Feeding infants and toddlers study: improvements needed in meeting infant feeding recommendations.

OBJECTIVE: To assess adherence to infant feeding recommendations among a sample of infants and toddlers four to 24 months of age in the United States. DESIGN: Descriptive analysis of data collected in the 2002 Feeding Infants and Toddlers Study (FITS) based on telephone interviews and 24-hour dietary recalls collected with the Nutrition Data System for Research of the University of Minnesota. SUBJECTS: A national random sample of 3,022 infants and toddlers age four to 24 months, including 2,024 infants age four to 11 months. MAIN OUTCOME MEASURES: Breastfeeding, timing of introduction of complementary foods, and adherence to infant feeding recommendations. STATISTICAL ANALYSES: Means and standard errors, percentile distributions, and percentages by age group (four to six months, seven to eight months, and nine to 11 months). RESULTS: About 76% of infants and toddlers were fully or partly breastfed at birth. This percentage declined to 30% at six months and 16% at 12 months-short of Healthy People 2010 goals of 50% and 25%, respectively. The average duration of breastfeeding was 5.5 months for all who initiated breastfeeding. About two-thirds of infants had been introduced to complementary foods between four and six months-the period recommended by the American Academy of Pediatrics (AAP); 17% consumed juice before the AAP recommended age of six months or later. Twenty-two percent of infants nine to 11 months consumed cow’s milk on a daily basis before the recommended age of 12 months or later, and one in 10 consumed french fries and/or sweetened beverages on any given day. APPLICATIONS/CONCLUSIONS: More parents and caregivers can benefit from guidance about the introduction of developmentally appropriate, micronutrient-rich first solid foods such as iron-rich infant cereals, iron-fortified grain products, meats, soft fruits, and cooked vegetables and the importance of breastfeeding through the first year of life. A smaller proportion of parents and caregivers require guidance on delaying the introduction of juices until six months of age and cow’s milk other than formula until one year of age.