Research fills the gap in evidence-based infant feeding guidelines

Imagine you are a parent of a 6-month-old and are looking to introduce solid foods to your baby. You are not sure what and how much to introduce first, so you look to dietary guidelines for help. You discover that the guidelines provide evidence-based dietary recommendations for all age groups except one—children under 2.

“My Plate is considered the gold standard for Meals on Wheels or school lunch programs,” Minghua Tang, Ph.D., said of the guidelines that replaced the United States Department of Agriculture (USDA) Food Pyramid in 2011. But when it comes to the very youngest among us, the current dietary guidelines have limited recommendations for infants and toddlers.

Tang is an adjoint associate professor of pediatrics in the University of Colorado School of Medicine section of nutrition and the Lillian Fountain Smith Endowed Chair Professor at Colorado State University. She is also a researcher at the Colorado Clinical and Translational Sciences Institute (CCTSI).

Tang said that a new mother might wonder: If I am breastfeeding, do the recommendations change? If I am formula feeding, do the recommendations change? “There are not a lot of recommendations because not a lot of high-quality research has been done focusing on this age group,” she said.

Tang hopes to change that. Once she wraps up her five-year study called the Maternal and Infant Nutrition Trial (MINT), she will publish her findings and share them with new parents who are hungry (pun intended) for the information.

“Infants deserve the same amount of attention as adults, if not more,” Tang said.

Studying the youngest among us

Tang’s research project launched in 2021 and will wrap up in 2026. She and her team, including registered dieticians, certified lactation consultants and research professionals work directly with moms, dads, and their babies to study how different foods affect growth and gut health.

“Our work during complementary feeding will contribute to the evidence base, which will support future dietary recommendations for infants and toddlers,” Tang said.

During the project, Tang’s research group discovered that many parents were interested in a new approach to introducing solid food called baby-led weaning. So, the researchers launched an offshoot of their primary study to focus on baby-led weaning vs. conventional weaning.

Social media has played a role in popularizing baby-led weaning, which gradually introduces solid foods rather than relying solely on purees. The practice allows babies to choose the foods they prefer as they feed themselves soft chunks of whole foods instead of being spoon-fed pureed food by their parents.

In June of this year, Tang’s team member and registered dietitian Kinzie Matzeller, MS, RDN, CLC, presented early findings from the study at the American Society of Nutrition Conference. Overall, Tang’s team found no difference in terms of calorie and nutrient intakes between the two groups who practiced the two types of weaning. Both types of weaning provide ample calories for growth and development.

Moving forward, the team will continue to study the influence of specific foods on babies’ growth and gut health. During the course of the study, parents and their babies visit the pediatric Clinical Translational Research Center (CTRC) at Children’s Hospital Colorado twice; once when they join the study, and then when the baby turns 1 year old. The CTRC is part of the CCTSI. Specialized research nurses measure the baby’s weight, length, head circumference, and collect blood samples.

“We rely very heavily on the CTRC nursing and nutrition core. We could not do it without their help. They are very supportive,” Tang said. “The CTRC nutrition core analyzes infant diet records. We will eventually use CTRC core labs as well.”

In between the appointments at the pediatric CTRC, research coordinators conduct monthly home visits, driving all over the Denver metropolitan area to see the babies and parents in their homes. They bring one month’s food supply for the baby as well as measuring them and collecting diet records and stool samples.

There are currently 260 families enrolled in the study. Once the study is complete, researchers will share with caregivers the results focused on their infant and also give them copies of conference abstracts and publications, Tang said.