Toddler formulas are a booming business in the United States, with sales of the beverages more than doubling in recent years as companies convinced parents their little ones needed the liquid boost. But many experts caution that these products, designed for children ages 1 to 3, don’t meet nutritional needs beyond what’s available in a typical toddler diet, are subject to less regulation than infant formula, and are expensive.
In addition, some parents feed infants the toddler versions even though they do not meet federal standards for infant formula and may not provide infants with adequate nutrients to support their growth.
Pediatricians and federal health officials say that when most children turn 1, they can start drinking cow’s milk or a plant-based milk substitute without sugar. in a 2019 “consensus” statement, the American Academy of Pediatrics and other health and nutrition organizations recommend against using infant formulas, saying they “offer no unique nutritional value beyond what might be obtained from healthy foods, and may add added sugars to the diet “. Infant formulas often contain sweeteners and fats that add calories.
Some of the same companies that produce— including Enfamil, Gerber, and Similac — also make toddler formulas, as do some smaller boutique brands that advertise organic or other special qualities. Toddler formulas are available almost everywhere infant formulas are sold and are marketed as providing additional nutrients to help children’s brain, immune system and eye development, among other benefits. They are different from medical formulas prescribed for children with specific needs.
A study 2020 found that infant formula sales in the US increased to $92 million in 2015 from $39 million in 2006.
Parents are often confused by the marketing of formulas, according to a study led by Jennifer Harris, marketing and public health researcher at the University of Connecticut. she found that 60% of caregivers Infant formulas falsely believed to have nutrients that infants cannot get from other foods.
Dr Antonio Porto, a pediatric gastroenterologist and professor of pediatrics at Yale University, said he worries these products may be giving young children more nutrients and calories than they need. Unlike what’s designed for infants, toddler formula has no nutritional regulations: Experts say it’s impossible to standardize a supplement for toddler diets because no two children are alike.
In focus groupsHarris said, parents report feeding their children toddler formula to fill in nutritional gaps when a child isn’t eating enough, a common concern among parents.
“Babies are usually voracious eaters,” he said. Dr Stephen Daniels, chairman of pediatrics at Children’s Hospital Colorado. But around one year of age, children’s growth plateaus, she said, and “suddenly they’re not as hungry as they used to be.” That can worry parents, she added, but “it’s a completely normal phenomenon.”
If parents have concerns about their children’s diet, Daniels said, they should consult a pediatrician or family doctor. Although picky eating sometimes worries parents, she said, it’s common among young children.
Blanche Lincoln, president of the Infant Nutrition Council of America, which represents the makers of Enfamil, Gerber, Similac and store brands, said in an email that infant formulas can be helpful because they can fill “nutritional gaps during this transition period. foods on the table.” Lincoln, a former U.S. senator from Arkansas, said the beverages “help contribute to the specific nutritional needs of young children by providing energy and important nutrients, as well as essential vitamins and minerals during this important period. growth and development”.
But toddler formula isn’t just eaten by toddlers, it’s also fed to babies. in a recent study, Porto and colleagues found that 5% of parents of infants reported giving their infants beverages marketed for the older age group. And Harris’ research indicated that 22% of parents of babies older than 6 months had fed their babies toddler formula in the previous month. Both studies were conducted before the recent infant formula shortage, which may have exacerbated the problem.
“Infant formulas and toddler formulas tend to be right next to each other in the supermarket,” Harris said. “They look similar, but toddler formulas are cheaper than infant formulas. So people confuse them and choose the wrong one. Or they think, ‘Oh, this is less expensive. I’ll buy this instead.’ “
According to an email from FDA spokesperson Lindsay Haake, infant beverages do not meet the definition of infant formula, so they are not subject to the same requirements. That means they don’t have to undergo the clinical trials and pathogen safety tests that baby versions do. “Unlike infant formulas, toddler formulas are not necessary to meet the nutritional needs of intended consumers,” Haake said.
In a statement to KHN, the Infant Nutrition Council of America said, “Toddler beverages have a distinctive nutritional composition and use of infant formula; the two are not interchangeable. The label for infant nutrition beverages explicitly identifies the product as a toddler beverage intended for children over 12 months of age on the front of the package label.”
However, several expensive brands of infant formula made by smaller companies, often advertised as being made with goat’s milk, Whole milk A2 (which lacks a common milk protein), or non-soy vegan ingredients, meet the nutritional requirements for babies, and some advertise it.
Harris argued that this also confuses parents and should not be allowed. Just because an infant formula has the nutritional ingredients required by the FDA for infant formula doesn’t mean it has met the other tests required for infant formula, she said.
Federal regulators have not forced either company to recall those products. In an email, FDA spokeswoman Marianna Naum said: “FDA does not comment on potential enforcement actions.”
One company, Nature’s One, whose infant formulas are called “Baby’s Only,” received warning letters a decade ago from the FDA about its marketing to babies. That case was closed in 2016. The company’s website says that the Baby’s Only formula “meets nutrient requirements for infants” cast “Baby’s Only Organic® can be served up to 3 years of ageCritics say the language implies that formula is fine for babies under 1 year old. The company’s website and Instagram account feature customer testimonials from parents who report feeding their babies the formula, as well as photos of babies drinking it.
Jay Highman, CEO and president of Nature’s One, said that Baby’s Only is clearly labeled as a toddler formula and that the back of the can says “Baby’s Only is intended for infants 1 year of age and older OR when directed by a health professional.” He also said that since the company launched in 1999, its formulas have met all required nutritional, manufacturing and safety standards for infant formulas, though not necessarily. “We behaved like we were baby formula, but we were selling it as toddler formula,” Highman said.
He said FDA-required clinical trials are a big barrier to bringing a new infant formula to market and many other countries don’t require a clinical trial. Baby’s Only recently completed a clinical trial, she said, and the company hopes to be able to sell it as an infant formula soon.
However, pediatricians and nutrition experts continue to warn parents against using the beverages for young children. “There is no question that infant formula is very important in the first year of life,” Daniels said. But he doesn’t recommend the version for young children “because it’s not as useful, because it’s confusing, because it’s expensive.”
KHN (Kaiser Health News) is a national newsroom that produces detailed journalism on health issues. Along with Policy Analysis and Polling, KHN is one of the top three operating programs in KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization that provides information on health issues to the nation.