby 411 and Toddler 411. “Plus, some manufacturers of commercial non-organic milk are rBGH free now, too.”

Tips for making the switch
Sometimes, switching to whole milk can be challenging not only for parents, but for the baby, too. At first, your baby might refuse to drink the milk, especially if he doesn’t like the taste or isn’t accustomed to drinking from a cup. Here are some tips for helping your baby transition to cow’s milk:

• Gradually switch from breast or bottle to a cup before your baby’s first birthday, says Dr. Russell, so that he can get used to drinking from another source.

• If your baby is rejecting the cow’s milk because of the taste, start by combining it with breast milk. “Sometimes if mom can pump some milk and mix some of the cow’s milk with it to get them used to the taste, that helps,” says Kenneth Wible, M.D., medical director of the Pediatric Care Center at Children’s Mercy Hospitals and Clinics in Kansas City. “Then they can gradually increase the percentage of cow’s milk and reduce the amount of breast milk.”

• Russell adds that persistence is key as you make the transition. “Parents might find it helpful to offer the milk in small spoonfuls or mixed with familiar foods until the child gets more accustomed to the new taste,” she says. “Using a fun or colorful cup might also help to encourage the child to try the milk.”

Generally, your 1- to 2-year-old should have between 16 and 24 ounces of milk each day. The AAP cautions parents to limit a baby’s milk intake to one quart (32 ounces) per day. More than this can provide too many calories and may decrease a baby’s appetite for other foods. Offer cow’s milk at mealtimes, along with some water, or in between meals as a snack. If you’re struggling with getting your baby to drink milk, you can try whole-fat yogurt made especially for babies, or calcium-rich vegetables like broccoli, Brussels sprouts, leafy greens, or pinto beans. Juices fortified with calcium or whole soy milk can also be good choices.

Some babies transition to cow’s milk at age 1, others at age 2 or 3, and some never acquire a taste for cow’s milk. Every baby is different. Your baby will let you know when he is ready for a new skill (drinking from a cup) and a new taste (cow’s milk).

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Earlier this month, Congress unveiled new legislation to provide children with year-round access to healthier foods. The “Improving Nutrition for America’s Children Act of 2010”—a bill introduced by U.S. Rep. George Miller (D-CA), chair of the House Education and Labor Committee; U.S. Rep. Carolyn McCarthy (D-NY), chairwoman of the Subcommittee on Healthy Families and Communities; U.S. Rep. Todd Russell Platts (R-PA), ranking Member on the Subcommittee on Healthy Families and Communities; and other lawmakers—is the next step toward fulfilling President Obama’s mission to end child hunger in America by 2015.

If passed, the bill (companion legislation to the “Healthy, Hunger-Free Kids Act of 2010” which was introduced in April) will give all children access to nutritious meals, improve the quality of meals children eat both in and out of school and in child care settings, implement new school food safety guidelines, and, for the first time, establish nutrition standards for food sold in schools.

For millions of children, the food offered at school or in child care is their only chance for a healthy meal throughout the day. According to the United States Department of Agriculture, as of 2008, more than 49 million Americans, including more than 16 million children, live in households that experienced hunger more than once during the previous year. But it’s not just about getting enough to eat; it’s about getting the right stuff to eat, too. U.S. children currently receive 50 percent of their daily calories from added fats and sugars, and due to obesity-related health issues, are predicted to be the first generation of kids to die at a younger age than their parents. Nationally, one-third of all children are either overweight or at risk of becoming obese.

Says Chairman Miller in a video statement to the press, “This is a smart policy that responds to the significant need to help improve children’s health and well being. The child nutrition programs in school and after school play an integral role in how children thrive both physically and academically. We need to ensure that there are no gaps in the healthy meals for children after school, during the summer, on weekends, during school vacations because we know that hunger never takes a vacation.”

With America on the brink of a national crisis regarding our children’s health, it’s unthinkable that this bill would not be passed, unanimously. The future health of our children—the future health of the nation—depends on it.

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When we were kids, many of us learned spelling from Cookie Monster, counting from Count Von Count, and cheerful tenacity from Big Bird. Today’s children are learning much more than that. The folks behind Sesame Street—the show that’s been educating children since 1969—are reaching out to a new generation in a new way, teaching kids the ABCs of healthy eating and healthy living.

Sesame Workshop, the nonprofit educational group that developed Sesame Street, has partnered with AmeriChoice (the UnitedHealth Group company that provides health benefits for public and state programs) to develop a bilingual education outreach program that helps families make food choices that are affordable and nutritious and will set the stage for lifelong healthy eating habits.

What’s at stake?
More than 20 percent of children in the United States currently don’t have sufficient access to nutritional, affordable food, largely as a result of the recession. Those most impacted are low-income families who are dealing with “food insecurity,” which the U.S. Department of Agriculture (USDA) and the U.S. Department of Health and Human Services say takes place in households where family members don’t have adequate access to enough food to meet basic needs. According to the USDA, as of 2008, more than 49 million Americans, including more than 16 million kids, live in households that experienced hunger more than once during the previous year.

Meanwhile, childhood obesity continues to rise and has tripled over the last three decades. This might seem to conflict with the USDA’s hunger statistics, but in many families where finances are limited, healthy foods aren’t an option; children grow up learning poor eating habits, which, over time, leads to weight gain and a greater risk for obesity.

The new initiative from the Sesame Workshop is designed to tackle some of the contributing factors to the rise in obesity, and specifically to provide resources for parents of children ages 2 through 5 years who may not have sufficient access to healthy foods. According to Sesame Workshop, a child’s eating habits are largely shaped by 4 years old, so it’s important to get kids on the right track early.

How does the program work?
The new program, Healthy Habits, will give a fresh look to the materials developed in 2004 by the Sesame Workshop, Nemours, and KidsHealth for the Healthy Habits for Life program. Information about the Healthy Habits kits and how to get your free kit will be available online at Sesame Workshop’s website.

In addition, program sponsor, AmeriChoice will be sending Healthy Habits for Life messages to three million low-income families participating in its health care programs.

Available in both English and Spanish, the kits include an original DVD starring Sesame Street characters, as well as kid-friendly recipes, activity cards, and a guide for parents about nutritional and economical food choices, including tips on making the trip to the grocery store fun and educational. In addition to tips for parents, the kits also provide activities for kids to learn about healthy eating and healthy living, including a lesson on “sometime foods” (like cookies and sweets) and “anytime foods” (like fruits and vegetables).

Cookie Monster (of all characters) teaches kids about fruits and vegetables in Build Me a Salad where children learn to put together their favorite foods in a healthy way; in A Meal For a Monster and Me, kids get to make choices about healthy meals for Elmo and friends. And in Adding Up to Five, children are asked to keep track of their own fruit and vegetable choices during the day.

“This is an opportunity for Sesame Street to continue to harness its power to help families and their children make healthful, nutritional decisions despite a limited income, at a time when nurturing children’s overall development is so critical and the subsequent positive effects can last a lifetime,” says Gary E. Knell, president and chief executive officer of Sesame Workshop, in a press release.

The program is a smart, effective way to get kids excited about making good choices for their bodies and their minds, and is designed to help both children and parents learn about health and nutrition. As Michelle Obama says in a video clip on Sesame Workshop’s website, “If you want your child to have healthy habits, practice healthy habits too, because you are your child’s best role model.”

Not just sometime but anytime.