by Amy Spangler
July 20, 2010

Disguised as a means for insuring that finicky toddlers would get essential vitamins and nutrients, Enfagrow was pulled from the market on June 9, 2010 in a surprise announcement by its maker, Mead Johnson. Originally launched in July 2009 sporting a vanilla flavor, it was the release of a chocolate flavored version in February 2010 that proved to be not only unhealthy but unwise. With 19 grams of sugar in each 6-ounce serving, critics of Enfagrow chocolate weren’t hard to find. And with childhood obesity having reached epidemic proportions, many argued that the last thing most children needed was a super-sweet, high-calorie food.

The name alone, Enfagrow Premium chocolate toddler formula, was enough to incite detractors. What toddler needs a formula? Why should parents pay a premium for an expensive supplement that takes the place of much-needed fruits, vegetables, whole grains, and dairy products?

Unlike its chocolate counterpart, Enfagrow plain and vanilla will remain on the market because of, according to Mead Johnson, “numerous positive comments from grateful parents who have told us that they consider these products an important option for helping to meet their child’s overall nutritional needs, especially those who are picky or erratic eaters.”

But for parents rightly concerned about the added sugar, it’s important to know that according to the label on the container, Enfagrow vanilla has 18 grams of sugar per serving—only one less than the chocolate version. If that’s not enough sugar to reinforce your toddler’s preference for all things sweet, Mead Johnson provides recipes online for banana muffins, pancakes, and strawberry or banana smoothies with 28, 18, 16, and 21 grams of sugar per serving, respectively.

Putting sugar aside, this controversy begs the question, when (at what age?) and how (in the womb? through breast milk?) do children acquire taste preferences. And do those preferences affect their risk for becoming overweight later in life?

Preferences develop in utero
A 2001 study found that babies (when fed foods with certain flavors) responded differently to the flavors of foods eaten by their mothers during pregnancy, suggesting that a child’s taste preference can be influenced even before she is born.

Research conducted in a 2004 study found that in utero exposure to different flavors may affect food preferences after birth. This study involved four groups of formula-fed babies. One group was fed a traditional cow’s milk based formula; a second group was given an unpleasant tasting predigested formula; the remaining groups were fed a combination of the cow’s milk based formula for three months and the predigested formula for four months. After seven months the babies were videotaped on three separate days while feeding on the different formulas. Results showed that the longer the exposure to a specific flavor, the greater the acceptance of the flavor. This supports the theory that exposure to different flavors—whether via amniotic fluid, breast milk, or formula—may affect individual food and flavor preferences.

The extent to which flavor preferences are genetically predetermined was the topic of a 2005 study. A total of 143 pairs of mothers and their babies were screened for the presence of a taste receptor gene associated with bitter and sweet tastes. The results showed that the presence of the gene was associated with taste preferences in children, but the same was not true for adults, which suggests that cultural and environmental factors can override genetically determined preferences.

What role does breastfeeding play?
When two groups of 4- to 8-month-old infants (44 percent of whom were breastfed) were given either green beans alone, or green beans followed by peaches, the food was more likely to be accepted if the breastfeeding mother ate the food regularly. On the contrary, when the formula feeding mothers ate more green beans, there was no difference in their infants’ acceptance of the vegetable. However, repeated exposure to a food did result in greater acceptance in both the breastfed and bottle-fed children. These findings highlight the need for parents to continue to offer babies healthy foods, even though the foods may not be well received at first. Healthy foods include:

• fruits and vegetables
• fat-free or low-fat milk and milk products
• lean meats, poultry, and fish
• beans and nuts
• eggs
• whole grain cereals and rice

Be sure to include nutrient-dense foods as well, such as:

• avocados
• broccoli
• brown rice and other grains
• cheese
• eggs
• fish
• kidney beans
• pasta
• peanut butter
• potatoes
• poultry
• squash
• sweet potatoes
• tofu
• yogurt

There is no need to restrict foods beyond six months, even in children with a family history of food allergies. Parents are advised to introduce new foods one at a time (ideally in the early part of the day, just in case a child has an allergic reaction), and to wait 3-5 days in between.

Food preferences and obesity
It’s clear from the data that foods eaten by mothers during pregnancy and while breastfeeding can impact babies’ food preferences. Study results also underscore the fact that the preferences may not persist once a baby is weaned unless the foods continue to be offered. What is less clear is how food preferences affect the risk for obesity and to what extent parents, siblings, and peers acting as role models can modify those effects.

There’s a limit to what First Lady Michelle Obama can accomplish with her Let’s Move campaign. Parents are the key to preventing obesity in kids. Eating a healthy diet during pregnancy and while breastfeeding may be beneficial in the short-term, but it’s the foods that parents and caregivers offer day in and day out that kids wind up preferring.

Tips for keeping kids healthy and fit:

• Set a good example by eating healthy foods yourself.
• Be patient but persistent. Commit to offering your child a new food at least 10 times.
• Make fresh fruits and vegetables readily available (cleaned, peeled, cut). Children are more likely to eat healthy foods when they can see them.
• Avoid sweetened drinks including sweetened fruit juices, which play a major role in shaping kids’ tastes for sweets.
• Buy fewer high-calorie, low-nutrient foods. But allow kids to have “junk food” occasionally. Denying access to a particular food may actually increase rather than decrease a food preference.
• Teach your children about “sometime” foods and “anytime” foods. Avoid labeling foods as “good” or ”bad.”
• Don’t use food as a reward. Find another way to reward good behavior.
• Insist on healthy foods in school cafeterias and vending machines.
• Discourage eating meals or snacks while watching TV. Children (and adults) are less likely to pay attention to feelings of fullness and more likely to overeat.
• Limit the amount of time your child spends watching TV, playing video games, and using a computer.
• Exercise together regularly. Walk, bike, swim, dance, or garden—anything that keeps you active!