Research ArticleCaregiver's Provision of Non-Recommended Commercially Prepared Milk-Based Drinks to Infants and Toddlers
Section snippets
INTRODUCTION
In 2018, the American Academy of Pediatrics participated in an expert panel to establish comprehensive guidance on optimal beverage consumption by young children (up to 5 years).1 Healthy Eating Research (HER) convened the panel in recognition of the importance of healthy beverage intake in reducing the risk of diet-related chronic diseases, including obesity, type 2 diabetes, and dental caries. Experts counseled against serving cow's milk or other types of milk (other than breastmilk or
METHODS
This study used a cross-sectional online survey of US primary caregivers of infants (aged 6–11 months), infants in transition (aged 12 months), and toddlers (aged 13–36 months). The large nonprobability sample (n = 1,645) included a diverse sample of participants for meaningful comparisons between demographic groups. This analysis reports the incidence of caregivers’ provision of commercially prepared infant formula, toddler milk, cow's milk, and plant milk in the past month. The survey also
RESULTS
The sample participants (N = 1,645) were mostly female, aged 25–44 years, married, with at least some college education, and approximately half had household incomes < $40,000 (Table 1). Because of sampling procedures, participants were diverse in race/ethnicity. Of the original 2,426 participants, 13% did not meet inclusion criteria, and 14% did not complete the survey for a completion rate of 72%. Data for an additional 107 participants were excluded because of inconsistent responses.
DISCUSSION
Although the majority of caregivers in this sample reported providing recommended milk types to their child, common provision of non-recommended milk types and racial, ethnic, and cultural differences raise concerns.1,2 Furthermore, wide variation in the age that children transitioned from breastmilk and/or commercially prepared infant formula to cow's milk, including frequent transition after 12 months, suggests the need for additional guidance on best practices for this transition.
IMPLICATIONS FOR RESEARCH AND PRACTICE
The results of this study indicate an opportunity for public health education campaigns, community outreach, and additional guidance from health care providers, especially regarding potential nutrient deficiencies, dehydration, and undernutrition when providing cow's milk or plant milk to infants and replacing breastmilk (or commercially prepared infant formula). Furthermore, health care and public health guidance could provide caregivers with strategies for weaning their 12-month-old child
ACKNOWLEDGMENTS
This research was supported by a grant from the Robert Wood Johnson Foundation. The funder did not have any role in study design, collection, analysis, interpretation of data, writing the report, or the decision to submit the report for publication.
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Toddler Milk Perceptions and Responses to Front-of-Package Claims and Product Warnings: A Qualitative Study of Caregivers of Toddlers
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Conflict of Interest Disclosure: The authors have not stated any conflicts of interest.
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Dr Romo-Palafox was affiliated with the Rudd Center for Food Policy & Obesity, University of Connecticut at the time this study was completed.