Feeding Patterns of Infants and Toddlers: The Mexico Case Study

Salvador Villalpando-Carrión and Alison L. Eldridge

Understanding the feeding patterns of Mexican infants and toddlers has required a large amount of effort due to the lack of recent reliable data. The double burden of obesity and micronutrient deficiency has caused alarm, identifying the need to discover when and how inadequate consumption of nutrients take place in such a diverse country. The types of foods and beverages that children consume have drastically changed in recent years, although there is poor factual knowledge around this matter. Another issue is that many physicians and health care professionals are bystanders in the practice of complementary feeding. There is a national recommendation for the introduction of complementary feeding that serves as a nationwide reference. Breastfeeding is strongly recommended. The national policy is for exclusive breastfeeding for at least 6 months, and introduction of complementary foods should not start before this age. 

FITS Mexico (the Feeding Infants and Toddlers Study) was initiated to address the lack of knowledge of the actual feeding patterns of Mexican children. Secondary data analyses from a nationally representative sample of over 5,000 children from ENSANUT 2012 (Encuesta Nacional de Salud y Nutrición – the Mexican National Health and Nutrition Survey) were used to review the feeding and drinking patterns of Mexican children in depth [1–4]. Micronutrient and food sources of nutrients were analyzed. Appropriate and inappropriate foods and beverages were considered at the end point analyses of the feeding patterns. Also, a broad country panel of experts were involved in developing new feeding recommendations according to the FITS findings for healthy infants [5]. 

Low rates of exclusive breastfeeding were found in infants less than 6 months old [1]. We also reported that 31 and 35% of 6- to 11.9-monthold infants consumed cow’s milk or sugar-sweetened beverages, respectively [2]. Few infants received iron-rich food sources, such as fortified infant cereal or meats. One half of 6- to 47.9-month-old children consumed fruit, but 85% did not consumed vegetables as a distinct serving on the day of the recall. After 12 months of age, over 80% of toddlers consumed some type of sweet or sugar-sweetened beverages on any given day. Between 18 and 36% of toddlers did not meet the estimated average requirement for iron, and about 40% did not meet that for zinc. In contrast, more than 30% of toddlers exceeded the tolerable upper intake level of sodium daily [3]. 

Feeding patterns in Mexican children seem to be established early in life. Food groups consumed with poor micronutrient intakes and high energy consumption might explain the nutritional condition for the Mexican population through all age groups. Regional experts have used this information to set new and more strict recommendations for child feeding [5]. Public policy must change accordingly. Continuous study of feeding patterns in a population, especially in children, will be a powerful tool to monitor health and nutrition status for the whole country.

References

  1. Deming D, Reidy K, Afeich M, et al: Early feeding patterns among Mexican babies: findings from the National Health and Nutrition Survey 2012 and implications for health and obesity prevention. BMC Nutr 2015;1:40.
  2. Afeiche MC, Villalpando-Carrion S, Reidy KC, et al: Many infants and young children are not compliant with Mexican and international complementary feeding recommendations for milk and other beverages. Nutrients 2018;10:E466.
  3. Piernas C, Miles D, Deming D, et al: Estimating usual intakes mainly affects the micronutrient distribution among infants, toddlers and pre-schoolers from the 2012 Mexican National Health and Nutrition Survey. Public Health Nutr 2016;19:1017–1026.
  4. Denney L, Afeiche M, Eldridge A, Villalpando-Carrion S: Food sources of energy and nutrients in infants, toddlers, and young children from the Mexican National Health and Nutrition Survey 2012. Nutrients 2017;9:E494.
  5. Romero-Velarde E, Villalpando-Carrion S, Perez-Lizaur AB, et al: Consenso para las prácticas de alimentación complementaria en lactantes sanos. Bol Med Hosp Infant Mex 2016;73:338–356.