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Nutrition Provided to Infants in Licensed Childcare Centers and Homes: A Descriptive Study

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Abstract

Background

Infant nutrition can influence development, eating behaviors and obesity risk. Nearly half of infants in the U.S. are in non-parental care where they consume much of their daily nutrition. Because little is known about the quality of infant nutrition in childcare, the study objective was to characterize the foods and beverages provided to infants in childcare in California.

Methods

From a randomly selected sample of 2,400 licensed childcare in California, 736 responded to a 2016 survey; a subset of 297 cared for infants. Differences in 26 foods and 7 beverages provided between centers and homes, and by CACFP participation, were assessed using logistic regression models adjusted for CACFP participation and whether the site was a center or home, respectively.

Results

Several differences between centers and homes were identified. One the day prior to the survey, more centers than homes ever provided cow’s milk (25.1% vs 13.0%, p = 0.02) and whole grains (76.7% vs 62.9%, p = 0.03), and fewer centers than homes provided frozen treats (1.4% vs 10.3%, p = 0.003). When comparing difference by CACFP participation, fewer CACFP than non-CACFP sites usually provided breastmilk (32.6% vs 54.2%, p = 0.0004) and ever provided cow’s milk (14.2% vs 37.1%, p < 0.0001). On the day prior to the survey, more CACFP than non-CACFP provided vegetables (91.0% vs 80.8%, p = 0.02), fruit (centers only) (97.2% vs 80.8%, p = 0.0003), and infant cereals (86.0% vs 61.2%, p < 0.0001). Fewer CACFP than non-CACFP provided sweetened yogurt (14.8% vs 36.7%, p < 0.0001).

Conclusions for Practice

Childcare centers and CACFP participants tended to serve nutritious foods more than childcare homes and non-CACFP participants, respectively. Additional education and policies for childcare providers on appropriate foods and beverages for infants is recommended.

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Acknowledgements

We would like to acknowledge Gemma DiMatteo, graduate student researcher, and other undergraduate students for their help on the project. The project was funded by the Robert Wood Johnson Foundation Healthy Eating Research Program (Grant No. #73245) with additional support from the National Institutes of Health (Grant No. R25 #HL125451): Short Term Research Education Program to Increase Diversity in Health Related Research/Bay Area Summer Research Internship Program, California Institute for Regenerative Medicine (Grant No. #EDUC 3-08399), Leveraging Investment in High-School Training Summer Program to Accelerate Regenerative Medicine Knowledge (Light-a-SPARK), and Doris Duke Charitable Foundation Clinical Research Continuum: High school to College Program (Grant #2016-143), The CHORI Summer Research Internship Program.

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Author notes

  1. Klara Gurzo

    Present address: Department of Public Health Sciences, Stockholm University, Sveavägen 160, 106 91, Sveaplan, Sweden

  2. Lilly Nhan

    Present address: Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E. Young Drive South, 26-051B CHS, Box 951772, Los Angeles, CA, 90095, USA

  3. Elyse Homel Vitale

    Present address: Child Care Food Program Roundtable, Los Angeles, CA, USA

  4. Sallie Yoshida

    Present address: Social Policy Research Associates, 1333 Broadway, Suite 301, Oakland, CA, 94612, USA

Authors and Affiliations

  1. Division of Agriculture and Natural Resources, Nutrition Policy Institute, University of California, 2115 Milvia Street, 3rd Floor, Berkeley, CA, 94704, USA

    Danielle L. Lee, Klara Gurzo, Lilly Nhan & Lorrene D. Ritchie

  2. California Food Policy Advocates, 1970 Broadway, Suite 760, Oakland, CA, 94612, USA

    Elyse Homel Vitale

  3. Sarah Samuels Center for Public Health Research & Evaluation, 1222 Preservation Park Way, Oakland, CA, 94612, USA

    Sallie Yoshida

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  1. Danielle L. Lee
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Correspondence to Lorrene D. Ritchie.

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Lee, D.L., Gurzo, K., Nhan, L. et al. Nutrition Provided to Infants in Licensed Childcare Centers and Homes: A Descriptive Study. Matern Child Health J 24, 932–942 (2020). https://doi.org/10.1007/s10995-020-02929-z

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