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Infant and Toddler Feeding and Development

A Special Issue of Nutrients (ISSN 2072-6643) belonging to the section "Pediatric Nutrition".

Deadline for manuscript submissions: closed (15 June 2026) | Viewed by 16179

Editors


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Guest Editor
Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
Interests: nutrition and child development; early child development; parenting interventions; nurturing care; food insecurity; obesity
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC 27412, USA
Interests: food and nutrition security; infant feeding; health disparities
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Childhood overweight and obesity are global concerns that can amplify low productivity and increase healthcare expenditure by raising children’s risk of developing diabetes and cardiovascular problems, including poor psychosocial health. Obesity prevention and treatment trials introduced during school age have had limited sustainable impacts, leading to recommendations that health promotion and obesity prevention be initiated during infancy and toddlerhood.

Growth patterns established during infancy and toddlerhood are foundational in children’s subsequent growth and development. Children who experience rapid weight gain during their first two years are at an elevated risk of facing lifelong overweight and obesity. Recommendations for feeding practices for infants based on the World Health Organization, UNICEF, and the 2020-2025 Dietary Guidelines for Americans include breast milk for the first six months, followed by complementary feeding at approximately six months, and the continuation of breast milk in a nurturant context that is responsive to infants’ hunger and satiety cues. Recommendations for toddlers include providing a variety of nutrient-rich foods in a daily routine of three meals and two to three snacks, listening to toddlers’ hunger and fullness cues, making mealtime pleasant by eating together, and avoiding pressuring toddlers to eat or using food as a reward or punishment. Across the world, modifiable conditions, including political, environmental, economic, and family factors may either challenge or promote optimal infant and toddler feeding. For this Special Issue exploring infant and toddler feeding practices, we welcome a wide variety of papers that incorporate the contextual aspects of feeding related to growth and development outcomes, addressing both food and feeding, including, but not limited to, the following topics:

  1. Determinants of early weight gain;
  2. Observational or interventional designs;
  3. Quantitative or qualitative methods;
  4. Breast milk from the breast vs. from the bottle;
  5. Breast milk vs. formula;
  6. Infant and toddler feeding and policy implications;
  7. Infant and toddler feeding and child care centers;
  8. National and global studies;
  9. Well-designed implementation studies, regardless of impact;
  10. Cross-sectional and longitudinal designs;
  11. Social and cultural aspects of infant food and feeding practices;
  12. Feeding practices, appetite, development and growth;
  13. Responsive feeding in the context of nurturing care;
  14. Infant feeding and father perspectives and influences;
  15. Infant and toddler feeding decisions and food companies;
  16. Infant and toddler feeding and maternal health and well-being;
  17. Infant and toddler feeding, health and development.

Prof. Dr. Maureen M. Black
Dr. Jigna M. Dharod
Guest Editors

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Keywords

  • milk-feeding
  • complementary foods
  • feeding styles
  • self-regulation
  • growth
  • development

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Published Papers (13 papers)

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20 pages, 316 KB  
Article
Primarily Null Associations Between the Nursing Child Assessment Feeding Scale and Maternal Feeding Behaviors, Infant Eating Behaviors, Diet, and Growth: A Prospective Cohort Study
by Cin Cin Tan, Julie Sturza, Alison K. Ventura, Alison L. Miller, Ashley N. Gearhardt, Niko Kaciroti and Julie C. Lumeng
Nutrients 2026, 18(15), 2532; https://doi.org/10.3390/nu18152532 - 4 Aug 2026
Viewed by 415
Abstract
Background/Objectives: The predictive value of the Nursing Child Assessment Feeding Scale (NCAFS) for eating, diet, and growth outcomes among healthy infants is not well-described. Methods: In this prospective cohort study, healthy infants (n = 227) were assessed with the NCAFS [...] Read more.
Background/Objectives: The predictive value of the Nursing Child Assessment Feeding Scale (NCAFS) for eating, diet, and growth outcomes among healthy infants is not well-described. Methods: In this prospective cohort study, healthy infants (n = 227) were assessed with the NCAFS at 0.5, 2, and 4 months and outcomes were measured concurrently and at 12 months. Maternal feeding and infant eating behaviors were observed during a separate feeding and assessed with the Infant Feeding Styles Questionnaire, Baby Eating Behavior Questionnaire, Children’s Eating Behavior Questionnaire-Toddler, and a diet questionnaire. Sucking was measured and anthropometry obtained. Results: In mixed models with repeated measures, concurrent associations included maternal verbalization while waiting for a separate feeding with maternal Sensitivity to Cues (β = 0.80) and maternal Cognitive Growth Fostering (β = 1.05); maternal verbalization during a separate feeding with maternal Social–Emotional Growth Fostering (β = 1.10) and maternal Cognitive Growth Fostering (β = 1.37); suck duration with infant Clarity of Cues (β = −5.35); feeding duration with maternal Social–Emotional Growth Fostering (β = 0.04), maternal Cognitive Growth Fostering (β = 0.03), and infant Responsiveness to Caregiver (β = 0.06); and bottle-feeding intensity with maternal Social–Emotional Growth Fostering (β = −1.11). Prospective associations included maternal Sensitivity to Cues with infant weight-for-length z-score change per month (β = −0.02) and maternal Social–Emotional Growth Fostering with breastmilk feeding intensity (β = 0.06). Conclusions: Associations were primarily null. However, more social interaction during feeding, less nutritive sucking (i.e., shorter suck duration), longer feeding duration, and lower bottle-feeding intensity were associated with more optimal NCAFS scores concurrently, and more optimal NCAFS scores were associated with lower weight-for-length z-score change and greater breastmilk feeding intensity prospectively. Full article
(This article belongs to the Special Issue Infant and Toddler Feeding and Development)
12 pages, 345 KB  
Article
Feeding Type at 6–12 Months and Early-Life Iron-Related Hematologic Changes in Infants: A Longitudinal Birth Cohort Study
by Jiyoung Jeong, Minyoung Jung, Jeongmin Song, Sukyung Kim, Joonghyun Ahn, Mijeong Kwon, Mi Jin Kim, Yoon Jung Yang, Jihyun Kim and Kangmo Ahn
Nutrients 2026, 18(13), 2197; https://doi.org/10.3390/nu18132197 - 6 Jul 2026
Viewed by 598
Abstract
Background/Objectives: The World Health Organization recommends continued breastfeeding for up to 2 years of age. However, because breast milk contains less iron than formula milk, prolonged exclusive breastfeeding may increase the risk of iron deficiency anemia. This study aimed to compare iron status [...] Read more.
Background/Objectives: The World Health Organization recommends continued breastfeeding for up to 2 years of age. However, because breast milk contains less iron than formula milk, prolonged exclusive breastfeeding may increase the risk of iron deficiency anemia. This study aimed to compare iron status and growth outcomes at 12 and 36 months based on feeding methods during the 6–12-month period. Methods: In this prospective birth cohort study, we followed 126 children from birth to 36 months. Participants were categorized into breastfeeding (BF, n = 21), formula feeding (FF, n = 62), and mixed feeding (MF, n = 43) groups according to milk feeding over 6–12 months of age. Anthropometric measurements and iron parameters were compared among groups at 12 and 36 months. Results: At 12 months, the BF group had significantly lower weight and height compared to the MF group. Hemoglobin, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration were significantly lower in the BF group than in the FF and MF groups, while red cell distribution width was significantly higher in the BF group. At 36 months, no differences in anthropometrics or iron parameters were observed among the groups. Conclusions: Infants breastfed without formula from 6 to 12 months showed lower iron-related hematologic parameters at 12 months, which largely resolved by 36 months. These findings highlight late infancy as a potentially vulnerable period for insufficient iron intake and support the importance of adequate iron supplementation and timely introduction of iron-rich complementary foods during this critical developmental stage. Full article
(This article belongs to the Special Issue Infant and Toddler Feeding and Development)
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19 pages, 585 KB  
Article
Extending the Validity of the Feeding Practices and Structure Questionnaire Solid Feeding Version (FPSQ-S) to Mothers and Fathers Living with Socioeconomic Disadvantage
by Smita Nambiar, Jeffrey T. H. So and Elena Jansen
Nutrients 2026, 18(13), 2046; https://doi.org/10.3390/nu18132046 - 23 Jun 2026
Viewed by 1797
Abstract
Background/Objective: Parental feeding practices play an important role in shaping children’s dietary intake, eating behaviours, and long-term health outcomes. Although several questionnaires assess feeding practices, few have been validated among socioeconomically disadvantaged populations, despite these groups being disproportionately affected by food insecurity and [...] Read more.
Background/Objective: Parental feeding practices play an important role in shaping children’s dietary intake, eating behaviours, and long-term health outcomes. Although several questionnaires assess feeding practices, few have been validated among socioeconomically disadvantaged populations, despite these groups being disproportionately affected by food insecurity and diet-related health inequities. This study assessed the structural validity and internal consistency of the Feeding Practices and Structure Questionnaire—Solid Feeding version (FPSQ-S)—among socioeconomically disadvantaged mothers and fathers of young children. Methods: Two cross-sectional online surveys were conducted with 178 mothers and 94 fathers of children aged 5–35 months living in disadvantaged households. Confirmatory factor analysis was used to examine the structural validity of the FPSQ-S. Internal consistency was assessed using Cronbach’s alpha and Hancock’s H coefficients. Results: The original six-factor FPSQ-S structure was retained and demonstrated acceptable overall model fit in this disadvantaged sample (CFI = 0.846, TLI = 0.821, RMSEA = 0.070). Internal consistency ranged from acceptable to excellent across subscales (Cronbach’s α = 0.63–0.93; Hancock’s H = 0.64–0.93). Most items loaded satisfactorily onto their intended constructs; however, two items within the Feeding on Demand construct demonstrated weak factor loadings, and this construct showed lower reliability than the remaining subscales Conclusions: This is the first study to evaluate the FPSQ-S among socioeconomically disadvantaged mothers and fathers of children aged 5–35 months. The FPSQ-S demonstrated acceptable structural validity and reliability. While the six-factor structure was largely supported, further refinement of the Feeding on Demand construct and additional psychometric evaluation are warranted. Full article
(This article belongs to the Special Issue Infant and Toddler Feeding and Development)
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18 pages, 348 KB  
Article
Perspectives of Parents with Developmental Disabilities on Disability-Related Factors Influencing Their Infant Feeding Decisions: A Mixed Methods Study
by Stacy V. Lu, Susan M. Gross and Allison L. West
Nutrients 2026, 18(11), 1674; https://doi.org/10.3390/nu18111674 - 23 May 2026
Viewed by 534
Abstract
Background/Objectives: The practices that parents use to feed their infants have important implications for life course health and well-being. However, little is known about the infant feeding experiences and decisions of parents with developmental disabilities. This study used a mixed methods design [...] Read more.
Background/Objectives: The practices that parents use to feed their infants have important implications for life course health and well-being. However, little is known about the infant feeding experiences and decisions of parents with developmental disabilities. This study used a mixed methods design to gain an in-depth understanding of the infant feeding experiences and decisions of parents with developmental disabilities in the United States. Methods: Between July 2024 and June 2025, 18 parents with developmental disabilities completed a one-time quantitative survey, seven of whom also completed three individual qualitative interviews. Analytical procedures included descriptive statistics of quantitative survey data and thematic analysis of qualitative interviews, followed by integration of the two forms of data. All interview participants completed member checking of preliminary themes. Results: Parents with developmental disabilities described varied experiences with breastfeeding, formula feeding, and introducing solid foods to their infants at around six months. Four disability-related factors influenced parents’ decisions across different infant feeding practices: (1) sensitivity to sensory stimuli; (2) demands on executive function; (3) “rigid thinking” about breastfeeding; and (4) medication use. Conclusions: Findings suggest parents with developmental disabilities may benefit from direct and customized support with infant feeding. Changes to improve access to disability-affirming care are warranted. Full article
(This article belongs to the Special Issue Infant and Toddler Feeding and Development)
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14 pages, 1045 KB  
Article
Feeding Mode Is Associated with Infant Night Sleep Trajectories During the First Postnatal Year
by Magdalena Olson, Li Liu, Elizabeth Reifsnider, Dean V. Coonrod, Sarada S. Panchanathan, Megan E. Petrov and Corrie M. Whisner
Nutrients 2026, 18(11), 1650; https://doi.org/10.3390/nu18111650 - 22 May 2026
Viewed by 1366
Abstract
Background: Short sleep and formula feeding during infancy are associated with increased risk of childhood obesity. Feeding practices and sleep arrangements vary during infancy and may also be dynamic, yet their impact on infant night sleep duration remains unclear. Understanding these relationships is [...] Read more.
Background: Short sleep and formula feeding during infancy are associated with increased risk of childhood obesity. Feeding practices and sleep arrangements vary during infancy and may also be dynamic, yet their impact on infant night sleep duration remains unclear. Understanding these relationships is crucial for formulating recommendations to support breastfeeding and address sleep concerns. Objective: We examined the association between feeding mode and parent-reported infant night sleep duration during the first postnatal year, while additionally evaluating night-weaning and bedsharing as contextual sleep-related practices. Methods: Infants in the Phoenix Metropolitan Area (n = 193) were followed up at 3, 8, 13, 26, 39, and 52 weeks post-birth. Sleep and feeding questionnaires were answered at each visit. A multilevel growth model estimated infant night sleep duration trajectories by feeding mode (ordinal: exclusive formula, mixed, exclusive breastfeeding), night-weaning, and bedsharing as time-variant predictors. Maternal education and household income were covariates to account for differences in study attrition. Results: Infant night sleep duration followed a curvilinear trajectory, starting at 7.92 h (95% CI: 5.78, 10.06) and increasing by 0.40 h/month (95% CI: 0.21, 0.60), with a deceleration over time (0.02 h/month2, p < 0.001). Each increase in levels of breast milk consumption was associated with an increase in infant night sleep duration (B = 0.87 h, p < 0.001), but the association weakened as the infant aged (B = −0.07 h/month, p < 0.001). Despite 59.7% of bedsharing infants being exclusively breastfed, bedsharing was not significantly associated with infant night sleep duration. Similarly, night-weaning was not significantly associated with infant night sleep duration. Conclusions: Breastfeeding is associated with longer infant night sleep duration, whereas bedsharing showed no association despite its correlation with breastfeeding. This research highlights the importance of breastfeeding in early life, not only for its developmental benefits but also for its relationship with infant night sleep duration, an essential component of healthy infant growth. Full article
(This article belongs to the Special Issue Infant and Toddler Feeding and Development)
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12 pages, 677 KB  
Article
Dietary Iron Sources Among 9-Month-Old Infants from Low-Income Households
by Elizabeth F. Acquah, Jeffrey D. Labban, Seth M. Armah, Maureen M. Black, Marjorie Jenkins, Deborah Clarice Andoh and Jigna M. Dharod
Nutrients 2026, 18(9), 1417; https://doi.org/10.3390/nu18091417 - 30 Apr 2026
Viewed by 873
Abstract
Background: The 2025–2030 Dietary Guidelines for Americans recommend that 6–12-month-old infants receive 11 mg iron/day. The contribution of iron-rich foods in meeting guidelines is unclear. Objectives: The aims were to: (1) determine the contribution of iron-fortified cereal, infant formula and heme-iron [...] Read more.
Background: The 2025–2030 Dietary Guidelines for Americans recommend that 6–12-month-old infants receive 11 mg iron/day. The contribution of iron-rich foods in meeting guidelines is unclear. Objectives: The aims were to: (1) determine the contribution of iron-fortified cereal, infant formula and heme-iron sources to infants’ total dietary iron intake; (2) examine differences in iron adequacy by milk-feeding type; and (3) identify feeding patterns associated with meeting daily iron requirements through dietary sources. Methods: Mothers of infants were recruited from a pediatric clinic and 24 h feeding recalls were conducted to estimate infants’ iron intake. Infants’ milk-feeding types were: breastmilk only (BF), mixed (MF), or infant formula only (FF). Main outcomes were: meeting/not meeting daily iron requirement (11 mg) overall and by milk-feeding type; contribution of iron-fortified infant cereal, formula and meat to daily iron intake. Descriptive statistics, bivariate chi-square tests, and multivariate logistic regression analyses were conducted. Results: Most participants identified as African American or Hispanic (76%) and were enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (84%). Thirty-nine percent consumed < 11 mg iron/day from dietary sources. By milk-feeding type, inadequate iron intake was significantly higher among the BF (72%) and MF (74%) groups vs. the FF group (24%, p < 0.05). Iron-fortified cereals were consumed by 46% of infants and provided a median iron intake of 6.75 mg. Among the FF group, infant formula provided 63% of the daily iron requirement. Conclusions: Inadequate dietary iron intake is common. Iron-fortified cereal is an important dietary iron source. Future research is warranted to understand the relations among infants’ daily iron intake, iron sources (heme vs. non-heme), and iron status. Full article
(This article belongs to the Special Issue Infant and Toddler Feeding and Development)
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22 pages, 560 KB  
Article
The First Foods Qualitative Study: Using the Developmental Niche Framework to Understand Caregiver and Infant Feeding Interactions During the Complementary Feeding Period
by Susan L. Johnson, Katherine J. Barrett, Kameron J. Moding and Catherine A. Forestell
Nutrients 2026, 18(7), 1121; https://doi.org/10.3390/nu18071121 - 31 Mar 2026
Viewed by 918
Abstract
Objectives: The transition to complementary feeding represents an important interval in child nutrition and development. Nutrient demands for growth are high, yet less is known regarding how caregivers make decisions regarding the introduction of solid foods to their infants and what influences [...] Read more.
Objectives: The transition to complementary feeding represents an important interval in child nutrition and development. Nutrient demands for growth are high, yet less is known regarding how caregivers make decisions regarding the introduction of solid foods to their infants and what influences their choices and feeding practices. Methods: Semi-structured interviews were conducted via Zoom with caregivers (N = 46, 83% mothers) of typically developing children (6–24 months of age) residing in the United States. A content analytic approach, with consensus coding performed by team members, was undertaken. The Developmental Niche framework guided thematic analysis. Results: Four major themes and four subthemes were identified: (1) Caregivers’ Approach Introducing Solid Foods with Anticipation and Concern, including subthemes of the (a) timing and order of complementary foods (CF) offered to children and (b) foods caregivers avoid offering; (2) Caregivers’ and Children’s Learning, including subthemes of (a) children’s rapid learning and skill development, and (b) the concurrent rapid demands for changes in food parenting; (3) Drivers of Caregivers’ Decisions Related to Offering Solid Foods to their Children; and (4) The Goal of CF: Integration of the Child into Family Mealtimes. Conclusions: Caregivers seek to provide adequate nutrition while balancing children’s health needs with the challenge of encouraging acceptance of family foods and respecting individual preferences. Juggling myriad demands (e.g., time, convenience, other family members, cultural traditions, and expectations), caregivers seek to help their children develop a healthy relationship with food. Full article
(This article belongs to the Special Issue Infant and Toddler Feeding and Development)
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13 pages, 237 KB  
Article
Factors Related to Pregnancy and Childbirth and Their Relationship with Exclusive Breastfeeding—A Cross-Sectional Study
by Marcelina Porożyńska and Anna Weronika Szablewska
Nutrients 2026, 18(3), 447; https://doi.org/10.3390/nu18030447 - 29 Jan 2026
Cited by 3 | Viewed by 1771
Abstract
Background/Objectives: The World Health Organisation (WHO) recommends exclusive breastfeeding for the first six months of life, but exclusive breastfeeding (EBF) rates remain low in many countries, including Poland. Factors related to pregnancy, childbirth and the organisation of care can significantly affect the maintenance [...] Read more.
Background/Objectives: The World Health Organisation (WHO) recommends exclusive breastfeeding for the first six months of life, but exclusive breastfeeding (EBF) rates remain low in many countries, including Poland. Factors related to pregnancy, childbirth and the organisation of care can significantly affect the maintenance of lactation. There is a lack of representative data on these relationships in Poland, which makes it difficult to plan effective support measures. The aim of this study is to analyse the relationship between pregnancy and perinatal factors and exclusive breastfeeding in infants aged 6 to 12 months. Methods: This cross-sectional online survey was conducted between April and October 2025. A total of 557 women aged ≥18 years with infants aged 6–12 months participated in the research. Data were collected using a structured questionnaire covering sociodemographic characteristics, the course of pregnancy and childbirth, postpartum complications, early breastfeeding experiences and maternal birth satisfaction assessed using the Polish version of the Birth Satisfaction Scale—Revised (BSS-R). Multivariable logistic regression analysis was used to identify factors associated with exclusive breastfeeding up to six months. Results: Exclusive breastfeeding was significantly associated with vaginal delivery, the absence of postpartum complications and a lack of early breastfeeding problems in the first days postpartum, with initial lactation difficulties emerging as its strongest predictor. Most specific pregnancy-related conditions, maternal birth satisfaction and selected recommended hospital practices, including early skin-to-skin contact, were not independently associated with exclusive breastfeeding in the model. Conclusions: Exclusive breastfeeding up to six months is primarily determined by factors operating in the immediate perinatal and early postpartum period, particularly postpartum clinical stability and successful early lactation. Targeted support during this critical window may be key to improving exclusive breastfeeding outcomes. Full article
(This article belongs to the Special Issue Infant and Toddler Feeding and Development)
18 pages, 484 KB  
Article
Trace Element Intake from Dairy-Free Infant Porridges and Its Nutritional and Safety Implications for Infants Aged Six Months and Older
by Zuzanna Chronchol, Agata Witczak and Kamila Pokorska-Niewiada
Nutrients 2026, 18(2), 333; https://doi.org/10.3390/nu18020333 - 20 Jan 2026
Cited by 1 | Viewed by 854
Abstract
Background/Objectives: Following the cessation of breastfeeding, cereal-based complementary foods are commonly introduced into the diet of infants. Among these products, dairy-free infant porridges constitute an important component of early complementary feeding. This study aimed to evaluate dietary exposure to selected essential (Zn, [...] Read more.
Background/Objectives: Following the cessation of breastfeeding, cereal-based complementary foods are commonly introduced into the diet of infants. Among these products, dairy-free infant porridges constitute an important component of early complementary feeding. This study aimed to evaluate dietary exposure to selected essential (Zn, Fe, Mn, and Cu) and potentially toxic (Pb, Cd, and Hg) trace elements resulting from the consumption of dairy-free infant porridges by children aged six months and older. Products with different cereal compositions available on the Polish market were analyzed. Methods: Trace element concentrations were determined after microwave-assisted digestion using inductively coupled plasma atomic emission spectrometry (ICP-AES) and atomic absorption spectrometry for mercury (Hg-AAS). Results: A single recommended serving of dairy-free infant porridge contributed to the intake of essential trace elements, providing approximately 50% of the RDA for copper, 21% for zinc, 15% of the AI for manganese, and 5.7% of the RDA for iron. The concentrations of potentially harmful elements were low (Pb: 0.002–0.004 mg/kg; Cd: <0.001–0.003 mg/kg; Hg: <0.001–0.001 mg/kg). The estimated daily intake of these elements did not exceed 0.01 µg/kg body weight per day. Conclusions: Dairy-free infant porridges may contribute to the intake of essential trace elements in infants, while exposure to lead, cadmium, and mercury appears to remain low when products are consumed according to recommended serving sizes. Full article
(This article belongs to the Special Issue Infant and Toddler Feeding and Development)
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16 pages, 600 KB  
Article
Stunting Among HIV-Exposed and HIV-Free Children in eSwatini: A Retrospective Evaluation of Associations with Birthweight, Feeding, and Caregiving Practices
by Bareng A. S. Nonyane, Letha Varughese, Jigna M. Dharod, Xolisile Dlamini, Andrea Ruff and Maureen M. Black
Nutrients 2026, 18(2), 198; https://doi.org/10.3390/nu18020198 - 8 Jan 2026
Viewed by 865
Abstract
Background/Objectives. Associations between stunting and dietary practices have been understudied among HIV-exposed and HIV-free children. We investigated associations between birthweight, socio-demographics, and dietary and feeding practices with stunting at 9 and 18 months among children in eSwatini. Methods. We used generalized [...] Read more.
Background/Objectives. Associations between stunting and dietary practices have been understudied among HIV-exposed and HIV-free children. We investigated associations between birthweight, socio-demographics, and dietary and feeding practices with stunting at 9 and 18 months among children in eSwatini. Methods. We used generalized linear mixed models (GLMs) with a logit link to characterize associations between stunting and birthweight quartiles, socio-demographics, maternal characteristics, and infant dietary diversity scores. We examined the moderating effects of dietary factors on relations between birthweight and stunting. Generalized structural equation models characterized direct and indirect associations between exposures and stunting at 18 months, mediated through stunting at 9 months. Results. We included 367 HIV-exposed and HIV-free children. Infants in the third and fourth birthweight quartiles had reduced odds of stunting at 9 months [adjusted odds ratio (adj OR) 0.24 (IQR 0.11, 0.55), p < 0.001; 0.10 (0.03, 0.33), p < 0.001, respectively]. Moderation by dietary diversity was limited to a relative decline in the second birthweight quartile. Stunting prevalence significantly increased from 9 months (21%) to 18 months (37%). Mediated by stunting at 9 months, there were significant direct and indirect effects of birthweight and dietary diversity on stunting at 18 months. Conclusions. Among HIV-exposed and HIV-free children, stunting prevalence increased with age and was associated with lower birthweight. Dietary diversity attenuated stunting risk among children in the second birthweight quartile. Prenatal strategies to reduce low birth weight (LBW) and additional attention to the social determinants of health, particularly dietary diversity, are warranted in programs and policies to reduce stunting. Full article
(This article belongs to the Special Issue Infant and Toddler Feeding and Development)
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24 pages, 684 KB  
Article
“What Do You Need?” Formative Research to Develop a Comprehensive Maternal Needs Assessment Tool for Infant and Young Child Nourishment and Care in the United States
by Mercy Eloho Sosanya, Laura Birgit Mueller, Caleb Martin and Jennifer L. Temple
Nutrients 2025, 17(24), 3825; https://doi.org/10.3390/nu17243825 - 6 Dec 2025
Viewed by 1230
Abstract
Background/Objectives: Despite substantial healthcare spending, U.S. mothers encounter fragmented support systems for infant feeding, care, and maternal mental health. While existing needs assessment instruments target parents of ill or preterm infants, no validated tool captures the full range of informational, psychosocial, and structural [...] Read more.
Background/Objectives: Despite substantial healthcare spending, U.S. mothers encounter fragmented support systems for infant feeding, care, and maternal mental health. While existing needs assessment instruments target parents of ill or preterm infants, no validated tool captures the full range of informational, psychosocial, and structural needs among mothers of healthy, full-term infants. This formative mixed-methods study sought to identify and prioritize maternal needs across multiple socioecological levels to guide the development of a comprehensive Maternal Needs Assessment Tool (MNAT). Methods: Guided by the socioecological model, six virtual focus groups were conducted with U.S. mothers of healthy infants < 2 years (analytic sample = 28). Thematic analysis in ATLAS.ti (Version 25) identified key needs, which informed the creation of a 10-domain Maternal Needs Assessment Ranking Questionnaire (MNARQ). Participants (n = 22) rated each domain’s importance on a five-point scale; weighted mean ranks were calculated in SPSS (Version 30). Results: Seven overarching themes across ten domains emerged: infant and young child feeding and care, maternal psychosocial wellbeing, parenting knowledge and skills, interpersonal and community support, institutional assistance, and work-policy environments. The highest-ranked domains of need were complementary feeding, child development, care and health, social norms, networking and support, maternal mental health, and breastfeeding guidance. Mothers described pervasive informational confusion, inadequate professional and peer support, and institutional barriers such as limited postpartum follow-up, inflexible daycare policies, and WIC hurdles in formula substitution for infants with allergies. Conclusions: Maternal needs encompass intersecting personal, social, and structural factors. Findings will inform the development and validation of a national Maternal Needs Assessment Tool to guide integrated maternal and child health programs. Full article
(This article belongs to the Special Issue Infant and Toddler Feeding and Development)
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12 pages, 434 KB  
Article
Maternal Pressure and Frequent Use of Bottle During Feeding Moderate Infant Food Cue Reactivity over Time
by Lenka H. Shriver, Yu Chen, Cheryl Buehler, Laurie Wideman and Esther M. Leerkes
Nutrients 2025, 17(22), 3605; https://doi.org/10.3390/nu17223605 - 18 Nov 2025
Viewed by 1091
Abstract
Background: Food cue reactivity (FCR) has been associated with a higher obesity risk, but little is known about what factors influence FCR during infancy. This study examined the moderating effects of maternal feeding styles and bottle feeding on the associations between 2-month [...] Read more.
Background: Food cue reactivity (FCR) has been associated with a higher obesity risk, but little is known about what factors influence FCR during infancy. This study examined the moderating effects of maternal feeding styles and bottle feeding on the associations between 2-month and 6-month FCR. Methods: Data came from 299 mother–infant dyads who participated in a larger early-obesity-risk study and provided information via online questionnaires (i.e., socio-demographics) and/or during lab visits (i.e., anthropometrics) prenatally and at 2 and 6 months postpartum. Food-related practices (i.e., bottle use, milk type), feeding styles and FCR were measured by previously validated mother-reported measures: Infant Feeding Practices, Infant Feeding Styles, and Baby Eating Behavior Questionnaires. A regression model with moderation effects between 2-month FCR, feeding styles, and bottle feeding on 6-month FCR was tested using Mplus, controlling for selected variables (i.e., milk type, infant birthweight). Maternal pressure interacted with 2-month FCR and bottle feeding to predict 6-month FCR. Results: The moderating role of higher pressure was significant only for infants who received most of their feeds via a bottle (“high” bottle feeding). No other interactions were significant. Maternal feeding pressure in combination with frequent bottle feeding further strengthens the positive association between early and late FCR in infancy. Conclusions: Given the previously established links between FCR and weight outcomes among children, reducing the controlling maternal feeding practice of pressure during feeding in infancy, especially among mothers who frequently bottle feed, might be an important intervention target for optimizing weight outcomes in the first year of life. Full article
(This article belongs to the Special Issue Infant and Toddler Feeding and Development)
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Review

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Review
Beyond “It’s Just a Phase”: A Review of Picky Eating in Children
by Pedro Alarcon and Yvan Vandenplas
Nutrients 2026, 18(8), 1247; https://doi.org/10.3390/nu18081247 - 15 Apr 2026
Cited by 1 | Viewed by 2528
Abstract
Picky eating is one of the most frequent feeding problems in childhood and is often dismissed as a normal developmental phase. Despite a steadily expanding body of research, uncertainty persists regarding its clinical relevance, assessment, and management. This review synthesizes recent evidence on [...] Read more.
Picky eating is one of the most frequent feeding problems in childhood and is often dismissed as a normal developmental phase. Despite a steadily expanding body of research, uncertainty persists regarding its clinical relevance, assessment, and management. This review synthesizes recent evidence on picky eating in children, with a specific focus on definitions, epidemiology, developmental trajectories, underlying mechanisms, clinical impact, and interventions. Reliance on broad definitions and prevalence estimates has obscured clinically meaningful distinctions between transient, developmentally typical food selectivity and persistent patterns associated with nutritional risk, functional impairment, and family stress. Drawing on contemporary data, we propose a continuum-based, phenotype-oriented framework that emphasizes persistence, severity, and functional impact rather than food refusal alone. Advances in understanding picky eating have not consistently translated into improved clinical care, highlighting persistent gaps in implementation, access, and dissemination of evidence-based feeding guidance. Finally, we outline priorities for future research and practice aimed at improving outcomes for children with clinically relevant picky eating. Full article
(This article belongs to the Special Issue Infant and Toddler Feeding and Development)
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