Over recent years, NACCHO, with support from the Centers for Disease Control and Prevention, Division of Nutrition Physical Activity and Obesity (CDC-DNPAO), has worked alongside numerous local communities nationwide to identify and implement successful strategies aimed to improve infant and toddler nutrition security. To learn more about NACCHO’s infant and toddler nutrition initiatives, click here.

National Nutrition Month® is an annual campaign by the Academy of Nutrition and Dietetics dedicated to fostering informed food choices and developing healthy feeding habits in the United States. The 2024 theme, “Beyond the Table”, highlighted the farm-to-fork journey of nutrition, acknowledged the various places and ways we eat - whether at home or on the go - and emphasized the importance of food sustainability efforts. To celebrate, the National Association for County and City Health Officials (NACCHO) highlighted the importance of infant and toddler nutrition security. 

In honor of the 2024 National Nutrition Month® theme, “Beyond the Table”, NACCHO hosted a celebratory webinar on Wednesday, March 20, 2024, entitled, Beyond Baby’s Highchair: Improving Infant & Toddler Nutrition Security. Participants learned about the nation’s early childhood nutrition landscape, and NACCHO’s early childhood nutrition security initiatives, and viewed newly released and culturally responsive nutrition education resources.

To review the recording for the NACCHO webinar, click here.

To earn 1.5 CPEUs and 1.5 L-CERPS, click here.

To pre-register for the e-learning course, click here.

The first 1,000 days of life, the period from pregnancy through a child’s second birthday, represents a critical window for establishing healthy dietary patterns, fostering a responsive feeding environment, and mitigating the risk of chronic disease. Further, human milk feeding and the introduction of age-appropriate, healthy, and nutrient-dense complementary foods during this period are key for optimal growth and development of young children.    

Unfortunately, the food options available for many babies often fall short, with about 1 in 7 young children in the United States experiencing nutrition insecurity – a consequence of unjust structural barriers that disproportionately impact historically marginalized communities. In 2022 alone, 6.4 million households with children under eighteen faced food insecurity, making infants particularly vulnerable. Among the food insecure, Black and Hispanic children, rural populations, and single-mother households are disproportionately impacted by hunger.    

In unique and complex combinations, various factors – such as food insecurity, poverty, infrastructure, and culture – shape the dietary landscape for infants. Thus, the accessibility and availability of nutritious foods are vital to our food systems and indispensable for the growth and development of future generations.   

Farm to Plate: Our Local Food System and Nutrition Landscape

 Local food systems greatly influence how food is cultivated from the source and served to our children. Our local food systems should provide infants and children with the diets they need to grow and develop healthily. The term food system is described as “everything from farm to table”, which includes how food is produced, processed, distributed, marketed, and consumed. These local food systems are vulnerable to environmental, economic, political, and social contexts, which ultimately affect the types of foods available to infants and toddlers.  

Environmental factors including climate change, soil health, and water availability impact local food production, with extreme weather events like floods or droughts reducing the amount and diversity of crops produced for communities. Economic factors like market forces and transportation costs also play a role in the types and quality of foods available in communities. Regional farmers often struggle to compete with larger-scale producers, but direct-to-consumer initiatives that support farmers’ markets and community-supported agriculture (CSA) programs help bridge the demand for locally grown foods with the challenges of a competing agricultural market. 

Policy impacts nutrition security, with food assistance programs like WIC and free and reduced school meal programs improving access to healthy foods for vulnerable community members. However, these programs are underutilized due to government mistrust, confusing enrollment processes, stigma, and limited food options and infrastructure.

 Furthermore, Black, Indigenous, and People of Color (BIPOC) and other historically marginalized communities disproportionately experience food and nutrition insecurity due to unjust structural and institutional barriers that amplify economic, environmental, political, and social contexts. It is critical to our nation’s health equity journey to understand the local nutrition landscape and the challenges of our nation’s many communities to establish and sustain effective nutrition security for all infants and toddlers.  Establishing intentional initiatives nationwide requires tackling each of these, and other, factors to strengthen our food systems.   

Setting the Table Together: The Power of Culturally Diverse Representation 

When supporting families and caretakers to nourish their children by facilitating access to local food and nutrition support programs, our nation must recognize and honor cultural diversity. It is important to acknowledge that each family and community has their own unique beliefs, traditions, and cultural practices that shape their lifestyle. Thus, decisions about a child’s feeding habits and options are informed by these very experiences. From parents, caretakers, and siblings, to cousins, friends, and neighbors, the community and social networks that surround an infant or toddler influence a child’s nutritional norms and lay the foundation for a child’s short- and long-term feeding habits. The culture of feeding impacts how a child understands food and feeding as a form of nutrition, from the timing and frequency of feeding to the foods and flavors commonly enjoyed. To ensure optimal nutrition and feeding habits, a child’s community and social network must understand the value of their role in ensuring proper nourishment and cultivating healthy eating habits for a child into adulthood. 

It is with this understanding that NACCHO encourages community programs that address infant and toddler nutrition security to be co-created or led by community members, particularly parents and primary caregivers, and implemented by local infrastructure supports. This approach can ensure that local beliefs and practices for infant feeding and nutrition are built into the framework of the program design, which introduces opportunities for sustainability when integrated with local infrastructure. This ultimately ensures that community-led programs reflect the culture, language, knowledge, experiences, and needs of its members. Even further, this dynamic lends to the establishment of trusting relationships and the empowerment of culture and community. More importantly, this framework sets a standard threshold for the transparency needed to tackle multifaceted challenges at the community level, such as food insecurity, economic instability, poverty, and access to adequate and nutritious foods.  

In alignment with these principles, NACCHO has collaborated with communities to culturally diversify the infant and toddler chapter of the 2020-2025 Dietary Guidelines for Americans. The following guides offer culturally tailored nutrition guidelines and recipes, and a comprehensive community directory for food accessibility among different cultural communities: 

• Feeding Infants and Toddlers in Chinese and Vietnamese Communities (English, Chinese, and Vietnamese)  
• Feeding Infants and Toddlers – Highlighting African, Black, and Caribbean Heritage Foods 
• Feeding Infants and Toddlers – Highlighting Hispanic Heritage Foods 

* NACCHO is collaborating with Indian/Punjabi/Hindi, Arabic, Pashto, and Kurdish communities to co-create nutrition education materials, slated to launch in the Summer of 2024. 

By acknowledging and respecting cultural food practices and traditions, these culturally responsive nutrition materials enhance the effectiveness of nutrition education efforts and promote engagement with more communities in more settings: community centers, schools, clinics, hospitals, nonprofit organizations, and government agencies. Additionally, these materials can be circulated among a variety of professionals: nutritionists, educators, healthcare providers, and community leaders. Through these additional materials, the local health system is better equipped to promote health equity among infants and toddlers and to address the community’s nutrition infrastructure.    

References 

1. Miller GD, Kanter M, Rycken L, Comerford KB, Gardner NM, Brown KA. Food Systems Transformation for Child Health and Well-Being: The Essential Role of Dairy. Int J Environ Res Public Health. 2021 Oct 8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8507772/ 

2. Key Statistics & Graphics. USDA. (2023). https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-u-s/key-statistics-graphics/ 

3. Nearly 11 Million Kids Face Food Insecurity As Statistic Dips to 20-Year Low. The Annie E. Casey Foundation. (2023). https://www.aecf.org/blog/near...