During the first years of life, the sweetness of sugars has a capacity to hinder or to help in laying a strong nutritional foundation for food preferences that often extend over a lifetime. Aside from supplying 4 g/kcal of energy, sugars are non-nutritive. However, sugars have a powerful attribute, sweetness, which strongly influences human food preference. A child's first relationship with sweet taste begins even before birth and continues to evolve throughout complementary feeding. The sweetness of breastmilk encourages consumption and soothes the neonate. Conversely, inappropriate introduction of non-milk solids and beverages that are sweet at 0-4 months of age raises the newborn's risk for later obesity and may discourage the acceptance of other bitter or sour foods. Although cereals, fruits, 100% fruit juices, and some grains have naturally occurring sugars that impart sweet flavor notes, there is no clear role for added sugars between 6 and 12 months of age. Yet, 60% of infants are introduced to foods and beverages containing added sugars, threatening diet quality. Pairing foods with naturally occurring sugars, such as fruits, with foods that tend to be resisted initially, such as vegetables, can mask bitterness and promote acceptance. Utilizing the infants' extraordinary capacity for sensory-motor exploration is another strategy to expose them repeatedly to challenging tastes and flavors. The transitional year, as breast milk and infant formula are withdrawn, is a time when nutritional needs are high and diet quality often precarious. Rapid growth, along with brain and cognitive development, demand high-quality nutrition. Snacks are necessary both for energy and valuable nutrients. However, the selection of snack foods often exposes toddlers to items that offer concentrated energy with low nutrient value. Recent trends suggest a rapid fall in added sugars among infants and toddlers. Parenting practices that use small amounts of sugars to promote nutrient-rich foods from all 5 food groups can enhance rather than hinder their child's emerging dietary pattern.

1.
American Academy of Pediatrics, Committee on Nutrition: Complementary feeding; in Kleinman RE, Greer F (eds): Pediatric Nutrition, ed 7. Elk Grove Village, American Academy of Pediatrics, 2013.
2.
Son'kin V, Tambovtseva R: Energy metabolism in children and adolescents; in Clark K (ed): Bioenergetics. InTech Press, 2012, chapter 5, pp 121-142.
3.
Bode L: The functional biology of human milk oligosaccharides. Early Hum Dev 2015;91:619-622.
4.
Lönnerdal B: Bioactive proteins in human milk: health, nutrition, and implications for infant formulas. J Pediatr 2016;173(suppl): S4-S9.
5.
Martin CR, Ling PR, Blackburn GL: Review of Infant Feeding: Key features of breast milk and infant formula. Nutrients 2016;8:279-290.
6.
Davis EC, Wang M, Donovan SM: The role of early life nutrition in the establishment of gastrointestinal microbial composition and function. Gut Microbes 2017;8:143-171.
7.
Castanys-Muñoz E, Martin MJ, Vazquez E: Building a beneficial microbiome from birth. Adv Nutr 2016;7:323-330.
8.
Center on the Developing Child at Harvard University: Resource Library. http://developingchild.harvard.edu/resources/ (accessed June 30, 2017).
9.
Nyaradi A, et al: The role of nutrition in children's neurocognitive development, from pregnancy through childhood. Front Hum Neruosci 2013;7:1-15.
10.
González HF, Visentin S: Micronutrients and neurodevelopment: an update. Arch Argent Pediatr 2016;114:570-575.
11.
Gould JF: Complementary feeding, micronutrients, and developmental outcomes of children. Nestle Nutr Inst Workshop Ser 2017;87:13-28.
12.
Desor JA, Maller O, Turner RE: Taste in acceptance of sugars by human infants. J Comp Physiol Psychol 1973;84:496-501.
13.
Beauchamp GK, Moran M: Dietary experience and sweet taste preference in human infants. Appetite 1982;3:139-152.
14.
Mennella JA, Bobowski NK: The sweetness and bitterness of childhood: insights from basic research on taste preferences. Physiol Behav 2015;152(pt B):502-507.
15.
McDaniel MR, Barker E, Lederer CL: Sensory characterization of human milk. J Dairy Sci 1989;72:1149-1158.
16.
Hayes JE, Johnson SL: Sensory aspects of bitter and sweet tastes during early childhood. Nutr Today 2017;52(2 suppl):s41-s51.
17.
Johnson SL, Hayes JE: Developmental readiness, caregiver and child feeding behaviors, and sensory science as a framework for feeding young children. Nutr Today 2017;52(2 suppl):S30-S40.
18.
Hetherington MM: Understanding infant eating behaviour - lessons learned from observation. Physiol Behav 2017;176:117-124.
19.
Bembich S, Davanzo R, Brovedani P, Clarici A, Massaccesi S, Demarini S: Functional neuroimaging of breastfeeding analgesia by multichannel near-infrared spectroscopy. Neonatology 2013;104:255-259.
20.
Lehtonen J, Könönen M, Purhonen M, Partanen J, Saarikoski S, Launiala K: The effect of nursing on the brain activity of the newborn. J Pediatr 1998;132:646-651.
21.
Mennella JA, Daniels LM, Reiter AR: Learning to like vegetables during breastfeeding: a randomized clinical trial of lactating mothers and infants. Am J Clin Nutr 2017;106:67-76.
22.
Lawless HT: Flavor; in Friedman MP, Carterette EC (eds): Cognitive Ecology. San Diego, Academic Press, 1996, pp 325-380.
23.
CDC NCHS: National Health and Nutrition Examination Survey (NHANES). https://www.cdc.gov/nchs/nhanes/index.htm (accessed June 19, 2017).
24.
Briefel RR, Kalb LM, condon E, et al: The Feeding Infants and Toddlers Study 2008: study design and methods. J Am Diet Assoc 2010;110(suppl 1):s16-s26.
25.
Gerber Medical Group, Nestle Nutrition: The Feeding Infants and Toddler Study. https://medical.gerber.com/nestle-science/feeding-infants-and-toddlers-study (accessed June 17, 2017)
26.
Miles G, Siega-Riz AM: Trends in food and beverage consumption among infants and toddlers: 2005-2012. Pediatrics 2017;139:e20163290.
27.
Clayton HB, Li R, Perrine CG, Scanlon KS: Prevalence and reasons for introducing infants early to solid foods: variations by milk feeding type. Pediatrics 2013;131:e1108-e1114.
28.
Section on Breastfeeding, American Academy of Pediatrics: Breastfeeding and the use of human milk. Pediatrics 2012;129.
29.
Murray R: Influences on the initial dietary pattern of infants from birth to 24 months. Nutr Today 2017;52(suppl 2):S25-S29.
30.
Birch LL, Doub AE: Learning to eat: birth to age 2 y. Am J Clin Nutr 2014;99:723S-728S.
31.
Green JR, Simione M, Le Reverend B, Wilson EM, Richburg B, Alder M, Del Valle M, Loret C: Advancement in texture in early complementary feeding and the relevance to developmental outcomes. Nestle Nutr Inst Workshop Ser 2017;89:29-38.
32.
Kleinman RE, Coletta FA: Historical overview of transitional feeding recommendations and vegetable feeding practices for infants and young children. Nutr Today 2016;51:7-13.
33.
Infant Feeding Joint Working Group and Health Canada: Nutrition for healthy term infants: recommendations from six to 24 months. 2013. http://www.hc-sc.gc.ca/fn-an/nutrition/infant-nourisson/recom/recom-6-24-months-6-24-mois-eng.php (accessed June 15, 2017).
34.
Grimes CA, Szymlek-Gay EA, Campbell KJ, Nicklas TA: Food sources of total energy and nutrients among U.S. infants and toddlers: National Health and Nutrition Examination Survey 2005-2012. Nutrients 2015;17:6797-6836.
35.
Moshfegh AJ, Rhodes DG, Goldman JD, Clemens JC: Characterizing the dietary landscape of children, 12 to 35 months old. Nutr Today 2017;52(suppl 2):s52-s59.
36.
Welsh AJ, Figueroa J: Intake of added sugars during the early toddler period. Nutr Today 2017;52(2 suppl):S60-S68.
37.
Siega-Riz AM, Kinlaw A, Deming DM, Reidy KC: New findings from the Feeding Infants and Toddlers Study 2008. Nestle Nutr Workshop Ser Pediatr Program 2011;68:83-100.
38.
Perez-Escamilla R, Segura-Perez S, Lott M (eds): Robert Wood Johnson Foundation Healthy Eating Research: Building Evidence to Prevent Childhood Obesity. Feeding Guidelines of Infants and Young Toddlers: A Responsive Parenting Approach. February 2017. www.healthyeatingresearch.org (accessed June 12, 2017).
39.
Byrd-Bredbenner C, Ferruzzi MG, Fulgoni III VL, Murray R, Pivonka E, Wallace TC: Satisfying America's fruit gap: summary of an expert roundtable on the role of 100% fruit juice. J Food Sci 2017;82:1523-1534.
40.
Heyman MB, Abrams SA; Section on Gastroenterology, Hepatology and Nutrition, Committee on Nutrition: Fruit juice in infants, children, and adolescents: current recommendations. Pediatrics 2017;139: e20170967.
41.
Auerbach BJ, Wolf FM, Hikida A, Vallil-Buchman P, Littman A, Thompson D, Louden D, Taber DR, Krieger J: Fruit juice and change in BMI: a meta-analysis. Pediatrics 2017;139:e20162454.
42.
Ross ES: Flavor and taste development in the first years of life; in Black RE, Makrides M, Ong KK (eds): Complementary Feeding: Building the Foundations for a Healthy Life. Nestle Nutr Inst Workshop Ser 2017;87:49-58.
43.
Centers for Disease Control: 2015-2020 Dietary Guidelines for Americans (DGA), ed 8. https://health.gov/dietaryguidelines/2015/resources/2015-2020_Dietary_Guidelines.pdf (accessed June 15, 2017).
44.
World Health Organization: Sugars intake for adults and children guideline. WHO reference number: WHO/NMH/NHD/15.2 (executive summary). 2015. http://www.who.int/nutrition/publications/guidelines/sugars_intake/en/ (accessed June 21, 2017).
45.
Bailey RL, Barr SI: Introduction: sweet taste perception and feeding toddlers. Nutr Today 2017;52:S3-S5.
46.
Fangupo LJ, Heath AM, Williams SM, Erickson Williams LW, Morison BJ, Fleming EA, Taylor BJ, Wheeler BJ, Taylor RW: A baby-led approach to eating solids and risk of choking. Pediatrics 2016;138:e20160772.
47.
Daniels LA: Complementary feeding in an obesogenic environment: behavioral and dietary quality outcomes and interventions; in Black RE, Makrides M, Ong KK (eds): Complementary Feeding: Building the Foundations for a Healthy Life. Nestle Nutr Inst Workshop Ser 2017;87:167-181.
48.
Daniels L, Heath AL, Williams SM, Cameron SL, Fleming EA, Taylor BJ, Wheeler BJ, Gibson RS, Taylor RW: Baby-Led Introduction to SolidS (BLISS) study: a randomised controlled trial of a baby-led approach to complementary feeding. BMC Pediatr 2015;15:179.
49.
Morison BJ, Taylor RW, Haszard JJ, Schramm CJ, Williams Erickson L, Fangupo LJ, Fleming EA, Luciano A, Heath AL: How different are baby-led weaning and conventional complementary feeding? A cross-sectional study of infants aged 6-8 months. BMJ Open 2016;6:e010665.
50.
Davis CM: Results of the self-selection of diets by young children. Can Med Assoc J 1939;41:257-261.
51.
Scott J, Davey K, Ahwong E, Devenish G, Ha D, Do L: A comparison by milk feeding method of the nutrient intake of a cohort of Australian toddlers. Nutrients 2016;8:501.
52.
Ghisolfi J, Fantino M, Turck D, de Courcy GP, Vidailhet M: Nutrient intakes of children aged 1-2 years as a function of milk consumption, cows' milk or growing-up milk. Public Health Nutr 2013;16:524-534.
53.
Butte NF, Fox MK, Briefel RR, Siega-Riz AM, Dwyer JT, Deming DM, Reidy KC: Nutrient intakes of US infants, toddlers, and preschoolers meet or exceed dietary reference intakes. Am Diet Assoc 2010;110(suppl):S27-S37.
54.
Ahluwalia N, Herrick KA, Rossen LM, Rhodes D, Kit B, Moshfegh A, Dodd KW: Usual nutrient intakes of US infants and toddlers generally meet or exceed dietary reference intakes: findings from NHANES 2009-2012. Am J Clin Nutr 2016;104:1167-1174.
55.
Hamner HC, Perrine CG, Scanlon KS: Usual Intake of key minerals among children in the second year of life, NHANES 2003-2012. Nutrients 2016;8:E468.
56.
Smithers LG, Golley RK, Mittinty MN, Brazionis L, Northstone K, Emmett P, et al: Dietary patterns at 6, 15 and 24 months of age are associated with IQ at 8 years of age. Eur J Epidemiol 2012;27:525-535.
57.
Smithers LG, Golley RK, Mittinty MN, Brazionis L, Northstone K, Emmett P, et al: Do dietary trajectories between infancy and toddlerhood influence IQ in childhood and adolescence? Results from a prospective birth cohort study. PLoS One 2013;8:e58904.
58.
Nyaradi A, Li J, Foster JK, Hickling S, Jacques A, O'Sullivan TA, Oddy WH: Good-quality diet in the early years may have a positive effect on academic achievement. Acta Paediatr 2016;105:e209-e218.
59.
Deming DM, Briefel RR, Reidy KC: Infant feeding practices and food consumption patterns of children participating in WIC. J Nutr Educ Behav 2014;46(3 suppl):S29-S37.
60.
Guyenet S: Sugar intake and obesity. Whole Health Source, 2015. https://www.cato-unbound.org/2017/01/11/stephan-guyenet/americans-eat-too-much-cake-government-isnt-blame (accessed August 3, 2017).
61.
Piernas C, Popkin BM: Trends in snacking among U.S. children. Health Aff (Millwood) 2010;29:398-404.
62.
Hess J, Slavin J: Snacking for a cause: nutritional insufficiencies and excesses of U.S. children, a critical review of food consumption patterns and macronutrient and micronutrient intake of U.S. children. Nutrients 2014;6:4750-4759.
63.
Younginer NA, Blake CE, Davison KK, Blaine RE, Ganter C, Orloski A. Fisher JO: „What do you think of when I say the word ‘snack'?” Towards a cohesive definition among low-income caregivers of preschool-age children. Appetite 2016;98:35-40.
64.
American Academy of Pediatrics, Council on School Health, Committee on Nutrition: Snacks, sweetened beverages, added sugars, and schools. Pediatrics 2015;135:575-583.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.