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Influences on the Initial Dietary Pattern Among Children From Birth to 24 Months

Murray, Robert D. MD, FAAP

doi: 10.1097/NT.0000000000000195
Feature Article

The Dietary Guidelines for Americans (DGA), published every 5 years, review existing evidence and distill it into recommendations for sound nutrition. The Agricultural Act of 2014 mandated that the next edition of the DGA include recommendations aimed at the infant from birth to 24 months old. Recognizing the close relationship between fetal development and lifelong health, maternal nutrition during pregnancy was also included in the directive. This is a unique stage of life, characterized not only by specific nutritional requirements but also by rapidly changing sources of nutrition. High energy needs, rapid growth, and neural expansion, as well as fundamental cognitive, motor, and social-emotional development, depend on a high-quality diet for optimal outcomes. By the age of 2 to 3 years, the child will have acquired the type of stable eating habits and food preferences that together comprise what the DGA 2015-2020 described as a dietary pattern; that is, they are consuming foods and beverages in a routine that tends to persist over time. Initial exposure to foods and flavors that will culminate in personal food preferences represents an opportunity to establish a strong foundation for a child’s lifelong nutrition. Taking advantage of this opportunity will hinge on the translation of nutrition science into practical parenting guidance for a heterogeneous, culturally diverse US population. This article will examine some of the many influences that shape a child’s initial eating pattern.

Robert D. Murray, MD, FAAP, is a (retired) professor of pediatrics and of human nutrition and a member of the Food Innovation Center, The Ohio State University in Columbus.

This article is based on a presentation by Dr Robert Murray during a conference held in Washington, DC, on October 29–30, 2015. This conference was funded by the Sugar Association and planned in part by the Department of Pediatrics Section of Nutrition, School of Medicine, University of Colorado Anschutz Medical Campus. Dr. Murray received travel expenses and an honorarium from The Sugar Association for his participation in the conference.

Dr Murray received an honorarium from Lippincott Williams and Wilkins for the preparation of this article. This article appears in the Nutrition Today supplement, Sweet Taste Perception and Feeding Toddlers, funded by The Sugar Association.

Dr Murray serves as a consultant for the Sabra Dipping Company, the Egg Nutrition Council, and the Haas Avocado Board. He is also a consultant and speaker for the National Dairy Council, Dannon Company, and Abbott Nutrition.

Correspondence: Robert D. Murray, MD, FAAP, 1629 Berkshire Rd, Columbus, OH 43221 (

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