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Toddler formula lacks nutritional benefits, expert pediatrics group says

'Not only is toddler formula more expensive compared with cow's milk, but they aren't necessary for a child's development'

toddler formula
Many experts say these toddler formulas are often unnecessary and do not guarantee sufficient childhood nutrition. Photo by Getty

Toddler formulas marketed for children 12 months and older don’t provide a nutritional advantage in most cases, according to new clinical guidance published Friday by the American Academy of Pediatrics.

The guidance also criticized the “questionable marketing practices” of the companies that make these products, underscoring concerns shared by many pediatricians that parents now have misconceptions about the nutritional benefits of these supplemental beverages.

National Post

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Toddler formulas came on the market in the 1990s and are specialized milk- or plant-based beverages for children between 12 and 36 months old. They are marketed to parents as a transition drink used to wean children off human milk or infant formula.

However, many experts say these toddler formulas are often unnecessary and do not guarantee sufficient childhood nutrition.

“I think there is a misconception across the board for many families,” said Anandita Pal, a Houston-based pediatrician. “Many parents automatically assume that the natural progression is to move to toddler formula, but those supplements are not always necessary unless the child’s pediatrician recommends it.”

Steven A. Abrams, one of the lead authors of the report and a former member of the Committee on Nutrition of the American Academy of Pediatrics, said the impetus for publishing this guidance was to provide a helpful tool that pediatricians can use when talking to families about their child’s nutritional needs.

For example, toddler milk can be a crucial alternative when recommended by pediatricians for children who cannot consume milk due to allergies, lactose intolerance or other health concerns.

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“A small number of children have medical needs for specialized products after a year of age, and most of these are given either by pediatricians or many times by pediatric gastroenterologists,” said Abrams. “These children may have chronic health problems or might not be growing well for some reason, so we certainly are not suggesting that specialized nutritional products for children with specific health needs . . . shouldn’t be used.”

In the guidance, the authors also note that toddler milks can offer some benefit by enhancing vitamin D and E levels compared to unfortified cow’s milk. But nearly all cow’s milk sold in the United States is fortified with vitamin D, making older-child formula potentially obsolete for those who are able to consume a healthy diet of solid foods.

“Not only is toddler formula more expensive compared with cow’s milk, but they aren’t necessary for a child’s development,” Abrams said. “Some families might believe these products provide some health benefits, but there is no evidence [to support that claim].”

A burgeoning business

The report notes that toddler formulas have become a burgeoning business as manufacturers have significantly increased their advertising efforts – lining the shelves of large grocery stores and appealing to parents who might believe these supplements are necessary for their child’s development.

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Toddler formula can cost upward of $40 per 30-ounce can, whereas conventional whole milk can cost around $4.33 per gallon, according to USDA estimates.

The industry trade group the Infant Nutrition Council of America says toddler formulas fill a much-needed gap in nutrition, a belief that is not shared by the AAP.

“Toddler nutritional drinks can contribute to nutritional intake and potentially fill nutrition gaps for children 12 months and older,” INCA said in an emailed statement in response to a query from The Washington Post.

In 2015, makers of toddler formula spent $17 million to advertise toddler milk, compared with less than $10 million on infant formula advertising, according to a study published in the journal Public Health Nutrition. From 2011 to 2015, toddler milk advertising increased by 74 percent while infant formula advertising declined by 68 percent.

Infant formula is subject to more stringent regulations under the Infant Formula Act passed by Congress in 1980, and amended in 1986. That act established rigorous quality and safety standards to ensure that infant formula is a reliable source of nutrition for babies, since it might be their sole source of liquid nutrition.

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By contrast, the nutritional standards and guidelines that exist for toddler formulas are not as comprehensive or strict because children older than 12 months do not rely solely on milk or formula and can transition to a varied diet.

“So if families are thinking that [toddler] formula is giving all the nutrients that their child needs, then we are misleading and misguiding parents,” said Jessica Nash, a pediatrician at Children’s National Hospital in D.C.

The new guidance builds on previous reports from health experts. In 2019 the AAP, the Academy of Nutrition and Dietetics, the American Academy of Pediatric Dentistry and the American Heart Association issued a consensus statement that advised against using toddler formulas.

These products have raised concerns among pediatric experts, primarily due to their content, which often includes added sugars. Researchers have found links between consuming formulas that contain corn syrup solids and an elevated risk of obesity, which has been tied to an increase in fatty liver disease in kids.

The four organizations said at the time that while there is no evidence to indicate the products posed a health risk, “they offer no unique nutritional value beyond what could be obtained with healthy foods; furthermore, they may contribute added sugars to the diet.”

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