The obligation to care for infants and very small children differs little between cultures and socioeconomic groups. Despite the dramatic differences in most aspects of their lives, parents in a remote village in Nigeria and their counterparts in any suburban American home share one basic responsibility-providing their children with sufficient quantities of foods whose nutritional value is adequate to ensure their health and development.
Division of Nutritional Sciences professor Gretel Pelto has studied feeding practices for infants and young children around the world. She says the period requiring the most attention is from birth until sometime between 24 and 30 months of age. During that time, children are completely dependent on others for food. Dependence continues until they become physiologically and psychologically mature enough to meet their nutritional requirements from the household diet, provided that household resources are adequate.
Pelto and other nutritional scientists divide this period of dependence into two stages. During the first stage, from birth until around six months, children are able to obtain all the nutrients they need to thrive from breast milk. "It's the perfect food, there's no question about it," she says. "But there comes a point at which we outgrow the capacity to sustain life on breast milk alone, because the milk doesn't contain all the nutrients in adequate quantities to meet infants' growing needs."
To meet the expanding nutritional needs of their children, mothers in all cultures begin to augment breast milk with what researchers call complementary foods. As children increase their consumption of complementary foods, they are gradually weaned from the breast. In many cultures family care practices during this time are designed to promote independence, including children learning to feed themselves. As children develop independence, the mother-child bond that characterizes the earliest days of infancy often weakens.
In the United States and other industrialized nations, complementary foods are easily obtained at the grocery store and feature labels with names like Gerber and Beech Nut. In many poor communities, however, complementary foods must be prepared by parents or caregivers from whatever is available locally. The food source of choice is often low-density grains, which are ground and made into a semi-liquid pap and fed to children. Although filling, these paps do not supply all the nutrients required by developing children. As a result, children often suffer malnutrition, which may cause delays in cognitive and physical development and exacerbate illnesses and infections. In addition, the more malnourished the children are, the more likely it is for them to die from common infectious diseases.
"Malnutrition in the 6- to 30-month age group is the number one malnutrition problem in the world," says Pelto, whose master's and Ph.D. degrees are in medical anthropology. "From an evolutionary standpoint, this is the crisis period for Homo sapiens. Our developmental period is longer than those of other animals. On the positive side, this characteristic allows for the development of larger brains, speech, and all the other wonderful abilities humans have. On the down side, this creates unique problems that require behavioral solutions."
Although efficacy trials have shown that nutrition intervention programs can be effective in preventing developmental delays in pre-school children in conditions of endemic malnutrition, the 6- to 30-month age group remains difficult to reach. One of the problems is inadequate scientific knowledge about what caregiving practices, including complementary feeding practices, are most effective at ensuring nutritional intake and preventing developmental delays.
Pelto's studies of parental feeding practices, for example, have revealed a wide spectrum of approaches that are deeply rooted in culture and, in some cases, have potentially negative effects on child development. …