Howard Fischer
Uppsala, Sweden

“[Clara Davis did] one of the most fundamental and far-reaching pieces of work that has been done in my time.”¹
– Dr. Joseph Brennemann (1872–1944), chief of pediatrics, Children’s Memorial Hospital, Chicago

Clara M. Davis (1878–1959) received her M.D. degree in 1901. While practicing pediatrics in Chicago, Illinois in the 1920s, she thought that the “experts” in the feeding of infants offered overly dogmatic and rigid advice. Dr. L. Emmett Holt, one of these experts, said a child must be fed the same food—a precisely compounded “formula”—in the same amounts, at the same time each day.² It was also stated in the Journal of the American Medical Association (1935) that “No one can satisfactorily prescribe food for an infant who does not have knowledge of the composition of that food.”³ At that time, most visits to pediatricians were because of children refusing to eat.⁴

Dr. Davis wondered if human children, like other animals, had some sort of instinct that allowed them to pick a healthy, balanced diet from the foods available. To see if this was so, she performed the “world’s largest, most detailed, and most ambitious dietary experiment.”⁵ She studied fifteen infants, aged six to eleven months, who had never had solid foods. All of the children lived, and were studied, in a special feeding center. They were all there for at least six months, and two were studied there for four-and-one-half years. At study entry, four children were undernourished, two children had rickets on X-ray, and three had clinically obvious rickets. About 36,000 daily food records were compiled.

The children were presented with thirty-three foods of animal and vegetable origin, which supplied all the needed amino acids, fats, carbohydrates, vitamins, and minerals. No canned, processed, or modified foods were offered, including none with added sugars or modified milk products. All the children were weighed before and after each meal. Height, weight, bone X-rays, and stool quality and quantity were observed. The one child with severe rickets had a small dose of cod liver oil (which contained the vitamin D he needed) placed daily on his tray. He spontaneously took it until his rickets healed. The supervising adults were not permitted to hint in any way what type or how much food should be eaten. The children picked different foods on different days. No child had colic, constipation, vomiting, or diarrhea. They all took the recommended number of calories per day. No child developed scurvy or vitamin B₁₂ deficiency. The experiment simply finished with fifteen healthy, well-nourished children.^6-8 Davis’ conclusion was that parents, not the doctors, should select the foods and offer them to their children.

A study performed a half-century later⁹ measured the energy intake of fifteen children, two to five-years old, on two days a week for three weeks. They found, as Davis did, that the intake at individual meals varied, but the total daily energy intake was relatively constant for each child. A high-energy intake meal was often followed by low-energy intake at the next meal. The authors concluded, “As revealed by Clara Davis sixty years ago, the successful feeding of children is best accomplished by providing them with a variety of healthful foods and allowing them to eat what they wish.”

References

1. Benjamin Scheindlin. “‘Take one more bite for me’: Clara Davis and the feeding of young children.” Gastronomica, 5(1), 2005.
2. L. Emmett Holt. The Care and Feeding of Children: A Catechism for the Use of Mothers and Children’s Nurses. New York: D. Appleton and Company, 1907.
3. Chris van Tulleken. Ultra-Processed People. London: Cornerstone Press, 2023.
4. Stephen Strauss. “Clara M. Davis and the wisdom of letting children choose their own diets.” Can Med Assoc J, November 7, 2006.
5. Strauss, “Clara M. Davis.”
6. Clara Davis. “Results of the self-selection of diets by young children.” Can Med Assoc J, 41(3), 1939.
7. Van Tulleken, Ultra-Processed People.
8. Strauss, “Clara M. Davis.”
9. Leann Birch et al. “The variability of young children’s energy intake.” N Engl J Med, 324, 1991.