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Preventing Childhood Obesity: Health in the Balance
variety experienced by the formula-fed infant) may also have more general effects, promoting the infant’s acceptance of a wide range of new foods as he or she matures; further research is needed in this area (Mennella and Beauchamp, 1998; Lederman et al., 2004).
Much remains to be learned about the extent of the association between breastfeeding and childhood obesity. Nonetheless, breastfeeding is likely to be at least weakly protective against obesity, and despite the fact that the protective effects may be overwhelmed by events and environmental factors that occur later in childhood, there are numerous ancillary benefits of breastfeeding (AAP, 2004). Breastfeeding is recommended for allinfants. Exclusive breastfeeding is recommended for the first 4 to 6 monthsof life and breastfeeding, along with the age-appropriate introduction ofcomplementary foods, is encouraged for the first year of life. This is in accordance with the American Academy of Pediatrics (2004) statement recommending breastfeeding and stating that in developed countries “complementary foods may be introduced between 4 and 6 months” and the World Health Organization (2003) recommendation that encourages exclusive breastfeeding for the first 6 months of life, to the extent that this is practical for the mother and family.
Another issue that is discussed regarding infant feeding is serving size—ensuring that infants receive the appropriate amounts of milk or foods. Research has shown that early in life, infants are responsive to the energy density of food and are capable of controlling the volume taken during a feeding. Thus, even by about 6 weeks of age, infants can adjust the volume of formula consumed based on the energy density of the formula, so that total energy intake remains relatively constant (Fomon et al., 1975). Nonetheless, there is the possibility that infants can be coaxed to eat beyond satiety and that has been postulated by several researchers as a potential contributor to childhood obesity (Bergmann et al., 2003; Dewey, 2003; Lederman et al., 2004). Concern has been expressed that precocious introduction of sweetened beverages and high-fat/sweet-tasting foods may be important contributors to childhood obesity by possibly developing early preferences for such foods and beverages (Fox et al., 2004; Lederman et al., 2004). Documentation that such concerns are well founded are the findings from the Feeding Infants and Toddlers Study (FITS) that soft drinks and French fries are being fed to infants as young as 7 months of age (Fox et al., 2004).
Toddlers and Young Children
Children tend to avoid new foods. But during the transition from the exclusive milk diet of infancy to consuming a varied, modified adult diet, virtually all foods are new to the child. Fortunately, it has been found that